Enamel Loss Research Articles

A Repeatable and Reproducible Digital Method to Quantify the Cement Excess and Enamel Loss after Debonding Lingual Multibracket Appliance Therapy

The aim of the present study is to present a repeatable, reproductible, and accurate morphometric measurement method for measuring and quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances. Ten conventional lingual brackets were cemented in 10 extracted teeth embedded into an epoxy resin model simulating a dental arch. This model was scanned before and after bonding the lingual brackets, after debonding, and after polishing the surfaces. We also performed a Micro-Computed Tomography scan of the lingual brackets used. Afterward, the standard tessellation language (STL) digital file was aligned, each tooth was segmented individually, and the file was re-aligned using engineer morphometry software. Inter-operator and intra-operator comparative analyses were performed using the ANOVA test, and the repeatability and reproducibility of the morphometric measurement technique were analyzed using Gage R&R statistical analysis. Repeatability showed 0.07% and 0.16% variability associated with the area and volume measures, respectively, while reproducibility showed 0.00% variability associated with the area and volume measures, respectively. In conclusion, the morphometric measurement technique is a repeatable, reproductible, and accurate morphometric measurement method for quantifying the area and volume of cement that remains after fixed lingual multibracket appliance debonding, enamel loss after fixed lingual multibracket appliance debonding, and the volume of cement used to adhere fixed lingual multibracket appliances.

In Vitro Study of Surface Changes Induced on Enamel and Cementum by Different Scaling and Polishing Techniques.

To determine how the currently available techniques of scaling and root planing, used either alone or with additional polishing techniques, affect the substance thickness and surface roughness of enamel and cementum. After extraction, impacted third molars were prepared and subjected to air polishing with a nonabrasive powder, ultrasonic scaling, or hand instrumentation. All three techniques were performed alone and in combinations for a total of 9 treatment groups. The control group consisted of untreated surfaces. Optical microcoordination measurements were conducted to separately assess substance loss, mean roughness depth (Rz), and roughness average (Ra) on enamel and cementum. The Rz results were analysed using a t-test for paired samples. Air polishing alone and with additional rubber-cup polishing using a paste were the only two approaches which caused no enamel loss. Both groups also entailed less cementum loss (≤ 20 μm) than any of the other seven groups, and both yielded the most favorable Rz results on enamel. Air polishing alone was the only group to reveal no significant change in Rz from untreated cementum (p = 0.999). The other 8 approaches statistically significantly reduced the surface roughness of cementum (p ≤ 0.017). Air polishing with a nonabrasive powder yielded the best hard-tissue preservation. Combining any of the scaling techniques with additional polishing was not beneficial; on the contrary, they caused even more abrasion of hard tissue on both enamel and cementum.

ACPT gene is inactivated in mammalian lineages that lack enamel or teeth.

Loss of tooth or enamel is widespread in multiple mammal lineages. Although several studies have been reported, the evolutionary mechanisms of tooth/enamel loss are still unclear. Most previous studies have found that some tooth-related genes have been inactivated in toothless and/or enamel-less mammals, such as ENAM, ODAM, C4orf26, AMBN, AMTN, DSPP, etc. Here, we conducted evolutionary analyses on ACPT playing a key role in amelogenesis, to interrogate the mechanisms. We obtained the ACPT sequences from 116 species, including edentulous and enamel-less mammals. The results shows that variant ORF-disrupting mutations were detected in ACPT coding region among nine edentulous baleen whales and three enamel-less taxa (pygmy sperm whale, aardvark, nine-banded armadillo). Furtherly, selective pressure uncovered that the selective constraints have been relaxed among all toothless and enamel-less lineages. Moreover, our results support the hypothesis that mineralized teeth were lost or degenerated in the common ancestor of crown Mysticeti through two shared single-base sites deletion in exon 4 and 5 of ACPT among all living baleen whales. DN/dS values on transitional branches were used to estimate ACPT inactivation records. In the case of aardvark, inactivation of ACPT was estimated at ~23.60–28.32 Ma, which is earlier than oldest aardvark fossil record (Orycteropus minutus, ~19 Ma), suggesting that ACPT inactivation may result in degeneration or loss of enamel. Conversely, the inactivation time of ACPT estimated in armadillo (~10.18–11.30 Ma) is later than oldest fossil record, suggesting that inactivation of ACPT may result from degeneration or loss of enamel in these mammals. Our findings suggested that different mechanisms of degeneration of tooth/enamel might exist among toothless and enamel-less lineages during evolution. Our study further considered that ACPT is a novel gene for studying tooth evolution.

