Dentin Erosion Research Articles

Fast monitoring of tooth erosion caused by medicaments used in the treatment of respiratory diseases by ATR-FTIR and μ-EDXRF analysis.

The present study aimed to evaluate the erosive potential of four most commonly prescribed syrup medicaments for respiratory diseases. Attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy combined with multivariate statistical analysis and micro-energy-dispersive X-ray fluorescence spectrometry (μ-EDXRF) mapping was performed. Fifty-five root dentin fragments obtained from the buccal surface of 30 bovine teeth were prepared and divided into five experimental groups (n=10): control-artificial saliva (S), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS). The S group was stored only in artificial saliva and the other groups were treated with the medicaments (immersed for 1min in 3mL of the medication, three times daily, with 1-h intervals between the immersion cycles, during 5days, 15 immersion cycles). There were a significant decrease in the Ca and P weight percentages (wt%) for dentin after medication treatments, except for AC (p>0.05). Mineral content of dentin showed a clear gradation with increasing Ca and P wt% reduction in the order S<AC<AM<BR<SS. SS resulted in a significant increase in Ca/P ratio when compared to the control (p<0.001). ATR-FTIR combined with multivariate, statistical analysis can quickly and reliably indicate extent of dentin erosion. Considering syrups with high-erosive potential should always follow with proper oral hygiene practices or search for an alternative medications void of such detrimental effects. Regular and prolonged use of these medicaments might bear the risk of causing erosion.

Effect of different diode laser wavelengths on root dentin decontamination infected with Enterococcus faecalis

The objective of this study was to evaluate the antibacterial effect and the ultrastructural alterations of diode laser with different wavelengths (808nm and 970nm) and its association with irrigating solutions (2.5% sodium hypochlorite and 2% chlorhexidine) in root dentin contaminated by a five days biofilm. Thirteen uniradicular teeth were sectioned into 100 dentin intraradicular blocks. Initially, the blocks were immersed for 5min in 17% EDTA and washed with distilled water for 5min, then samples were sterilized for 30min at 120°C. The dentin samples were inoculated with 0.1mL of E. faecalis suspension in 5mL BHI (Brain Heart Infusion) and incubated at 37°C for 5days. After contamination, the specimens were distributed into ten groups (n=10) according to surface treatment: GI - 5mL NaOCl 2.5%, GII - 5mL NaOCl 2.5%+808nm diode (0.1W for 20s), GIII - 5mL NaOCl 2.5%+970nm diode (0.5W for 4s), GIV - 808nm diode (0.1W for 20s), GV - 970nm diode (0.5W for 4s), GVI - CHX 2%, GVII - CHX 2%+808nm diode (0.1W for 20s), GVIII - CHX 2%+970nm diode (0.5W for 4s), GIX - positive control and GX - negative control. Bacterial growth was analyzed by turbidity and optical density of the growth medium by spectrophotometry (nm). Then, the specimens were processed for analysis ultrastructural changes of the dentin surface by SEM. The data was subject to the One-way ANOVA test. GI (77.5±12.1), GII (72.5±12.2), GIII (68.7±8.7), GV (68.3±8.7), GVI (62.0±5.5) and GVII (67.5±3.3) were statistically similar and statistically different from GIV (58.8±25.0), GVIII (59.2±4.0) and control groups (p<0.05). SEM analysis showed a modified amorphous organic matrix layer with melted intertubular dentin when dentin samples were irradiated with 970nm diode laser; erosion of the intertubular dentin in blocks submitted to 808nm diode laser irradiation; and an increased erosion of the intertubular dentin when 2.5% NaOCl was associated to the different wavelengths lasers. All the therapeutic protocols were able to reduce the bacterial contingent in dentin blocks, and the association of diode laser and solutions did not significantly improve the reduction of the bacterial contingent.

