Enamel Surface Research Articles

Effect of enamel deproteinization with 5.25% sodium hypochlorite on the bond strength of orthodontic brackets. An experimental study.

In the search for alternatives to increase the bond strength of brackets, when necessary, this study proposes to apply the enamel deproteinization protocol to eliminate the proteins in the surface enamel to achieve better etching patterns and thereby increase bond strength. The aim of this study was to evaluate the effect of sodium hypochlorite as a deproteinizing agent on the bond strength of metal brackets. Forty bovine teeth were randomly and equally divided into two groups. The experimental group (n=20) underwent a deproteinization treatment with sodium hypochlorite at 5.25% for 60 seconds prior to acid etching of the enamel with 37% phosphoric acid and bracket bonding with Transbond XTTM resin. The control group (n=20) underwent enamel etching with 37% phosphoric acid and bracket bonding with Transbond XTTM resin. Shear strength and the adhesive remnant index were evaluated and the Students t and Chi-square tests were used (P<0.05). The bond strength values of the control group (27.72±6.42 Mpa) were not significantly lower compared to the experimental group (29.21± 7.96 Mpa) (p=0.259). The adhesive remnant index showed a similar behavior in both groups, with the amount of adhesive remaining on the enamel being less than 50% in most samples of both the control and experimental group. Deproteinization treatment of bovine tooth enamel with 5.25% sodium hypochlorite for 60 seconds prior to enamel acid etching does not improve the bond strength of a resin in orthodontic bracket bonding. Key words:Deproteinization, sodium hypochlorite, bracket bonding, orthodontics.

Effects of Thermocycling with Two Different Curing Techniques on Enamel Micro-Cracks Formation, Debonding, and Failure Modes of Ceramic Brackets: An In Vitro Study.

Despite the rise in popularity of ceramic braces for adults, the risk of enamel microcracks (EMCs) upon removal remains a significant drawback for both dental professionals and patients. Our study aimed to assess the effects of thermocycling, pre-curing, and co-curing techniques with different bonding agents on the enamel surface of teeth after the removal of ceramic brackets. We also examined the incidence, quantity, length, and direction of EMCs on tooth surfaces. Additionally, the adhesive remnant index (ARI) scores and orthodontic bracket bond failure modes were evaluated and compared. The study divided 40 extracted upper canine teeth into ten groups for further analysis. Two groups had intact enamel as the negative control, while the remaining groups had orthodontic ceramic brackets bonded using different bonding agents and curing techniques. Thermocycling was performed in five groups, and ARI was assessed after debonding. The study findings were statistically significant (p < 0.05) in demonstrating the impact of curing techniques on EMCs and debonding outcomes. Seventh-generation bonding agents resulted in complete adhesive removal (ARI = 0). The microcracks' incidence, number, and length showed insignificant results. Differences in ARI between thermocycler and non-thermocycler samples were insignificant. Both co-curing and pre-curing techniques yielded comparable ARI results. This study highlights the importance of using advanced bonding agents to minimize enamel damage during ceramic bracket debonding.

Remineralization efficiency of three different agents on artificially produced enamel lesions: A micro-CT study.

This study aimed to assess the remineralization efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro-CT analysis. On extracted impacted third molars, artificial enamel lesions were prepared. Twenty-eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP-ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro-CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro-Wilk test, repeated measures two-way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established. SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01). All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization. Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long-term.

Destruction of cariogenic biofilms by antimicrobial photodynamic therapy mediated by phycocyanin and toluidine blue along with sodium fluoride varnish or titanium tetrafluoride

