Changes In Enamel Research Articles

Dental dysplasia in childhood cancer survivors: a case series of permanent tooth abnormalities.

This study was performed to investigate the association of dental dysplasia with childhood cancer. We examined the occurrence of agenesis, microdontia, and enamel changes of permanent teeth in pediatric cancer survivors. Seventy-six patients with pediatric cancer and hematologic diseases were referred to our department for the first time from October 2005 to December 2019. Of these, 17 patients who presented for a checkup in our department fulfilled the study criteria and were analyzed. Clinical examinations and panoramic radiographs were performed to investigate dental dysplasia of permanent teeth. A total of 34 developmental abnormalities (18 missing teeth, 16 cases of microdontia) occurred in 5 patients. The patients' medical records were also analyzed to assess the relationships of specific types of dysplasia with the treatment duration and cumulative drug dose administered. All five pediatric cancer survivors had dental dysplasia; all five had tooth agenesis, and four had microdontia. All five patients were < 4 years of age and had undergone high-dose chemotherapy. In this study, childhood cancer survivors who received high-dose chemotherapy before age 4 years experienced the dental dysplasia, including tooth agenesis, microdontia. These findings highlight the need for careful dental monitoring and early intervention in pediatric patients undergoing high-dose chemotherapy. This research was conducted in accordance with the Declaration of Helsinki and approved by the Medical Ethics Committee of the Medical University of Kobe (protocol code No. B230066, 1 September 2023).

CARIES STATUS MEASURED WITH THE ICDAS II ON QUALITY OF LIFE IN CHILDREN

Dental caries is an infection of the hard part of the teeth that is very vulnerable in children. Unaddressed tooth decay interferes with child development, especially primary school-age children who have an impact on quality of life, discomfort and experience learning disorders that affect academic achievement. In the ICDAS II index, caries measurement can be seen from the stage of development starting from clinically visible enamel changes to more extensive cavitation. This study aims to determine the relationship of caries status measured by ICDAS II to quality of life in 12-year-old children. Analytic research with cross sectional method. The study population was 12 years old students with a purposive sampling technique of 43 samples. Data obtained using caries examination sheets and quality of life questionnaires. The statistical test used in the study was Kendall's tau-b test. The results showed that the relationship between caries status measured by ICDAS II to quality of life obtained a p-value of 0.000 with a correlation value of 0.515 which is included in the strong relationship category. The conclusion is that this study found a significant relationship between caries status measured by ICDAS II and quality of life in 12-year-old children.

Surface and Mineral Changes of Primary Enamel after Laser Diode Irradiation and Application of Remineralization Agents: A Comparative In Vitro Study.

The purpose of this study is to evaluate the remineralization potential of primary teeth enamel after being exposed to different laser diode therapies. Ninety-six vestibular primary teeth enamel samples were divided into eight groups (n = 12) with varying treatments: control (G1), CPP-ACP-fluoride varnish (G2), diode lasers at 980 nm (G3), 808 nm (G4), 450 nm (G5), 980 nm + CPP-ACP-fluoride varnish (G6), 808 nm + CPP-ACP-fluoride varnish (G7), and 450 nm + CPP-ACP-fluoride varnish (G8). Each sample was assessed using a DIAGNOdent® (KaVo Dental, Biberach, Germany), at baseline, post-treatment, and post-pH cycle remineralization. SEM imaging was performed before and after treatment and following the pH cycle. The results indicated that the 980 nm and 808 nm diode lasers, both alone and in combination with CPP-ACP-fluoride varnish, either maintained or increased the calcium (Ca) weight percentage (Wt%) in the enamel. The 980 nm diode laser combined with CPP-ACP-fluoride varnish (G6) showed a significant increase in Ca Wt%, suggesting a strong remineralization effect. Similarly, the 808 nm diode laser alone (G4) also promoted a substantial increase in Ca Wt%. In contrast, the 450 nm diode laser, whether applied alone or in combination with CPP-ACP-fluoride varnish, resulted in a lower Ca Wt% and an increase in phosphorus (P) Wt%. Most groups, except for the CPP-ACP-fluoride varnish alone (G2), demonstrated an increase in P Wt%, indicating a complex interaction between laser therapy and enamel remineralization. The combined use of laser therapy with CPP-ACP-fluoride varnish significantly enhanced the remineralization of temporary teeth enamel. The 980 nm diode laser + CPP-ACP-fluoride varnish showed the most pronounced improvement in remineralization, while the 808 nm diode laser alone also effectively increased calcium solubility. These findings suggest that higher-wavelength diode lasers, particularly when combined with remineralizing agents, can effectively enhance the mineral content of primary teeth and promote enamel remineralization.

