Incipient Enamel Research Articles

Comparative evaluation of the remineralizing potential of Salvadora persica and probiotic yogurt on incipient enamel lesions: An ex-vivo study.

Salvadora persica (miswak) is known to exert antibacterial, antifungal, antioxidant, and anticariogenic effects by elevating the pH of plaque after the consumption of sucrose. The study aimed to compare the effectiveness of S. persica and probiotic yogurt in the remineralization of tooth enamel on artificially produced enamel lesions. A total of 40 intact human premolars were collected and each tooth was sectioned longitudinally into 2 identical halves in a buccolingual direction. The buccal halves were selected for inclusion in this study, and standardized windows (5 mm× 3 mm) were isolated on the buccal surface of the enamel. The samples were incubated in a demineralizing solution at 37°C for 96 h. Subsequently, they were randomly selected for treatment with one of the experimental remineralizing solutions (S. persica or probiotic yogurt). After treatment, the samples were examined using scanning electron microscopy (SEM), energy dispersive X-ray (EDX) and polarized light microscopy at baseline, after demineralization and after remineralization. The remineralizing effect of S. persica was found to be greater than that of probiotic yogurt. With regard to mineral content, S. persica exhibited the highest calcium and phosphorus levels among all groups. No significant differences were observed between the samples treated with S. persica and normal enamel. Salvadora persica extract has been demonstrated to effectively reduce the demineralization of enamel in experimental conditions. Furthermore, it has the potential to restore the mineral content to its original level.

Stain removal, abrasion and anticaries properties of a novel low abrasion dentifrice containing micro-fibrillated cellulose: in vitro assessments

ObjectivesThis laboratory study assessed the performance of a novel fluoride dentifrice containing micro-fibrillated cellulose (MFC) and entrapped silica. MethodsRemoval of extrinsic stains was assessed using the pellicle cleaning ratio (PCR) method, and radioactive dentin abrasivity (RDA) was measured, to calculate a cleaning efficiency index (CEI). Fluoride efficacy was evaluated using widely used remineralization and fluoride uptake methods. The test product (Protegera™) was compared to common dentifrices (Crest - Cavity Protection™ and ProHealth™, Sensodyne Pronamel™, Arm & Hammer™ Advanced Whitening, Crest ProHealth™, and Colgate Optic White™). ResultsThe PCR for the MFC dentifrice (141) was comparable to three known marketed stain-removing dentifrices (Arm & Hammer™ Advanced Whitening, Crest ProHealth™, and Colgate Optic White™) but it had a significantly lower RDA (88 ± 6) than 5 other products. This gave it the highest CEI of the tested products (2.0). In a 10-day pH cycling study, the fluoride efficacy of the MFC product was comparable to Sensodyne Pronamel and Crest Cavity Protection. The MFC dentifrice was superior for promoting fluoride uptake into incipient enamel lesions compared to the USP reference dentifrice. ConclusionThe MFC dentifrice has low abrasion, but despite this, it is highly effective in removing stained pellicle. It also is an efficacious fluoride source when compared to relevant commercially available fluoride dentifrices with high dentin abrasivity. Clinical significanceThe addition of micro-fibrillated cellulose to a fluoride dentifrice gives a low abrasive product that can effectively remove external stains, and serve as an effective fluoride source. This combination of benefits seems well suited to enamel protection and caries prevention.

