Incipient Caries Research Articles

Confocal laser scanning reflection microscopy applied to the remineralization studies in incipient caries lesions

To evaluate through roughness parameters measurement the penetration of calcium phosphate stabilized by casein phosphopeptides (CPP-ACP) in the subsurface zone of the incipient caries lesions known in dentistry as white spot lesion (WSL). To our knowledge, there is no data about roughness parameters to evaluate the demineralization-remineralization process in the body of the lesion. WSL was generated in vitro in 10 dental samples and sectioned in half of them (longitudinal section). CPP-ACP was applied on the WSL (3 minutes daily for 60 days). Roughness parameters (Rp and Ra) were measured on the longitudinal section with a laser scanning confocal microscope in the reflection acquisition mode (CLSRM), either in the WSL or sound enamel, before and after applying CPP-ACP. CLSRM is a non-contact method able to detect small irregularities more precisely due to the small spot of laser illumination (0.5 μm). Mixed linear models were carried out, using the treatment as a fixed factor and the tooth as a random factor (significance level 5%). Rp and Ra values in WSL area before applying the remineralization protocol (WSL pre) were significantly higher than in the sound enamel of the same samples. After applying CPP-ACP, Rp and Ra values decreased significantly with respect to the WSL pre and were similar to the values of these parameters in sound enamel. roughness parameters were used as an indirect way to measure the porosity of WSL at subsurface level. The decrease of these parameters could be interpreted as the remineralization of WSL by the ability of CPP-ACP to penetrate the body of the lesion. Clinical significance: WSL is characterized by the loss of minerals from the enamel and an increase in porosity at the subsurface level. The effectiveness of remineralizing substances would be determined by their ability to penetrate the body of the lesion and reduce porosity.

Effect of Addition of Incipient Carious Lesions in Caries Diagnostic Criteria on Prevalence of Caries in North Indian Preschool Children of East Lucknow Region.

ABSTRACTAim and objectiveTo investigate the effect of the addition of incipient carious lesions into the WHO caries index on the prevalence of caries in preschoolers of East Lucknow city.Study designA cross-sectional observational study was conducted on 530 participants in the age-group of 3–6 years.Materials and methodsThe participants were randomly selected from nursery schools of the East Lucknow region. The dental caries status was assessed according to WHO and Ekstrand's criteria. In addition, the prevalence of cavitated and incipient carious lesions was also evaluated. The data were then subjected to statistical analysis.StatisticsChi-square test and Wilcoxon signed-rank test were performed to carry out statistical analysis. p value < 0.005 was taken as statistically significant.ResultsOut of 530 participants examined, caries prevalence by WHO and Ekstrand's criteria was (36.8%) and (57.4%), respectively. The mean dmft values according to WHO criteria and Ekstrand's criteria were 1.16 and 1.60, respectively. The prevalence of cavitated carious lesions was higher (66.27%) when compared with that of incipient carious lesions (33.73%).ConclusionA significant number of incipient carious lesions observed in the present study is an indication to include these lesions in caries diagnostic criteria. This would help in determining the exact prevalence of caries and aid in implementing proper preventive protocols for remineralization of incipient carious lesions.How to cite this articleAsad F, Singh N, Rathore M, et al. Effect of Addition of Incipient Carious Lesions in Caries Diagnostic Criteria on Prevalence of Caries in North Indian Preschool Children of East Lucknow Region. Int J Clin Pediatr Dent 2021;14(5):644–647.

Effect of blue light plus chlorhexidine therapy on Streptococcus mutans biofilm and its regrowth in an in vitro orthodontic model