Posteruptive Loss of Enamel Proteins Concurs with Gain in Enamel Hardness.

Tooth enamel maturation requires the removal of proteins from the mineralizing enamel matrix to allow for crystallite growth until full hardness is reached to meet the mechanical needs of mastication. While this process takes up to several years in humans before the tooth erupts, it is greatly accelerated in in the faster developing pig. As a result, pig teeth erupt with softer, protein-rich enamel that is similar to hypomineralized human enamel but continues to harden quickly after eruption.Proteins, such as albumin, that bind to enamel crystals and prevent crystal growth and enamel hardening have been suggested as cause for hypomineralized human enamel that does not naturally harden after eruption. However, albumin is abundant in pig enamel. It is unclear whether fast posteruptive enamel hardening in pigs occurs despite the high protein content or requires a facilitated protein loss to allow for crystal growth. This study asked how the protein content in porcine enamel changes after eruption in relation to saliva. Based on previous data demonstrating the high albumin content in erupted porcine enamel, we hypothesize that following pre-eruptive maturation, enamel and saliva derived enzymes facilitate protein removal from porcine enamel after eruption. We analyzed enamel and the saliva proteome at three critical timepoints: at the time of tooth eruption, 2 weeks after eruption, and enamel 6 weeks after eruption. We used only fourth deciduous premolars and saliva samples from animals sacrificed at the respective time points to determine the organic content in tooth enamel, saliva, and saliva proteins within enamel. We found a decrease in the number of proteins and their abundancy in enamel with posteruptive time, including a decrease in serum albumin within enamel. The rapid decrease in the first two weeks is in line with previously reported rapid increase in mineral density of porcine enamel after eruption. In addition to the enamel proteases KLK-4 and MMP-20, we identified serine-, cysteine-, aspartic-, and metalloproteases. Some of these were only identified in enamel, while almost half of the enzymes are in common with saliva at all timepoints. Our findings suggest that the fast posteruptive enamel maturation in the porcine model coincides with saliva exchange and influx of saliva enzymes into porous enamel.

Morphological features of enamel in fluorosis of different degrees of severity

The occurrence of dental fluorosis is facilitated by a violation of enamel mineralization caused by fluorides, which enter the human body in excess during its development and formation and have a toxic effect on enamel blasts. However, the molecular mechanisms involved in the pathogenesis of fluorosis are not fully understood. Enamel formation is a complex process involving cell proliferation and differentiation through epithelial-mesenchymal sequential secretion of matrix proteins, tissue-specific transport of ions including calcium and fluoride, and precipitation and alignment of enamel crystals through interactions between organic and inorganic molecules. Understanding the morphological features of enamel changes during fluoride intoxication of the human body in the endemic region allows us to clearly understand the need for a comprehensive solution to this medical and social problem. The aim was to study the morphological features of enamel in fluorosis in residents of the endemic region of Ukraine, in particular the Poltava region. The work examines different groups of teeth (both intact and affected by fluorosis) removed for orthodontic or clinical indications in men and women aged 17 to 40 years. Morphological signs were studied first on native, and later on histochemically stained sections. It was established that the violation of the structure of the enamel layer of the teeth in mild and severe fluorosis is characterized by both partial and complete violation of the movement of the enamel prisms with signs of destruction. Fragmentation and homogeneity throughout the entire thickness were found in some areas of the enamel. When evaluating histochemically stained sections of teeth affected by fluorosis, it was established that dystrophic changes in the enamel structure and accumulation of acidic glycosaminoglycans in the lesions are more characteristic of mild and moderate forms. Under the conditions of a severe form of fluorosis, complete destruction of the prisms, fragmentation of the lamella, homogenization of areas on the entire enamel layer, which is due to the uneven distribution of acidic mucopolysaccharides, have been established. Morphologically and histochemically dystrophic changes in the areas of the affected enamel are confirmed by uneven distribution and accumulation of acidic glycosaminoglycans. An assessment of the effect of fluoride intoxication on the state of tooth enamel was carried out, which will allow to expand the possibilities of preventive measures for related specialists, as well as to create and develop additional treatment methods that will contribute to the improvement of physical and aesthetic indicators of teeth. dental health.

