Tooth Mineralization Research Articles

The Role of Serum Vitamin D Levels and Vitamin D Receptor (VDR) Gene Variants on Dental Caries

Background/Objectives: Vitamin D helps the mineralization of bone, teeth, and other calcified tissues by regulating calcium–phosphate metabolism. The nuclear activation of the vitamin D receptor (VDR) gene is essential for the effectiveness of vitamin D. The main objective of this study is to determine the role of vitamin D levels and VDR gene variants in dental caries. Methods: This study included 128 3–6-year-old children who were divided into 64 caries-free and 64 carious children. Blood samples were taken, and serum 25-hydroxyvitamin D levels were measured. Intraoral examinations were performed to record dmft index values. Genetic testing was performed on 26 children to examine VDR gene variations. Relevant gene regions were amplified using PCR and sequenced via Sanger sequencing in a total of 13 caries-free and 13 carious children. Stats analyses included chi-square/trend tests to compare count data; Student’s T/Mann–Whitney U tests for two-group normally/non-normally distributed data; and the Kruskal–Wallis test for 3+ groups with non-normal data. Results: The results showed that vitamin D levels were relatively low in the caries group, but no statistically significant relationship was found between vitamin D levels and caries. No mutations were detected in the VDR gene in either group, and there was no significant difference observed in terms of the number of ApaI, TaqI, and FokI polymorphisms. Based on these findings, the use of prophylactic vitamin D supplements to prevent caries formation or development cannot be recommended. Conclusions: This study provides important insights into the relationship between vitamin D and dental caries and can contribute to the development of effective preventive strategies for oral and dental health.

Erosive potential of children’s chewable vitamin supplements: An in vitro investigation

Background. Chewable vitamins are dietary supplements in which vitamins are combined with a flavor that appeals to children. The acidic nature of some vitamins and some flavoring agents may cause dental erosion. We investigated the effect of children’s chewable vitamin supplements on the loss of minerals in teeth. Methods. Forty-two human tooth enamel samples were prepared and randomly assigned to seven groups (n=6). Six groups contained different chewable vitamin tablets dissolved in deionized water, and a control group contained only deionized water. Each tablet was ground before its dissolution, and its pH was measured. Each tooth sample was immersed in a vitamin solution and artificial saliva in periodic cycles for 14 days. Each sample was weighed before and after immersion to calculate its weight loss percentage. Scanning electron microscopy was used to investigate the morphology of the enamel surfaces. For statistical analysis, the weight loss percentages between groups were compared using Welch’s ANOVA, followed by post hoc Dunnett’s T3 analysis (P<0.05). Results. All the tested supplements were acidic, with a pH range of 2.99‒4.77. Most of the vitamin groups tested led to significant weight loss; it was greater for the vitamin C groups than the multivitamin groups. Scanning electron microscopy revealed erosion and destruction of enamel surfaces following vitamin exposure. Conclusion. All the chewable vitamin supplements were acidic, with the majority potentially eroding enamel. The erosive potential was less pronounced in vitamin supplements containing minerals.

Unlocking Osseointegration: Surface Engineering Strategies for Enhanced Dental Implant Integration.

Tooth loss is a prevalent problem faced by individuals of all ages across the globe. Various biomaterials, such as metals, bioceramics, polymers, composites of ceramics and polymers, etc., have been used for the manufacturing of dental implants. The success of a dental implant primarily depends on its osseointegration rate. The current surface modification techniques fail to imbibe the basics of tooth development, which can impart better mineralization and osseointegration. This can be improved by developing an understanding of the developmental pathways of dental tissue. Stimulating the correct signaling pathways through inductive material systems can bring about a paradigm shift in dental implant materials. The current review focuses on the developmental pathway and mineralization process that happen during tooth formation and how surface modifications can help in biomimetic mineralization, thereby enhancing osseointegration. We further describe the effect of dental implant surface modifications on mineralization, osteoinduction, and osseointegration; both in vitro and in vivo. The review will help us to understand the natural process of teeth development and mineralization and how the surface properties of dental implants can be further improved to mimic teeth development, in turn increasing osseointegration.

Improving Enamel Acid Resistance by an Intraoral Fluoride-Release Device Incorporating Cationic Hydroxy Cellulose Gel Using 3D Printer Molding.

