Enamel Erosion Research Articles

A Comparative Study of the Effect of Tooth Mousse Plus Remin Pro and Fluor Protector Gel on Enamel Erosion: An In Vitro Study.

The purpose of this in vitro study was to assess the effect of Tooth Mousse Plus, Remin Pro, and Fluor Protector Gel on enamel erosion, measuring mean weight loss after exposure to a demineralizing agent. A total of 60 sound-extracted permanent incisors were sectioned and enamel specimens were randomly distributed to different groups. The initial weight of all specimens was registered. The samples were randomly divided into four groups (n = 30). Group I specimens were treated with tap water (control). Groups II, III, and IV were treated with Tooth Mousse, Remin Pro, and Fluor Protector Gel application. After that, specimens were placed all together in a plastic container with 6 mL of a soft drink and immersed for 8 minutes at room temperature, dried, and weighed. Specimens were weighed after each immersion period and mean weight loss was calculated. The data was analyzed for probability distribution using the Kolmogorov-Smirnov test. The intergroup comparison was done using a one-way analysis of variance (ANOVA) followed by post hoc analysis. According to pairwise comparisons in post hoc analysis, the weight of specimens at baseline was significantly greater than the weight of specimens on day 12. The difference in the mean weight of the specimen from baseline to day 12 was 2.833 mg for group I, 2.367 mg for group II, 1.467 mg for group III, and 2.133 mg for group IV. Tooth Mousse Plus, Remin Pro, and Fluor Protector Gel have no significant effect on dental erosion. Shukla K, Saxena A, Joshi J, et al. A Comparative Study of the Effect of Tooth Mousse Plus Remin Pro and Fluor Protector Gel on Enamel Erosion: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S57-S62.

Acquired pellicle engineering with the association of cystatin and vitamin E against enamel erosion

ObjectiveEvaluate CaneCPI-5 associated with Vitamin E in acquired enamel pellicle (AEP) engineering to prevent dental erosion. Methods180 human enamel specimens were divided into 12 groups and treated with the following solutions: Cane+VitT and Cane+VitS- CaneCPI-5 + Vit E; Vit+CaneT and Vit+CaneS- Vit E + CaneCPI-5; VitT and VitS- Vit E; CaneT and CaneS- CaneCPI-5; ControlT and ControlS - AmF/NaF/SnCl2; WaterT and WaterS- Deionized water. Groups’ name followed by “T” were first treated (200 μl; 2 min) and then incubated in human saliva (200 μl; 1 h) to form the AEP. For groups followed by “S”, the AEP was formed and then treatment was applied. The erosive challenge consisted of immersion in 1% citric acid (1 min, 1x/day, for 3 days). The percentage of superficial hardness loss (%SHL) and the relative surface reflection intensity (%SRI) were subjected to normality and homogeneity tests, Shapiro-Wilk and Levene tests, respectively. Subsequently, the data were analyzed using two-way ANOVA, Tukey's test and Pearson's correlation (p < 0.005). ResultsFor%SHL and%SRI, water controls showed significantly lower protective capacity. Cane+VitT, Cane+VitS, and Vit+CaneS presented the lowest%SHL, and VitT and VitS did not differ from Vit+CaneT, but they were different from the other groups (p = 0.002). The greatest%SRI was found for the Cane+VitT, Vit+CaneT, VitT, Cane+VitS, Vit+CaneS, and VitS groups, which did not significantly differ. CaneT and ControlT, showed similar reflections compared to CaneS and ControlS. ConclusionCaneCPI-5 and Vitamin E demonstrated a synergistic protective effect against initial erosion. Clinical significanceThe results open up new possibilities for preventive approaches against erosion through the acquired pellicle engineering, with the combination of CaneCPI-5 and Vitamin E, which demonstrated to be more effective than commercial stannous mouthwash. Further research is warranted to explore the potential of this combination in diverse clinical settings.

