Enamel Surface Changes Research Articles

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

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

The effects of beverage erosion on enamel: evaluating surface characteristics and loss of calcium and phosphate ions

BackgroundThe erosive impacts of various beverages on dental enamel have been identified as a potential erosive threat to dental hard tissues. This in vitro study aimed to address this by utilizing a systematic approach and advanced analytical methods to study enamel erosion due to selected beverages in a simulated oral environment.MethodsForty-nine extracted sound second premolar teeth were collected, disinfected, and prepared. These teeth were randomly allocated into seven groups, each exposed to a different beverage: distilled water, mineral water, instant coffee, black tea, Pepsi-Cola, orange juice, and synthetic vinegar. The modified Nordini Artificial Model (mNAM) was used to simulate the oral cavity. The enamel surfaces were scanned using a Scanning Electron Microscope (SEM) and analyzed using Energy-Dispersive X-ray Spectroscopy (EDS). Surface hardness was measured using the Knoop Hardness Scale. Statistical analysis was conducted using the Wilcoxon signed-rank test, with a significance level set at p < 0.05.ResultsDistilled water and mineral water exhibited no significant changes in enamel surface or hardness. Coffee caused an 8–9% loss of calcium and phosphate, indicating potential erosion. Black tea showed signs of remineralization rather than demineralization. Pepsi-Cola and orange juice caused substantial erosion, with Pepsi-Cola resulting in a nearly 24% loss of calcium. Vinegar had a marked erosive effect, with a 17% loss of both calcium and phosphate. SEM images corroborated these findings, showing pronounced enamel prisms and increased visibility of minor cracks in post-treatment teeth. EDS analysis revealed significant changes in the elemental composition of the enamel.ConclusionsThis study categorised beverages based on their pH and fluoride content, revealing that drinks like Pepsi-Cola and orange juice are acidic but low in fluoride, whereas black tea, mineral water, and vinegar are acidic yet contain fluoride. The study suggests that the decrease in pH of acidic beverages may contribute to dental erosion, with fluoride as a mitigating factor. Among the various metrics assessed for evaluating dental erosion, hardness emerged as the most reliable quantitative parameter.

Correction to: Effect of femtosecond and ER:YAG laser systems on shear bond strength of enamel surface and morphological changes

Correction to: Effect of femtosecond and ER:YAG laser systems on shear bond strength of enamel surface and morphological changes

Research on Treating Demineralized Enamel with Different Remineralizing Agents before Bonding Orthodontic Brackets

Many orthodontic clinics have problems with patients who have dental demineralization. This study aimed to evaluate “the shear bond strength (SBS)” of braces after being bonded to demineralized teeth treated with herbal materials. Our study samples were divided into five groups. The first group was left with no treatment. The surfaces of the second, third, and fourth groups were first treated with a demineralizing solution. The second group was left after being demineralized without any subsequent treatment; the third group was treated with rosemary oil; the fourth was treated with ginger–honey. Casein phosphopeptide–amorphous calcium phosphate with fluoride paste (CPP–ACPF) was applied to the fifth group. A universal testing machine evaluated the SBS. A stereomicroscope was used to determine the adhesive remnant index (ARI). The enamel surface changes were observed using surface microhardness (SMH) testing, scanning electron microscopy (SEM), and energy dispersive spectrometry (EDS) to determine the element percentages. Our data revealed that the values of both SBS and SMH were significantly (p &lt; 0.05) increased after remineralization. Rosemary and ginger–honey significantly enhanced the SBS and SMH of the demineralized teeth.

