Artificial White Spot Lesions Research Articles

Effects of Magnesium Gel and Diode Laser in Combination on the Color Masking of Artificial White Spot Lesions: An in Vitro Study

Effects of Magnesium Gel and Diode Laser in Combination on the Color Masking of Artificial White Spot Lesions: An in Vitro Study

Comparative analysis of remineralizing efficacy of strontium-doped bioactive glass, BioMin, and NovaMin containing dentifrice on artificial white spot lesions after chlorhexidine pretreatment - An in vitro study.

This study aimed to compare the remineralizing efficacy of strontium-doped bioactive glass, BioMin, and NovaMin containing dentifrices on artificial white spot lesions (WSLs) after chlorhexidine (CHX) pretreatment using energy-dispersive X-ray analysis (EDAX). Twenty-four samples of maxillary first premolars extracted for orthodontic purposes were selected. Artificial WSLs were produced by immersing the samples in a prepared demineralizing solution for 3 days. All the samples were pretreated with CHX and divided into four groups and six samples each. Group A treated with strontium-doped bioactive glass, Group B with BioMin, Group C with NovaMin, and Group D with artificial saliva as the control group for 14 days. pH-cycling model was used to simulate the oral cavity changes. EDAX was used to record the values at baseline, demineralization, and after remineralization. Data were analyzed using one-way ANOVA (post hoc), followed by unpaired t-test and Scheffe tests with Statistical Package for the Social Sciences version 16. Strontium-doped bioactive glass exhibited a greater mineral regain compared to BioMin, NovaMin, and control groups. Strontium-doped bioactive glass has enhanced mineral deposition on carious teeth and may provide an alternative clinical strategy for remineralizing early enamel lesions.

Evaluation of Surface Microhardness of Artificial White Spot Lesion Treated with Three Different Treatment Approaches. An in-vitro study

Evaluation of Surface Microhardness of Artificial White Spot Lesion Treated with Three Different Treatment Approaches. An in-vitro study

The color stability of artificial white spot lesions treated with resin infiltration after exposure to staining beverages

BackgroundTo evaluate the effect of staining beverages on the color-changing of resin-infiltrated artificial white spot lesions (WSLs).MethodsThirty-five artificial WSLs were created by pH cycling on flat bovine teeth specimens. The WSLs were treated with resin infiltration and were divided into five groups based on staining beverages: artificial saliva, coffee, wine, green tea, and Coca-Cola. These specimens were subjected to a 28-day exposure to the respective beverages. Color stability was assessed using a spectrophotometer at different time points: baseline, after 7, 14, 21, and 28 days of exposure, and repolishing. The color difference (∆E) between each time point and the baseline was calculated. Statistical analysis was performed using two-way measures ANOVA with a significance level of p = 0.05.ResultsAll resin-infiltrated specimens exposed to staining beverages for 7 days exhibited more significant color changes than those exposed to artificial saliva. The color change patterns varied based on the type of beverage. The color alterations intensified with extended immersion in the wine and Coca-Cola groups, while there were no significant differences in the color of specimens after 28 days of immersion in the coffee and green tea groups. However, after cleaning with pumice powder, all specimens showed significantly reduced color changes compared to those observed after 28 days of immersion, except those immersed in coffee.ConclusionsExposure of resin-infiltrated bovine tooth specimens to staining beverages resulted in a significant color alteration as the immersion time increased. However, the staining effect could be minimized by cleaning with pumice powder, except for the coffee group.Clinical relevanceAfter resin infiltration treatment, patients should be advised to minimize the consumption of colored beverages to prevent staining that could impact esthetic appearance.