Fixed orthodontic appliances create areas of stagnation for dental biofilms and make it difficult to clean the teeth; therefore, there is a risk of developing incipient caries lesions during the orthodontic treatment. The objective of this study is to determine if the combination of 2 different therapies, phototherapy by blue light (BL) and the antimicrobial 0.12% chlorhexidine (CHX) on enamel, orthodontic brackets, and elastics, would reduce or inhibit mature Streptococcus mutans biofilms and their regrowth on these substrates 24hours after the application of the treatment; and if this treatment would interfere with bracket adhesion to the enamel. Biofilms of S. mutans UA159 were formed for 5-days over samples composed of a bovine enamel, orthodontic bracket, and orthodontic elastic. Then, the specimens were treated with 0.89% NaCl for 1minute, BL for 12minutes (72J/cm2), 0.12% CHX for 1minute, and BL for 12minutes, followed by 0.12% CHX for 1minute (BL+CHX). Biofilm was evaluated by colonies forming units and dry weight immediately after treatments and 24hours after treatments (regrowth). The pH of the spent media was measured on the fifth and sixth days. Biofilm formation on the samples after the treatments and regrowth was visually evaluated by confocal laser scanning microscopy. Shear bond strength (SBS) between bracket and enamel was evaluated using a universal testing machine at a crosshead speed of 1mm/min. After bonding, specimens were thermocycled (500× at 5-55°C), treated, and thermocycled again. After 5days of biofilm formation, BL+CHX significantly reduced the bacterial viability on enamel compared with NaCl (P=0.004) and BL (P=0.014). For bracket and elastic, all the treatments resulted in similar bacterial viability (P ≥0.081). In the regrowth, CHX and BL+CHX significantly reduced the bacterial viability in the enamel compared with the NaCl (P≤0.015) and BL (P≤0.013). For bracket, BL+CHX significantly reduced the bacterial viability compared with NaCl (P=0.008) and BL (P=0.009). For the elastic, BL+CHX eliminated the biofilms from the substrate. CHX and BL+CHX significantly reduced the bacterial viability 24hours after treatment for all substrates (P≤0.05). The media pH significantly increased when samples were treated with CHX and BL+CHX (P≤0.001). Confocal laser scanning microscopy images visually showed an abundant quantity of red cells in the samples treated with BL+CHX. There was no difference in the SBS between the treatments (P ≥0.932). The association between BL and CHX reduced S. mutans biofilm and its regrowth on an invitro orthodontic model and did not influence the bonding strength between bracket and enamel.

Protocol for the development of a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL)

BackgroundEnamel white spot lesions (WSLs), characterized by an opaque, matt, and chalky white appearance of enamel, are a sign of incipient caries. WSLs are common in orthodontic practice and can affect both the oral health and dental aesthetics of patients. Extensive studies have been conducted to evaluate the effectiveness of prevention or treatment for orthodontically induced enamel WSLs. However, substantial heterogeneity has been found in the outcomes used for the prevention and treatment of WSLs in literature, which prevents researchers from comparing and combining the results of different studies to draw more decisive conclusions. Therefore, we aim to develop a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL).MethodsThe development of COS-OWSL comprises four phases: (1) a scoping review to identify and summarize all existing outcomes that have been used in trials on the prevention or treatment of orthodontically induced WSLs; (2) qualitative interviews with orthodontic patients without (for prevention) and with WSL-affected teeth (for treatment) and relevant dental professionals to identify additional outcomes relevant to them; (3) Delphi surveys to collect opinions from key stakeholders including patients, dental professionals, and researchers and to reach a preliminary consensus; and (4) a consensus meeting to develop the final COS-OWSL.DiscussionThe COS-OWSL will be developed to facilitate the synthesis of evidence regarding the prevention and treatment of orthodontically induced WSLs and to promote the consistent use of relevant patient-important outcomes among future studies in this field.Trial registrationCore Outcome Measures in Effectiveness Trials (COMET) initiative (the COS-WSL project) 1399

Predicting dental caries increment using salivary biomarkers in a remote Indigenous Australian child population