Self-reported sleep bruxism is associated with vitamin D deficiency and low dietary calcium intake: a case-control study

BackgroundSleep bruxism may result in deleterious effects including loss of tooth enamel,fracture of teeth or restorations, teeth hypersensitivity or pain, and headache. The aim was to study the link between sleep bruxism, low serum vitamin D, low consumption of dietary calcium, psychological symptoms, and frequent headache.MethodsThis case-controlled study included 50 individuals with sleep bruxism and 50 age and gender matched controls. 25-hydroxyvitamin D was measured in serum. Hospital Anxiety and Depression Scale was used to measure anxiety and depression. Data about dietary calcium and frequent headache were self-reported.ResultsParticipants with sleep bruxism had lower 25-hydroxyvitamin D and higher scores of anxiety and depression compared to controls (p < 0.05). Vitamin D deficiency, abnormal scores of anxiety and depression, low calcium consumption (< 323 mg/day), and frequent headache were reported in higher % of individuals with sleep bruxism compared to controls (p < 0.05). Binary logistic regression showed that sleep bruxism was significantly associated with vitamin D deficiency (OR = 6.66, p = 0.02), low consumption of dietary calcium (OR = 5.94, p = 0.01), and frequent headache (OR = 9.24, p < 0.001). Multiple linear regression showed that anxiety was significantly associated with decreased 25-hydroxyvitamin D (p = 0.03), increased scores of depression (p < 0.001) and female sex (p = 0.01). Binary logistic regression also showed that frequent headache was significantly associated with sleep bruxism (OR = 5.51, p < 0.01).ConclusionsSleep bruxism was associated with vitamin D deficiency and low consumption of calcium and was also associated with increased scores of anxiety and depression. Further investigations should be performed to check if vitamin D and calcium supplementation could relieve sleep bruxism.

Perception of Dentists towards Periodontal Diagnosis, Treatment and Referral in Belagavi District, Karnataka, India: A Cross-sectional Study

Introduction: The loss of tooth structure in natural tooth can be attributed to several aetiological factors like dental caries, traumatic injuries and non carious lesions like attrition, abrasion, erosion. All the lesions result in loss of enamel and dentin which eventually need to be replaced with restorative materials. Aim: To evaluate the effect of different acidic solutions on the surface microhardness of three different nanocomposite restorative materials after one day and six weeks time interval. Materials and Methods: The present in-vitro study comprised of three different composite resin materials, Filtek Z 350 (3M ESPE, St. Paul, USA), Ceram X Mono (Dentsply, Konstanz, India) and Tetric N Ceram (Ivoclar Vivadent, Schaan, Liechtenstein). Twenty four samples were divided into three groups. Group I: Eight specimens of each restorative material were immersed individually in 10 mL of artificial saliva. Group II: Eight specimens of each restorative material were immersed in artificial saliva for four hours and later immersed for five minutes in a tube containing 10 mL of coca cola under stirring and later stored in artificial saliva. This process was repeated for three times a day. Group III: Eight specimens of each test material were individually immersed in artificial saliva for four hours and later immersed in 10 mL of hydrochloric acid (HCl) for five minutes under stirring and later stored in artificial saliva. This process was done three times a day. Vicker’s diamond indenter was used to test the microhardness. Paired t-test, independent t-test, one-way Analysis of Variance (one-way ANOVA) and post hoc test were used for analysis. Results: There was no significant statistical difference (p-value &gt;0.05) in the surface microhardness between all the tested solutions after day 1 time period of Filtek Z 350. There was significant difference of the surface microhardness between all the groups in all the solutions except for Filtek Z 350 and Ceram X Mono in HCl solution at 6 weeks. Conclusion: There was statistically significant reduction in surface microhardness of the three composites immersed in all the three solutions of artificial saliva, coca cola and hydrochloric acid after day 1 and six weeks time interval

Effect of Erosive Challenges on Microhardness of Three Different Nanocomposites: An In-vitro Study