Effects of 35% Versus 10% Carbamide Peroxide At-Home Bleaching Agents with or without MI Paste Plus on Enamel Properties

This study compared the effects of 35% with 10% carbamide peroxide (CP) home used bleaching agents on enamel color change, microhardness, and surface changes in association with MI paste plus (CPP -ACPF). Forty buccal and lingual enamel samples from twenty human third molars were prepared and divided into four groups (n=10). The groups were bleached for two weeks according to different bleaching regimens as follow; G1 bleached with 10%CP, G2 bleached with 35%CP, G3 bleached with a mixture of 10%CP and MI paste plus, and G4 bleached with a mixture of 35%CP and MI paste plus. Color change was recorded with a colorimeter before and after bleaching and total color differences (ΔE*) was calculated. Vickers microhardness test was recorded for all the samples before and after treatment. One sample from each group was evaluated for surface changes by scan electron microscopy (SEM). The data were analyzed with repeated measure of variance and student's t-test at p&lt;0.05. No significant difference in ΔE* was recorded among the four groups (p&gt;0.05). Significant reduction in enamel microhardness was only recorded for G2 (p=0.003). SEM for G3 and G4 showed obvious mineral deposition. Similar teeth color whitening can be resulted after two weeks of bleaching with both 10%CP and 35%CP when used as recommended by the manufacturer with and without the addition of MI paste plus. Using 35%CP decreased enamel microhardness significantly, whereas MI paste plus when mixed with both bleaching agents could compensate for the microhardness reduction.

Erosion behaviour of human, bovine and equine dental hard tissues

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

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

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

Comparative Evaluation on the Effects of Three Pediatric Syrups on Microhardness, Roughness and Staining of the Primary Teeth Enamel: An In-Vitro Study.

​​​​​Introduction One of the most prevalent oral diseases is dental caries. Syrups are commonly used by children who have difficulty swallowing tablets and capsules. Some medications can make dental caries worse and cause the enamel to erode. Most of the time, parents are unaware that a number of foods, drinks, and syrup-formulated pediatric drugs include sugar, whichcan cause erosion of primary teeth, resulting in plaque accumulation and dental caries.Henceforth, theaim of this study is to assess the effects of pediatric syrups on the microhardness, roughness, and staining ability of primary tooth enamel as a result of daily intake of syrup. Methods Eighty primary teeth, including both anterior and posterior, that required extraction due to pre-shedding mobility were randomly divided into four groups of twenty samples each. Samples were exposed to multivitamin syrup (Rudimin), iron syrup (C Pink), and diuretic syrup (Furosemide). The samples were submerged in 10 mL of the respective medication once daily for five minutes for 21 days. On days 0 and 21, enamel surfaces were assessed for changes in microhardness, roughness, and staining. The microhardness was assessed using a Micro Vickers microhardness tester machine; the roughness was assessed using a Mitutoyo surface roughness tester; and the staining ability was assessed using a spectrophotometer, and data processing was done using the analysis of variance (ANOVA) test andTukey's post hoc analysis. Results The changes in enamel surface for microhardness, roughness, and staining were assessed twice, at days 0 and 21. Group 4 (Furoped) showed a significant difference in surface microhardnessand staining ability of enamel surfaces with a statistically significant p-value (<0.05). When roughness was compared, allthree interventions had a significant difference from the control group, whereas there was no statistically significant difference between the intervention groups. Conclusion This study concludes that pediatric syrups can significantly weaken the enamel of primary teeth, resulting in loss of enamel surface microhardness and roughness making them vulnerable to caries. Since frequent consumption of these syrups is correlated with tooth decay, certain precautions like oral hygiene maintenance and rinsingwith water after taking the syrup should be done to prevent dental caries, as consumption of medicinal syrups by children cannot be avoided.