Innovation of nano-hydrogels loaded with amelogenin peptide and hydroxyapatite nano-particles for remineralisation of artificially induced white spot lesions

BackgroundWhite spot lesions are a common side effect of fixed orthodontics. This study investigates chitosan-based hydrogels using amelogenin peptide as a scaffold to facilitate hydroxyapatite nanoparticle attachment, assembly, and organisation, aiding in enamel remineralisation. Materials and methodsThree groups were prepared to carry out remineralisation experiments after creating artificial white spot lesions on extracted 1st premolars. The first group served as a control with no treatment, while the experimental groups were treated with either amelogenin peptide/chitosan hydrogel or amelogenin peptide + hydroxyapatite/chitosan hydrogel. Remineralisation was conducted for three weeks. The interaction between amelogenin peptide and hydroxyapatite nanoparticles was evaluated using TEM, UV–Vis, FTIR, zeta potential, and Raman spectroscopy. Remineralisation potential was assessed through enamel microhardness, fluorescence, and XRD. Surface characteristics of demineralised and remineralised enamel were examined by SEM at different magnifications, and chemical compositions were analysed using an EDX analyser. one-way ANOVA and Tukey HSD post hoc multi-comparison tests were performed to find statistical differences between groups. A pairwise comparison was performed to examine if there were significant differences within each group. Significant differences were considered at a P < 0.05. ResultsThe results demonstrated that amelogenin peptide adsorbs onto hydroxyapatite. TEM images revealed the self-assembly of peptide nanoparticles and their adsorption onto hydroxyapatite nanoparticles. UV–Vis spectroscopy, FTIR spectroscopy, Zeta Potential, and Raman Spectroscopy confirmed the binding between amelogenin peptide and hydroxyapatite. The novel hydrogel significantly improved the microhardness and fluorescence values of demineralised enamel. Energy-dispersive X-ray Spectroscopy and X-ray diffractometry revealed the formation of new hydroxyapatite crystals on demineralised enamel, with a calcium-to-phosphorus ratio comparable to natural enamel hydroxyapatite. Structural analysis via SEM showed improved surface texture with the occlusion of demineralised surface porosities. Overall, the hydrogel enhanced hardness, fluorescence, morphology, and chemical composition compared to demineralised enamel. ConclusionsChitosan-based hydrogels provide a promising remineralising strategy that bio-mimics natural enamel regrowth.

Comparative Analysis of the Effectiveness of Four Distinct Remineralizing Agents in Artificial White Spot Lesions Following Chitosan Nanoparticle Pretreatment: An In Vitro Study

Comparative Analysis of the Effectiveness of Four Distinct Remineralizing Agents in Artificial White Spot Lesions Following Chitosan Nanoparticle Pretreatment: An In Vitro Study

Development of an Artificial White Spot Lesion Creation Protocol: A Preliminary Study.

Protocols that determine the lesion depth of specific demineralization solutions are lacking. This in vitro study aimed to evaluate various lesion depths of artificial white spot lesions (WSLs) at different exposure times. Materials and methods: Artificial WSLs were created by placing 30 extracted human premolar teeth into 0.05M acetate buffer solution with a controlled environment of pH 4.4 at 37ºC, which were then exposed in the solution for various durations of 4, 5, 6, 8, 10, and 12 days. The specimens were visually examined using theEkstrand-Ricketts-Kidd (ERK) system to confirm the WSL, followed by buccolingual sectioning, and evaluated under a scanning electron microscope (SEM) to measure the lesion depth. The SEM showed that the mean lesion depths of representative specimens were 101.33 µm (day 4), 124 µm (day 5), 159 µm (day 6), 187 µm (day 8), 202 µm (day 10), and 212 µm (day 12). The artificial WSL was visually demonstrated in grades 1 and 2 of the ERK system. The depths of the lesions increased as the duration increased from day 4 to day 12, indicating that the lesion depths increased with the more prolonged exposure to the acetate buffer solution.

The Effect of Non-Invasive Treatment Techniques on the Color Masking Ability and Surface Roughness of Induced Enamel Lesions (An in vitro Study).