BackgroundThe burden of childhood dental caries amongst Indigenous Australians is higher than in other Australians. Because of differences in lifestyle and the evolutionary history of the oral microbiota, associated risk indicators may differ. Here, we evaluate associations between caries increment, salivary biomarkers and baseline caries among children aged 5–17 years residing in a remote rural Indigenous community.MethodsThis study was part of a trial assessing cost-effectiveness of an intervention to prevent dental caries among children. Baseline epidemiology and application of topical caries-preventive measures was conducted in 2015, followed-up in 2016 and 2017. Children who did not consent or failed to attend the prevention visits but did attend for follow-up epidemiology constituted a natural comparison group for evaluating the intervention. Saliva flow, pH, buffering and bacterial loads were measured at all visits. Caries was scored by the International Caries Detection and Assessment system. Outcome was caries increment. Explanatory variables were sex, being in experimental or comparison group, baseline caries, saliva flowrate and buffering, pH, and salivary loads of mutans streptococci (MS), Lactobacilli (LB), and yeast. Chi Square tests compared caries incidence in relation to explanatory variables and Generalised Linear Models explored associations between explanatory and outcome variables.ResultsOf 408 participants at baseline, only 208 presented at 2-year follow-up. Of caries-free children at baseline, significantly fewer had incipient (p = 0.01) and advanced (p = 0.04) caries after two years. Children in the experimental group experienced fewer tooth surfaces with advanced caries (p = 0.02) than comparison children. Having caries at baseline (p = 0.02) and low salivary flow-rates (p < 0.001) saw a significant increase in advanced caries after two years. Children with high salivary loads of MS (p = 0.03) and LB (p = 0.004) experienced more advanced carious surfaces. Multivariable analysis revealed 58% reduction (p = 0.001) in advanced caries among children with high salivary flow rates. Caries increment was 61% (p = 0.03) more for incipient and 121% (p = 0.007) more for advanced caries among children who harboured higher loads of MS.ConclusionAs with other ethnicities, children with low salivary flow and those with high MS had higher incipient and advanced caries increments after two years. Such risk assessments facilitate targeted preventive interventions for such communities.Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), No: ACTRN12615000693527: 3 July 2015.

Assessment of the preventive effects of Nd:YAG laser associated with fluoride on enamel caries using optical coherence tomography and FTIR spectroscopy

ObjectiveThis in vitro study characterized and monitored, by Optical Coherence Tomography (OCT) and Fourier Transformed Infrared Spectroscopy (FTIR), the effects of the association of acidulated phosphate fluoride gel (APF-gel) and Nd:YAG (neodymiun:yttrium-aluminum-garnet) laser, as sequencial treatments, in the prevention of incipient enamel caries lesions.Methods120 human enamel samples were randomized into 3 groups (n = 40): APF-gel (1.23% F-, 4 min.); Laser+APF (Nd:YAG laser irradiation—0.6W, 84.9J/cm2, 10Hz, followed by APF-gel); and APF+Laser (APF-gel followed by laser irradiation). The samples were subjected to a 15-day pH-cycling, evaluated by OCT (quantification of optical attenuation coefficient–OAC) and FTIR (analysis of carbonate and phosphate content) before treatments, after treatments, and on the 5th, 10th and 15th days of pH-cycling. The statistical analysis was performed (α = 5%).ResultsThe Optical Attenuation Coefficient (OAC) assessed by OCT increases with the progression of demineralization, and the Laser+APF presented the highest values of OAC in 10th and 15th days of pH-cycling. Nd:YAG decreased the carbonate content after treatment regardless of the application order of the APF-gel, while APF-gel did not interfere in the composition of enamel. The carbonate content was also changed in the first 5 days of the pH-cycling in all groups.ConclusionNd:YAG laser irradiation before or after the application of APF-gel did not influence the appearance of incipient caries lesions, showing no synergistic effect. Regardless of the application order of the APF-gel, laser irradiation reduces the carbonate content of the enamel, which also changes during the demineralization process. However, irradiation before the application of APF-gel increased the speed of progression of the lesions, which positively impacts public health as it can prevent caries disease, even in high risk individuals. OCT and FTIR are suitable for assessing this effect.

Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis

The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included “early caries” and “caries detection.” Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81–0.89, followed by ICDAS-II at 0.62–1, DIAGNOdent (DD) at 0.48–1, and bitewing radiography (BW) at 0–0.29. The corresponding specificity (Sp) range was: DD Pen 0.71–0.8, ICDAS-II 0.5–0.84, DD 0.54–1, and BW 0.96–1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7–0.96 and DD Pen 0.55–0.90, followed by ICDAS-II 0.25–0.93, and BW 0–0.83. The Sp range was: DD 0.54–1, DD Pen 0.71–1, ICDAS-II 0.44–1, and BW 0.6–1. For approximal surfaces, the Se was: BW 0.75–0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6–0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55–1, DD Pen 0.63–1, ICDAS-II 0.42–1, and BW 0.31–0.96; the respective Sp was: DD 0.5–1, DD Pen 0.44–1, ICDAS-II 0.61–1, and BW 0.79–0.98. For approximal surfaces, the Se range was: DD Pen 0.58–0.63, ICDAS-II 0.42–0.55, and BW 0.14–0.71. The corresponding Sp range was: DD Pen 0.85–0.87, ICDAS-II 0.73–0.93, and BW 0.79–0.98. Se and Sp values varied, due to the heterogeneity regarding the setting of individual studies. Evidently, robust conclusions cannot be drawn, and different diagnostic means should be used as adjuncts to clinical examination. In permanent teeth, visual examination may be enhanced by DD on occlusal surfaces and BW on approximal surfaces. In primary teeth, DD Pen may serve as a supplementary tool across all surfaces.