Combined use of stannous fluoride-containing mouth rinse and toothpaste prevents enamel erosion in vitro

ObjectiveTo compare the protective effect of commercial stannous-containing mouth rinses on enamel erosion in a simulated 5-day in vitro cycling model.Materials and methods81 human enamel specimens were embedded in resin blocks and divided into nine groups as follows; group 1: stannous fluoride (1000SnF2) toothpaste; groups 2,3, and 4 were the same as group 1 plus Elmex®, PerioMed™, and Meridol®, respectively, group 5: stannous fluoride (1450SnF2) toothpaste, groups 6, 7, and 8 were the same as group 5 plus Elmex®, PerioMed™, and Meridol®, respectively, group 9: negative control. An erosive challenge was induced with a 1 min hydrochloric acid (0.01 M, pH 2.2) treatment 3 times per day. Each cycle included immersing in the toothpaste slurry twice for two minutes and a one-minute rinse. The enamel slabs were immersed in artificial saliva between each erosive cycle and incubated overnight at 37 °C. Surface hardness loss and enamel loss were determined by Knoop surface hardness and non-contact profilometry, respectively. Finally, enamel surfaces were analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDS).ResultsAll three mouth rinses had similar protective effects against erosion when using adjunct with 1000 SnF2 toothpaste (p > 0.05). With 1450 SnF2 toothpaste, Elmex® presented significantly lower surface hardness loss than Meridol® (p < 0.05). The combined use of Elmex® or PerioMed™ with toothpaste provided significantly better erosion protection than toothpaste alone, either 1000 or 1450 SnF2. In addition, 1000SnF2 toothpaste adjunct with mouth rinse is comparable to 1450 SnF2 toothpaste alone in preventing enamel erosion.ConclusionAll three mouth rinses reduced enamel erosion. The additional use of a high concentration stannous containing mouth rinse with 1450 SnF2 toothpaste increases the protective effect against enamel erosion in vitro.Clinical significanceTo date, no standard protocol for preventing dental erosion is available. There are three stannous-containing mouth rinses on the market; however, no study compared their efficacy or indicated whether using adjuncts with anti-erosion toothpaste provides additional benefits. This study found that adding stannous mouth rinse to twice-daily toothpaste increases erosion protection.

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.

Erosion-inhibiting potential of the stannous fluoride-enriched CPP-ACP complex in vitro

Currently available anti-erosive agents only provide partial protection, emphasizing the need to enhance their performance. By characterizing erosive enamel wear at the nanoscale, the aim of this in vitro study was to assess the anti-erosive effects of SnF2 and CPP-ACP both individually and synergistically. Erosion depths were assessed longitudinally on 40 polished human enamel specimens after 1, 5, and 10 erosion cycles. Each cycle comprised one-min erosion in citric acid (pH 3.0) and one-min treatment in whole saliva (control group) or a slurry of one of the three anti-erosive pastes (10% CPP-ACP; 0.45% SnF2 (1100 ppm F); or SnF2/CPP-ACP (10% CPP-ACP + 0.45% SnF2)) (n = 10 per group). Scratch depths were assessed longitudinally in separate experiments using a similar protocol after 1, 5, and 10 cycles. Compared with the control groups, all slurries reduced erosion depths after 1 cycle (p ≤ 0.004) and scratch depths after 5 cycles (p ≤ 0.012). The order of anti-erosive potential was SnF2/CPP-ACP > SnF2 > CPP-ACP > control for erosion depth analysis, and SnF2/CPP-ACP > (SnF2 = CPP-ACP) > control for scratch depth analysis. These data provide ‘proof of concept’ evidence that SnF2/CPP-ACP has superior anti-erosive potential compared to SnF2 or CPP-ACP alone.

Influence of violet LED and fluoride-containing carbamide peroxide bleaching gels on early-stage eroded/abraded teeth

PurposeThis study evaluated enamel with early-stage erosion/abrasion following bleaching with 20% and 45% carbamide peroxide (CP) gels containing fluoride (F) and irradiated with violet LED (LED). MethodsEnamel blocks were immersed in 1% citric acid (5 min) and artificial saliva (120 min) three times to produce early-stage enamel erosion. Simulated toothbrushing was performed only after the first saliva immersion, to provoke enamel abrasion. The erosive/abraded enamel samples were submitted to (n=10): LED/CP20, CP20, LED/CP20_F, CP20_F, LED/CP45, CP45, LED/CP45_F, CP45_F, LED, and control (without treatment). The pH of the gels was assessed, and color (ΔE00) and whiteness index (ΔWID) changes were calculated after cycling (T1), and 7 days from bleaching (T2). Enamel surface roughness average (Ra) and Knoop microhardness (kg/mm2, %SHR) were evaluated at baseline (T0) at T1 and T2. Scanning electron microscopy evaluated the enamel surface morphology at T2. ResultsThe gels’ pH was neutral and CP20 and CP45 exhibited no differences in ΔE00 and ΔWID (p>0.05) but LED increased these parameters for CP20_F and CP45. Erosion/abrasion significantly decreased mean kg/mm2, and the LED group was the only one not increasing microhardness after bleaching (p>0.05). None of the groups fully recovered the initial microhardness. All groups exhibited %SHR similar to the control (p>0.05) and the increase in Ra was detected only after erosion/abrasion. CP20_F groups exhibited a more preserved enamel morphology. ConclusionLight irradiation combined with low-concentrated CP gel promoted a bleaching effect comparable to the high-concentrated CP. The bleaching protocols did not adversely impact the surface of early-stage eroded/abraded enamel.