Impact of sodium fluoride and nano silver fluoride-based varnishes on remineralisation of enamel caries: an in-vitro study

Background: The aim of this study was to perform a comparative evaluation of 5% Sodium fluoride varnish, neutral nano silver fluoride (NSF) varnish and acidulated nano silver fluoride varnish in remineralising artificially induced enamel caries of primary teeth. Methods: 39 primary anterior teeth were sectioned 2mm below the cemento-enamel junction (CEJ) and mounted in acrylic resin blocks. Incipient enamel caries were induced on the samples artificially and primary Vicker’s surface microhardness (SMH) was assessed. Samples were divided equally and applied varnishes; Group 1: 5% Sodium fluoride varnish; Group 2: Neutral NSF varnish, and Group 3: Acidulated NSF varnish. A pH cycling protocol of 7 days was followed, and second Surface microhardness (SMH) testing was carried out. One sample from each group was observed for Scanning electron microscopy and Energy Dispersive Spectroscopy (SEM EDS). Statistical analysis was conducted using HSD Tukey and one way ANOVA tests. Results: There was a statistically significant difference between the pre-treatment and post-treatment values of all three groups. The difference in SMH after applying 5% Sodium fluoride varnish and acidulated NSF varnish was statistically significant (p<0.01). Similarly, neutral NSF varnish and acidulated NSF varnish also showed statistical significance (p<0.01). However, SMH after application of 5% Sodium fluoride varnish and neutral NSF varnish was statistically not significant. The SEM EDS analysis revealed the presence of an even fine granular layer of minerals on the surface of treated enamel in the acidulated NSF group whereas other groups showed uneven deposits of minerals. EDS showed fluoride and silver in groups containing NSF. Conclusions: Acidulated NSF varnish has the highest efficacy followed by neutral NSF varnish and 5% Sodium fluoride in remineralisation of enamel caries in primary teeth.

Evaluating the comparative efficacy of Bioactive glass containing Toothpaste, Amine fluoride-containing toothpaste and CPP-ACPF on remineralization of Artificial Incipient Enamel Lesion

Objectives: The purpose of this in-vitro study was to evaluate the comparative efficacy of Bioactive glass containing toothpaste (BioMin) and Amine fluoride-containing toothpaste (Amflor), and CPP-ACPF (GC Tooth mousse plus) on remineralization of artificial incipient enamel lesion and evaluated using Vickers micro-hardness test. Materials and Methods: A total of fifty freshly extracted premolar teeth were collected and decoronated at 1mm below the CEJ. An adhesive tape of size 4x4 mm is placed on the labial surface of each specimen. Following this, the specimens were mounted in acrylic resin moulds such that only the adhesive tape was exposed, and on the removal of the tape, a window of 4x4 mm is created. Then the specimens were randomly divided into five groups, among which specimens of four groups were subjected to demineralization for four days at 370c using an incubator. Group A (sound enamel), Group B (BioMin), Group C (CPP-ACPF), Group D (Amflor), Group E (demineralized lesion). The specimens of groups B,C,D were subjected to pH cycling for 10 days. Following whichmicro-hardness,all the specimens were evaluated using Vickers Micro-hardnessTest. Statistical analysis: The analysis was done using One Way ANOVA and inter-group comparison was done using a post hoc test. Results: Results showed statistically significant differences (p<0.001) between groups B,C,D, and group E. Among the interventional groups even though there was no significant difference, group B( BioMin) showed higher micro-hardness values when compared to group C (CPP-ACPF) and group D(Amf). Conclusion: Under the limitation of this study, it can be concluded that Bioactive glass-based toothpaste (BioMin) is a novel technology that can be used for the remineralization of early enamel caries.

Impact of sodium fluoride and nano silver fluoride-based varnishes on remineralisation of enamel caries: an in-vitro study