Conservative treatment of interproximal incipient caries lesions by resin infiltration

Minimally invasive dentistry is based on conservative techniques for the treatment of initial caries lesions, the so-called white spot lesions. One of the conservative maneuvers includes the use of enamel resin infiltrant: a low viscosity material that penetrates the enamel pores to stop lesion progression. Aim: Therefore, this case report aimed to describe the clinical case of a 28-year-old female patient under routine consultation, in which a radiographic examination showed the presence of two incipient caries lesions in the left upper premolars. Methods: The application of a resin infiltrating agent (Icon®, DMG – Hamburg, Germany) was chosen as treatment to stop caries lesions progression. Conclusion: The use of this conservative technique can be considered a promising approach for the prevention of dental tissue wear, and the resin infiltrant is considered an effective material.

COMPARISON BETWEEN GREEN TEA EXTRACT AND CASEIN PHOSPHOPEPTIDE AMORPHOUS CALCIUM PHOSPHATE IN TREATMENT OF INCIPIENT CARIES IN PRIMARY TEETH: AN IN VITRO STUDY

ABSTRACT One of the major factors to prevent caries is to retrieve the mineral loss as early as possible through an internal source, which is natural saliva, or an external sources as artificial saliva, available remineralising agents and natural agents. The aim of the present study was to compare the effect of a natural agent called Green Tea Extract (GTE) and a synthetic remineralising agent called Casein Phosphopeptide Amorphous Calcium Phosphate fluoride (CPP-ACPF) in treatment of incipient caries in primary teeth through scanning electron microscope and Energy Dispersive X-Ray Analysis (SEM_EDX). Materials and methods: Fifteen extracted primary teeth were selected and randomly allocated into 2 groups: Group I: CPP-ACPF, Group II: green tea solution of green tea extract. All specimens were scanned with (SEM-EDX), analysis was carried out at baseline, after demineralization and later after remineralisation. Results: SEM-EDX evaluation showed that the surface minerals content mean value for groups I and II were decreased after demineralization and re-increased after remineralization. SEM also showed improvement in the enamel appearance and the surface became smooth after remineralisation. The surface minerals content mean value in the group treated by CPP-ACPF was higher than the recorded mean value for green tea group. Conclusions: both CPP-ACPF and green tea extract have comparable remineralisation potential. KEYWORDS: Casein phosphopeptide-amorphous calcium phosphate fluoride, SEM-EDX, primary teeth, green tea extract, white spot lesions.

Efficacy of Three Different Fluoride Varnishes on Incipient Carious Lesions

Efficacy of Three Different Fluoride Varnishes on Incipient Carious Lesions

STUDY OF THE EFFECT OF FLUORIDE ON LASER ENHANCED REMINERALIZATION OF DEMINERALIZED HUMAN ENAMEL

Background: Enamel is regularly subjected to demineralization and remineralization under different oral circumstances. Any interruption in the balance between demineralization and remineralization can initiate the formation of incipient caries lesions. However, in the early stage of formation these lesions can be remineralizedusing various preventive measures. Topical fluorides have shown positive results in the prevention of caries in several studies. The aim of this study was to determine the effects of combination between diode laser and topical fluoride application on the surface microhardness of the demineralized enamel. Materials and Methods: Four caries-free human premolars were examined under the stereomicroscope to exclude teeth with surface enamel defects. Buccal enamel surface microhardness (SMH) for all samples was measured by Micro Vickers Hardness Tester (MVHT). The samples were demineralized by 15% Hydrochloric acid (HCl) with PH average 4.5, then the SMH was measured. The demineralized teeth were subjected to fluoride toothpaste after diode laser application. Third evaluation for enamel SMH was performed after remineralization. Results: Enamel SMH of the control group has shown the highest values followed by the remineralization group while the least values were measured in the demineralization group. Conclusions: The results obtained in the study lead to the conclusion that application of fluoride toothpaste after diode laser could enhance the remineralization potential of the demineralized enamel.