A Newly Prepared Solution for the Removal of the Smear Layer

Aims: The aim of the study was to evaluate the ability of a mixture of (castor detergent and papain enzyme) MCP to remove the smear layer by using scanning electron microscope. Materials and Methods: Samples of 45 human extracted was divided in to 3 groups (A, B, and C) n = 15 and prepared endodontically using pro taper system up to size F 3, each group was irrigated with corresponding solution 3 ml in between each file size and 5 minutes as a final irrigant as following: Group A irrigated with distilled water (control negative). Group B irrigated with 2.5% (Sodium hypo chloride) NaOCL and 17% (Ethylene di amine tetra acetic acid) EDTA (control positive). Group C irrigated with 20% castor detergent and 4% papain enzyme as a mixture (MCP). Each sample was irrigated with 15 ml of distilled water and dried with paper points. The samples were sent for SEM photograph. Each sample was evaluated at three levels (apical, middle, and cervical part of the canal) Results: MCP solution showed partial removal of both organic and inorganic parts (dual action) of smear layer from the 3 levels of root canals, but the apical one was significantly less clean than the other two, also it has a more gentle effect of erosion than EDTA with NaOCl. EDTA with NaOCl has the ability to remove the smear layer completely from the canal, but still the apical third was significantly less clean than that of other two. It is impossible to remove the smear layer completely by NaOCl and EDTA without erosion of the inner surface of irrigated canal when EDTA was used as a final irrigant for 5 minutes. Conclusion: solution had the ability to remove the smear layer partially at the three levels of a root canal without dentin erosion. While EDTA had the ability to remove the smear layer completely at the three levels of canal with obvious dentinal erosion. Still the apical area has mechanical and anatomical limitation in root canal irrigation.

Effect of a Bioactive Glass Ceramic on the Control of Enamel and Dentin Erosion Lesions.

This study evaluated the effect of a bioactive glass ceramic for the control of erosion and caries lesions. Fragments (n=10) of bovine enamel and root dentin received daily application of different treatments (Biosilicate; Acidulated Phosphate Fluoride- APF; Untreated - control) during the performance of erosive cycles. Surfaces were analyzed with 3D optical profilometry to quantify the superficial loss in four periods (1, 7, 14 and 21 days), as well as the lesion depth with confocal laser scanning microscopy. For caries progression assessment, initial Knoop microhardness was measured on enamel bovine fragments. Initial carious lesions were developed and specimens were divided into three groups (n=10), according to the daily topical application (Biosilicate; APF; no application - control), during the de-remineralization cycles for 14 days. Final microhardness was obtained to calculate the change of surface microhardness. Subsurface demineralization was analyzed using cross-sectional microhardness (depths 10, 30, 50, 70, 90, 110 and 220 µm). Data were tested using ANOVA and Tukey's test (a=5%). Results of erosive evaluation showed that Biosilicate promoted the lowest (p<0.05) values of surface loss, regardless of time, for both enamel and dentin; APF promoted lower (p<0.05) surface loss than control; analyzing different periods of time, APF did not show difference (p>0.05) between 14 and 21 days of demineralization. Results of enamel caries assessment showed that Biosilicate resulted in higher (p<0.05) surface and subsurface microhardness than both APF and control-applications. It may be concluded that Biosilicate application showed a higher potential to reduce surface loss and development of erosion and caries lesions.

Multi-walled carbon nanotubes/graphene oxide hybrid and nanohydroxyapatite composite: A novel coating to prevent dentin erosion

To date is emergent the development of novel coatings to protect erosion, especially to preventive dentistry and restorative dentistry. Here, for the first time we report the effectiveness of multi-walled carbon nanotube/graphene oxide hybrid carbon-base material (MWCNTO-GO) combined with nanohydroxyapatite (nHAp) as a protective coating for dentin erosion. Fourier transform Raman spectroscopy (FT-Raman), scanning electron (SEM), and transmission electron (TEM) microscopy were used to investigated the coatings and the effect of acidulated phosphate fluoride gel (APF) treatment on bovine teeth root dentin before and after erosion. The electrochemical corrosion performance of the coating was evaluated. Raman spectra identified that: (i) the phosphate (ν1PO43−) content of dentin was not significantly affected by the treatments and (ii) the carbonate (ν1CO32−) content in dentin increased when nHAp was used. However, the nHAp/MWCNTO-GO composite exposited lower levels of organic matrix (CH bonds) after erosion compared to other treatments. Interesting, SEM micrographs identified that the nHAp/MWCNTO-GO formed layers after erosive cycling when associate with APF treatment, indicating a possible chemical bond among them. Treatments of root dentin with nHAp, MWCNTO-GO, APF_MWCNTO-GO, and APF_nHAp/MWCNTO-GO increased the carbonate content, carbonate/phosphate ratio, and organic matrix band area after erosion. The potentiodynamic polarization curves and Nyquist plot showed that nHAp, MWCNT-GO and nHAp/MWCNT-GO composites acted as protective agents against corrosion process. Clearly, the nHAp/MWCNTO-GO composite was stable after erosive cycling and a thin and acid-resistant film was formed when associated to APF treatment.