ObjectiveEvaluation of the effect of phycocyanin (PC) and toluidine blue (TBO) along with sodium fluoride varnish (FV) or titanium tetrafluoride (TiF4) under the conditions of antimicrobial photodynamic therapy (PDT) on a dual-species cariogenic biofilm and on remineralization process. DesignAfter the development of Streptococcus mutans and Lactobacillus acidophilus dual-species biofilms on the human enamel disks, they were divided into 11 groups (n = 9): Control (0.9 % saline), PC, TBO, FV, and TiF4 alone, PC and TBO in combination with a 635 nm diode laser (PDT treatment), PC-PDT+ (PC + FV or TiF4 + 635 nm diode laser), and TBO-PDT+ (TBO + FV or TiF4 + 635 nm diode laser). After the treatment, crystal violet assay was performed to determine the reduction of cariogenic biofilms. Enamel remineralization changes were analyzed using energy dispersive X-ray spectroscopy (EDX) and field emission scanning electron microscopy (FESEM) for the calcium and phosphorus (Ca/P) ratio. ResultsOnly TBO-PDT+ showed superior antibiofilm activity when TiF4 was applied. Furthermore, the highest Ca/P ratio was found after treatment of enamel surfaces with TiF4-TBO-PDT+. The FESEM images showed that the enamel disks treated with TiF4 plus TBO-mediated PDT exhibited surface coating. However, TiF4 plus PC-mediated PDT cannot repair demineralized enamel. ConclusionsThese data suggest that TBO-PDT along with TiF4 can effectively reduce cariogenic biofilms and significantly remineralize enamel disks, opening new avenues in caries prevention.

Evaluation of the cumulative effect of photodynamic therapy and local fluoride on the microhardness and topography of demineralized enamel and cementum surfaces

BackgroundThe present study aimed to determine the cumulative effect of two photodynamic therapy methods with methylene blue and indocyanine green and two topical fluoride therapy methods with fluoride varnish and silver diamine fluoride alone and in combination on the microhardness and topography of demineralized enamel and cementum surfaces. Materials and methodsSeventy-two sound human teeth were selected, and their buccal and lingual surfaces were assigned to two main groups of enamel and cementum using simple randomization. The initial surface hardness (SH) of the enamel and cementum in each sample was determined using a micro-Vickers hardness tester using a 200-g force in 10 s. Then artificial caries was induced by immersion in a demineralizing/remineralizing solution (i.e., each tooth provided two samples, one on the buccal aspect and the other on the lingual aspect). Each enamel/cementum main group was divided into two subgroups using simple randomization based on the local fluoride type (fluoride varnish and silver diamine fluoride) and the type of the photosensitizer agent (methylene blue and indocyanine green). Finally, 16 groups were achieved (n = 9). The final surface hardness of the enamel and cementum samples was determined as described above. Finally, the sample surfaces were prepared for the surface topography evaluation under a scanning electron microscope. The baseline microhardness was compared between the 16 study groups in the first step using one-way ANOVA. Then, three-way ANOVA was used to evaluate the effect of fluoride, laser, and surface (enamel and cementum) on microhardness. ResultsAll the groups exhibited decreased microhardness due to the induction of artificial caries. In both main groups of enamel and cementum, the lowest decrease in microhardness was recorded with combined photodynamic therapy and methylene blue photosensitizer material and fluoride varnish (15.1 % for cementum and 16.7 % for enamel), and the highest decrease in microhardness was recorded in the methylene blue group (35.7 % for cementum and 34.9 % for enamel). ConclusionThe combination of photodynamic therapy with the photosensitizer substance methylene blue or indocyanine green together with fluoride varnish or silver diamine fluoride is effective on the remineralization of demineralized enamel and cementum. Although there is no difference between the combination of photodynamic therapy with fluoride varnish compared to fluoride varnish alone, both of these treatments are more effective than using photodynamic therapy alone.

A Comparative Analysis of Enamel Surface Roughness Following Various Interproximal Reduction Techniques: An Examination Using Scanning Electron Microscopy and Atomic Force Microscopy.