Clinical, Radiographic, and Histological Changes in Enamel and Dentin, According to Caries Care International&amp;#8482; Evaluation, In Permanent Posterior Teeth: An Observational Study

Clinical, Radiographic, and Histological Changes in Enamel and Dentin, According to Caries Care International&amp;#8482; Evaluation, In Permanent Posterior Teeth: An Observational Study

Is a White Diet Necessary for Tooth Bleaching Procedures? A Systematic Review and Meta-Analysis.

The aim of this investigation was to conduct a systematic review and meta-analysis to determine the necessity of a white diet during or following a bleaching procedure. This systematic review and meta-analysis followed the PRISMA guidelines meticulously. The research question was: Is a white diet necessary during and/or after a bleaching treatment? In vitro studies or clinical trials reporting the color change in bleached enamel after the use of a free-staining diet were considered for full-text review. For the analyses, a random-effects model was employed. Statistical significance was defined as a p-value < 0.05. A total of 17 documents were eligible for qualitative analysis: 5 clinical trials and 12 in vitro studies. Only data from the clinical trials were included in the meta-analysis. For at-home bleaching, differences in the color among the subjects were not statistically significant during the first (p = 0.64), second (p = 0.26) or third (p = 0.43) weeks of treatment. Also, the color difference one month after finishing the bleaching treatment were not statistically significant (p = 0.27). The color difference one month after finishing an in-office treatment showed that the restrictions on diet did not significantly improve the bleaching outcomes (p = 0.90). According to the findings of this review, dietary restrictions are not necessary during or after bleaching procedures.

Enamel changes of bleached teeth following application of an experimental combination of chitosan-bioactive glass

BackgroundConsidering the extensive use of bleaching agents and the occurrence of side effects such as enamel demineralization, this study aimed to assess the enamel changes of bleached teeth following the experimental application of chitosan-bioactive glass (CH-BG).MethodsIn this in vitro study, CH-BG (containing 66% BG) was synthesized and characterized by Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). Thirty sound human premolars were bleached with 40% hydrogen peroxide, and the weight% of calcium and phosphorus elements of the buccal enamel surface was quantified before and after bleaching by scanning electron microscopy/ energy-dispersive X-ray spectroscopy (SEM, EDX). Depending on the surface treatment of the enamel surface, the specimens were divided into three groups (n = 10): control (no treatment), MI Paste (MI), and CH-BG. Then the specimens were stored in artificial saliva for 14 days. The SEM/EDX analyses were performed again on the enamel surface. Data were analyzed by one-way ANOVA and Tukey’s test and a p-value of < 0.05 was considered statistically significant.ResultsIn all groups, the weight% of calcium and phosphorus elements of enamel decreased after bleaching; this reduction was significant for phosphorus (p < 0.05) and insignificant for calcium (p > 0.05). After 14 days of remineralization, the weight% of both calcium and phosphorus elements was significantly higher compared to their bleached counterparts in both MI and CH-BG groups (p < 0.05). Following the remineralization process, the difference between MI and CH-BG groups was not significant (p > 0.05) but both had a significant difference with the control group in this regard (p < 0.05).ConclusionsThe synthesized CH-BG compound showed an efficacy comparable to that of MI Paste for enamel remineralization of bleached teeth.

Analysis of Calcium and Phosphate Ion Extraction From Dental Enamel by Bleaching Gels Using Ion Chromatography, Micro-CT, and SEM.