Comparison of efficiency of ethylenediaminetetraacetic acid, citric acid, and etidronate in the removal of calcium hydroxide intracanal medicament using scanning electron microscopic analysis: An in-vitro study

Context:Being integral to root canal therapy, obturation can be performed adequately only after the removal of intracanal medicament. One technique involves the use of chelating agents such as ethylenediaminetetraacetic acid (EDTA) and citric acid. Etidronic acid, a relatively new chelator, has smear layer removal ability and lesser dentinal erosion. It is untested in calcium hydroxide (Ca[OH]2) medicament removal.Aim:The aim of this study was to compare the efficiency of irrigation protocols (EDTA, citric acid, and etidronate) in Ca(OH)2 removal.Materials and Methods:Forty-five single-rooted mandibular premolars were decoronated, instrumented, and filled with Ca(OH)2. After 7 days incubation, Ca(OH)2 was removed by three irrigation protocols (Group-I: 17% EDTA; Group-II: 10% citric acid; and Group-III: 18% etidronate). Roots were split and analyzed (scanning electron microscope, ×1500). Chelator solution pH was tested. Data were analyzed by Kruskal–Wallis ANOVA and Mann–Whitney U-test.Results:Group-III (coronal-third) and Groups-I and II (middle-third) had highest cleanliness scores; Groups-II and III (apical-third) had lowest scores. Comparing the thirds, all groups showed difference in scores. pH of Groups-I, II, and III were 6.8, 1.4, and 0.3, respectively.Conclusion:The solution pH of citric acid and etidronate impacts their Ca(OH)2 removal efficiency in different ways: the highly alkaline pH of Ca(OH)2 increases citric acid pH toward neutrality, where it becomes an inefficient chelator; on the contrary, high acidity of etidronate compensates for its weaker chelation. Etidronate may not require 5 min duration for Ca(OH)2 removal due to the likelihood of dentinal erosion.

Surface-Sensitive Microwear Texture Analysis of Attrition and Erosion

Scale-sensitive fractal analysis of high-resolution 3-dimensional surface reconstructions of wear patterns has advanced our knowledge in evolutionary biology, and has opened up opportunities for translatory applications in clinical practice. To elucidate the microwear characteristics of attrition and erosion in worn natural teeth, we scanned 50 extracted human teeth using a confocal profiler at a high optical resolution (X–Y, 0.17 µm; Z < 3 nm). Our hypothesis was that microwear complexity would be greater in erosion and that anisotropy would be greater in attrition. The teeth were divided into 4 groups, including 2 wear types (attrition and erosion) and 2 locations (anterior and posterior teeth; n = 12 for each anterior group, n = 13 for each posterior group) for 2 tissue types (enamel and dentine). The raw 3-dimensional data cloud was subjected to a newly developed rigorous standardization technique to reduce interscanner variability as well as to filter anomalous scanning data. Linear mixed effects (regression) analyses conducted separately for the dependent variables, complexity and anisotropy, showed the following effects of the independent variables: significant interactions between wear type and tissue type (P = 0.0157 and P = 0.0003, respectively) and significant effects of location (P < 0.0001 and P = 0.0035, respectively). There were significant associations between complexity and anisotropy when the dependent variable was either complexity (P = 0.0003) or anisotropy (P = 0.0014). Our findings of greater complexity in erosion and greater anisotropy in attrition confirm our hypothesis. The greatest geometric means were noted in dentine erosion for complexity and dentine attrition for anisotropy. Dentine also exhibited microwear characteristics that were more consistent with wear types than enamel. Overall, our findings could complement macrowear assessment in dental clinical practice and research and could assist in the early detection and management of pathologic tooth wear.