The aim of this in vitro study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color masking of white spot lesions and surface roughness. A total of 45 sound teeth were used in this study. All the teeth were sectioned along the long axes into two halves, lingual and buccal to get 90 specimens. All specimens were immersed in a demineralized solution for 7 days. The specimens were divided randomly into three equal groups (n = 30) according to the type of treatment; Group 1 (n = 30) was treated with fluoride varnish (Clinpro); Group 2 (n = 30) was treated by resin infiltration (Icon); and Group 3 (n = 30) was used as a control group with no treatment. The color and surface roughness were measured three times at baseline (T1), directly after induction of artificial white spot lesions (WSLs) (T2), and directly after application of the treatment options (T3). The colors were measured using a portable reflective spectrophotometer and the 3D surface roughness was measured using a Light Sectioning Vision System. Data were collected and statistically analyzed using T test and Mann-Whitney U test. Surface roughness was almost equal in the study groups with no statistically significant differences reported. Icon showed slightly higher color scores than that of ClinPro. The Icon produced favorable esthetic results compared to the fluoride therapy while no significant differences were reported regarding the surface roughness.

Evaluation of resin infiltration for inhibiting initial caries progression: An in vitro study using Micro-Computed Tomographic analysis

ObjectiveTo evaluate the changes in lesion depth and mineral density of resin infiltration-treated white spot lesions against asimulated oral environment using thermal and acidic challenges in vitro. Materials and methodsTwo enamel slabs were prepared from each buccal surface of permanent human premolars, for a total of 56 slabs. Artificial white spot lesions were induced. One specimen was treated with resin infiltration, while the other was used as an untreated control. A micro-CT was used to assess the lesion depth and mineral density of each specimen. Subsequently, all specimens were subjected to 10,000 cycles of thermocycling and pH cycling for 10 days before being re-evaluated using the micro-CT. Lesion depth and mineral density were examined and compared between before and after aging procedures within each group by the paired sample t-test. The independent samples t-test was utilized to compare lesion depth progression and percentage change of mineral density between groups. ResultsAfter aging, there was both a significant lesion depth progression and a mineral loss in the control and resin infiltration groups. Mean lesion depth progression was 132.88 ± 4.18 µm for the control group and 52.31 ± 4.16 µm for resin infiltration group. Percentage mineral density loss as a percentage for the control and resin infiltration groups were 16.1 ± 0.64 % and 8.83 ± 0.30 %, respectively. The resin infiltration group demonstrated a significantly lower mean lesion depth progression and percentage changes in mineral loss compared to the control group. ConclusionsThe lesion depth and mineral density changes in the resin infiltrated-treated group were lower than untreated white spot lesions after aging procedures using thermal and acidic challenges. Clinical significanceResin infiltration is a promising approach to inhibit the progression of white spot lesions related to the initial stage of dental caries.

An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

Comparison of biofilm models for producing artificial active white spot lesions.

This study compared three protocols for developing artificial white spot lesions (WSL) using biofilm models. In total, 45 human enamel specimens were sterilized and allocated into three groups based on the biofilm model: Streptococcus sobrinus and Lactobacillus casei (Ss+Lc), Streptococcus sobrinus (Ss), or Streptococcus mutans (Sm). Specimens were incubated in filter-sterilized human saliva to form the acquired pellicle and then subjected to the biofilm challenge consisting of three days of incubation with bacteria (for demineralization) and one day of remineralization, which was performed once for Ss+Lc (four days total), four times for Ss (16 days total), and three times for Sm (12 days total). After WSL creation, the lesion fluorescence, depth, and chemical composition were assessed using Quantitative Light-induced Fluorescence (QLF), Polarized Light Microscopy (PLM), and Raman Spectroscopy, respectively. Statistical analysis consisted of two-way ANOVA followed by Tukey's post hoc test (α=0.05). WSL created using the Ss+Lc protocol presented statistically significant higher fluorescence loss (ΔF) and integrated fluorescence (ΔQ) in comparison to the other two protocols (p<0.001). In addition, Ss+Lc resulted in significantly deeper WSL (137.5 µm), followed by Ss (84.1 µm) and Sm (54.9 µm) (p<0.001). While high mineral content was observed in sound enamel surrounding the WSL, lesions created with the Ss+Lc protocol showed the highest demineralization level and changes in the mineral content among the three protocols. The biofilm model using S. sobrinus and L. casei for four days was the most appropriate and simplified protocol for developing artificial active WSL with lower fluorescence, higher demineralization, and greater depth.