Erosive effects of commercially available alcoholic beverages on enamel.

This study aimed to investigate the effects of four alcoholic beverages on enamel erosion. Fifty enamel specimens were randomly allocated into the following five groups (n=10): group 1, water as negative control; group 2, red wine; group 3, white wine; group 4, distilled spirit; and group 5, beer. The specimens were immersed in the respective solution for a 16 h demineralization, followed by an 8 h remineralization in artificial saliva. Cyclic de- and re-mineralization were performed for 8 days. Surface roughness, microhardness and morphology of the enamel specimens were studied after the cycling. The results were analyzed by One-way ANOVA and Dunnett's post-hoc test (p<0.05). All investigated beverages showed an erosive effect on enamel. White wine had the highest erosive potential whereas distilled spirit had the least.

Major considerations of dental care and treatments for pregnant and breast-feeding women: a concise systematic review

Introduction: Dental treatment for pregnant women is still a source of insecurity for many professionals, including those in the dental field. Among the changes present is the increase in the rate of dental caries, acid enamel erosion, and, of paramount importance, a greater predisposition to periodontal disease. Objective: It was to present the main considerations of dental care and treatment in pregnant and lactating women through a concise systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to February 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2014 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 120 articles were found, 29 articles were evaluated in full and 16 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 32 studies that did not meet GRADE. Drug therapy in pregnant and breastfeeding women, as well as any form of surgical intervention, always requires a careful assessment of the risks potentially involved in this practice. In this way, the dental surgeon must prescribe rationally and responsibly, to avoid the undesirable effects that may be caused by the use of medications. It is of paramount importance, the constantly updating of the professional, through the search for recent information in updated references or specialized centers, about the drugs and their possible harmful effects on the mother and the child.

The effect of Phytosphingosine and bioactive glass-ceramics in preventing dental enamel erosion.

This study evaluated the effect of phytosphingosine (PHS) and bioactive glass-ceramic (Biosilicate) on dental enamel in terms of color alteration (ΔE), microhardness, and surface roughness when submitted to erosive challenge (EC). Sixty specimens of bovine teeth (6×6×2mm) were obtained. Initial color (Easyshade, VITA), KHN (HMV-2, Shimadzu), and Ra (SJ-201P, Mitutoyo) measurements were performed. Specimens were separated into groups according to treatments: PHS, 10% Biosilicate, PHS+10% Biosilicate, and artificial saliva (control) and submitted to EC with Coca-Cola for 2 min. This cycle was repeated 4 times daily/15 days. Between cycles, specimens remained in artificial saliva (2 h/37°C). After daily cycles, they were also stored in artificial saliva at 37ºC. Final color, microhardness, and surface roughness measurements were done. Color and KHN data were analyzed by one-way ANOVA, Tukey's test; and Ra, by 2-way ANOVA, repeated measures, and Tukey's test (p<.05). The highest ΔE occurred in Saliva+EC (p<.05). Groups treated with PHS presented lower color change than Saliva+EC (p<.05). All the groups presented mean values above the 50:50% perceptibility (50:50%PT) and acceptability (50:50%AT) thresholds, except for control that showed mean value above 50:50%PT but below 50:50%AT. Biosilicate+EC showed higher relative microhardness than Saliva+EC (p<.05), but was similar to PHS+EC and PHS+Biosilicate+EC. Final enamel surface roughness increased for all the groups (p<.05), except for the control. The Biosilicate may prevent enamel mineral loss induced by erosion better than saliva. The PHS associated or not to Biosilicate demonstrated better color stability than saliva.