Comparative Analysis of Dentinal Erosion after Passive Ultrasonic Irrigation versus Irrigation with Reciprocating Activation: An Environmental Scanning Electron Study

IntroductionThe aim of this study was to assess ex vivo the erosive effects of passive ultrasonic irrigation versus irrigation with reciprocating activation on the dentinal surface of the root canal at 3 predetermined levels using environmental scanning electron microscopy. MethodsTen roots of mandibular premolars were prepared using the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland). The specimens were embedded in flasks cleaved longitudinally, and indentations were made 3.0, 6.0, and 9.0 mm from the apex. The specimens in the control group (n = 10) were cleaned in an ultrasonic bath containing 2.5% sodium hypochlorite and 17% EDTA and then dried. Then, environmental scanning electron microscopic images were obtained at magnification × 800. The specimens were then reassembled in their flasks, and the NaOCl and EDTA solutions were activated according to the conditions established for the experimental groups (ie, the passive ultrasonic irrigation group [n = 5] and the EasyClean (Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) group, irrigation with reciprocating activation with the EasyClean instrument [n = 5]). The specimens of both experimental groups were analyzed in the same manner as in the control group. Analysis of the dentinal surface topography was conducted using the 3D Roughness Reconstruction program (Phenom-World BV, Eindhoven, the Netherlands) as a means for assessing erosion. The data were evaluated by means of the Kruskal-Wallis, Student-Newman-Keuls, and Mann-Whitney tests. ResultsIn the EasyClean group, the degree of dentinal erosion at 3.0 mm was significantly higher than at 9.0 mm. In the other comparisons, there was no statistically significant difference (P < .05). ConclusionsThe final irrigation techniques tested were equivalent in relation to the degree of erosion caused to the dentinal surface.

Final irrigation protocols may affect intraradicular dentin ultrastructure.

The aim of this study was to evaluate the effect of different irrigation protocols on the root dentin structure using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Thirty-nine lower bovine incisors were hemisected longitudinally and randomly divided into 13 groups (n=3). After the root halves were reassembled, it was applied a specific irrigation protocol for each group, as following: G1, distilled water (control); G2, 0.9% saline; G3, saline+17% EDTA; G4, saline+PUI; G5, saline+PUI+EDTA; G6 to G9 received the same protocol as above replacing 0.9% saline by 2.5% NaOCl; and G10 to G13 by 2% CHX. One-half of each sample was prepared and evaluated using SEM and the other one by TEM observations. TEM descriptive analysis showed modifications in dentin organic ultrastructure, characterized by the thinning of dentin collagen fibrils, caused by NaOCl, enhanced by EDTA and/or PUI. SEM analysis showed that NaOCl with PUI caused significantly larger erosion of the peritubular dentin than in all the other groups (P<0.05), followed by NaOCl+EDTA and NaOCl+EDTA+PUI. NaOCl caused ultrastructural alterations in the dentin collagen, and enhanced by EDTA and/or PUI, promoted peritubular and intertubular erosion. The effect of irrigating solutions on dentin ultrastructure was still unclear. The acknowledgment about the kind of solution, concentrations, application time, and sequence of use was important to achieve the right sanitization without jeopardizing the dentin ultrastructure quality.

Evaluation of Root Canal Dentin Erosion after Different Irrigation Methods Using Energy-dispersive X-ray Spectroscopy

IntroductionThe purpose of this study was to examine the level of erosion in root dentin caused by different irrigation methods and protocols. MethodsThirty-five extracted upper molar teeth were instrumented and divided into 7 groups to undergo treatment by different methods: negative control, GentleWave System (Sonendo Inc, Laguna Hills, CA), and syringe needle irrigation following different protocols. The teeth were instrumented to size #25/.08 or #30/.09 for needle irrigation groups and to ProTaper size S1 for the GentleWave group under 5% sodium hypochlorite (NaOCl). The needle irrigation groups were subjected to final rinses of 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA (3% N2 + 8% E2), 2 minutes of 3% NaOCl + 2 minutes of 8% EDTA + 1 minute of 3% NaOCl (3% N2 + 8% E2 + 3% N1), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA (5% N2 + 17% E2), 2 minutes of 5% NaOCl + 2 minutes of 17% EDTA + 1 minute of 5% NaOCl (5% N2 + 17% E2 + 5% N1), and 5 minutes of 5% NaOCl + 5 minutes of 17% EDTA + 5 minutes of 5% NaOCl (5% N5 + 17% E5 + 5% N5), respectively. The root canal surface was observed by scanning electron microscopy, and the dentin composition was analyzed by continuous line scanning for 300 μm into dentin using energy-dispersive X-ray spectroscopy. ResultsA slight but statistically significant decrease of calcium and an increase of carbon was measured in the 5% N2 + 17% E2 group in comparison with the control; no significant difference was found among GentleWave, 3% N2 + 8% E2, and 5% N2 + 17% E2 (P > .05). A final 1-minute rinse with 3% or 5% NaOCl reduced calcium and phosphorus to a significantly lower level than in groups without a 1-minute final rinse (P < .05). Final irrigation with 5% NaOCl for 5 minutes removed almost all calcium and phosphorus. Scanning electron microscopy showed canal wall erosion when an additional final irrigation with NaOCl was done. ConclusionsNaOCl followed by final EDTA irrigation performed either by syringe needle or the GentleWave System caused minimal dentin erosion. Erosion was measured as increased loss of calcium and phosphorus in samples in which additional final irrigation was performed using NaOCl after EDTA.