Treatment of shallow and deep white spot lesions with three different mouthwashes evaluated by laser fluorescence (an in vitro study)

This research aims to find how three different types of mouthwashes affect the depth of artificial white spot lesions. Teeth with various depths of white spot lesions were immersed in either splat mouthwash, Biorepair mouthwash, Sensodyne mouthwash, or artificial saliva (control)twice daily for one minute for 4 weeks and 8 weeks at 37°C. After this immersion procedure, lesion depth was measured using a diagnosed pen score. A one-way analysis of variance, Dunnett T3 and Tukey's post hoc α = .05 were used to analyze the testing data. Splat mouthwash enhanced the WSL remineralization and made the lowest ΔF compared with other mouthwashes in shallow and deep enamel after 4 and 8 weeks of treatment. In the repair groups, after 4 weeks of treatment, significant recovery was observed in shallow enamel. Further improvement in shallow WSL after 8 weeks of treatment with biorepair mouthwash was observed compared to Sensodyne and the control group. Splat mouthwash is more effective than other mouthwashes in remineralizing two depths of WSLs at different time points. Keywords: DIAGNOdent pen, Shallow enamel, Deep enamel, white spot lesion.

Impact of Various Remineralizing Agents on Artificial White Spot Lesion on Primary Teeth-A Comparative Study.

The aim of the current research was to assess the effectiveness of different remineralizing substances on artificial white spot lesions on deciduous teeth. 45 deciduous teeth without dental caries constituted the study group for this in vitro research. A 3 mm by 3 mm window of enamel was uncovered at the occluso-gingival midpoint of the coronal labial surface; an acid-resistant nail varnish was coated alongside the uncovered enamel surface of all specimens, employing vertical strokes. Demineralization was executed for the tenure of 72 hours at 37°C temperature in an incubator. The forty-five specimens, fifteen in each group, were assigned to the investigational groups plus a control group as: Group A: Control, Group B: Calcium sucrose phosphate (CaSP), Group C: Casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF). Microhardness tester was employed for testing the microhardness of the enamel surface using a Vickers diamond indenter laden with twenty-five milligrams for approximately ten seconds. Vickers hardness number (VHN) calculations for the microhardness were performed at baseline and on the fourteenth day. The CPP-ACPF group exhibited greater mean microhardness value at 236.14 ± 2.12, in pursuit by CaSP group with a score of 231.98 ± 3.16 and then the control group at 220.22 ± 5.08. An extremely statistically significant difference was seen amid the groups. The current research arrived at a conclusion that both the remineralizing substances were certainly efficient in handling early dental caries, and additionally, casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF) was found highly efficient as a remineralizing substance, in pursuit by calcium sucrose phosphate (CaSP).

Surface roughness and microhardness of enamel white spot lesions treated with different treatment methods