Introduction: The loss of tooth structure in natural tooth can be attributed to several aetiological factors like dental caries, traumatic injuries and non carious lesions like attrition, abrasion, erosion. All the lesions result in loss of enamel and dentin which eventually need to be replaced with restorative materials. Aim: To evaluate the effect of different acidic solutions on the surface microhardness of three different nanocomposite restorative materials after one day and six weeks time interval. Materials and Methods: The present in-vitro study comprised of three different composite resin materials, Filtek Z 350 (3M ESPE, St. Paul, USA), Ceram X Mono (Dentsply, Konstanz, India) and Tetric N Ceram (Ivoclar Vivadent, Schaan, Liechtenstein). Twenty four samples were divided into three groups. Group I: Eight specimens of each restorative material were immersed individually in 10 mL of artificial saliva. Group II: Eight specimens of each restorative material were immersed in artificial saliva for four hours and later immersed for five minutes in a tube containing 10 mL of coca cola under stirring and later stored in artificial saliva. This process was repeated for three times a day. Group III: Eight specimens of each test material were individually immersed in artificial saliva for four hours and later immersed in 10 mL of hydrochloric acid (HCl) for five minutes under stirring and later stored in artificial saliva. This process was done three times a day. Vicker’s diamond indenter was used to test the microhardness. Paired t-test, independent t-test, one-way Analysis of Variance (one-way ANOVA) and post hoc test were used for analysis. Results: There was no significant statistical difference (p-value &gt;0.05) in the surface microhardness between all the tested solutions after day 1 time period of Filtek Z 350. There was significant difference of the surface microhardness between all the groups in all the solutions except for Filtek Z 350 and Ceram X Mono in HCl solution at 6 weeks. Conclusion: There was statistically significant reduction in surface microhardness of the three composites immersed in all the three solutions of artificial saliva, coca cola and hydrochloric acid after day 1 and six weeks time interval

Weight-loss and surface roughness of enamel after microabrasion procedure with different agents

Abstract Introduction Enamel microabrasion is achieved by abrasion of the enamel surface and it is a quick, practical and efficient procedure. Objective It was assessed the weight loss and surface aspect of enamel after microabrasion procedures with commercial and mixtures made in-office. Material and method Eighty bovine incisors were divided into four groups (n=10): OpalustreTM (6.6% HCl + silicon carbide); Whiteness RMTM (6% HCl + silicon carbide); 37% H3PO4 + pumice and 10% HCl + pumice. Treatment was performed by 15 applications of 10s duration. The enamel weight loss was determined by the difference in weight before and after the microabrasion. The surfaces were analyzed by a surface roughness equipment and scanning electron microscopy. Data were submitted to paired-T test, one-way ANOVA and Tukey tests (α=0.05). Result It was observed significantly weight loss for all groups. The difference in weight loss ranged from 0.037±0.012 for group 37% H3PO4 and from 0.054±0.009 for group 6,6% HCl. There was a significant increase in surface roughness for all groups and 10% HCl group showed the lower results (0.65±0.09). It was observed different patterns of enamel morphology by SEM images. Conclusion The in-office mixtures resulted in the lowest enamel structure loss (37% H3PO4) and the lowest surface roughness (10% HCl).

Protection of calcium silicate/sodium phosphate/fluoride toothpaste with serum on enamel and dentin erosive wear.

Objective To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin.Methodology Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva – 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO4/MFP (Regenerate-Unilever), and Si/PO4/MFP/BS (Si/PO4/MFP with dual BS – Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%).Results For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO4/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness.Conclusion The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW.

Prematurity and Dental Outcomes: A Short Communication Study

Background: The development of the teeth is affected by gestational age, and premature neonates are at greater risk for developing dental problems. In the present study, the deleterious effects of preterm birth on orodental tissues and structures were reviewed. Methods: A detailed research was carried out on MEDLINE, PubMed, and Google Scholar databases. English articles up to June 2019 were included and the search process was performed using the following keywords: “Dental outcomes”, “Tooth”, “Preterm”, “Prematurity”, and “Neonate”. Results: Literature review has revealed that alteration of tooth crown sizes, quantitative loss of enamel (i.e., enamel hypoplasia), and qualitative change in the enamel opacity (i.e., translucence appearance), or a combination of all are common in premature newborns. Delayed eruption of the first deciduous tooth is frequent among preterm neonates. Prematurity may also influence dental occlusion development, asymmetry in the jaws, and lateralization. Neonates with immature organs and enzymes are at greater risk for some complications, such as hemolytic jaundice and cholestasis. These complications, in addition to hyperbilirubinemia, may result in yellow, brown, or dark green discoloration in the primary teeth. Conclusion: Some measures can be adopted to improve dental outcomes in premature neonates, including prevention of preterm birth, avoiding problems associated with oral intubation, gentle passing and moistening oral tube feeding, and oral care with colostrum and soft swabs.