Stress and its role in the dentin hypersensitivity in rats

IntroductionThe perception of pain varies individually. Chronic stress leads to analgesia. The use of animal chronic mild stress model to mimic human condition was previously developed and now applied in the evaluation of pain perception in rats with dentin hypersensitivity (DH). AimsUsing DH model induced by dentin erosion (DE) mediated by acidic solution, the present study aimed the evaluation of the interaction of chronic stress and pain induced by DH in rats with DE. MethodsDH was induced by ad libitum 30-day intake of acidic solution. Stress was induced by the New York subway model. Body weight was weekly taken, during treatment. Groups WO (water, no stress), WS (water and stress), EO (acidic solution, no stress) and ES (acidic solution, stress) were submitted to treatments. ResultsAfter 30 days, all groups were submitted to DH test assessed by cold water stimuli in the labial surface of molars, for 5s, and the rats responses were scored as grades 0, 0.5, 1, 2, or 3. After euthanasia, blood was taken to obtain the levels of corticosterone, stomachs were observed in fresh preparations, kidneys and livers were submitted to histological evaluation. Open field model supported stress evaluation, as did corticosterone analysis. Stressed animals showed significant increase in pain perception and a decrease in locomotion frequency, tending to be more frequent in the periphery of the arena, corroborating stressed behavior and the need of protection as a pain relief. Corticosterone levels were increased in the stressed rats with dentin erosion and also corroborate present findings. Finally, reduction in weight gain was impaired in stressed group with dentin erosion. ConclusionThe animal model enabled the evaluation of how chronic mild stress interfered in DH pain perception.

Effects of QMix and ethylenediaminetetraacetic acid on decalcification and erosion of root canal dentin.

The aim of this study was to evaluate the effect of initial NaOCl on the decalcification and erosion ability of EDTA and QMix. Sixty-maxillary-incisors were bisected longitudinally and the tooth-halves were used. The experiment was conducted in two-sets. In set-I, 80-tooth halves were treated in the presence or absence of initial NaOCl and EDTA. In set-II, 40-tooth halves were immersed in NaOCl and QMix. After each treatment, calcium-ion release was determined with flame photometry. The erosion was imaged using SEM. Initial NaOCl led to concentration- and time-dependent increase in calcium removal effect of 17% EDTA (p<.05). The rate of calcium removal and root canal wall erosion was considerably more severe with the use of 5% NaOCl for 3min (p<.05). QMix as a final solution showed less decalcification and erosion than 17% EDTA when used 5% NaOCl as an initial irrigant (p<.05). Optimizing the concentration and application time of NaOCl can decrease the decalcification effect of chelating agents.

Ultrastructural analysis of uninstrumented root canal areas following various irrigation regimens

Abstract Introduction During endodontic treatment smaller or larger areas of root canal wall remain non-instrumented. This can affect prognosis of endodontic treatment as some bacteria may be left behind. The purpose of this study was to evaluate the morphology of non-instrumented areas of the root canal wall using scanning-electron-microscopy (SEM) after completed instrumentation and various irrigation regiments. Materials and Methods Eighteen single-rooted extracted teeth were divided into the six groups. One tooth in each group represented a control sample. In all samples only one half of the canal was instrumented using ISO 40 hand files. Control samples were subjected to an irrigation protocols without instrumentation. Irrigants used were physiological saline, 3% sodium hypochlorite and 15% of ethylene-diamine-tetra-acetate. Irrigation protocol included using each of these irrigants alone, or a combination of NaOCl and EDTA, as well as their combination with final irrigation using NaOCl or chlorhexidine. Then after, roots were sectioned longitudinally and prepared for SEM. Results Saline irrigation left pulpal debris on uninstrumented areas of the canal wall. Irrigation with 3% NaOCl left behind canal wall with different forms of calcospherites. However, after EDTA irrigation dentin appeared as an undulating surface with open tubules without a smear layer. The combination of NaOCl and EDTA showed remnants of calcospherites and open slightly widened dentinal tubules. Final irrigation with NaOCl on the uninstrumented areas showed enlarged dentinal tubules along with dentinal erosion, while after final irrigation with CHX clean dentin and open dentinal tubules without smear layer were noted. Conclusion From the morphological point of view, the most favorable effect of irrigation on both uninstrumented and uninstrumented canal walls was achieved after irrigation with NaOCl and EDTA or NaOCl, EDTA and chlorhexidine as the final irrigant.