To evaluate the volume and depth of enamel loss promoted by 37.5% and 7.5% hydrogen peroxide (HP) gels, and quantify the loss of calcium (Ca) and phosphate (P) ions by using ion chromatography (IC) analysis after bleaching. Sixty bovine enamel specimens were randomly divided into three groups: Control - no bleaching gel; HP37.5%, application of HP 37.5% for 45 minutes for 14 days; and HP7.5%, application of HP 7.5% for 3 applications of 8 minutes. The surface analysis (n=5) was performed using a scanning electron microscope (SEM) and dispersive energy system (EDS) to calcium and phosphorus dosage. The micro-CT was used for the enamel loss analysis (n=5). IC was used to analyze extracted Ca and P (n=10). Data were analyzed by one-way ANOVA and two-way repeated measures ANOVA, followed by Tukey and Dunnett's tests (α=0.05). Significantly higher volume and depth of enamel loss were found for bleached groups compared with the control group. HP7.5% had significantly higher enamel change than HP37.5%. SEM showed higher enamel porosity for HP37.5% and HP7.5% compared to control. The IC demonstrated a significant increase of Ca incorporated into the gel, however, only HP7.5% had a higher P presence than the control group. The HP7.5% showed higher Ca and P ion exchange than HP37.5% (p<0.001). HP37.5% and HP7.5%, caused enamel mineral changes compared with the control group. The IC method was demonstrated to be an effective methodology for detecting enamel mineral loss by the bleaching gel.

Case Repor Case Report and X t and X-ray Microtomography and Scanning Electr aphy and Scanning Electron Microscopy Analysis of Teeth with Hypocalcified Amelogenesis Imperfecta

Amelogenesis imperfecta (AI) is a genetic disease characterized by producing morphological and structural changes in tooth enamel. Objective: To highlight the morphological changes observed in teeth with hypocalcified AI based on scanning electron microscopy and microtomography analysis. Case report: An adult male had teeth seriously compromised by hypocalcified AI. The treatment plan involved removal of third molars followed by restorative and prosthetic treatment. After extraction, the teeth were analyzed by SEM and X-ray microtomography (microCT). Teeth with AI revealed the presence of microfractures arranged from the outer surface to the center of the enamel. Microfractures had a cracked or “cracked ground” pattern. SEM confirmed the presence of microfractures and distortion in the orientation of the enamel prisms in some regions. Conclusion: Teeth of patients with hypocalcified amelogenesis imperfecta IIIA subtype show significant structural changes that are closely related with the ease of fractures.

Determination of ultrasructural changes in the enamel of primary teeth in starting phases of early childhood caries, with and without local fluoride therapy

Early childhood caries is often found under the name connected with the manner of feeding nutrition of children such as “Baby bottle Syndrome” or “Baby bottle caries”. The aim of the study was to determine ultrastructural changes in the enamel of primary teeth in starting phases of early childhood caries, with and without local fluoride therapy, because it has of great influence in the preventive aspect of the disease. The investigation was done on laboratory tests on tree groups extracted primary teeth: one of 20 healthy mandibular incisors, as control group and two more groups of primary tested teeth: 10 maxillary incisors with initial lesion and 10 maxillary incisors with superficial form. The all dental samples were observed with Scanning Electron Microscope (SEM) and we made comparative analyzes in ultrastructural changes of enamel between untreated and treated teeth, and control group teeth. After that, we have analysis with SEM photo attachments. In some dental samples with initial lesion after local treatmant we managed to get almost healthy enamel, i.e. complete remineralization process. Once again, we have confirmation of one of the many benefits of fluoride in dentistry which is long been known.

Erosion behaviour of human, bovine and equine dental hard tissues

Dental hard tissues from different species are used in dental research, but little is known about their comparability. The aim of this study was to compare the erosive behaviour of dental hard tissues (enamel, dentin) obtained from human, bovine and equine teeth. In addition, the protective effect of the pellicle on each hard tissue under erosive conditions was determined. In situ pellicle formation was performed for 30 min on enamel and dentin samples from all species in four subjects. Calcium and phosphate release was assessed during 120 s of HCl incubation on both native and pellicle-covered enamel and dentin samples. SEM and TEM were used to examine surface changes in native enamel and dentin samples after acid incubation and the ultrastructure of the pellicle before and after erosive exposure. In general, bovine enamel and dentin showed the highest degree of erosion after acid exposure compared to human and equine samples. Erosion of human primary enamel tended to be higher than that of permanent teeth, whereas dentin showed the opposite behaviour. SEM showed that eroded equine dentin appeared more irregular than human or bovine dentin. TEM studies showed that primary enamel appeared to be most susceptible to erosion.