Preventive resin restoration - A narrative review

Conventional restorative dentistry methods persist predominant in the treatment of carious, even incipient carious, lesions when deterrence or remineralization must be the treatment of choice. According to preventative extension, when the tooth is prepared, all pits and fissures are eliminated with a bur to comfort the placement of amalgam. Lacking to acknowledge the significance and advantage of conservation of as much tooth structure as possible is indefensible in light of the technique options that the acid-etch procedure and the new resin materials offer the profession. The preventive resin restoration has several advantages. One of the important advantages is minimal tooth structure is removed compared with a conventional preparation, leaving a much stronger tooth. This is in contrast to the extension for prevention method by which elimination of better tooth structure to prevent repetitive decay at the same time weakens the tooth. As mentioned, the sealed restoration can eliminate recurrent caries.

Photoacoustic imaging of occlusal incipient caries in the visible and near-infrared range.

PurposeThis study aimed to demonstrate the presence of dental caries through a photoacoustic imaging system with visible and near-infrared wavelengths, highlighting the differences between the 2 spectral regions. The depth at which carious tissue could be detected was also verified.Materials and MethodsFifteen permanent molars were selected and classified as being sound or having incipient or advanced caries by visual inspection, radiography, and optical coherence tomography analysis prior to photoacoustic scanning. A photoacoustic imaging system operating with a nanosecond pulsed laser as the light excitation source at either 532 nm or 1064 nm and an acoustic transducer at 5 MHz was developed, characterized, and used. En-face and lateral (depth) photoacoustic signals were detected.ResultsThe results confirmed the potential of the photoacoustic method to detect caries. At both wavelengths, photoacoustic imaging effectively detected incipient and advanced caries. The reconstructed photoacoustic images confirmed that a higher intensity of the photoacoustic signal could be observed in regions with lesions, while sound surfaces showed much less photoacoustic signal. Photoacoustic signals at depths up to 4 mm at both 532 nm and 1064 nm were measured.ConclusionThe results presented here are promising and corroborate that photoacoustic imaging can be applied as a diagnostic tool in caries research. New studies should focus on developing a clinical model of photoacoustic imaging applications in dentistry, including soft tissues. The use of inexpensive light-emitting diodes together with a miniaturized detector will make photoacoustic imaging systems more flexible, user-friendly, and technologically viable.

The Evaluation of Different Treatments of Incipient Caries Lesions: An in Situ Study of Progression Using Fluorescence-based Methods.

Effective methods to control incipient caries lesions are needed. In this investigation, several methods provide encouraging results. This study aimed to evaluate in situ the inhibition of incipient caries lesion progression using different treatment protocols and to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, DIAGNOdent pen, and VistaProof fluorescence camera [FC]) in monitoring this process. The research was conducted in four phases: (1) at baseline, (2) after a first cariogenic challenge, (3) after treatment modalities, and (4) after a second cariogenic challenge. Sixteen volunteers used intraoral acrylic palatal appliances, each containing six enamel blocks (n=96). The cariogenic challenge was performed using a 20% sucrose solution over a 14-day period. The appliances were removed eight times a day and, upon removal, two drops of the solution were placed onto each enamel block. The enamel blocks were randomly assigned to three treatment groups: fluoride varnish ([FV] Duraphat; n=32), resin infiltrant ([RI] Icon; n=32), and adhesive system ([AS] Scotchbond; n=32). At the end of each phase, the surface microhardness (SMH) was measured, and two trained examiners evaluated the specimens using fluorescence-based methods. In addition, integrated mineral loss (ΔΔZ; vol%.min x μm) and lesion depth (ΔLD; μm) were evaluated using transverse microradiography. A two-way analysis of variance and a Tukey post hoc test were calculated (α=5%). Significant differences in SMH were observed according to the treatment, phases, and interaction of factors (p<0.001). Treatment with FV resulted in significantly higher SMH values in phases 3 and 4 compared to RI and AS, with the last two treatments resulting in similar values (p>0.05). The ΔΔZ value was similar for FV and AS but significantly higher for RI (p=0.016). ΔLD was not significantly different among the groups (p=0.126). Significant differences in the measurement of fluorescence for each fluorescence-based method were observed between each phase of the study (p<0.05). It can be concluded that all treatments were effective in inhibiting the in situ progression of incipient lesions, although to different degrees, with minor mineral loss changes observed for the AS and FV. Besides, all fluorescence-based methods tested, except for that using the FC device, were effective in monitoring caries lesion progression.