Interproximal enamel reduction (IER) is a minimally invasive therapeutic procedure commonly used in orthodontics to address both functional and aesthetic issues. Its mechanical effects on enamel surfaces induce the formation of grooves, furrows, scratches, depressions, and valleys. The aim of this study was to assess the enamel surface roughness resulting after the application of currently available methods for interproximal reduction. Ninety freshly extracted human teeth were divided into six groups and subjected to the stripping procedure, using a different method for each group (diamond burs, abrasive strips of 90 μm, 60 μm, 40 μm, 15 μm, and abrasive discs). A single individual performed stripping according to the manufacturer's recommendations, involving interproximal reduction on one tooth's proximal face and leaving the other side untreated. Qualitative and quantitative assessment of the enamel surfaces was carried out using Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM), obtaining 2D and volumetric 3D images of the enamel surface microstructure and nanostructure. The study found that diamond burs and abrasive strips of 60 μm and 90 μm increased enamel roughness due to intense de-structuring effects, while the 40 μm polisher had a gentler effect and 15 μm abrasive strips and polishing discs preserved enamel surface quality and removed natural wear traces.

Enamel matrix proteins in promoting saliva lubrication

Anti-wear performance of human enamel in the mouth is closely related to the lubrication of salivary pellicle. It is well known that the inorganic hydroxyapatite (HA) of the enamel plays an important role in the adsorption and pellicle-forming of salivary proteins on the enamel, but the role of enamel matrix proteins remains unclear. In this study, the adsorption and lubrication behavior of salivary proteins on original, heated, and deproteinated enamel surfaces was comparatively investigated using an atomic force microscopy and nano-indentation/scratch techniques. Compared with that on the original enamel surface, the adsorption and lubrication behavior of salivary proteins remains almost unchanged on the heated enamel surface (where the enamel matrix proteins are denatured but the size of HA crystalline nanoparticles keeps constant) but exhibits an obvious compromise on the deproteinated enamel surface (where the enamel matrix proteins are removed and agglomeration of HA crystallites occurs). The HA agglomeration weakens the electrostatic interaction of enamel surfaces with salivary proteins to cause a distinct negative influence on the adsorption and pellicle-forming of salivary proteins. Further, the negative effect is confirmed with a quartz crystal microbalance with dissipation. In summary, by regulating enamel nanostructure for appropriate electrostatic interactions between salivary proteins and enamel surfaces, the enamel matrix proteins play an essential role in the adsorption and pellicle-forming of salivary proteins on human enamel, and then contribute to saliva lubrication, which provides the enamel with an anti-wear mechanism. The findings will promote and assist the design of enamel-inspired anti-wear materials.

Pretreatment of enamel with Riboflavin activated photodynamic therapy and Er, Cr: YSGG laser for bonding of orthodontic bracket with adhesive modified with cerium oxide nanoparticles

AimTo assess the degree of conversion (DC) and shear bond strength (SBS) of experimental adhesive (EA) infused with and without 1 % Cerium oxide (CeO₂)-NPs on metallic bracket bonded to enamel conditioned with three different pretreatment regimes PDT-activated (Riboflavin) RF, ECY (Er, Cr: YSGG), and Phosphoric acid (PA). Material and MethodEA and EA modified with 1 % CeO₂-NPs were prepared. Characterization of CeO2NPs was assessed using a scanning electron microscope (SEM). Seventy-two premolars extracted due to periodontal or orthodontic reasons were disinfected. Samples were mounted and allocated into three groups according to enamel surface treatment before bracket bonding. Samples in Group 1 were pretreated with Traditional 37 % PA-gel; Specimens in Group 2 surface treated with RF-activated PDT, and samples in Group 3 were conditioned using ECY. Brackets were placed on conditioned surfaces and samples were aged and underwent SBS testing using UTM. ARI index was used to assess bond failure. DC was evaluated for both adhesives using FTIR. ANOVA and Tukey post hoc test were used to compare the means and standard deviation (SD) of SBS and DC in different experimental groups. ResultsEnamel conditioned with PA and RF activated by PDT demonstrated comparable bond values with 1 % CeO2 infused in EA and EA (p>0.05).ARI analysis shows that enamel conditioned with PA and RF activated by PDT showed the majority of failure types between 1 and 2 irrespective of the type of adhesive. DC value in EA (73.28±8.37) was the highest and comparable to 1 % CeO2 infused in EA (66.48±6.81) ConclusionRF-activated PDT can be used alternatively to 37 % PA for enamel conditioning when bonding metallic brackets. Infiltration of 1 % CeO2 NPs in EA improves SBS irrespective of the type of enamel conditioning. Infusion of 1 % CeO2 NPs in EA demonstrates no significant difference in DC compared to EA.