Background: The aim of this study was to perform a comparative evaluation of 5% Sodium fluoride varnish, neutral nano silver fluoride (NSF) varnish and acidulated nano silver fluoride varnish in remineralising artificially induced enamel caries of primary teeth. Methods: 39 primary anterior teeth were sectioned 2mm below the cemento-enamel junction (CEJ) and mounted in acrylic resin blocks. Incipient enamel caries were induced on the samples artificially and primary Vicker’s surface microhardness (SMH) was assessed. Samples were divided equally and applied varnishes; Group 1: 5% Sodium fluoride varnish; Group 2: Neutral NSF varnish, and Group 3: Acidulated NSF varnish. A pH cycling protocol of 7 days was followed, and second Surface microhardness (SMH) testing was carried out. One sample from each group was observed for Scanning electron microscopy and Energy Dispersive Spectroscopy (SEM EDS). Statistical analysis was conducted using HSD Tukey and one way ANOVA tests. Results: There was a statistically significant difference between the pre-treatment and post-treatment values of all three groups. The difference in SMH after applying 5% Sodium fluoride varnish and acidulated NSF varnish was statistically significant (p<0.01). Similarly, neutral NSF varnish and acidulated NSF varnish also showed statistical significance (p<0.01). However, SMH after application of 5% Sodium fluoride varnish and neutral NSF varnish was statistically not significant. The SEM EDS analysis revealed the presence of an even fine granular layer of minerals on the surface of treated enamel in the acidulated NSF group whereas other groups showed uneven deposits of minerals. EDS showed fluoride and silver in groups containing NSF. Conclusions: Acidulated NSF varnish has the highest efficacy followed by neutral NSF varnish and 5% Sodium fluoride in remineralisation of enamel caries in primary teeth.

Effect of Green Tea, Stevia Extract Solutions, and Fluoride-Based Mouthwash on Remineralization of Incipient Enamel Lesion: An In Vitro Study.

Effect of Green Tea, Stevia Extract Solutions, and Fluoride-Based Mouthwash on Remineralization of Incipient Enamel Lesion: An In Vitro Study.

Impact of Remineralization Potential of Biphasic Calcium Phosphate Powders on Incipient Enamel Caries

Impact of Remineralization Potential of Biphasic Calcium Phosphate Powders on Incipient Enamel Caries

Tooth-surface distribution of caries in Greek schoolchildren, using ICDAS-II index. A national pathfinder survey.

The objective of this cross-sectional nationwide study was to assess the caries status of Greek children, in regard to the severity and the distribution pattern of the lesions in the primary and permanent dentition at a tooth-surface level, based on ICDAS-II criteria. Study Design: A national survey was conducted in 15 urban and 9 rural sites and about 50 subjects were examined at each location across the country. Caries data, based on ICDAS-II index, were recorded on 4,410 children aged 5, 12, and 15-years by 10 calibrated dentists. The rankings of the most affected tooth-surfaces, the most vulnerable teeth found cavitated, the right-left symmetry of caries stages and its pattern of distribution shown per jaw or dentition were determined by using descriptive statistics (SPSS v.20). Caries lesions were quite frequent in this school aged child population and the most common code of ICDAS-II observed was that of incipient enamel caries, mainly on the occlusal surfaces, indicative of the need for fissure sealant application. For those surfaces with ICDAS-II=3-6, dental care and intensive prevention programmes, both at home and office based, are needed.

Evaluation of Incipient Enamel Caries at Smooth Tooth Surfaces Using SS-OCT.

(1) Background: Dental caries, if diagnosed at the initial stage, can be arrested and remineralized by a non-operative therapeutic approach preserving tooth structure. Accurate and reproducible diagnostic procedure is required for the successful management of incipient caries. The aim of this study was to evaluate the diagnostic accuracy of 3D swept-source optical coherence tomography (3D SS-OCT) for enamel caries at smooth tooth surface if the lesion was with remineralization. (2) Methods: Forty-seven tooth surfaces of 24 extracted human teeth visibly with/without enamel caries (ICDAS code 0–3) were selected and used in this study. The tooth surfaces of investigation site were cleaned and visually examined by four dentists. After the visual inspection, SS-OCT scanning was performed onto the enamel surfaces to construct a 3D image. The 2D tomographic images of the investigation site were chosen from the 3D dataset and dynamically displayed in video and evaluated by the examiners. A five-rank scale was used to score the level of enamel caries according to the following; 1: Intact enamel. 2: Noncavitated lesion with remineralization. 3: Superficial noncavitated lesion without remineralization. 4: Deep nonvacitated lesion without remineralization. 5: Enamel lesion with cavitation. Sensitivity and specificity for 3D OCT image and visual inspection were calculated. Diagnostic accuracy of each diagnostic method was calculated using weighted kappa. Statistical significance was defined at p = 0.05. (3) Results: 3D SS-OCT could clearly depict enamel caries at smooth tooth surface as a bright zone, based on the increased backscattering signal. It was noted that 3D SS-OCT showed higher sensitivity for the diagnosis of remineralized lesions and deep enamel lesions without cavitation, as well as cavitated enamel lesions (p < 0.05). No significant difference of specificity was observed between the two diagnostic methods (p > 0.05). Furthermore, 3D SS-OCT showed higher diagnostic accuracy than visual inspection (p < 0.05). (4) Conclusions: Within the limitations of this in vitro study, 3D SS-OCT showed higher diagnostic capacity for smooth surface enamel caries than visual inspection and could also discriminate lesion remineralization of enamel caries.