Protective Effect of Whole and Fat-Free Fluoridated Milk, Applied before or after Acid Challenge, against Dental Erosion

This study analysed in vitro the effect of milk against dental erosion, considering three factors: the type of milk (bovine whole/fat-free), the presence of different fluoride concentrations and the time of application (before/after erosive challenge). Bovine enamel (n = 15/group) and root dentine (n = 12/group) specimens were submitted to the following treatments: after the first erosive challenge - 0.9% NaCl solution (negative control), whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control); before the first erosive challenge - whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control). Specimens were submitted to demineralisation-remineralisation regimes 4 times/day for 5 days. The response variables were enamel and dentine loss (in micrometres). Data were analysed using Kruskal-Wallis/Dunn's test (p < 0.05). For enamel, whole milk containing 10 ppm F, applied before the erosive challenge, was the most protective treatment, but with no significant difference compared with the same treatment carried out after the erosive challenge. For dentine, whole fluoridated milk (all concentrations, after), fat-free 10 ppm F milk (after, before) and whole milk with or without F (except 2.5 ppm F, all before) significantly reduced dentine erosion. It seems that the presence of fluoride, especially at 10 ppm, is the most important factor in reducing dental erosion.

Preventive effect of toothpastes with MMP inhibitors on human dentine erosion and abrasion in vitro.

ABSTRACTThe use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro. Material and Methods Five groups each containing 12 specimens of human root dentine were prepared. The specimens were subjected to 1 min erosion by immersion in a cola drink, 4 times a day, for 5 d. Each day, after the first and last erosive challenges, the specimens were brushed for 15 s with a slurry of dentifrice and water (1:3) containing placebo, 1,100 ppm fluoride, 0.61% green tea extract, 0.12% chlorhexidine or 0.004% chlorhexidine (commercial toothpaste). Between the acid challenges, the specimens were stored in artificial saliva with remineralizing potential until the next treatment. Dentine loss was determined using profilometry. Data were analyzed using one-way ANOVA after log transform (p<0.05).Results The mean wear values (μm) were as follows: placebo 1.83±0.53; 0.61% green tea extract 1.00±0.21; fluoride 1.27±0.43; 0.12% chlorhexidine 1.19±0.30; and 0.004% chlorhexidine 1.22±0.46. There was a significant difference in wear between placebo and all the treatment toothpastes, which did not differ from each other.Conclusion The results suggest that toothpastes containing MMP inhibitors are as effective as those based on NaF in preventing dentine erosion and abrasion.

Preventive effects of different protective agents on dentin erosion: An in vitro investigation.

BackgroundThe purpose of this in vitro study was to evaluate the preventive effects of different protective agents on dentine erosion, measuring mean percentage weight loss. Dissolution of dentine under erosive challenges caused by soft drinks was analyzed: specimens were weighed following each immersion period, with mean percent weight losses calculated.Material and MethodsExtracted teeth were sectioned into uniform slabs. Seventy permanent enamel specimens were randomly distributed to seven groups. Initial weights of all dentin specimens were performed. The fluoride pastes Remin Pro, MI Paste Plus, Tooth Mousse, Biorepair, Biorepair Plus and Regenerate were used in this study. A control group was treated just with tap water. The specimens then were immersed in Coca-Cola for a total of 32 min at room temperature. Finally each specimen was dry and weighed. The mass loss was calculated as a percentage of that observed prior the fluoride pastes application. Weight loss data were subjected to Analysis of Variance (One-way ANOVA) followed by Bonferroni’s post hoc tests.ResultsPercent weight loss of specimens exposed to early stages in Coca-Cola showed linear progression with time. Specimen’s application of fluoridated varnishes such as Biorepair or Regenerate, prior immersion in Coca-Cola, significantly protect dentin from demineralization. Otherwise, application of Tooth Mousse or Biorepair Plus increased dentin demineralization starting from 24 min of immersion in Coca-Cola.ConclusionsDespite the limitations of this study, the protective pastes that showed the less weight loss due to the acidic challenge are Biorepair and Regenerate. Key words:Dentine, erosion, protective agents, soft drinks, toothpastes.