The effect of mouthwashes on fluoride dentifrices in preventing dental abrasion or erosion.

Erosive tooth wear (ETW) refers to the chemical dissolution of mineralized tissues by acids of non-bacterial origin. It occurs in the primary as well as the permanent dentition. In this study, our objectives were to investigate and compare the impact of chlorhexidine gluconate (CHX), essential oils (EO), and cetylpyridinium chloride (CPC) on ETW protection produced by conventional fluoride kinds of toothpaste. A clinically relevant in-vitro erosion/abrasion pH cycling model was employed to test the effect of the aforementioned mouthwashes on modulating the ability of NaF and SnF2 types of toothpaste. The mean dentin surface loss associated with NaF toothpaste was significantly lower than for the SnF2 toothpaste. On the other hand, enamel surface loss with SnF2 toothpaste was significantly lower than for the NaF toothpaste. Also, the surface loss of erosion was significantly higher when associated with abrasion than without brushing and for both enamel and dentin. There was no significant difference in the surface loss among all types of mouthwash. Commonly used types of mouthwash containing antimicrobial agents or additional fluoride do not impact fluoride toothpaste action on erosion/abrasion. Also, considering erosion only, the tested SnF2 dentifrice provided better protection against surface loss of enamel than the other.

Interplay between different manual toothbrushes and brushing loads on erosive tooth wear

ObjectiveTo investigate the effect of different types of manual toothbrushes and brushing loads on the progression of erosive tooth wear (ETW) on enamel. MethodsBovine enamel specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3 % citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, according to the toothbrushes tested (ultra-soft (a): Curaprox 5460; ultra-soft (b): Sensodyne Repair & Protect; soft (a): Colgate Slim Soft; soft (b): Oral-B Indicator Plus; medium: Johnson’s Professional; hard: Tek) and brushing loads (1.5 N, 3 N). Surface loss (SL, in μm) was assessed by optical profilometry on conclusion of the cycling. Some of the toothbrush characteristics were evaluated. Data were statistically analyzed (α = 0.05). ResultsFor the 1.5 N load, the hard brush showed the highest SL value, with statistical significance. The other toothbrushes did not differ significantly, except that ultra-soft (a) caused significantly higher SL than ultra-soft (b). For the 3 N load, hard and soft (a) exhibited the highest SL. Soft (b) and medium had the lowest SL value, with statistical significance. Only soft (a) and ultra-soft (b) showed significant difference between loads, with lower SL for the load of 1.5 N. None of the toothbrush characteristics were significantly correlated with SL. ConclusionsAlthough different degrees of enamel surface loss were observed with use of the different toothbrushes, no association was found between the toothbrush characteristics and SL. Depending on the toothbrush, the force of brushing was capable of modulating the ETW of enamel. Based on the brushing loads usually applied by healthy individuals, hard brushes are not recommended for use by patients with ETW. Clinical significanceThe use of hard bristle brushes is not recommended for use by individuals who exert healthy forces when brushing their teeth. The toothbrush characteristics are of secondary importance in terms of causing enamel loss in ETW.

Inhibitory Effect of Lactobacillus plantarum CCFM8724 towards Streptococcus mutans- and Candida albicans-Induced Caries in Rats.

Streptococcus mutans is a recognized cariogenic bacterium and a major producer of biofilm matrix. The presence of Candida albicans in dental plaque with S. mutans enhances the virulence leading to the onset of rampant caries which is similar to early childhood caries (ECC). The purpose of this study was to explore the effect of Lactobacillus plantarum CCFM8724 (CCFM8724) on the treatment and prevention of dental caries induced by S. mutans and C. albicans in vivo. Rats were divided into 6 groups: the control group and model group, 2 treatment groups, and 2 prevention groups (0.02% chlorhexidine or CCFM8724). The fluctuation of microbial colonization and the change of bacteria flora in rat oral cavity after sowing of L. plantarum CCFM8724 were investigated by colony-forming units (CFU) and microflora analysis. The caries of rats were assessed by microcomputed tomography (micro-CT) and Keyes scoring method. The results showed that L. plantarum CCFM8724 in both the treatment and prevention groups could significantly decrease the population of S. mutans and C. albicans in the rats' oral cavity (p < 0.001), the mineral loss of enamel (p < 0.05), and the scores of caries (p < 0.05). Besides, L. plantarum CCFM8724 exhibited better effects than chlorhexidine. Hence, L. plantarum CCFM8724 was proved to be a potential oral probiotic on caries treatment and prevention in vivo and it may have the prospect of application in dental caries (especially ECC) prevention products.