Prevalence of Caries According to the ICDAS II in Children from 6 and 12 Years of Age from Southern Ecuadorian Regions.

In Ecuador, national data on dental caries are scarce and the detection of incipient enamel lesions has been omitted. The objective of this study was to determine the prevalence of caries in school children aged 6 and 12 years of both sexes, belonging to urban and rural areas of three provinces of the country, using the International Caries Detection and Assessment System (ICDAS II). The sample consisted of 665 children from public schools, examined according to ICDASII. Caries prevalence and caries index were established using ICDAS II 2-6/C-G and ICDAS II 4-6/E-G criteria for comparison with WHO indicators. The Mann–Whitney U statistical test was used for comparison of two groups, the effect size was measured with the correlation coefficient. and the Kruskal–Wallis H test (p < 0.05) for multiple comparisons. Caries prevalence exceeded 87% for primary and permanent dentition. There were no significant differences according to province (p ≤ 0.05). The caries index at 6 years was 6.57 and at 12 years 9.21. The SIC was high at 12 years in rural areas. The prevalence of caries in the population studied was high despite the preventive measures established by health agencies.

In Vitro Effect of Strontium-Doped 45S5 Bioglass and Nd:YAG Laser on Microhardness of Demineralized Enamel

Background: This study aimed to assess the effect of strontium-doped 45S5 bioglass (BG) and Nd:YAG laser on the microhardness of demineralized enamel. Materials and Methods: In this in vitro, experimental study, 65 sound enamel samples were prepared of human premolars and polished, and then immersed in a demineralizing solution for 10 weeks. The samples were randomly divided into 5 groups of control, BG, laser, laser plus BG, and BG plus laser. Two samples of each group underwent assessment of surface morphology under a scanning electron microscope. Finally, the microhardness of samples was measured using a Vickers hardness tester, and data were analyzed by ANOVA. Results: The mean microhardness of the BG group was significantly higher than that of other groups (P&lt;0.05). The lowest microhardness was noted in the control group. The difference in microhardness was significant between laser and laser plus BG groups (P&lt;0.05). Further, the BG plus laser group had a significant difference in microhardness with BG and control groups (P&lt;0.05). The difference between laser plus BG and control groups was also significant in this respect (P&lt;0.05). Eventually, maximum morphological changes were observed in the BG group. Conclusions: Overall, BG seems to be effective for the treatment of incipient enamel caries. It effectively increases enamel microhardness and decreases mineral loss while preserving the integrity of the enamel surface.