Solutions Containing a Statherin-Derived Peptide Reduce Enamel Erosion in vitro

The effect of solutions containing a statherin-derived peptide (Stn15pSpS) on the protection against enamel erosion in vitro was evaluated. Bovine enamel specimens were divided into 4 groups (n = 15/group): (1) deionized water (negative control), (2) Elmex Erosion Protection™ (positive control), (3) 1.88 × 10⁻⁵ M Stn15pSpS, and (4) 3.76 × 10⁻⁵ M Stn15pSpS. The solutions were applied on the specimens for 1 min. Stimulated saliva was collected from 3 donors and used to form a 2-h acquired pellicle on the specimens. Then, the specimens were submitted to an erosive pH-cycling protocol 4 times/day, for 7 days (0.01 M HCl pH 2.0/45 s, artificial saliva/2 h, and artificial saliva overnight). The solutions were applied again during pH-cycling, 2 times/day for 1 min after the first and last erosive challenges. Enamel loss (μm) was assessed by contact profilometry. Data were analyzed by Kruskal-Wallis and Dunn’s test (p < 0.05). The best protection against erosion was conferred by Elmex Erosion Protection that significantly differed from all the other treatments, followed by the solutions containing Stn15pSpS, regardless of the concentration. However, 3.76 × 10⁻⁵ M Stn15pSpS did not differ from the negative control. The solution containing the lower concentration of Stn15pSpS protected against erosion in vitro, which should be confirmed using protocols that more closely resemble the clinical condition.

Through the Looking Glass: Skin Signs that Help Diagnose Eating Disorders.

Eating disorders (EDs) such as anorexia nervosa and bulimia nervosa have a plethora of skin manifestations. They can be categorized into skin signs of self-purging, skin signs of starvation, skin signs related to drug abuse, skin signs of psychiatric comorbidity, and miscellaneous signs. "Guiding signs" are valuable, because they are pointers to the diagnosis of an ED. They include hypertrichosis (lanugo-like hair), Russell's sign (knuckle calluses), self-induced dermatitis, and perimylolysis (tooth enamel erosion). Practitioners should recognize such skin signs promptly, as this helps to diagnose early which may improve the prognosis of ED. Management requires a multidisciplinary approach that focuses on psychotherapy combined with attention to medical complications, nutritional needs, and such non-psychiatric findings such as cutaneous manifestations. Psychotropic medications that are currently used in EDs include pimozide and atypical antipsychotic agents, such as aripiprazole and olanzapine, fluoxetine, and lisdexamfetamine.

Погребальные комплексы геоархеологического местонахождения Усть-Кеуль 1 (Северное Приангарье): проблемы культурно-хронологической идентификации

This paper presents results of a study of two burial complexes from the geoarchaeological site Ust-Keul 1 in Northern Angara region (excavations of 2012). Mortuary rites and grave goods were analyzed, thus making clear the issue of cultural affiliation of these complexes and defining their uniqueness for the Baikal-Yenisei Siberia. The burials were made by a method of inhumation in ground graves. In both cases structures above and within the graves are absent. The accompanying burial goods are presented by arrowheads with a triangular shape, a concave base and equally large barbs, and by a horn made connector (a cartridge case), the one that was used to attach the stone arrowhead to the arrow shaft. Results of the radiocarbon dating determine the age of the burials by the Late Bronze Age – the Early Iron Age. The dating raises the question about a time of the Tsepan culture bearers` infiltration into the Northern Angara region. Results of the odontological analysis are presented and even based on the description of the extremely fragmented remains, it was possible to define sex and age characteristics of the buried ones. The unearthed fragments and isolated teeth belonged to three individuals. The stage of tooth crowns formation and dental enamel erosion are indicators of the age of the buried ones. Two of them are adolescents (burials 1 and 2, individual 2), and the age of the third individual (burial 2, individual 1), based on the erosion, is between 35–45 years. The results of our research obtained not only with reliance on analogies with other burials in the Northern Angara region but also based on credible radiocarbon data, corroborate the assumption of a somewhat earlier dating of the Tsepan culture burials. There is a discussion about possible infiltration of the Tsepan culture bearers in the Northern Angara region at the end of the Late Bronze Age. However, the issue of a more reliable chronology of these burials under study still remains relevant. The radiocarbon data indicate, at first sight, their earlier age but measurements obtained for burial 2 from the two individuals have large discrepancies. Additionally, they may appear older due to a freshwater reservoir effect. The accompanying burial goods are scarce but allow us, with confidence, to define the burials from Ust-Keul 1 site as belonging to the Tsepan culture.