A study to assess the knowledge and awareness related to radiographic protection in undergraduate dental students

Introduction: In the field of dentistry, X-rays are utilized broadly for diagnosing dental diseases as well as providing therapeutic means.1 X-rays are used from mild conditions such as incipient caries to severe conditions such as alveolar bone loss and implant placement. Hence, dental therapist, office staff and the patients are at high risk to exposure of ionizing radiations. Aim of the Study: To study the knowledge and assessment related to radiographic protection in undergraduate dental students. Materials and Methods: The study was conducted among undergraduate dental students. For the study, we selected undergraduate dental students from 3rd year, 4th year and internship. A total of 120 students were included in the study. A questionnaire related to radiation protocol in the form of multiple choices was given to each participant and the response sheets were collected after 30 minutes. Results: A total of 120 undergraduate students were included in the study. The number of students from third year were 50, from final year were 39 and from internship were 31. We observed that in 3rd year, students with low knowledge were 24, moderate knowledge were 12 and with sufficient knowledge were 14. In 4th year, students with low knowledge were 12, moderate knowledge were 15 and with sufficient knowledge were 12. Conclusion: The interns and final year students are more knowledgeable and aware of radioprotection and its harmful effects on exposure as compared to third year students. The rigorous clinical training along with extensive theoretical teaching provided to final year students and interns posted in clinical departments, likely to be responsible for this difference in knowledge of students. Keywords: Dental students, Radiographic protection, X-rays.

Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study.

Aim and objectiveThe study was conducted to assess and compare the remineralization ability of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), bioactive glass-ceramic, and nanohydroxyapatite crystals using a confocal microscope.Materials and methodsEighty premolars and 80 deciduous central incisors were included in this study. Two windows of approximately 3 × 3 mm were created on the labial surface of the premolars and 2 × 2 mm on deciduous maxillary incisors. Artificial caries like lesions was created by demineralizing the sample windows. The teeth sections were then randomly assigned into four groups (n = 20). Specimens of the first group were once painted with fluoride varnish, while those in CPP-ACPF, bioactive glass-ceramic, and nanohydroxyapatite were brushed twice daily for 2 minutes each for 40 days, respectively. 150–200 μm longitudinal sections were obtained and were photographed under a confocal laser scanning microscope. They were quantified using a computerized imaging system for demineralization and later for remineralization. The recorded values were tabulated and analyzed using Fisher's test, analysis of variance (ANOVA), and post hoc Bonferroni's test.ResultsAll the materials used in the study showed remineralization potential at the end of 40 days in both permanent and deciduous teeth. The highest remineralization potential was observed in the fluoride varnish group followed by bioactive glass, CPP-ACFP, and nanohydroxyapatite in both permanent and deciduous teeth. In permanent teeth, the difference in the remineralization potential of fluoride varnish and bioactive glass was not statistically significant.ConclusionThe present study showed that self-applied bioactive glass has similar remineralization potential to fluoride varnish in permanent teeth. Therefore, bioactive glass can be used for the management of incipient caries lesions daily.How to cite this articleGoel T, Singhal A, Singh I, et al. Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(S-1):S34–S39.

Molecular Fingerprint Imaging to Identify Dental Caries Using Raman Spectroscopy.