Evaluation of enamel surface changes by different enamel conditioners and de-bonding procedure using optical coherence tomography: An in-vitro qualitative study

Introduction: The purpose of this study is to evaluate surface changes of enamel after using different enamel conditioning agents and bonding adhesives after de-bonding and clean-up of metal and ceramic brackets using optical coherence tomography. Method: Metal and ceramic brackets were bonded onto 120 pre-molars, divided into 4 groups [n=30] which were de-bonded after 24 hours. Enamel conditioners, bonding agents and adhesive resins of four different brands were used in each group. The images of enamel surface were captured with Optical Coherence Tomography [OCT] machine; pre-treatment (T0), post-etching (T1), after bracket de-bonding (T2) and post-cleanup (T3). A spectral domain optical coherence tomography system with 5?m axial spatial resolution was used. This was connected to a pre-configured computer system. A total of 480 images were evaluated for enamel surface evaluation. Results: OCT images obtained allowed us to evaluate the enamel surface after acid-etching and post de-bonding and clean-up procedures. 2D OCT analysis allowed in-depth analysis of enamel loss after various procedures. OCT also assisted in locating remnant adhesive layer after clean-up. Conclusion: OCT is a powerful clinical tool for the use in dentistry and can be used effectively to evaluate enamel surface loss after various procedures. Keywords: De-bonding Evaluation using Optical coherence tomography, Evaluation of enamel surface changes, Optical Coherence Tomography, OCT.

Erosive assessment of dry mouth lozenges and tablets on enamel and dentin

ObjectivesTo assess the erosive potential of dry mouth lozenges and tablets on enamel and dentin. Materials and methodsThe following lozenges and tablets were tested: Salese, Oracoat Xylimelts, Cotton Mouth, TheraBreath, DenTek OraMoist, SmartMouth, ACT, CVS Health, Rite Aid, Med Active, and Hager Pharma. pH Analysis: Each lozenge or tablet was crushed with a pestle and mortar and 5 g of the resultant powder was dissolved in 10 ml of distilled water (pH 7.02) The pH of each lozenge solution was assessed by using a calibrated pH meter. Titratable Acidity (TA) was determined by adding 0.1 M of NaOH to each homogenous tablet solution until the pH reached 7.0. Gravimetric Analysis was measured with freshly extracted molars crown/roots were sectioned at the CEJ and enamel and dentin specimens were fabricated. The specimens were then submerged in 5 ml of solution containing 2.5 gm of crushed tablets for 24 h, 48 h, 96 h and 14 days with measurements performed at each interval after drying. The solutions were renewed at each interval. ResultsSignificant correlation between pH and TA was observed for lozenges and tablets evaluated (p < 0.0001). Both variables were strongly correlated with enamel and dentin loss (p < 0.0001). For enamel, DenTek resulted in significantly more substance loss (p < 0.05) than with the other tested products, while Xylimelts presented the lowest percentage of substance loss. For dentin, Cotton Mouth resulted in the highest substance loss, and Xylimelts presented the lowest percentage of substance loss. ConclusionsThere is a strong correlation between the pH, tritatable aciditiy, and erosive potential of these products. DenTek and Cotton Mouth reported erosive effect to the enamel and dentin, respectively.Xylimelts performed better than the rest of the products in relationship to enamel and dentin.

Evaluation of enamel loss by scanning electron microscopy after debonding brackets place with four different adhesives.