Deterministic Modeling of the Issue of Dental Caries and Oral Bacterial Growth: A Brief Review

Dental caries is a chronic disease that mostly interferes with oral health worldwide. It is caused by acidic bacteria on the enamel surface, mainly Streptococcus mutans, forming an oral biofilm that can be transmitted among people. The spread behavior and population dynamics of bacteria must be studied to control this disease, which can be approached through mathematical modeling. In this review, we aimed to identify the utilization of compartmental models in studying bacterial behavior. The aim was to explore compartmental model utilization and reveal the research gaps. This study was conducted with the PRISMA guidelines for scoping reviews to identify an existing mathematical model to study the phenomenon. Four databases, Scopus, ScienceDirect, PubMed, and Dimensions, were used to search for related studies. Our results showed that compartmental model utilization for studying bacteria’s role in dental caries is sparse and poorly explained. Moreover, the constructed models have not yet considered more intervention efforts. A study is needed to explore this phenomenon by developing a mathematical model considering some situations. When conducted, it will result in more insights into controlling the spread of bacteria to prevent dental caries.

Impact of acid and laser etching of enamel on microleakage in different adhesive systems

This study aimed to evaluate the microleakage of light-cured and self-cured adhesives on enamel surfaces selectively etched with Er, Cr: YSGG laser or 35% phosphoric acid. A total of 60 class V cavities were prepared 1 mm above the cemento-enamel junction (CEJ). The specimens were randomly divided into six groups. Group 1: Clearfil SE Bond with no conditioning, Group 2: Tokuyama Universal Bond with no conditioning, Group 3: Clearfil SE Bond conditioned with 35% phosphoric acid, Group 4: Tokuyama Universal Bond conditioned with 35% phosphoric acid, Group 5: Clearfil SE Bond conditioned with Er, Cr: YSGG laser and Group 6: Tokuyama Universal Bond conditioned with Er, Cr: YSGG laser. Microleakage was evaluated qualitatively (visually) and quantitatively (ImageJ). The data were analyzed using IBM SPSS V23 and submitted to Kruskal–Wallis and Wilcoxon tests. The significance level was set at p < 0.05. In all evaluation methods, the microleakage scores exhibit significant differences (p*<0.001). Group 1 and Group 3 exhibited similar and lower microleakage values than the Group 5. In the occlusal margin, the microleakage values were similar in Group 2, Group 4, and Group 6, whereas in the gingival margin Group 4 showed significantly lower leakage compared to Group 2. Regardless of the etching protocols and adhesive systems used, less microleakage was observed on the occlusal surface than on the gingival surface. Phosphoric acid etching provides better results than laser etching for enamel surface treatment on both occlusal and gingival surfaces.

Enamel surface roughness after orthodontic adhesive removal: an in vitro study comparing four clearance methods

Enamel surface roughness after orthodontic adhesive removal: an in vitro study comparing four clearance methods