Tooth loss impairs mastication, deglutition and esthetics and affects systemic health through nutritional deficiency, weight loss, muscle weakness, delayed wound healing, and bone fragility. Approximately 90% of tooth loss is due to dental caries and periodontal disease. Accordingly, early treatment of dental caries is essential to maintaining quality of life. To date, the clinical diagnosis of dental caries has been based on each dentist’s subjective assessment, but this visual method lacks objectivity. To improve diagnostic ability, highly sensitive quantitative methods have been developed for the diagnosis and prevention of dental caries and are gradually becoming a mandatory item in modern dentistry. High-resolution Raman spectroscopy is a suitable tool for recognizing the subtle structural changes that occur in dental enamel in already developed or, more importantly, incipient dental caries. Raman analysis could soon emerge as a breakthrough in dentistry because of its high diagnostic sensitivity. In this study, we build upon our previous findings in a new analysis of dental caries using Raman spectroscopy imaging and discuss the possibility of using Raman photonic imaging in support of objective diagnostics in dentistry. Our findings support the Raman method of caries detection in comparison with other conventional or new approaches.

Novos métodos de diagnóstico para detecção da cárie dental-Revisão integrativa

O desenvolvimento de novos métodos na detecção de cárie tem o objetivo de facilitar o diagnóstico de lesões incipientes de cárie, superando a deficiência dos métodos convencionais. Objetivo: Mostrar as novas técnicas para ajudar na detecção de lesões incipientes. Método: Trata-se de uma revisão integrativa sobre novos métodos de diagnóstico para detecção da cárie dental realizada entre os meses de maio a junho de 2020 a partir de aquisição de dados científicos das plataformas SciELO, LILACS, Pubmed. Essa revisão é referente ao período de 2010 até 2020 nos idiomas: português, inglês. Utilizou-se para a realização da busca individual, os descritores: Odontologia; Cárie; Diagnóstico, além do cruzamento entre eles utilizando o operador booleano “AND”. Resultado: após a realização de uma busca na literatura foram encontrados dez artigos relacionados com novos metidos de diagnóstico para detecção da cárie dental. Conclusão: Apesar do surgimento de novos métodos promissores, a inspeção visual permanece como método de primeira escolha. Os demais métodos devem ser utilizados como ferramentas auxiliares para obtenção de um diagnóstico mais apurado.

Resin infiltrants- A new era in minimal intervention dentistry

Aim: The aim of this review article was to assess the technique of resin infiltration, its scientific basis and different applications in clinical situations. Data sources: Scientific papers published between 2014 and 2019 in English were searched using Pubmed data source. Conclusion: Resin infiltration can be a promising technique in the minimum intervention concept. It helps in masking the initial enamel lesions and also inhibits their progression into deeper areas. Eventhough more studies and clinical trials are required to confirm its effects, it can significantly reduce long term restorative needs and costs when combined with other caries remineralization programs. Keywords: Incipient caries, Minimal intervention dentistry, Resin infiltrant, White spot lesion.

Study of Demineralized Dental Enamel Treated with Different Fluorinated Compounds by Raman Spectroscopy.

Background: Current diagnostic methods for enamel caries detection are unable to detect caries lesions (incipient caries lesion) at a very early stage.Objective: This study aims to determine the remineralizing effect of three fluorinated compounds on demineralized subsurface tooth enamel using Raman spectroscopy characterization.Material and Methods: In this experimental study, sixty impacted 3rd molars, with intact anatomical crowns recently extracted and without structural defects, were sectioned longitudinally in a mesio-distal direction using a diamond disc, obtaining two working surfaces (buccal and lingual). The 120 working surfaces obtained were immersed for 96 h in a demineralization solution at 37°C in order to demineralize the enamel surface. All samples were randomly divided into three groups (n=30 each) and their surfaces were treated with silver diamine fluoride (SDF), Difluoride silane (DSF), and acidulated phosphate fluoride (APF), and with no treatment undertaken in the control group (CG). The samples were immersed in alternating solutions for demineralization and remineralization at pH 4.4 and pH 7.0, respectively. The results were analyzed with Principal Component Analysis (PCA) in order to determine the variance.Results: The most important difference (91.7%) is observed in APF group between PCA1 respect to PCA2, followed by DSF (91.5%) and SDF (76.3%) respectively. Therefore, a greater remineralization in the dental enamel can be observed by the three experimental groups. Conclusion: The APF and DSF have the effect of recovering the mineralization of dental enamel, except for the SDF. Functional groups OH- and PO43- were identified in all subsurface.