Detection of Erosive Changes on Smooth Surfaces with and without Orthodontic Brackets Using an Intraoral Scanner-An In Vitro Study.

Consumption of acidic beverages favours development of erosions. Modern diagnostic methods are required to detect erosions at an early stage. This study aimed to evaluate the suitability of an intraoral scanner (IOS) for detection of erosive changes on smooth surfaces adjacent to orthodontic brackets. Orthodontic metal brackets were attached to the buccal surfaces of 58 extracted permanent human teeth. Teeth were randomly divided into groups: A = 6% citric acid, B = Coca-Cola, C = Redbull, D = Powerade, E = Control, no acid exposure. Teeth were exposed to acid in three erosion cycles, followed by rinsing and brushing. Scans of teeth were performed at baseline and after each erosion cycle and enamel loss was measured. Quantitative light-induced fluorescence (QLF) measurements were performed as reference standard. Significant substance loss was measured in all acid groups after the second and third erosion cycle (p < 0.0001). Correlation between scans and QLF were significant (p = 0.001). With IOS, it was possible to detect and quantify enamel erosion at smooth surfaces with and without orthodontic brackets after a short exposure time. Considering the limitations of in vitro results, the use of IOS can be a promising digital tool to detect and monitor erosive enamel changes during fixed orthodontic treatment.

Effects of Different Light-Assisted Power Bleaching Techniques on the Penetration of Hydrogen Peroxide into the Pulp Chamber.

Background: In-office bleaching is one of the most commonly used procedures for discolored tooth treatment. Although the efficacy of tooth bleaching has been investigated, depending on the applied technique and the used materials, bleaching procedures might irritate the tooth pulp and induce surface changes in enamel. The aim of this study was to evaluate the effect of four different bleaching techniques on the penetration of hydrogen peroxide (HP) into the pulp chamber. Materials and methods: Seventy-two single-rooted sound human teeth were used. The samples were prepared and evaluated in four groups. Group 1: 35% HP gel alone (HP Gel); group 2: Nd:YAG laser (0.25 W and 10 Hz with a fiber tip size of 200 μm) irradiation was added (HP Gel+laser); group 3: HP gel mixed with graphite particles (10th of millimeter in size) derived from crashed pencil lead in association with Nd:YAG laser (HP Gel+laser+graphite); and group 4: HP gel in association with light-emitting diode (LED) (litex 686, 50 Hz, 450-490 nm) (HP Gel+LED). The amount of HP penetrating into the pulp chamber was evaluated using acetate buffer and standard graphs. Data were analyzed with one-way ANOVA test, using SPSS 17. Post hoc Tukey test was used for between-group comparisons (α = 0.05). Results: Statistical analyses showed that the HP Gel+laser+graphite group had significantly higher level of HP penetration than other groups (p < 0.001). Moreover, pulp chamber penetration of HP in the HP Gel+laser group was greater than the LED and control groups (p < 0.001). The difference between control and LED groups was not significant (p = 0.99). Conclusions: Laser bleaching associated with HP Gel and graphite particles resulted in increased penetration of HP into the pulp chamber compared with the LED and control groups.

Morphological structure of enamel caries in the dynamic process of demineralization and remineralization