Quantitative analysis of the degree of demineralization for bleached enamel by optical coherence tomography

BackgroundTooth bleaching imparts whitening effects along with adverse effects such as increased tooth sensitivity and enamel surface changes. Herein, we employed optical coherence tomography (OCT), a nondestructive optical detection technique, for evaluation of tooth enamel after treatment with peroxide-based bleaching agents. MethodsFifteen enamel samples were bleached using 38% acidic hydrogen peroxide-based bleach, subjected to OCT scanning, and then cross-sectioned and imaged under polarized light microscopy (PLM) and transverse microradiography (TMR). OCT cross-sectional images were compared with PLM and TMR. The depth and severity of demineralization produced in the bleached enamel were measured by OCT, PLM, and TMR. Comparison between the three techniques was performed using Kruskal-Wallis H non-parametric test and Pearson correlation. ResultsIn comparison with PLM and TMR, OCT clearly detected the changes in the enamel surface after hydrogen peroxide bleaching. Significant correlations (p<0.05) were observed in lesion depth between OCT and PLM (r=0.820), OCT and TMR (r=0.822), and TMR and PLM (r=0.861). There was no statistically significant difference in demineralization depth values measured by OCT, PLM, and TMR (p>0.05). ConclusionOCT can allow real-time, non-invasive imaging of artificially bleached tooth models and automatically measure the early changes in the enamel lesion structure upon exposure to hydrogen peroxide-based bleaching agents.

Remineralization potential of phosphorylated chitosan and silver diamine fluoride in comparison to sodium fluoride varnish: invitro study

PurposeThe purpose of this study was to evaluate and compare the remineralization potential of phosphorylated chitosan nanoparticles (Pchi) and silver diamine fluoride (SDF) compared to sodium fluoride varnish (NaF) on microhardness of artificial carious lesions in a biomimetic minimally invasive approach that is being regarded as the future of preventive dentistry.MethodsThe sample size included 40 intact extracted maxillary anterior human teeth. Baseline microhardness was recorded using Vickers hardness test and energy-dispersive X-ray spectroscopy (EDX). Artificial caries-like lesions were created on the exposed enamel by suspending all teeth in demineralizing solution for 10 days in a temperature of 37 °C and then the hardness and EDX were remeasured. Samples were then divided into four main groups: Group A (positive control group) n = 10, treated with NaF, Group B n = 10, treated with SDF, Group C n = 10, treated with Pchi and Group D (negative control group) n = 10 that received no treatment. After treatment, samples were incubated in artificial saliva solution at 37 °C in for 10 days and then reassessed. Data were then recorded, tabulated, and statistically analyzed using Kruskal–Wallis test and Wilcoxon signed test. Scanning electron microscope (SEM) was used to analyze the morphological changes of enamel surface after treatment.ResultsGroups B and C showed the highest calcium (Ca) and phosphate (P) content as well as hardness values, while group B had the highest percentage of fluoride. SEM revealed a smooth layer of mineral formed on the surface of enamel for both groups.ConclusionPchi and SDF showed the highest increase in enamel microhardness and remineralization potential.Clinical relevanceThe minimally invasive approach for remineralization could be enhanced using SDF and Pchi.

Effectiveness and Safety of Over-the-Counter Tooth-Whitening Agents Compared to Hydrogen Peroxide In Vitro.

(1) This study investigated the whitening effect, cytotoxicity and enamel surface alterations induced by different over-the-counter (OTC) bleaching agents in comparison to hydrogen peroxide. (2) Human teeth (n = 60) were randomly assigned into 6 groups (n = 10), stained with coffee solution for 7 d, followed by a whitening period of 7 d with either placebo, bromelain, sodium bicarbonate, sodium chlorite, PAP or hydrogen peroxide. Color measurements were performed with a spectrophotometer. Scanning electron micrographs (SEM) were taken to assess the enamel structure. Cytotoxicity of the tested substances was assessed based on the cell viability of primary human fibroblasts. (3) The application of all whitening gels resulted in a greater color difference of the enamel (ΔE) in comparison to the negative control. Hydrogen peroxide caused the greatest color difference. Bromelain and PAP treatment showed no enamel surface changes, in contrast to hydrogen peroxide treatment, which showed very mild interprismatic dissolution. Bromelain was the only non-cytotoxic agent. (4) The maximum effect achieved by all OTC bleaching agents was the removal of stains, whereas hydrogen peroxide was capable of further whitening the teeth. Bromelain treatment was neither cytotoxic, nor resulted in enamel surface alterations, and its whitening effect was less, yet still effective, compared to hydrogen peroxide.