Effect of CPP-ACPF, resin infiltration, and colloidal silica infiltration on surface microhardness of artificial white spot lesions in primary teeth: An in vitro study

Remineralizing agents such as fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) are popular treatment choices for incipient enamel lesions. Recently introduced resin infiltration enhances the esthetics of teeth affected by these enamel lesions. Furthermore, few studies reported the utilization of colloidal silica infiltration for the white spot lesions. However, the potency of these materials for treatment in primary teeth necessitates investigation.Thus, this study evaluated and compared the effectiveness of CPP-ACP fluoride (CPP-ACPF), resin infiltration, and colloidal silica infiltration on surface microhardness in artificial white spot lesions in primary incisors using the Vickers microhardness testing machine. In this in vitro study, on the labial surface of 45 primary incisors, artificial white spot lesions were created by immersing them in a demineralizing solution. According to the evaluation method, random distribution of specimens into three groups: Group 1: CPP-ACPF, Group 2: resin infiltration, and Group 3: colloidal silica infiltration. Specimens after treatment were stored in artificial saliva, followed by microhardness evaluation using Vickers microhardness. Microhardness readings at baseline, post demineralization, and after treating them with different materials were taken. The level of significance was 0.01. Enamel specimens treated with resin infiltration showed a high microhardness mean value compared to CPP-ACPF and colloidal silica infiltration. Resin infiltration is a promising and effective treatment option for incipient enamel lesions followed by CPP-ACPF compared to colloidal silica infiltration in primary teeth.

Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study

Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope. Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM). The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p <0.001). The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups. Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

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.

Amelogenin Peptide-Chitosan Hydrogel for Biomimetic Enamel Regrowth.

We designed synthetic peptides that have demonstrated an effective remineralization potential to restore incipient enamel decay. In order to develop a clinically viable approach we incorporated the amelogenin-derived peptides P26 and P32 into chitosan hydrogel and examined their efficacy in the remineralization of enamel. Peptides in chitosan exhibited increased stability in vitro as compared to peptides in solution at room temperature and at 37°C. Tooth models for enamel erosion (sections) and white spot lesions (blocks) were subject to periods of demineralization. Treatment groups were subjected to remineralization in artificial saliva in the presence of P26 and P32 in solution and in chitosan hydrogel (P26-CS and P32-CS). Quantitative light-induced fluorescence (QLF) was employed to analyze mineral density following demineralization and remineralization across all the treatment groups. Scanning electron microscopy and nanoindentation were used to characterize the surface structure and mechanical strength of regrown enamel. Control enamel sections treated in artificial saliva demonstrated randomly distributed, tiny, needle-shaped crystals with a low packing density and porosities displaying mineralization defects. In samples treated with P26-CS or P32-CS a denser coating of organized hydroxyapatite (HAP) crystals was formed covering the entire surfaces of demineralized enamel window. The hardness and modulus of enamel surfaces were increased after treatment with P26-CS and P32-CS with no significant difference in the mechanical properties between the two peptide hydrogels. Analysis of mineral density by QLF showed that in enamel sections P26 peptide alone or P26-CS significantly enhanced the remineralization. In enamel blocks P26 in solution had a better efficacy than P26-CS.

The most primitive Elasmotherium (Perissodactyla, Rhinocerotidae) from the Late Miocene of northern China

ABSTRACT The origin of Elasmotherium has been a puzzle for many years. Herein, we report the earliest representative of Elasmotherium, based on a Late Miocene skull from Dingbian County in Shaanxi, northwestern China. The skull bears a unique mosaic of primitive and derived features different from all hitherto known elasmotheres, henceforth demarcated as holotype of Elasmotherium primigenium sp. nov. Dental characters of E. primigenium are more primitive than any other known species of Elasmotherium, e.g. relatively incipient enamel folding, fairly weak lingual groove on the base of the protocone, relatively weaker crista, small and closed posterior valley and straight ectoloph. E. primigenium is evidently more primitive than all the known species of Elasmotherium, yet appreciably more derived than Sinotherium, thereby marking an important transitional species between Sinotherium and further species of the genus Elasmotherium.