Virtual bracket removal: a comparative assessment of different software packages

BackgroundHigh precision intra-oral scans, coupled with advanced software, enable virtual bracket removal (VBR) from digital models. VBR allows the delivery of retainers and clear aligners promptly following debonding, thus reducing the patients' appointments and minimizing the likelihood of tooth movement. The objective of this study was to compare the enamel surface before bonding and after VBR using three different Computer-aided design (CAD) software and to compare their accuracy.MethodsMaxillary scans of 20 participants starting orthodontic treatment were selected for inclusion in the study, who exhibited mild to moderate crowding and required bonding of brackets on the labial surface of permanent maxillary teeth (from the maxillary left first molar to the maxillary right first molar). Two intra-oral scans were conducted on the same day, before bonding and immediately after bonding using CEREC Omnicam (Sirona Dental Systems, Bensheim, Germany). The virtual removal of the brackets from the post-bonding models was performed using OrthoAnalyzer (3Shape, Copenhagen, Denmark), Meshmixer (Autodesk, San Rafael, Calif, USA), and EasyRx (LLC, Atlanta, GA, USA) software. The models that underwent VBR were superimposed on the pre-bonding models by Medit Link App (Medit, Seoul, South Korea) using surface-based registration. The changes in the enamel surface following VBR using the three software packages were quantified using the Medit Link App.ResultsThere was a significant difference among the 3Shape, Meshmixer, and EasyRx software in tooth surface change following VBR. Specifically, EasyRx exhibited lower levels of accuracy compared to the other two VBR software programs (p<.001, p<.001). A significant difference in enamel surface change was observed between tooth segments across all software groups, in both incisors and molars, with VBR of the molars exhibiting the lowest level of accuracy (3Shape p=.002, Meshmixer p<.001, EasyRx p<.001). Regarding the direction of tooth surface changes following VBR, it was observed that all three groups exhibited a significant increase in the percentage of inadequate bracket removal across all teeth segments.Conclusions3Shape and Meshmixer manual VBR software were found to be more accurate than EasyRx automated software, however, the differences were minimal and clinically insignificant.

Effect of multi-layer applications of self-etch universal bonding agents on the adhesion of resin composite to enamel.

To evaluate the effect of adhesive coats application on the enamel microtensile bond strength (µTBS) of universal adhesives, morphological etching pattern and their chemical interaction with hydroxyapatite (HA). Two universal adhesives were investigated: Scotchbond Universal (SBU, 3M) and Prime&Bond Universal (PBU, Dentsply). The adhesives were applied in self-etching mode on bovine enamel (n = 8) in one (1L), two (2L) or three coats (3L) and light-cured as per manufacturers' instructions. As controls adhesives were applied to etched enamel (H3PO4-37% phosphoric acid). Bonded specimens were cut into sticks that were stored in deionized water for 24h or 6months prior to µTBS testing. Two-way ANOVA and Tukey's test were used for statistical analysis of bond strength with α = 5%. For morphological SEM analysis, enamel surfaces were treated as aforementioned and immediately rinsed with acetone. The intensity of monomer-calcium salt formation from each treatment was measured via infrared spectroscopy (ATR-FTIR). All treatments presented no significant reduction on µTBS after aging (p > 0.05). However, SBU attained highest µTBS when applied in 3L. PBU showed higher µTBS when applied to H3PO4 etched enamel than 1L or 2L. Etching pattern was enhanced by 3L application, particularly with PBU. Chemical interaction was notably higher for SBU than PBU, with no relevant differences with more layers or prior H3PO4-etching. The application of three adhesive coats of universal adhesives in self-etch mode using may enhance the bonding performance and etching pattern to enamel, surpassing the H3PO4-etched enamel bond for SBU. The chemical interaction with calcium from enamel is not affected by number of coats or prior phosphoric acid etching.

Early diagnosis of early childhood caries: A simple novel tool (MAAC charts) for parents and caretakers