In vitro effectiveness of different dental bleaching protocols using violet LED

PurposeThere has been growing demand for dental bleaching worldwide, however, despite being effective, hydrogen peroxide (HP) can negatively affect the dental structure. Thus, new techniques, such as violet LED light have emerged and need to be studied. The aim of this study was to analyze and compare the effectiveness of violet LED light alone or combined with 35% HP gel. MethodsSix different tooth bleaching techniques (n = 10) were performed in intrinsically pigmented bovine teeth: G1 - 35% HP (1x/week for 4 weeks, 45 min of gel application); G2 - 35% HP (1x/week for 4 weeks, 15 min of gel application); G3 - violet LED (1x/week for 4 weeks); G4 - violet LED (2x/week for 2 weeks); G5 - violet LED (4x/week for 1 week); G6 - Violet LED + 35% HP (hybrid technique, 1x/week for 4 weeks, 15 min of gel application). Specimens were submitted to color evaluation at predetermined times using Konica Minolta® spectrophotometer, and the surface morphology (n = 3) was qualitatively analyzed by Scanning Electron Microscope (SEM). Data of the color change test were analyzed considering a 5% level of significance. ResultsThere was significant difference in color (p <0.05) for all groups after bleaching protocols. SEM analysis revealed that the greatest change in surface occurred in Group G1, with demineralization of the dental enamel. When considering the same time interval, there were no statistical differences for axis L*, but differences were shown for axis a* (G2, G3, G4 ≥ G1, G5 ≥ G6) and b* (G1, G2, G3, G4, G5 > G6). Regarding the comparison of ΔE00 between groups, results showed statistical difference between groups, with G1 ≥ G2, G5, G6 ≥ G3, G4. ConclusionBleaching protocols with less time (15 min) or no exposure to 35% HP (violet LED, 4x/week) could promote bleaching results as those obtained by the conventional technique using 35% HP for 45 min, with no enamel surface changes, showing to be a promising alternative to tooth bleaching.

Effect of ER, CR: YSGG laser debonding on enamel surface changes in stainless steel and ceramic brackets - An in-vitro study.

The aim of this in-vitro study was to observe and analyze the various enamel surface changes that occur due to laser debonding of metal and ceramic brackets, done by means of Er, Cr:YSGG laser. 90 extracted premolars were randomly allocated into one of six groups with 15 teeth each. The groups represent metal brackets (Groups A1, A2, A3) and ceramic brackets (Groups B1, B2, B3). Each sub-group represents the mode of debonding used in the study. Debonded teeth were analyzed under scanning electron microscopy (SEM) at 80X and at 1000X magnification at three sites. The adhesive remnant index (ARI) scores were analyzed and the presence of enamel damage was observed. ARI showed high score in Groups A1 and B1. SEM images of large composite remnants at the site of bracket in Groups A1 and B1 at the site of bracket and multiple enamel microcracks and fractures at interface and enamel adjacent to bracket in Groups A1 and B1. SEM images of minimal composite remnants at the site of bracket in Groups A2, A3, B2, and B3 and little to no presence of enamel microcracks or fractures at interface and enamel adjacent to bracket in Groups A2, A3, B2, and B3. The use of Er, Cr:YSGG laser in orthodontic practice, especially in the debonding procedures of orthodontic brackets provide quality care to patient with minimal post-treatment damages.

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.