According to modern ideas, the carious process at the white spot stage is reversible, so all the attention of scientists is directed to the development of means to restore the crystal lattice of tooth enamel. The purpose of the study is to evaluate morphological changes in caries at the white spot stage and the process of structural remineralization of the carious lesion area. Clinically active initial lesions were detected visually, using optical magnification and positive staining. Structural changes in enamel were studied by scanning electron microscopy of surface impressions obtained from the surface of demineralized enamel. Remineralizing therapy was carried out by applying ApaCare restorative gel (Germany) with nanodispersed highly active hydroxyapatite. Determination of the intensity of dental caries by the DMFT and dmft index showed 9.04 ± 0.40 points on average in the group of subjects, children with code 1 according to the ICDAS index made up 50.8%. Colour reactions showed 7.80 ± 0.21 points on average in the group. SEM visualized characteristic structural changes in the area of the carious spot – an increase in the porosity of the enamel surface with exposure of the fine crystalline structure and destruction of interprismatic fibrillar structures. When using a remineralizing agent, a roller-like deposition of an amorphous remineralizing substance is characteristic, and at the final stage, a smooth enamel surface with a fine crystal lattice is restored. The restoration of the prismatic structure of the enamel occurs due to the mineralization of the preserved fibrillar walls in the interprismatic space. Clinically, at this stage, the enamel visually restores its original shine, smoothness, and colour. In 81.8% of cases, the dye did not penetrate the previously demineralized enamel. The high level of non-cavitated active caries lesions can be largely controlled by the use of remineralizing agents. Further research involves studying the quantitative characteristics of the processes of de- and remineralization of tooth enamel.

Multi-resolution Correlative Ultrastructural and Chemical Analysis of Carious Enamel by Scanning Microscopy and Tomographic Imaging.

Caries, a major global disease associated with dental enamel demineralization, remains insufficiently understood to devise effective prevention or minimally invasive treatment. Understanding the ultrastructural changes in enamel is hampered by a lack of nanoscale characterization of the chemical spatial distributions within the dental tissue. This leads to the requirement to develop techniques based on various characterization methods. The purpose of the present study is to demonstrate the strength of analytic methods using a correlative technique on a single sample of human dental enamel as a specific case study to test the accuracy of techniques to compare regions in enamel. The science of the different techniques is integrated to genuinely study the enamel. The hierarchical structures within carious tissue were mapped using the combination of focused ion beam scanning electron microscopy with synchrotron X-ray tomography. The chemical changes were studied using scanning X-ray fluorescence (XRF) and X-ray wide-angle and small-angle scattering using a beam size below 80 nm for ångström and nanometer length scales. The analysis of XRF intensity gradients revealed subtle variations of Ca intensity in carious samples in comparison with those of normal mature enamel. In addition, the pathways for enamel rod demineralization were studied using X-ray ptychography. The results show the chemical and structural modification in carious enamel with differing locations. These results reinforce the need for multi-modal approaches to nanoscale analysis in complex hierarchically structured materials to interpret the changes of materials. The approach establishes a meticulous correlative characterization platform for the analysis of biomineralized tissues at the nanoscale, which adds confidence in the interpretation of the results and time-saving imaging techniques. The protocol demonstrated here using the dental tissue sample can be applied to other samples for statistical study and the investigation of nanoscale structural changes. The information gathered from the combination of methods could not be obtained with traditional individual techniques.

Maternal methylmercury exposure during early-life periods adversely affects mature enamel structure of offspring rats at human exposure levels: a concern for oral health.

Although there are many studies on the health effects of methylmercury (MeHg) toxicity during in utero and early development, little is known about its effects on mineralized tissues present in the oral cavity, such as enamel structure. Therefore, this study evaluated the effects of MeHg exposure on the physico-chemical, ultrastructural and functional properties of mature tooth enamel. Specifically, we studied offspring of mothers exposed to MeHg during the prenatal and postnatal periods which are the developmental stages associated with tooth enamel formation. Female rats were exposed to MeHg at a dose of 40 μg/kg/day for 42 days of pregnancy and lactation. The enamel of offspring was analyzed by (1) Fourier Transform Infrared Spectroscopy and Raman to assess physicochemical composition, (2) Scanning Electron Microscopy for ultrastructural evaluation, (3) Transmitted Polarizing Light Microscopy for analysis of the enamel extracellular matrix, and (4) resistance and hardness were evaluated by microhardness. The results showed that MeHg exposure during this sensitive enamel formation period induced changes in inorganic and organic content and enamel prisms ultrastructure alterations and disturbed the organic extracellular matrix due to a decreased enamel strength. These novel findings establish for the first time that maternal exposure to MeHg pre and postnatal promoted relevant changes in mature enamel of their offspring rats.