REMINERALIZATION POTENTIAL OF GINGER AND ROSEMARY HERBALS VERSUS SODIUM FLUORIDE IN TREATMENT OF WHITE SPOT LESIONS: A RANDOMIZED CLINICAL TRIAL

ABSTRACT: Aim: The current study was conducted to evaluate the effectiveness of ginger and rosemary herbals versus sodium fluoride in remineralization of incipient enamel caries. Methodology: white spot lesions in anterior teeth of post orthodontic debanding patients received randomly two types of remineralizing agents, either ginger and rosemary gel or sodium fluoride varnish (bifluorid 10). White spot lesions were evaluated at base line one month and after 3, 6 months follow up periods by two blinded assessors to assess white spot lesion progression by Kavo DIAGNOdent. Results: Mann-Whitney test showed that there at baseline, sodium fluoride varnish group yielded similar readings as ginger and rosemary gel group (P=0.060). While at 1 month, ginger and rosemary gel group showed significantly higher readings compared to sodium fluoride varnish group (P<0.001). However, there were no statistically significant differences in readings of both groups at 3 months (P=0.302) and 6 months (P=0.070). Conclusion: Fluoride varnish and ginger and rosemary gel can decrease post-orthodontic white spot lesions. The herbals ginger and rosemary may be preferable for prevention purposes on initial remineralization of enamel lesions as more natural products are preferred today. Keywords: white spot lesions, ginger and rosemary in initial caries, sodium fluoride varnish, DIAGNOdent.

Comparative evaluation of the effect of black and green tea on artificially demineralized permanent enamel: in vitro study

ABSTRACT Purpose: To evaluate and compare the effect of black and green tea on initial enamel caries like lesions of extracted human permanent teeth through microhardness analysis and polarized light microscopic evaluation. Materials and methods: Fifty extracted young premolars with a standardized window on enamel were immersed in a demineralizing solution for 48 hours to produce subsurface enamel lesions. They were divided into two groups according to the type of treatment (n= 25), group I: teeth were treated by black tea infusion; group II: teeth were treated by green tea infusion. The enamel surface microhardness was measured at baseline, after the incipient enamel lesion, and after treatment. Additional twenty young premolars were selected and prepared for evaluation of the changes in enamel birefringence using the polarized light microscope. Results: Both groups showed a statistically significant increase in enamel surface microhardness after treatment as compared to the demineralization phase. By comparing the two groups, there was a statistically significant difference in the percentage of surface microhardness recovery after treatment in favor of the black tea group (P <0.0001). The polarized light microscope showed an increase in the negative enamel birefringence in both groups with less degree in the green tea group. Conclusion: Both black and green tea have a remineralizing effect on the initial enamel caries lesions with better effect of the black tea. Keywords: Initial enamel lesions, Black tea, Green tea, Microhardness, Polarized light microscope.

Comparative Remineralization Efficacy of Topical NovaMin and Fluoride on Incipient Enamel Lesions in Primary Teeth: Scanning Electron Microscope and Vickers Microhardness Evaluation.

Objective Evaluating the potential remineralization effect of NovaMin prophylaxis paste on artificial enamel lesions in primary teeth using Vickers microhardness and scanning electron microscope. Materials and Methods Forty sound buccal and lingual surfaces of human primary canine teeth were randomly divided into two groups after creating artificially demineralized lesions (G1: NovaMin and G2: fluoride; 20 per group) and then treated with the respective remineralization agents. The remineralization cycle repeated twice daily for 10 days. The groups were evaluated with Vickers microhardness and scanning electron microscope before and after de/remineralization. Results Statistically significant difference of microhardness was observed between demineralized enamel and remineralized enamel with group 1 and group 2 ( p = 0.000 and p = 0.000, respectively). No statistically significant difference of microhardness was observed between two remineralized agents ( p = 0.368). Conclusion Within the limitation of this in vitro study, NovaMin enhances the remineralization process equally to fluoride.

Evidence-based consensus for treating incipient enamel caries in adults by non-invasive methods: recommendations by GRADE guideline.

Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries.Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions.