Changes In Enamel Research Articles

Changes in tooth enamel due to bleaching

Changes in tooth enamel due to bleaching

The Effect of a Bioactive Oral System and CO2 Laser on Enamel Susceptibility to Acid Challenge.

This study evaluated the structural changes of enamel treated by the Regenerate system and carbon dioxide (CO2) laser against acid challenge. Thirty human enamel slabs were prepared and assigned into three groups: Group I: untreated (control); Group II: treated with the Regenerate system; and Group III exposed to CO2 laser. All specimens were subjected to an acid challenge (pH 4.5-7.0) for 14 days. Specimens were evaluated and compared at 120 points using five Raman microspectroscopic peaks; the phosphate vibrations ν1, ν2, ν3, and ν4 at 960, 433, 1029, and 579 cm-1, respectively, and the carbonate at 1070 cm-1, followed by Vickers microhardness test. The ratio of carbonate to phosphate was correlated to the equivalent microhardness numbers. The intensities of phosphate peaks ν1, ν2, and ν4 were reduced in all groups post-acid challenge, while the carbonate and ν3 were significantly increased (p < 0.000). Surfaces treated by Regenerate exhibited higher peak intensity of phosphate and carbonate before and after pH-cycling (p < 0.05). The mineral content in enamel had a direct effect on tissue microhardness, and the CO2-lased surfaces showed a reduced carbonate content and higher microhardness values. Both approaches induced surface changes that can protect enamel against acid challenge resulting in a significant benefit for dental healthcare.

DIAGNOdent versus International Caries Detection and Assessment System in detection of incipient carious lesions: A diagnostic accuracy study.

The present investigation aimed at assessing the diagnostic accuracy of DIAGNOdent compared to the International Caries Detection and Assessment System-II (ICDAS-II) in the detection of facial, smooth surface noncavitated carious lesions. Sixty patients were enrolled in the current study according to the eligibility criteria. There were 161 teeth with noncavitated, white spot carious lesions and 32 sound teeth. Before examination, teeth were cleaned and polished and all patients were assessed under standardized operating conditions: preset dental unit position, operating light, and prolonged air drying (approximately 5 s). All teeth were assessed by two calibrated examiners individually without any contact using ICDAS-II and DIAGNOdent. The diagnostic accuracy of DIAGNOdent device was determined, including sensitivity, specificity, overall accuracy, positive and negative predictive values, and receiver operating characteristic curve analysis. Chi-square test was conducted to compare the distribution of ICDAS-II and DIAGNOdent scores. Inter-observer agreement between assessors was evaluated using Cohen's kappa test. In the current study, DIAGNOdent had an overall accuracy of 84.45% with sensitivity and specificity of 87.58% and 96.87%, respectively, and +PV and -PV of 97.7% and 83.9%, respectively, when score 0 represented sound tooth surface, while scores 1 and 2 were considered clinically noncavitated carious lesions. Moreover, when only ICDAS score 1 was considered representing first visual change in enamel, DIAGNOdent had an accuracy of 74.15% with sensitivity and specificity of 83.53% and 90.62%, respectively, and +PV and -PV of 93% and 78.6%, respectively. In the present study, when only ICDAS score 2 was considered representing distinct visual change in enamel, DIAGNOdent had an accuracy of 100% with sensitivity and specificity of 100% and 100%, respectively, and +PV and -PV of 100% and 100%, respectively. The overall performance of DIAGNOdent was equivalent to the visual inspection using ICDAS-II. DIAGNOdent might be considered a useful adjunctive device for detection and monitoring development of noncavitated carious lesions on facial smooth surfaces.

Comparison of micromorphological changes in enamel using SEM analysis after conventional and erbium, chromium:yttrium, scandium, gallium, and garnet hard-tissue laser fissurotomy: An in vitro study.

Well articulated by John Knowles - "Everything has to evolve or else it perishes." With the paradigm shift of emphasis toward the prevention of dental caries, it has been proven that laser irradiation protects against both caries initiation and caries progression. The aim of the study was to evaluate and compare the micromorphology of caries-free extracted premolars using a Scanning electron microscope (SEM) after fissurotomy by conventional fissurotomy bur and erbium, chromium: yttrium, scandium, gallium, and garnet (ER, CR: YSGG) hard-tissue laser. Sixty caries-free premolars extracted atraumatically for orthodontic treatment were included in the study. The samples were divided into two groups randomly (Group 1: fissurotomy by bur, n = 30, and Group 2: fissurotomy by hard-tissue laser, n = 30). Each sample was further divided into halves from the occlusal surface wherein one-half of the occlusal surface received fissurotomy procedure and the other half was control. Samples were analyzed by scanning electron microscopy (SEM) for micromorphological changes. Profile image of control samples revealed the disorganization of enamel surface at the junction of fissures forming a heterogeneous tissue and agglomeration of enamel with deep pit and fissure. On the contrary, the image of experimented samples (with laser fissurotomy) showed smooth enamel surface and homogeneous enamel subsurface with wider pit and fissure owing to self-cleansing ability. On the grounds of the present study results, it could be concluded that the intervention of ER, CR: YSGG hard-tissue laser possesses self-cleansable pit and fissures for caries prevention and has the potential to irradicate the smear layer entirely for superior attachment of remineralizing agents.

Structural and microelemental changes in enamel under the influence of various methods of preparation

Structural and microelemental changes in enamel under the influence of various methods of preparation

Correction to: In vitro evaluation of microhardness, surface roughness, and color changes in bleached enamel after Biscover LV application

Correction to: In vitro evaluation of microhardness, surface roughness, and color changes in bleached enamel after Biscover LV application

Ozone and microstructural morphological changes of tooth enamel.

The paper aims to study the impact of ozone (O3) treatment on the microstructural changes of the tooth enamel after the treatment at different time intervals. The ozonation was performed with gaseous O3 produced by HealOzone X4, the demineralization level was measured with the DiagnoDent Pen 2190 device, and the microstructure changes of enamel surface were observed using scanning electron microscopy (SEM) analysis. The results showed the exposure to O3 for 40-50 seconds enhanced enamel micro-hardness and ensures a rate of remineralization between 96.82-97.38%. In conclusion, in search of new minimally invasive solutions in the treatment of caries and to offer antimicrobial support of the oral cavity, the use of O3 as an alternative therapy to classical solutions may be a viable solution in dentistry.

Enamel Hypoplasia as a Marker for Sex Estimation: A Review

Abstract: Changes in enamel during teeth development are permanently recorded, and some, like enamel hypoplasia (EH), can be linked with stressful events. As males and females may respond differently to stress, EH may have a different prevalence between the sexes. The present work mainly aims to identify which factors may lead to the different EH types, analyse how they manifest between sexes, and check if, in the presence of EH, one can infer about a person’s sex. Our results point to occasional differences in EH prevalence in deciduous dentition between sexes, with males displaying more EH. As for permanent dentition, EH prevalence appears to be strongly associated with the living conditions, namely nutrition, occluding any possible sex bias. Therefore, EH in deciduous teeth can be useful for sex estimation; yet, in permanent dentition, other factors may be responsible for the differences and more studies, with control of environmental factors (for example, twin studies) are needed to understand if sex differences exist as well.

In Vitro Evaluation of Microhardness, Surface Roughness, and Color Changes in Bleached Enamel after Biscover LV Application

In Vitro Evaluation of Microhardness, Surface Roughness, and Color Changes in Bleached Enamel after Biscover LV Application

Fluoride in water, health implications and plant-based remediation strategies

Abstract The high prevalence of dental fluorosis and bone mineralization deficiency as a result of exposure to fluorides has increased in Kenya over the years due to consumption of water with elevated levels of fluoride. The World Health Organization (WHO) provides a guideline of 1.5 mg/L level of fluoride in drinking water. However, majority of studies carried out in Kenya over the last 40 plus years have indicated very high levels of fluoride in drinking water in various regions, with a prevalence in dental fluorosis observed in children and adults living in Rift valley and central regions due to basaltic and volcanic rocks. Unfortunately, this trend of fluoride-induced enamel changes has been observed in other regions such as Nairobi and Machakos which were originally presumed to contain low fluoride levels. This study sought to analyse the applicability of Maerua subcordata root powder (MSRP) in the removal of fluorides in borehole drinking water. Fresh Maerua subcordata roots were peeled to obtain the white flesh, chopped into small pieces, dried and ground into powder. The process parameters varied were; fluoride ion concentration [F−] (0–12 mg/L), adsorbent dosage (0–200 g/L) and equilibration time (30–240 min) [F−] were hence analysed before and after treatment using ion selective electrode (ISE) fluoride meter. Results indicated that MSRP is a viable plant in fluoride treatment with approximately 68% fluoride ion removal efficiency. An MSRP dosage of 200 g/L was found optimal in [F−] reduction while a 2 mg/L [F−] concentration recorded the highest reduction of [F−]. The optimal equilibration time was found to be 30 min. The results can be used to develop a low-cost column for treatment of high fluoride waters in rural areas using MSRP. Borehole samples were treated with MSRP using the optimized conditions; however their reduction levels were lower than the [F−] standards used. It is envisaged that with further modification and/or doping with zero-valent iron nanoparticles, it’s efficiency will be improved.