Early Childhood Caries (ECC) is a condition associated with nearly 123 risk factors. Among all the risk factors, enamel defects or enamel hypoplasia (ED/EH) has been shown to be the primary risk factor. ED/EH comprises the earliest changes that manifest on newly erupted primary tooth surfaces soon after its eruption. ED/EH appears as white lines or patches, either as demarcated or diffuse opacities on the enamel surface. It is often observed on the labial and buccal surfaces of the newly erupted primary maxillary incisors. A simple self-report tool for mothers/caretakers, healthcare professionals, and primary care workers to diagnose early changes in ECC may facilitate early diagnosis. The MAAC chart was developed to prevent ECC in children with cleft lip and palate. These charts, primarily developed to educate parents, caregivers, healthcare professionals, and primary health care providers, illustrate the variations in ED/EH on the enamel surface (demarcated and diffuse opacities on various maxillary teeth) as a collage of pictures organized as incisors and canines. This paper describes a novel and simple, tool called ‘MAAC charts’ providing guidance on early signs of Early childhood caries (ECC) for health professionals, parents and caretakers. MAAC charts can be useful for Pediatric dentists while providing anticipatory guidance during early first dental visits in their office. Pediatric dentists can suggest paediatricians to use these MAAC charts, in vaccinations clinics and various in/out patient settings to provide oral health related anticipatory guidance. Pediatric dentists can use these MAAC charts in large scale public health campaigns focused on preventing ECC.

Effects of experimental in-office bleaching gels incorporated with co-doped titanium dioxide nanoparticles on dental enamel physical properties.

To evaluate the physical properties of enamel submitted to hydrogen peroxide (HP) incorporated with titanium dioxide nanoparticles (NP) co-doped with nitrogen and fluorine and irradiated with violet LED light (LT). Enamel-dentin disks were randomly allocated (T0) into groups, according to HP (HP6, HP15, or HP35) and NP (no NP, 5NP, or 10NP) concentrations, and irradiated or not with LT. A negative control (NC) group was set. After three bleaching sessions (T1, T2, and T3), specimens were stored in saliva for 14days (T4). Enamel surface microhardness number (KHN), surface roughness (Ra), cross-sectional microhardness (ΔS), energy-dispersive spectroscopy (EDS), scanning electron (SEM), and polarized light (PLM) microscopies were performed. Surface KHN was significantly influenced by NP over time, independently of LT irradiation. At T3 and T4, gels with 5NP and 10NP exhibited no KHN differences compared to NC and baseline values, which were not observed under the absence of NP. NP incorporation did not statistically interfere with the ΔS and Ra. PLM images exhibited surface/subsurface darkening areas suggestive of demineralizing regions. SEM demonstrated some intraprismatic affection in the groups without NP. EDS reported a higher enamel calcium to phosphorus ratio following 10NP gels applications. Gels with NP maintained the enamel surface microhardness levels and seemed to control surface morphology, upholding the mineral content. None of the proposed experimental protocols have negatively influenced the enamel surface roughness and the cross-sectional microhardness.

Adhesive Performance of Pit and Fissure Sealants on Deproteinized Enamel with Different Proteolytic Agents: In Vitro Study.

The objective of this work was to assess the efficacy of different proteolytic agents on the bond strength of pit and fissure sealants to bovine enamel. Eighty-four bovine enamel specimens were randomly assigned in groups according to the pit and fissure sealant applied (HelioSeal F or Dyad Flow). Then, the specimens were subdivided according to the proteolytic agent used (n = 7): Group 1, distilled water (control); Group 2, 10 wt.% Tergazyme®; Group 3, 10 wt.% ZYME®; Group 4, 10% papain gel; Group 5, 10% bromelain gel; and Group 6, 5.25 wt.% sodium hypochlorite. The cell viability of the proteolytic solutions was assessed through the MTT assay. The proteolytic agents were applied on the enamel surface prior to the acid-etching procedure; then, the pit and fissure sealants were placed. The micro-shear bond strength was evaluated after 24 h or 6 months of water storing at 37 °C. Representative SEM images were taken for each experimental group. The bond strength data were statistically analyzed by a three-way ANOVA test using a significance level of α = 0.05. Bromelain and papain proteolytic solutions did not exert any cytotoxic effect on the human dental pulp cells. After 24 h and 6 months of aging, for both pit and fissure sealants, sodium hypochlorite, papain, bromelain, and Tergazyme® achieved statistically significant higher bond strength values (p < 0.05). Irrespective of the deproteinizing agent used, Dyad Flow resulted in a better bond strength after 6 months of aging. The type 1 etching pattern was identified for sodium hypochlorite, papain, and bromelain. Tergazyme®, papain, and bromelain demonstrated efficacy in deproteinizing enamel surfaces prior to acid etching, leading to the improved bond strength of pit and fissure sealants. Clinically, this suggests that these proteolytic agents can be considered viable alternatives to traditional methods for enhancing sealant retention and longevity. Utilizing these agents in dental practice could potentially reduce sealant failures.