To Evaluate the Efficacy of an Innovative Irrigant on Smear Layer Removal - SEM Analysis.

The goal of endodontic therapy is to completely eliminate the microorganisms and the smear layer from the root canal in order to provide a good seal of the root filling materials. The aim of this study was to find a viable alternative irrigant, which is easily available with less erosion and clinically acceptable smear layer removal by comparing the efficacy of EDTA and commercially available super-oxidized water, named Oxum, as a final rinse on smear layer removal and erosion in relation to coronal, middle and apical thirds of radicular dentin using Scanning Electron Microscope (SEM) analysis. Freshly extracted 30 human lower second premolar teeth with straight roots and type I canal anatomy were selected. The root canals were cleaned and shaped using Universal Protaper Rotary System. Irrigation was performed with 1 ml of 2.5% of NaOCl solution after each instrument change. The final irrigation (5 ml) sequence was as follows: Group I- 17% EDTA, Group II - OXUM, and Group III - 0.9% saline (control) for one minute. Then, the root canals were finally irrigated with 5ml of distilled water to remove any precipitate. The roots were then gently split into two halves using a chisel and subjected to SEM analysis. The SEM photomicrographs were evaluated by two independent examiners and Mann Whitney results showed that there was no statistically significant difference between the two examiners. Non-parametric statistical analysis of all experimental groups showed significant difference between coronal, middle and apical third for smear layer removal with p-value<0.05. For erosion, in group II (oxum) showed statistically significant difference between coronal, middle and apical third and it showed significantly less dentine erosion when compared to EDTA. Within the limitations of the present study, Oxum the commercially available super-oxidized water proved to be equally effective in smear layer removal with less erosion when compared to EDTA.

Effect of cranberry and proanthocyanidin in dentin erosion prevention

Effect of cranberry and proanthocyanidin in dentin erosion prevention

Effect of acidic solutions on the microhardness of dentin and set OrthoMTA and their cytotoxicity on murine macrophage.

ObjectivesTo evaluate the effects of three acids on the microhardness of set mineral trioxide aggregate (MTA) and root dentin, and cytotoxicity on murine macrophage.Materials and MethodsOrthoMTA (BioMTA) was mixed and packed into the human root dentin blocks of 1.5 mm diameter and 5 mm height. Four groups, each of ten roots, were exposed to 10% citric acid (CA), 5% glycolic acid (GA), 17% ethylenediaminetetraacetic acid (EDTA), and saline for five minutes after setting of the OrthoMTA. Vickers surface microhardness of set MTA and dentin was measured before and after exposure to solutions, and compared between groups using one-way ANOVA with Tukey test. The microhardness value of each group was analyzed using student t test. Acid-treated OrthoMTA and dentin was examined by scanning electron microscope (SEM). Cell viability of tested solutions was assessed using WST-8 assay and murine macrophage.ResultsThree test solutions reduced microhardness of dentin. 17% EDTA demonstrated severe dentinal erosion, significantly reduced the dentinal microhardness compared to 10% CA (p = 0.034) or 5% GA (p = 0.006). 10% CA or 5% GA significantly reduced the surface microhardness of set MTA compared to 17% EDTA and saline (p < 0.001). Acid-treated OrthoMTA demonstrated microporous structure with destruction of globular crystal. EDTA exhibited significantly more cellular toxicity than the other acidic solutions at diluted concentrations (0.2, 0.5, 1.0%).ConclusionsTested acidic solutions reduced microhardness of root dentin. Five minute's application of 10% CA and 5% GA significantly reduced the microhardness of set OrthoMTA with lower cellular cytotoxicity compared to 17% EDTA.

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

Objective This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss.Material and Methods Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl2/NaF/AmF (Erosion Protection®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF4 (pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); 5) 0.063% NaF+0.036% TiF4 (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05).Results Mouthrinses containing TiF4 or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF4 (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF4 (58.3%), SnCl2/NaF/AmF (52%) and 0.063% NaF+0.036% TiF4 (40%). NaF solution (13.3%) did not significantly differ from control.Conclusion The daily application of experimental mouthrinse containing TiF4 and NaF has the ability to reduce dentin erosion, as well as Erosion Protection® and TiF4 alone.