2 - Buccal vs. Occlusal Enamel Erosion and Attrition in vitro

2 - Buccal vs. Occlusal Enamel Erosion and Attrition in vitro

Rinsing solutions containing natural extracts and fluoride prevent enamel erosion in vitro.

Polyphenols interact with salivary proteins and thus can improve the pellicle's erosion protective properties. This effect could be exploited to create rinsing solutions with polyphenols as active ingredients for erosion prevention. Different from the current gold standard for erosion protective rinsing solutions, these rinses would not rely on stannous ions. This would offer alternatives for patients with concerns regarding the composition of rinsing solutions and preferring bio-products. To develop an erosion-preventive rinsing solution containing natural polyphenol-rich extracts. Solutions were prepared with polyphenols from either grapeseed extract or cranberry extract, 500 ppm fluoride added, and additionally flavors and sweeteners. Controls were deionized water, 500 ppm fluoride solution, and the gold standard rinse in the field (Sn2+/F-). In total, 135 enamel specimens (n=15/group) were subjected to five cycles of salivary pellicle formation (30 min, 37°C), modification with the solutions (2 min, 25°C), further salivary pellicle formation (60 min, 37°C), and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), surface reflection intensity (rSRI), and amount of calcium release (CaR) were investigated. Data were analyzed with Kruskal-Wallis and Wilcoxon rank sum tests (α=0.05). The polyphenol solutions containing fluoride, as well as additional flavors, protected enamel better than fluoride alone, and similar to the Sn2+/F- solution, when investigating both rSMH and CaR. When measuring rSRI, Sn2+/F- showed the best protection, while the polyphenol solutions were similar to fluoride. For two of the three assessed parameters (rSMH and CaR), both developed polyphenol-rich rinsing solutions were able to protect enamel from erosion, improving/potentializing the effect of fluoride and matching the protection offered by the current gold standard rinsing solution.

The Prevalence Of Enamel Defects Among The Students Of Secondary School (Age 14-17) In Baghdad/Alrosafa

Aim of the study: To study the occurrence of enamel defects, the most common type and what gender is more affected on the students at the secondary school in Baghdad-Alrosafa.&#x0D; Materials and methods: Eight hundred and fifty students in the secondary school in Baghdad-Alrosafa were included in this study without any systemic disease with a 425 male and 425 female aging from 14 to 17 years old. A diagnostic instrument probe, mirror, gloves and tweezer were used. All students were examined clinically for the presence of enamel defect like enamel fluorosis, amelogenesis imperfecta, enamel erosion, abrasion and attrition. T-test was used for statistical analysis.&#x0D; Results: Results of the current study showed a high percentage of enamel defect occurring in females than in males and a high significant difference recorded at 17 years old in enamel fluorosis with an enamel attrition recording a higher percentage than other anomalies.&#x0D; Conclusion: conclusion of study is that the enamel defect occurs in females more than males and molar teeth have a higher prevalence than other teeth. Attrition recorded a higher percentage than other defects followed by enamel fluorosis and the lower one is amelogenesis imperfacta.

Clinical condition of teeth and dentition in children and adolescents with cerebral palsy