The clinically adequate shear bond strengths (SBS) should be from 2.8 to 10 MPa. The aim of this research is to observe tooth enamel loss through a scanning electron microscope (SEM) during the debonding of braces of four adhesive systems. Then, 100 premolars were used in 4 groups of 25 specimens each, for Transbond MIP (G1), Enlight (G2), Stylus (G3), and Transbond Plus SEP (G4). The research was done under the NOM ISO/TS 11405:2015. Gemini 3M were placed under the manufacturer's recommendations. The SBS test was done at 24 hr in an Instron electromechanical universal testing machine at 1 mm/1 min. Adhesive remnant index (ARI) was measured, all of the brackets where examined in the SEM. For the shear bonding strength G1 = 10.09 ± 2.73 MPa, G2 = 9.27 ± 3.99 MPa, G3 = 7.83 ± 4.46 MPa, and G4 = 6.40 ± 2.85 MPa statistically significant differences were found when comparing the four groups (p = .002). In the Tukey post hoc test, G1 versus G4 and G2 versus G4, statistically significant differences were found. For the ARI a value of 1 in 46%, followed by a value of 2 in 38%, a value of 3 in 13% and a value of 0 in 3% of the total samples, finding statistically significant differences (p < .001). In relation to the tooth enamel loss due to SBS, statistically significant differences were found (p = .326). G1 and G4 had not statistically significant differences. Even though our results concur with the appropriate clinical values, we observed tooth enamel loss with Transbond Plus SEP and Stylus.

Effect of titanium tetrafluoride/sodium fluoride solutions containing chitosan at different viscosities on the protection of enamel erosion in vitro

ObjectiveThe aim of this in vitro study was to evaluate the protective effect against enamel erosion of experimental solutions containing TiF4/NaF and Chitosan compared to a commercial SnCl2/NaF/AmF solution. DesignBovine enamel samples were divided (n = 15/group) into: (1) commercial solution SnCl2/NaF/AmF (500 ppm F−, positive control); (2) NaF/TiF4 (490 ppm F−); (3) similar to 2 plus 0.5 % chitosan (Ch) (500 mPas), (4) similar to 2 plus 0.5 % chitosan (2000 mPas), (5) negative control (water), (6) 0.5 % chitosan (500 mPas) and (7) 0.5 % chitosan (2000 mPas). The samples were submitted to a pH cycling (0.1 % citric acid, 4 × 90 s/day, interposed by artificial saliva) and daily treatment application (after the last erosive challenge, 1 × 30 s/day) for seven days. After the first day, the surface reflection intensity changes (% rSRI) were measured. After 7 days, the erosive enamel loss was quantified by contact profilometer. The % rSRI and the enamel loss (μm) were compared using ANOVA/Tukey and Kruskal-Wallis/Dunn, respectively (p < 0.05). ResultsThe solution containing TiF4/NaF plus Ch 500 mPas was the only able to reduce the early erosive demineralization compared to negative control (p = 0.003). However, it did not differ from the other solutions. Enamel samples treated with SnCl2/NaF/AmF presented the lowest median loss value [0.72 (0.18) μm] followed by both TiF4 + Ch [1.24 (0.49) and 1.28 (0.25)]; which significantly differed from the negative control [1.70 (0.27)]. ConclusionThe experimental solution containing TiF4/NaF plus chitosan (2000 mPas) has comparable effect to SnCl2/NaF/AmF on the protection against enamel erosion.

Identification of Key Functional Motifs of Native Amelogenin Protein for Dental Enamel Remineralisation.

Dental caries or tooth decay is a preventable and multifactorial disease that affects billions of people globally and is a particular concern in younger populations. This decay arises from acid demineralisation of tooth enamel resulting in mineral loss from the subsurface. The remineralisation of early enamel carious lesions could prevent the cavitation of teeth. The enamel protein amelogenin constitutes 90% of the total enamel matrix protein in teeth and plays a key role in the biomineralisation of tooth enamel. The physiological importance of amelogenin has led to the investigation of the possible development of amelogenin-derived biomimetics against dental caries. We herein review the literature on amelogenin, its primary and secondary structure, comparison to related species, and its’ in vivo processing to bioactive peptide fragments. The key structural motifs of amelogenin that enable enamel remineralisation are discussed. The presence of several motifs in the amelogenin structure (such as polyproline, N- and C-terminal domains and C-terminal orientation) were shown to play a critical role in the formation of particle shape during remineralization. Understanding the function/structure relationships of amelogenin can aid in the rational design of synthetic polypeptides for biomineralisation, halting enamel loss and leading to improved therapies for tooth decay.

Comparative evaluation of the efficacy of the desensitizing and remineralizing agent in the reduction of dentin hypersensitivity after orthodontic debonding - a randomized clinical trial.