Drug Persuaded Growing Defects of Teeth

The purpose of this research was to determine the impact that regularly prescribed drugs have on dental tissues. Certain drugs can cause sensitivity in dental tissues if they are used by pregnant women for an extended period. This research focused on a small set of drugs, such as aspirin, estrogen, and lithium that have been shown to have adverse effects on human tissue throughout the developing stages of pregnancy. Only female rabbits participated in the study. The animals in the experiment were split into four groups, and each group had (n=7) subjects. Three of them were for the study of drug treatments and the fourth one was taken as a control. They were administered drugs in predetermined doses based on their weights up until they gave birth. These rabbits were bred specifically to be utilized in scientific studies. Variations in tooth size, mineral content, and composition of enamel (the hard, protective layer of dental tissue), and ultrastructural changes in enamel surfaces were among the variables examined by scanning electron microscopy (SEM). At the age of three months, researchers analyzed the teeth to look for signs of congenital abnormalities that may have begun in utero. Six hundred seventy-two samples were analyzed using volumetric methods prior to tooth extraction. After the teeth were removed, 336 samples were analyzed using a scanning electron microscope and energy-dispersive X-ray spectroscopy to determine the mineral composition and examine the surface structure of the enamel (SEM-EDX). The chemical analyses and volumetric measurements showed a huge range of variance among samples between the control and experimental groups. The incisors and the premolars were found to be teeth with aesthetic and functional flaws. It was observed that the incisors and molars were aesthetically and functionally compromised teeth. However, this research has the potential to link long-term drug usage with dental drugs. It may also help future researchers focus on the role of drug-related factors in disease development. In dentistry, it could be useful for cosmetic and practical purposes. The results of the study were supposed to reveal which drugs should be avoided or used with caution during pregnancy and provide new avenues for further study. Keywords: drug persuaded, growing defects, teeth

Effect of conventional and power office bleaching with diode laser and led light on enamel microhardness

Aim: The present study aimed to asses enamel microhardness after office bleaching with diode laser and LED light compared to the conventional bleaching procedure. Methods: Thirty-nine human premolar teeth were collected and randomly divided into three groups regarding of the bleaching technique. Group 1: Snow O bleaching gel with LED light-curing unit; Group 2: Snow L bleaching gel with diode laser irradiation; and Group 3: Opalescence Boost bleaching gel with no light source in group 3. Enamel surface changes were evaluated in one tooth in each study group and one intact tooth as a reference under a scanning electron microscope (SEM). In the remaining samples (n=12), enamel microhardness was determined by Vickers microhardness test before and after bleaching. Data were analyzed with repeated-measures ANOVA to compare microhardness changes, followed by post hoc Tukey tests at the 0.05 significance level. Results: Enamel microhardness decreased in all the groups after bleaching, with the maximum decrease in microhardness in the Snow O bleaching group with LED light, which was significantly higher than the other groups (P=0.002). The two other groups did not exhibit any significant difference in microhardness decrease (P&gt;0.05). Conclusion: Based on the limitations of this study, it can be concluded power bleaching with 980nm diode laser was less time-consuming compare to conventional bleaching procedure and yielded better outcomes in terms of enamel surface microhardness compared to the use of an LED light-curing unit.

Changes in enamel surface after use of nanoencapsulated fluoride for dental caries remineralization: an in vitro study

Aim: To evaluate through an in vitro study surface changes on decayed enamel after the use of fluoridated dentifrices involving nanoencapsulated technology (NanoF). Methods: Forty blocks of human enamel were distributed among four groups (n = 10): 50% NanoF + 50% NaF (50% nF), 100% NanoF (100% nF), 100% NaF as the positive control (PC) and without fluoride as the negative control (NC). The specimens were subjected to a pH cycling model for 7 days. Surface microhardness (SMH), linear surface roughness (Ra) and area surface roughness (Sa) were measured before and after the carious lesion formation and at the end of the treatment. Percentages of surface microhardness recovery (%SMHR), altered Ra (%RaC) and altered Sa (%SaC) were calculated. The data were analyzed using the ANOVA test, repeated-measures ANOVA and Pearson's correlation test (p&lt;0.05). Results: No significant differences among groups were found for Ra, Sa, %RaC or %SaC (p&gt;0.05). Ra and Sa increased after treatment. A significant correlation was found between Ra and Sa. The PC dentifrice had the highest %SMHR, followed by 100% nF (p&lt;0.05). In contrast, no surface remineralization was found in the 50% nF and NC groups. Conclusion: Enamel surface changes were found after the remineralizing treatment with 100% nF group. The majority of dentifrices with fluoride provided an increase in the roughness and surface microhardness. Nanotechnology is an innovative, promising method for the controlled release of fluoride and the remineralization of teeth with dental caries.