BACKGROUND: Literature and statistical data reveal the increasing incidence of psychoneurological diseases (PND) and thus dental pathologies with PND in children and adolescents. Thus, the authors examined the structures and frequency of dental defects and deformities in patients with PND. Children and adolescents with PND aged 718 years are at high risk for the development of dental pathologies, and oxidative stress and immune system disorder present major associations with the pathogenesis of dental pathologies.&#x0D; AIM: To determine the structure and frequency of dental defects and deformities in children and adolescents with PND and study the etiopathogenetic factors and mechanism of pathology formation to guide the development of preventive measures.&#x0D; MATERIAL AND METHODS: The study comprehensively analyzed the data of 299 patients aged 718 years, of which 143 were diagnosed with PND based on the International Classification of Disease 10th Revision (main group; МG) and 156 somatically healthy patients with dental pathologies (control group; CG). The participants were divided into two subgroups: 75 patients aged 712 years (52.44%; МG-1) and 68 patients aged 1318 years (47.55%; МG-2) from the main group (MG) and 65 (41.66%; CG-1) and 91 (58.33%; CG-2) patients from the CG of the respective age groups.&#x0D; RESULTS: The incidence rates of caries in the temporary teeth of MG-1 and CG-1 were 97.33% and 84.61% and in the permanent teeth of MG-2 and CG-2 were 95.58 and 87.91%, respectively. In the pre-eruptive period, the rates of dental lesions were as follows: hypoplasia, 20.97%; impaired dentition, 49.65%; primary adentia, 47.55%; anomalies of the completeness of teeth, 64.33%; endemic fluorosis of teeth, 2.79% in patients with PND; and 12.17%, 12.17%, 26.92%, 11.53%, and 0.6% in children and adolescents in CG, respectively (p 0.0001): disappearance of dental hard tissues, 9.09%; dental injuries, 24.47%; enamel necrosis, 7.7%; enamel erosion, 17.5% of patients with MG. In children and adolescents of CG, only tooth trauma was noted in 7.7% and enamel necrosis in 1.3%. In patients with PND, 49.6% had distal occlusion; 37.8%, cross occlusion; 31.6%, neutral occlusion; 29.9%, deep incisor occlusion; 25.9%, deep incisor malocclusion; 54.5%, narrowing of the lower dentition; 43.3%, crowding of teeth in the lower jaw; 26.6%, diastemas; and tremas, 23.8%.&#x0D; CONCLUSION: Non-carious lesions of the teeth and a shift in the timing of the development of temporary and permanent teeth are more common in MG than in CG and lead to impaired dental anatomy and disrupt the aesthetics of smiles, speech, etc. Moreover, hypertrophic gingivitis and local periodontitis were characteristic of children with severe PND, who are at high risk for dental pathologies associated with oxidative stress and genetically related immune system disorders, especially in older children with PND.

The dynamic interplay of dietary acid pH and concentration during early-stage human enamel and dentine erosion

Dental erosion continues to be a significant global health concern affecting nearly 30% of adults world-wide. With increasing soft drink consumption predominantly driving its prevalence, strategies for prevention and control are often implemented when erosion is severe, or rates are high in the populace. While factors affecting dental erosion such as pH on enamel has received much attention, the effect of dietary acid concentration when factored out to a commercially available pH has yet to be determined. Furthermore, understanding these effects on dentine, which is known to be more susceptible to erosion than enamel can unravel structure property relationships between acid characteristics and hard tissue types. This study aimed to develop structure-property relationships between dietary acid concentration, and pH, on the nano-textural and nano-mechanical properties of human enamel and dentine during short-term simulated drinking. To achieve this, a novel sample preparation methodology and analysis approach was developed by applying atomic force microscopy (AFM) in quantitative imaging mode. This enabled simultaneous measurement of enamel and dentine morphology and mechanical properties. Flow-cells were used to simulate drinking, exposing polished and smear layer free human enamel and dentine to 30 s repeated cycles of unbuffered citric acid 6% (pH = 1.88) and 1% (w/v) (pH = 2.55) and commercially available buffered pH = 3.8 states, for up to 180 s. The same 50 µm × 50 µm area of specimen morphology was analysed using in-house developed nanotextural analysis using the bearing area curve (BAC) with a focus on roughness (Ra), normalised peak (PA) and valley areas (VA). Mechanical properties were simultaneously measured for stiffness (N/m) after each 30 s. While all studies agree pH is a major factor in the erosion of enamel, here its dominance over the treatment time varied, with concentration surpassing the importance of pH after initial acid contact. Conversely, dentine erosion showed concentration-dependent changes in morpho-mechanical properties only. These results not only highlight the dynamic process of erosion, but how the interplay between acid characteristics and dental tissue type impact the progression of very early-stage erosion.

The Effect of Silver Diamine Fluoride, CPP-ACP/NaF, and Sodium Fluoride Varnish on Deciduous Enamel Erosion by Daily Snack ( Drink) in Children/ An In Vitro Study

Objective: Most children consume carbonated soft drinks and fruit juices daily, inducing detrimental low pH and contributing to dental erosion. The current study aimed to assess and compare the efficacy of a single application of 38% Silver diamine fluoride (38% SDF), CPP-ACP/NaF varnish, and Sodium fluoride varnish (NaF) in the prevention of enamel demineralization in primary teeth against daily snack drink in children. &#x0D; Methods: Forty primary anterior teeth (n=40) were divided into four groups and exposed to the following treatments (n=10): G1= 38%SDF (e- SDF TM); G2= CPP-ACP/NaF (MI VarnishTM); G3= NaF varnish (FluoroDose®); G4= Distilled water. The specimens were submitted for four days, with six pH cycles per day (10 minutes in orange juice) (SUNQUICK, IRAQ). Artificial saliva was used to remineralize the specimens after erosion challenges and as storage media between cycles. After four days of pH cycling, all the specimens were subjected to an atomic absorption spectrometer (AAS) to measure the amount of Calcium and phosphorus loss in each acidic solution. Scanning Electron Microscope evaluated the enamel topographic characteristics. &#x0D; Results: All varnishes promoted better results for protecting enamel than the distilled water, with a difference. However, 38% of SDF demonstrated less Calcium and phosphorus loss than CPP-ACP/NaF, NaF varnish, and distilled water (p &lt; 0.001). &#x0D; Conclusions: Considering calcium and phosphorus loss values, a single application of each 38% SDF, MI varnish, and Naf effectively inhibited enamel erosion after four days of an erosive challenge, although the best protective effect was in favor of SDF.

&lt;strong&gt;The effect of acidulated phosphate fluoride (APF) gel against erosion on enamel microstructure of primary teeth which soaked with Citrus aurantifolia &lt;/strong&gt;

ABSTRACTIntroduction: Erosion is a common dental problem that is especially prevalent in children due to the increasing consumption of acidic food and beverages. APF gel is believed to be effective in reducing the demineralization effect of the teeth as well as escalating the remineralization process. This research aims to determine and evaluate the effectiveness of 1.23% APF gel as a preventive agent for the erosion of tooth enamel, specifically in deciduous teeth. Methods: This type of research is true experimental research. The population of this research would be primary teeth extracted from children, using a purposive sampling technique with inclusive and exclusive criteria. A total amount of 5 maxillary primary central incisors were extracted and cleaned. APF gel was applied repetitively on the left side of the teeth for 4 minutes every hour, whereas the right side was left as it is. Samples were then analyzed using a scanning electron microscope (SEM). A qualitative and subjective analysis regarding the micromorphological features of the erosion can be done. Result: The side of teeth without APF gel application has a greater erosion rate compared with teeth with APF gel application. The tooth which is demineralized shows a honeycomb structure of the interprismatic enamel. As for the dentinal tubules, teeth without APF gel application have a bigger opening of dentinal tubules, going up to 7.868 micrometers in size compared to teeth with APF gel application (1-2 micrometers). Conclusion: The application of professional acidulated phosphate fluoride (APF) gel on deciduous teeth even when soaked in Citrus aurantifolia, is proven to be effective in preventing dental erosion.Keywords: acidulated phosphate fluoride (APF) gel; citrus aurantifolia; dental erosion; primary tooth

Comparative analysis of the effect of Bioactive Glass 45S5 on enamel erosion progression in human dentitions (in vitro study)

ObjectivesThe aim of the present study was to compare the surface morphology alterations, mineral content, and surface roughness of eroded enamel surface versus eroded enamel surface which was preceded by Bioactive Glass 45S5 (BAG45S5) application in both primary and permanent human dentitions.Materials and methodsFifty-two primary teeth and fifty-two permanent teeth were selected. Teeth were randomly divided into 4 groups of twenty-six teeth each. Groups A1 and B1 underwent erosion with 1% citric acid, while groups A2 and B2 were subjected to application of BAG45S5 powder followed by the same erosive conditions as A1 and B1. Measurements were performed by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and surface profilometry. They were used to examine the surface morphology alterations, mineral content, and surface roughness, respectively.ResultsSEM of enamel which received BAG45S5 showed smoother surface in primary teeth post erosion. EDX analysis showed that enamel exhibited crucial resistance to mineral loss in the group which received BAG45S5 prior to inducing erosion as compared to the induced erosion-only group. This was significant (p < 0.005) in both human dentitions. Erosion-only groups showed significantly less surface roughness in permanent teeth (p < 0.045). A marked decrease in surface roughness was observed in surfaces receiving BAG45S5, primary teeth (p < 0.001), and permanent teeth (p < 0.001).ConclusionsBioactive Glass 45S5 proved successful against erosive conditions in both primary and permanent teeth with better performance in the permanent teeth so it can be regarded as a means of prevention.Clinical relevanceBioactive Glass 45S5 powder could be used not only to remove stains but also as a prophylactic preventive measure against the multiple episodes of acidic food and beverage consumption in children.