IntroductionEnamel loss is a common problem during various orthodontic procedures. The study aims to compare the efficacy of a desensitizer and remineralizer in the reduction of the dentin hypersensitivity (DH) associated with enamel microcracks after orthodontic debonding.MethodsA unicentric two arm parallel study with 30 subjects randomly assigned to each groups following debonding. Group-1 subjects were treated with Gluma® desensitizer (5% glutaraldehyde and 35% hydroxyethyl methacrylate (HEMA)) and the Group-2 intervention included a remineralizing agent GC Tooth Mousse Plus® (casein phospho peptide and amorphous calcium Fluro phosphate (CPP:ACFP)). The Visual Analogue Scale (VAS) was utilized to evaluate DH as subjective perception of pain following the Air blast test and Cold test. The VAS scale was indexed from 0–10 markings based on the intensity of perception. Five different time points T0 and T1 - immediately after debonding and intervention on day 1, T2 – 48 hours, and T3 after 72 hours were taken for the assessment of VAS scores.ResultsThe VAS scores for the airblast test for group 1 were (2.73, 0, 0.06, 0.03) and group 2 (2.46, 0, 0.16, 0.13) at different periods. The sensitivity scores for the cold blast test for group 1 were (2.73, 0, 0.13, 0.03) and for group 2 (2.46, 0, 0.16, 0.13). There was 98 percent reduction in DH between T0 and T3 and was statistically significant (p<0.05) for both the groups.ConclusionGluma® desensitizer and GC Tooth Mousse Plus® are equally effective in the reduction of DH in the orthodontic patient following debonding.

Stannous Fluoride Effects on Enamel: A Systematic Review.

In recent years there has been a lot of talk about toothpastes with a particular chemical compound: stannous fluoride (SnF2). Its presence is currently still highly controversial, as the latter could have negative health effects. The different companies that produce toothpastes express its dosage in ppm. The purpose of this systematic literature review is to analyze all randomized clinical trials in the literature over the last 10 years and to draw clear results on the function of stannous fluoride, for this purpose the authors performed a Mann–Whitney U Test. Materials: The first analysis of the literature produced a number greater than 800 results, subsequently applying the inclusion and exclusion criteria, and following a manual analysis of the results, 26 manuscripts have been obtained. Results: From the results analyzed in this review, it could be shown that stannous fluoride does not present important contraindications, if not those commonly reported for fluorine. A meta-analysis on enamel loss has been conducted, it shows that SnF2 products provide better results with a p < 0.05 value. Conclusion: This compound could have significant effects in favor of erosion and recalcification of the enamel, on the biofilm formation, gingival inflammation, and in addition, it could be an important aid in the removal of tooth stains and halitosis.

Low-level gallium-aluminum-arsenide (GaAlAs) diode laser irradiation (λ 830 nm) associated with and without fluoridated gel in the prevention of enamel erosion

This in vitro study evaluated the effect of a low-level gallium-aluminum-arsenide (GaAlAs) diode laser irradiation against erosion in bovine enamel without and combined with fluoride (F), as well as compared the effect of the F treatment alone. Eight-four enamel samples were used for 8 groups: negative control (artificial saliva, S); positive control (neutral fluoride gel, F); diode laser (222 J/cm2, L1); diode laser (444 J/cm2, L2); F_L1; F_L2; L1_F; L2_F. Fluoride gel was applied only once before or after irradiation. Laser treatment occurred with an 830-nm diode laser (continuous, beam diameter 0.028 cm2, power 100 mW, power density 3.57 W/cm2). The irradiation was conducted one time (L1, energy 6.2 J, 62 s, energy density 222 J/cm2) or two times (L2, energy 12.4 J, 124 s, energy density 444 J/cm2). The specimens were submitted to erosive challenge using orange juice. Surface compositional changes by micro energy-dispersive X-ray fluorescence spectrometry (μ-EDXRF), surface roughness, and surface morphology by scanning electron microscopy (SEM) were evaluated after cycling. The laser energy density and the fluoride application (before or after laser) affected the mineral content. Treatments with the association laser/fluoride resulted in lower roughness values (Ra, μm) than in the negative control (p < 0.05). L1 treatment produced higher Ra values in the enamel than in the positive control (p < 0.05). The SEM images showed clear enamel loss after S and F and erosion compared with those of the laser-irradiated groups. The association of F gel with laser in this order resulted in relevant enamel protection.