BASIC DIRECTIONS IN FLUOROSIS TREATMENT

The territory of Poltava region belongs to the Buchatsky hydrogeological province, whose groundwater is characterized by an elevated fluorine level content. The cause of endemic dental fluorosis particularly in the children’s population of the region is water consumption with surplus concentration of this chemical element. Also, having fluorosis a condition that develops from a high fluoride concentration in drinking water- causes disorder of hard tooth tissues maturing, mineralizationand teeth germ development. This, in turn, has a negative influence on enamel amelogenin synthesis and violation of the crystals maturing, determines a surface porosity. The chalky spots, brown pigmentation, and enamel erosion destruction lesions are characterized the different severity manifestation of the fluorosis.&#x0D; The purpose of our research was to conduct a thorough analysis of all the material we found on this topic, gather all possible information on new trends in recent years in the treatment of dental fluorosis: what are the methods, their origins, indications for use, clinical stages and advantages.&#x0D; Dental enamel fluorosis requires different approaches to treatment depending on the severity of clinical manifestations. Obviously, as the leading method is remineralizing therapy. One of the method is offered by Nikolishina E.V. etc. [6], which is carried out in the following way: after carry out of the professional hygiene procedure, next step, individual caps were made of transparent silicone filled with 10% solution «Poltavsky Bishofit» and applied on the fluorosis teeth, daily course consist with 30 minutes and 10-20 procedures.&#x0D; Enamel microabrasion is the first minimally invasive treatment method of mild and moderate dental fluorosis using to removes opaque brown spots and surface roughness smoothing, providing a flat and shinier surface. The microabrasion technique involves etching with mild acid in combination with application of abrasive components. Resin infiltration has also become a popular treating dental fluorosis technique without loss of hard tissue.&#x0D; Resin infiltration is based on the application of hydrochloric acid to the hard tissues of the tooth and subsequent coating with a low-viscosity resin that penetrates into the microspaces of the tooth enamel. The cloaking effect is based on the refractive index. The optical properties of the affected enamel change and it looks like a healthy enamel surrounding. The indication to dental fluorosis treatment of severity forms in permanent teeth with mature roots is restoration of teeth, veneers, orthopedic crowns, if the microabrasive method hasn’t aesthetic effect efficiency.&#x0D; Thus, in cases of aesthetic changes due to fluorosis, minimally invasive restorative approaches that preserve dental hard tissue such as microabrasion method, external bleaching or resin infiltration should be considered before invasive restorative procedures. More invasive treatments may be considered if the results remain unsatisfactory.

In vitro comparative evaluation of physical and chemical properties of surface enamel after using APF and SDF with or without laser activation.

To evaluate and compare the changes in physical and chemical properties of the enamel surface after application of Silver Diamine Fluoride (SDF), Acidulated Phosphate Fluoride (APF), LASER activated SDF and LASER activated APF. Sample consisted of 72 freshly extracted healthy human premolar teeth, extracted for orthodontic purpose, free from caries, fracture or any anomalies. The selected samples were randomly divided into four groups (n = 18): Group 1 (SDF); Group 2 (APF); Group 3 (LASER activated SDF) and Group 4 (LASER activated APF). All samples were evaluated for values of DIAGNOdent at baseline, after demineralisation and after remineralisation. They were further divided and assessed for colour changes, surface alterations and fluoride content of surface enamel using Spectrophotometer, Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometry respectively. The statistical analysis was done using One-Way ANOVA, Tukey's HSD test, Mann-Whitney U test and Kruskal-Wallis Test. Highest remineralising potential and maximum colour changes of surface enamel was exhibited by Group 3. Scanning Electron Micrographs of Group 3 and Group 4 exhibited regular globular structures of enamel whereas Group 1 and Group 2 showed irregular globular surface of the enamel at 2000× and 5000× magnification. Maximum fluoride uptake on the surface enamel was seen in Group 4 followed by Group 3. Use of LASER activated topical fluorides helps to achieve superior caries prevention. LASER activated APF can be used as an aesthetic alternative to SDF, as LASER activated APF showed higher uptake of fluoride on the enamel surface without discoloration effect.

Use of Raman spectroscopy for assessment of changes in enamel and dentin composition after in-office whitening

Use of Raman spectroscopy for assessment of changes in enamel and dentin composition after in-office whitening