Examining the Effectiveness of Polyamidoamine (PAMAM) Dendrimers for Enamel Lesion Remineralization: A Systematic Review.

White spot lesions (WSLs) and demineralized enamel surfaces are common dental issues that can lead to further complications if untreated. The potential of various remineralizing agents has been extensively studied, but the efficacy of polyamidoamine (PAMAM) dendrimers in promoting enamel remineralization remains to be fully elucidated. This systematic review aims to evaluate the remineralizing potential of PAMAM on WSLs and demineralized enamel surfaces.To identify relevant studies, a comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library. Inclusion criteria comprised in vitro and in vivo studies that assessed the effects of PAMAM on WSLs or demineralized enamel. Data extraction and quality assessment were performed independently by two reviewers. The primary outcomes measured were changes in enamel microhardness, surface morphology, and mineral content. Five studies met the inclusion criteria, comprising in vitro studies. The results indicated that PAMAM demonstrated a significant remineralizing effect on demineralized enamel surfaces, as evidenced by increased microhardness and improved surface morphology. The studies varied in their methodological approaches but collectively supported the potential of PAMAM in enamel remineralization. PAMAM dendrimers exhibit promising remineralizing properties for treating WSLs and demineralized enamel surfaces.

Comparison of Microleakage around Resin Composite Restorations bonded to Er, Cr:YSGG Laser Treated Enamel and Dentin Surfaces versus Conventional Acid Etching: An In-Vitro Study

Comparison of Microleakage around Resin Composite Restorations bonded to Er, Cr:YSGG Laser Treated Enamel and Dentin Surfaces versus Conventional Acid Etching: An In-Vitro Study

Effect of Different In-Office Bleaching techniques on Enamel Color and Surface Roughness: In Vitro Study

Effect of Different In-Office Bleaching techniques on Enamel Color and Surface Roughness: In Vitro Study

Evaluation of Antimicrobial Efficiency, Shear Bond Strength, and Adhesive Remnant Index of TiO2 Infiltrated Orthodontic Adhesive - An In Vitro Study.

Enamel demineralization is an unavoidable adverse effect encountered with bonding brackets in orthodontic therapy. Introducing nanoparticles into the composite adhesive paste can prevent enamel demineralization. Titanium dioxide (TiO2) is known to exhibit direct antimicrobial efficiency. This study aimed to assess the antibacterial efficiency and shear bond strength (SBS) of an orthodontic bonding composite infiltrated with TiO2 nanoparticles. This in vitro study evaluated the efficiency of TiO2 nanoparticle-incorporated light-curing orthodontic composite paste (ENLIGHT, ORMCO). Twenty extracted premolars were randomly and equally allocated to the two study groups, N = 10. While a conventional composite was utilized for the bonding brackets in Group I, a TiO2-incorporated composite was used in Group 2. The adhesive remnant index (ARI) scores given by Artun and Bergland et al. and SBS were determined. Furthermore, the antimicrobial efficiency was estimated using the minimum inhibitory concentration (MIC)/minimum bactericidal concentration (MBC) and agar well diffusion assay for six composite disc specimens. The results were statistically analyzed using the chi-square test and Student's t test, at P < 0.05. After 24 h of curing, no statistical mean difference was observed between the two groups in terms of ARI or SBS scores (P > 0.05). However, there was a significant increase in the antimicrobial efficiency of Group II when compared with Group I (P < 0.05). TiO2 nanoparticle-incorporated orthodontic composites improve the antimicrobial efficiency with no significant change in the SBS. The ARI scores indicate the presence of 50% remnant orthodontic composite on the tooth enamel surface post debonding.