Laminate veneer ceramics in aesthetic rehabilitation of teeth with fluorosis: a 10-year follow-up study

BackgroundFluorosis is one of the color anomalies seen in teeth. White lines and blurred areas associated with mild fluorosis are barely noticeable; in its severe form, tooth enamel surface changes ranging from staining and pitting may be observed. The treatment of fluorosis not only provides aesthetic and functional correction but also helps to improve the patient's self-esteem.MethodsThe present retrospective study evaluated the clinical quality, success rate, and estimated survival of porcelain laminate veneers in teeth with anterior fluorosis. Three hundred fifty-eight porcelain laminate veneers (254 in the anterior maxilla and 104 in the mandible) were "functional" restorations that covered the incisal edge and part of the palatal/lingual side of the tooth with a 1 mm high palatal bevel. Ceramic veneers were fabricated with lithium disilicate reinforced glass–ceramic material (IPS e.max Press, Ivoclar Vivadent, Schaan, Liechtenstein). The modified United States Public Health Service criteria were used for clinical evaluation of the restorations.ResultsOn the basis of these criteria, marginal adaptation, color match, marginal discoloration, surface roughness, restoration fracture, tooth fracture, restoration wear, antagonist tooth wear, caries and postoperative sensitivity were evaluated yearly. The survival rate in the current study was ≥ 0.997 for 10 years.ConclusionsThe results of this clinical study should encourage clinicians to consider ceramic veneers over crown restorations when restoring the smile of patients with advanced fluorosis.

Morphological and porosity changes in primary enamel surface after an in vitro demineralization model.

In vitro models are very useful in dentistry, especially to evaluate preventive methods against dental caries. Although they have been used for more than 30 years, specific demineralization models have not been established for primary enamel, which is more prone to demineralization than permanent enamel. This study evaluates porosity changes in primary enamel surface after a demineralization model through a scientifically validated analytical tool. Nine healthy human anterior primary teeth extracted for therapeutic reasons were included in this study, previous informed consent. The samples were randomly assigned to three groups n=3: G1_2D, G2_4D, and G3_7D. Scanning electron microscopy (SEM) images at ×200 and ×1000 were taken during two stages: before demineralization (BD) and after demineralization (AD). Morphological characterization was observed at ×1000, while porosity (pore count and perimeter) was analyzed by the ImageJ program, using ×200 SEM images previously converted. Several statistical analyses were used to determine differences (p ≤ .05). Morphological characterization AD revealed new pits and cracks on the enamel surface in G1_2D and G2_4D groups. Localized eroded enamel areas were observed in G3_7D. Pore count of enamel surface BD ranged from 64.26 ± 37.62 to 97.93 ± 34.25 and AD ranged from 150.06 ± 64.86 to 256 ± 58.14. AD, G_4D exhibited a decrease in pore perimeter contrary to G_2D and G_7D. Significant differences were observed. Finally, morphological changes were more evident as days of demineralization increased; 7 days of immersion could be employed as an enamel erosive model. The pore count increased after the demineralization model, BD pores perimeter was heterogeneous, and AD varied according to the immersion period. Morphological changes were more evident as days of demineralization increased. Seven days of immersion could be employed as an enamel erosive model. The initial porosity seems to be a determining factor for the final porousness. The pore perimeter of the primary enamel varied according to the immersion period on the demineralization model.

Effect of femtosecond and ER:YAG laser systems on shear bond strength of enamel surface and morphological changes

Effect of femtosecond and ER:YAG laser systems on shear bond strength of enamel surface and morphological changes