ObjectiveTo analyse the surface roughness and microhardness of artificial enamel white spot lesions before and after WSL formation, after treatment (Opalsutre™ microabrasion, Sylc® bioactive glass, and ICON® resin infiltration), and after pH cycling with the help of the profilometer surface roughness tester and the digital Vickers microhardness tester. Materials and methodsSeventy-five extracted molars were used to acquire one hundred specimens. 50 specimens were randomly assigned to five groups (n = 10) for the surface roughness study: 1) Sound group, 2) WSL group, 3) micro abrasion (MA; Opalustre, Ultradent, South Jordan, UT, USA), 4) bioactive glass 45S5 Sylc powder (Sylc; Denfotex Research Ltd, Inverkeithing, UK), and 5) ICON resin infiltration (ICON; DMG, Hamburg, Germany). An additional 25 specimens were used to obtain 50 enamel slabs for the surface microhardness study, which were also assigned to the same groups. All groups underwent a final stage of pH cycling. Surface roughness and surface microhardness measurements were performed at different stages for all groups. ResultsRegarding surface roughness, ICON significantly reduced the surface roughness compared to Opalustre and Sylc, with no significant difference between Opalustre and Sylc. In terms of surface microhardness, ICON showed the highest improvement, followed by Sylc and then Opalustre. Both surface roughness and microhardness were significantly affected by demineralization, partially improved after treatment, and then regressed significantly after pH cycling. ConclusionICON resin infiltrant can be considered as a superior treatment option for improving surface roughness and microhardness, while Opalustre demonstrated relatively the poorest performance compared to the other treatment options. It is noteworthy that the pH cycling procedure had an adverse impact irrespective of the treatment option used.

Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study

BackgroundThis study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth.MethodsForty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey’s post hoc test were used at p ≤ 0.05 to identify significant differences.ResultsInsignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish.ConclusionsIn primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.

Remineralization and Aesthetic Effect of Three Agents on Artificial White Spot Lesions: An in vitro study

Remineralization and Aesthetic Effect of Three Agents on Artificial White Spot Lesions: An in vitro study

Methylene Blue Penetration of Resin Infiltration and Resin Sealant in Artificial White-Spot Lesions.

This study determined the potency of resin infiltrations and resin sealant in impeding microleakage on artificial white-spot lesions (AWL) by methylene blue penetration. Eighty AWL specimens were randomly separated into two groups for water storage for 24 hours (groups 1-4) and 20,000 cycles of thermocycling (TC) (groups 5-8). Each group was then separated into four subgroups (n = 10) based on the AWL surface treatments: (1) no Tx, (2) treated with resin infiltration (ICON, DMG, Hamburg, Germany), (3) treated with resin infiltration (Surface pre-reacted glass-ionomer (S-PRG) barrier coat, SHOFU, Kyoto, Japan), (4) treated with resin sealant (Clinpro sealant, 3M ESPE, Minnesota, United States). Nail varnish was covered to all samples, with the exception of a 4 × 4 mm2 patch on the buccal measurement region, which was subsequently submerged in a 2% methylene blue solution and cut into buccolingual sections. Stereomicroscope measurements were used to calculate methylene blue penetration scores. The Kruskal-Wallis test and the Bonferroni post-hoc correction were performed to evaluate the data. Application of resin infiltrants and resin sealant reduced microleakage in AWL by methylene penetration both before and after thermal cycling. In addition, group 6 (ICON + TC) and group 7 (S-PRG + TC) had a significantly different value from group 8 (sealant + TC). Both the resin infiltration approach and the resin sealant seem to help seal AWL and might perhaps offer long-term defense against microleakage in AWL caused by methylene blue penetration. The greatest sealing and defense for microleakage in AWL were demonstrated by the resin infiltrations.

Nano-hydroxyapatite-induced remineralization of artificial white spot lesions after bleaching treatment with 10% carbamide peroxide.

To assessed in vitro the effect of nanohydroxyapatite (n-HA) to improve the aesthetic appearance and microhardness of white spot lesions (WSL) when associated with a low-concentration bleaching agent (carbamide peroxide-CP10%). Enamel/dentin specimens (n=60) of 5 × 5 × 2.2 mm were prepared, of these, 48 were submitted to pH-cycling to create artificial WSL. Subsequently, these were allocated into five groups (n=12): n-HA; n-HA + CP10%; CP10%; WSL control (WSLC ); sound control (Sound). The color was assessed at baseline, pre-treatment, and post-treatment using a spectrophotometer, and the color (ΔE/ΔE00 ) and whiteness index (ΔWID) alterations were determined. The enamel cross-sectional microhardness (CSMH) was evaluated (post-treatment) with a Knoop indenter, 25gf/5s, 20-200 μm. The data was analyzed through generalized linear models (α=5%). ΔE and ΔE00 were significantly higher for the bleached groups (n-HA + CP10% and CP10%), and the n-HA was higher than the WSLC group (p < 0.05). ΔWID was significantly higher for the bleached groups (p < 0.05). The CSMH values were significantly higher in the sound group than in the n-HA, CP10%, and WSLC groups (p < 0.05). The WSLC had lower microhardness than the n-HA + CP10% and sound groups (p < 0.05). n-HA is suitable to remineralize and recover the color of the WSL. However, its association with CP10% maintains the esthetical outcome while increasing its in-depth remineralizing effect. Considering the aesthetic and functional repercussions of the WSL persistence, treatments that tend to improve its physical appearance and reinforce its weakened substructure in a non-invasive way are ideal. For this associating low-concentration, bleaching agents to the remineralizing treatments is promising to treat this type of lesions.

Efficacy of Three Commercially Available Fluoride Releasing Varnishes in Remineralization of Artificial White Spot Lesions Evaluated by Laser Fluorescence

Introduction: This study aimed to assess the remineralization of shallow and deep artificial white spot lesion (WSL) by the application of three fluoride releasing varnishes. Methods: Sixty-four extracted premolars were subjected to acid attack inducing two depths of WSLs. Using a DIAGNOdent pen, teeth were divided into two groups according to the WSL depth: shallow enamel (SE) and deep enamel (DE). Then each was subdivided into four intervention groups of eight teeth each: MI varnish, Clinpro White varnish, Clinpro XT, or control (artificial saliva). Laser fluorescence were measured via DIAGNOdent pen at baseline, demineralization stage, 24 h, 4 weeks, and 8 weeks after intervention. Results: For each lesion depth, there were statistically significant differences among the agents after intervention (P &lt; 0.01) and among time intervals for each group (P &lt; 0.01). Conclusion: MI varnish is more effective than Clinpro White varnish or Clinpro XT in remineralizing two depths of WSLs at different time points.

Novel hybrid-glass-based material for infiltration of early caries lesions

ObjectivesTo assess the effectiveness of two experimental, hybrid-glass-based infiltrants in arresting artificial white spot lesions (WSLs) in vitro, and to compare it with resin-based infiltrant Icon. MethodsArtificial WSLs were formed on bovine enamel specimens (n = 68). Specimens were divided into four groups according to WSLs treatment: 1) no-treatment control (NTC), 2) infiltration with Icon (Icon), 3) infiltration with experimental hybrid-glass material (EXP), and 4) infiltration with experimental hybrid-glass material containing hydroxyapatite (HAp) nanoparticles (1%) (EXP-HAp). Half of the specimens from each group were subjected to cariogenic challenge using pH-cycling, consisting of a 7-day alternate incubation (37⁰C) in demineralization (4 h/day, pH=4.6) and remineralization solutions (20 h/day, pH=7.2). Another half of the specimens was incubated in distilled water (control). Caries progression was assessed by measuring surface micro-hardness (SMH), roughness (Ra) and average surface level, and by analyzing WSLs morphology. Non-cycled and pH-cycled specimens were compared with Man-Whitney U test, while different treatment groups were compared with Kruskal-Wallis test with pairwise comparisons (p < 0.05). ResultsIn all groups (NTC, Icon and EXP-HAp) except EXP, SMH decreased significantly after pH cycling. In addition, SMH increased in EXP upon pH cycling and was significantly higher than in other pH-cycled groups (<0.001). Ra increased considerably, while surface level decreased after pH cycling in all groups except in EXP. Signs of demineralization and roughness increase in NTC, Icon and EXP-HAp were also observed with the SEM. SignificanceExperimental hybrid-glass-based material without HAp-nanoparticles could completely arrest the progression of WSLs, unlike its version with HAp-nanoparticles and resin-based infiltrant Icon.