Impact of Dentistry Materials on Chemical Remineralisation/Infiltration versus Salivary Remineralisation of Enamel-In Vitro Study.

The aim of this study is to evaluate salivary remineralisation versus chemical remineralisation/infiltration of enamel, using different dentistry materials. The enamel changes were studied using confocal laser scanning microscopy (CLSM), and the depth of lesions and demineralisation/remineralisation/infiltration percentage were calculated. Additionally, the macro elemental composition of the teeth was performed using atomic absorption spectroscopy (AAS). Two studies were performed: (i) demineralisation of enamel in 3% citric acid and infiltration treatment with infiltration resin (Icon, DMG), remineralisation with Fluor Protector (Ivoclar Vivadent) and artificial saliva pH 8; and (ii) enamel demineralisation in saliva at pH 3 and remineralisation at salivary pH 8. The results showed that, firstly, for the remineralisation of demineralised enamel samples, Fluor Protector (Ivoclar Vivadent) was very effective for medium demineralised lesions followed by saliva remineralisation. In cases of deep demineralisation lesions where fluoride could not penetrate, low viscosity resin (Icon, DMG, Hamburg) effectively infiltrated to stop the demineralisation process. Secondly, remineralisation in salivary conditions needed supplementary study over a longer period, to analyse the habits, diet and nutrition of patients in detail. Finally, demineralisation/remineralisation processes were found to influence the macro elemental composition of enamel demineralisation, with natural saliva proving to be less aggressive in terms of decreasing Ca and Mg content.

ESTHETIC MANAGEMENT OF DEVELOPMENTAL ENAMEL DEFECT WITH RESIN INFILTRATION TECHNIQUE

Developmental defects cause color changes in enamel, compromising the esthetic appearance of the tooth and therefore affecting the child's quality of life. The resin inltration technique has shown a positive esthetic effect in the treatment of developmental enamel defects with different etiologies and is regarded as micro invasive procedure since only a small amount of enamel is removed in this procedure. The present paper reports the effectiveness of the resin inltration technique (Icon, DMG) in the management of localised enamel hypomineralisation of permanent teeth after trauma to the primary predecessor.

Comparative Assessment of pH and Degree of Surface Roughness of Enamel When Etched with Five Commercially Available Etchants: An In Vitro Study

To evaluate the pH and degree of surface roughness caused by five commercially and readily available etchants on tooth enamel. Five different etchants were chosen. An electric pH meter was utilized to test the pH of the etchants employed. Fifteen maxillary bicuspids that had been extracted were cleansed and stored in thymol solution. The samples were sorted into five groups of three each. A noncontact profilometer was employed to assess the microsurface changes of the pre-etched enamel. The teeth were then etched for 30 seconds with respect to the group to which they belonged before being cleaned and dried. The surface roughness after etching was analyzed, measured and values were tabulated. Descriptive statistics and paired t-test were done. The pH of the etchants and surface roughness of the enamel are varied across the five groups, though they have the same composition of 37% orthophosphoric acid. Etchant from Group C was found to be most acidic while the one manufactured by Group E was least acidic. Ivoclar, DPI, and DTECH showed a statistically significant value in surface roughness parameter post-etching (p <0.05). A statistical difference that was significant was observed with the Kruskal-Wallis test for surface roughness parameter (p <0.05). All five etchants had varied pH and the amount of surface roughness was also varied though the composition was the same. Further elemental analysis of these etchants has to be done to validate the results obtained. Etchants of the same composition should ideally produce the same effect on the tooth enamel surface, but etchants from different manufacturers produce different levels of surface roughness which could be due to differences in the composition of the prepared etchant. The study was conducted to assist in making an educated selection about the most cost-effective but efficient etchant for clinical application.

Resin infiltrant as a treatment of common changes in dental enamel: narrative literature review

Minimally invasive dentistry has been considered the most suitable method of choice in order to prevent and treat changes in the tooth surface, such as the initial caries lesions, characterized as white spot. This type of conduction aims to maintain the tooth structure, as long as there is no sign of cavitation on the surface. Thus, in 2009 a material was created based on monomers and additives denominated resinous infiltrant, which has the function of paralyzing this white spot lesion acting through diffusion, where the material fills the microporosities. The only material commercially available is Icon®, which, despite having numerous benefits, has some limitations. Some studies with experimental material have been developed in order to try to minimize the limitations of commercial material. Therefore, this literature review aims to address the characteristics, function, application and indications of the material, as well as its limitations.

Remineralizing Effect from Topical Fluoride Treatment on Inicial Lesion of Early Childhood Caries

The starting phase on early childhood caries or circular caries is an initial lesion, known as macula Alba or white spot, which is reversible, stops or reverses (perform biological repairs). In the initial lesion stage (macula alba) with the removal of caries the causative agent (dental plaque) on the one hand, and taking maximum preventive measures on the other hand: proper nutrition of the young child, salivation with normal pH and saliva composition, adequate mechanical and chemical control of dental plaque, by maintaining proper oral hygiene and topical application of fluoride preparations in various forms, conditions are created for the predominance of remineralization processes in relation to demineralization, which compensates for the insufficiency of minerals and may lead to the disappearance of the initial lesion (restutio ad integrum). Purpose of the Study investigation: Evaluation of ultra-structural enamel changes in the enamel in the starting phase on initial lesion of circular caries - Early childhood caries. It is done with Scanning Electronic Microscope (SEM) evaluation of remineralizing effects in enamel ultrastructure at the stage of initial lesion and superficial form, after topical application of fluoride-based preparation (p-p amino fluoride). Material and method: The investigation was done on laboratory tests on extracted 20 healthy lower incisions and two more groups with 10 upper incisions, where some have topical fluoride compression treatment with SEM (Scanning Electron Microscope), and the others did not have the treatment. After that, we have analysis of the remineralizing effect of fluorides with SEM photo attachments. Results: In some dental samples we managed to get almost healthy enamel, i.e. complete remineralization process of the inicial lesion. Conclusion: Once again, we have confirmation of one of the many benefits of fluoride in dentistry which is long been known.

Effect of an orthodontic resin modified with silver-nanoparticles on enamel color change

BackgroundTo evaluate the effect of an orthodontic resin modified with various concentrations of silver-nanoparticles (AgNPs) on enamel color. Material and MethodsTwenty lower premolars were collected and divided into four groups (n = 5) according to the concentration of AgNPs (0.05%, 0.1%, 0.5%, and 1% wt/wt). Additionally, a group bonded with a conventional resin was used as control (n=5). Previous to the bracket bonding, enamel color was measuring with a spectrophotometer. Specimens were stored for 6 months in deionized water. Brackets were debonded and color changes of enamel were calculated with the CIEDE 2000 formula (∆E00). One-way ANOVA and Tukey test were used to assess the color change (α = .05). ResultsThe control group showed the lowest ∆E00 values, and no significant difference was observed when compared to the group with 0.05% of AgNPs (P > .05). The highest color change was observed in the group with 1% of AgNPs (∆E00 = 8.04±1.48), however no significant difference was observed between groups with 0.1% and 0.5% AgNPs. ConclusionsThe incorporation of AgNPs into orthodontic resin result in tooth color alteration. Lower concentrations of AgNPs should be considered to minimize negative changes in enamel color. Key words:White spot lesions, antibacterial, orthodontics, adhesive, Silver-nanoparticles.

Effect of bleaching gels with different thickeners under normal and hyposalivation conditions: in situ study

Bleaching gel thickeners induce important changes in tooth enamel and these changes are reversed by saliva. This in situ study aimed to evaluate the effect of bleaching gels with different thickeners on tooth enamel under normal and hyposalivation conditions. Of 28 participants, 14 had normal salivary flow and 14 had low salivary flow. For each salivary flow, four types of treatment were performed with different thickeners: no bleaching (negative control), bleaching with a commercial 10% carbamide peroxide (CP) gel with carbopol (positive control) and bleaching with experimental 10% CP gels with natrosol and aristoflex. Participants used a palatal appliance containing bovine enamel/dentin specimens for 15 days. From day 2 to day 15, specimens were bleached extraorally. The bleaching gel was applied according to the groups for four hours. When the bleaching gel was removed, the palatal appliance was inserted again in the participants' mouth until the next day for another bleaching application. This procedure was repeated for 14 days and on day 15, surface microhardness (SMH), color (ΔE*ab and ΔE00), surface roughness (Ra), scanning electron microscopy (SEM), and energy-dispersive X-ray spectrometry (EDS) analyses were performed and data were subjected to statistical analysis. Neither salivary flow nor thickeners influenced ΔE*ab and ΔE00 results. Carbopol had the lowest SMH, the highest Ra, and the lowest Ca% among all groups. For normal flow, natrosol and aristoflex had higher SMH. For low flow, aristoflex had higher SMH and natrosol and aristoflex had lower Ra. Aristoflex had higher Ca% and Ca/P and differed from carbopol for normal flow. For normal flow, 10% CP gels with natrosol and aristoflex caused fewer surface changes, and for low flow, only the 10% CP gel with aristoflex.

The structure and prevalence of superficial carious and non-carious lesions of permanent and deciduous enamel in children who presented for routine dental care in various districts of St. Petersburg

Relevance. To increase the effectiveness of prevention and treatment protocols, it is above all necessary to consider the activity of caries, especially at the early enamel lesion stage, in the form of a white spot, to make the correct diagnosis based on a clinical examination, which assesses the location, change in surface hardness, symmetry, contour shape, depth, color and opacity of the lesion. Different causes of superficial enamel discoloration, in the form of white spots, are paramount for the restorative treatment as the quality of the enamel preparation affects the marginal fit and the durability of the restoration. However, poor oral hygiene, disturbance in eating behavior affect the course of non-carious hard-tissue diseases, which caries may complicate. Purpose – to optimize the diagnosis of initial dental enamel lesions to improve the caries prevention quality.Materials and methods. The study examined 460 children living in the Central and Krasnoselsky districts of St. Petersburg. The following indices assessed hard tissue condition: OHI-S, Greene and Vermillion; OHI by O'Leary T., Drake R., Naylor; White spot lesions index, Gorelick L, Geiger A. M, Gwinnett A. J., DMFT and df; caries activity.Results. The total prevalence of superficial (initial) lesions of hard tissues was 37.82%, i.e. 174 people out of 460 examined patients had superficial enamel lesions according to the criteria of I and II categories. The study found enamel changes in the age groups: 5-6 years (130) – 36 people (27.69%); 12 years old (175) – 62 people (35.42%); 15 years old (155) – 76 people (49.03%).Conclusions. Focusing on the caries activity signs rather than a precise differential diagnosis of the lesion nature is necessary to provide well-timed treatment and prevention upon detecting initial enamel lesion at a dental check-up.

In vivo effectiveness of visual inspection and laser fluorescence in the diagnosis of early pit-and-fissure carious lesions: A cross-sectional study in a group of Romanian children.

General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. The evaluation of 237 occlusal surfaces and caries risk assessment were performed in 96 children aged 7 to 15 years. The presence of pit-and-fissure noncavitated lesions was recorded using ICDAS-II scoring system and laser fluorescence. Statistical analysis was performed using McNemar test, with a level of significance of P < .05. The caries risk was measured for all participants. In 109 occlusal surfaces both methods identified enamel changes (46%) and in 62 cases both methods excluded the carious lesion (26.2%). The statistical analysis showed a significant moderate agreement between ICDAS-II code and DiagnoDent pen measurements (McNemar chi-squared statistic 9.5, P = .002 and Cohen kappa coefficient = 0.427). The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.

Possibility of Raman spectroscopy method use for evaluation of periodontitis-affected tooth enamel before and after open curettage

The results of the research of enamel of periodontitis-affected teeth before and after open curettage are presented in the work. The Raman spectroscopy method was used as an evaluation method of curettage influence on tooth enamel. Chemometric analysis of the Raman spectra of tooth enamel before and after curettage was made. Spectral changes of tooth enamel were detected. It was found that after the procedure of open curettage spectral changes occur in tooth enamel related to the changes in mineral composition and organic matrix forming.