An intraoral fluoride-releasing device (IFRD) is a cost-effective tool for introducing fluoride into the oral cavity. It allows prolonged uptake of low concentrations of fluoride into teeth. We developed a new IFRD using 3D additive manufacturing and a new low-release fluoride gel. Gels for IFRDs were synthesized from hydroxyethyl cellulose (SE600) and cationic hydroxyethyl cellulose (L200). We compared the effects of the new cationic fluoride slow-release gel and non-cationic gel on enamel acid resistance in vitro. Cationization significantly increased fluoride ion concentration, as evident from its concentrations of 0.68 ± 0.08 ppm for SE600 and 4.24 ± 0.83 ppm for L200 after 60 min of immersion in distilled water. In addition, the acid resistance of bovine tooth enamel post-application was analyzed by measuring tooth loss, mineral loss (ΔZ), and lesion depth (Ld) using polarized light microscopy, electron microscopy, and micro-radiography. Compared to the SE600 group, the cationic L200 group had significantly reduced ΔZ and Ld, enhancing enamel acid resistance. This device could be implemented in areas where adequate oral care is challenging, including preventive dentistry, ward management, nursing homes, and dental clinic visits.

COMPARATIVE CHARACTERISTICS OF METHODS FOR THE PREVENTION OF DENTAL CARIES IN CHILDREN OF EARLY CHILDHOOD

The high prevalence and intensity of early childhood caries in Ukraine and in the world indicate insuffi cient attention of practical dentistry to the prevention of dental caries in young children. The development of adapted prevention programs considering the risk factors for the development of the disease remains relevant.Aim of the study. To compare the eff ectiveness of methods of pre- and postnatal prevention of early childhood dental caries based on correction of the microbial environment of the oral cavity and macro- and microelemental nutrition.Material and methods. The work was carried out within the framework of the research work of the Department of Pediatric Dentistry of the Bukovinian State Medical University «Development of methods of prevention and treatment of major dental diseases in children, taking into account the risk factors of their development» (DR # 0121U110122). The prenatal method of dental caries prevention was applied to a group of pregnant women (30 persons) whose average age was (25,17±1,05) years. It included the use of Elevit Pronatal and Iodomarin 200, one tablet daily, starting from the second trimester ofpregnancy, and a course of local probiotic therapy with BioGaya ProDentis chewable tablets, used for 20 days in the second trimester of pregnancy and 20 days before delivery. As a method of postnatal prevention of dental caries in children, a preventive complex was used, including the use of the probiotic BioGaya ProDentis and the vitamin and mineral complex Supervit. The course lasted three weeks twice a year. The preventive complex was applied to a group of children aged 2-3 years. The number of children in the control group was 30. The mean age of the group was (2.51±1.30) years. The eff ectiveness of preventive measures was evaluated by the prevalence and intensity of caries of primary teeth («kpv» and «kpppv»), the state of oral hygiene (M. E. Kuzmina index), the content of phosphate ions, inorganic and ionized calcium in the oral fluid of children, the content of mutans streptococci in the oral cavity and the concentration of sIgA in the oral fl uid of children. Statistical processing of the study results was performed using standard methods of variation. The study complied with all bioethical norms (conclusion of the Bioethics Commission of the Bukovinian State Medical University No. 4 dated 15.12.2022).Results of the study. The use of preventive complexes for early childhood caries, based on the supplementation of macro- and microelements and the infl uence on the microbial landscape of the oral cavity, are eff ective methods of prevention of caries of temporary teeth in children, which is confi rmed by a decrease in the prevalence and intensity of dental caries in children in the dynamics of their observation. Prenatal measures are more eff ective in the prevention of early childhood caries in children, as they optimize the processes of primary mineralization of hard dental tissues and thus strengthen them, reducing the risk of dental caries. Postnatal use of the drugs has a slightly lower preventive eff ect on early childhood caries, while it has a positive eff ect on the processes of secondary mineralization of tooth enamel, as it was found that the level of phosphate ions in the oral fl uid of children under these conditions increased by 23.72 % (p<0.05), and the level of total calcium decreased by 15.84 % and its free fraction by 25.86 % (p<0.05).Conclusions. Our results suggest that both methods of prevention of early childhood caries are eff ective, but prenatal prophylaxis is clinically more eff ective with respect to the hard tissues of temporary teeth in children, due to its eff ect on the processes of primary mineralization of enamel. Postnatal prophylactic measures have a positive eff ect on the secondary mineralization of the hard tissues of temporary teeth and the primary mineralization of permanent teeth and will have a clinical result in the long term.

The Remineralization of Enamel from Saliva: A Chemical Perspective.

The natural remineralization of enamel is of major importance for oral health. In principle, early erosions (demineralization) induced by acidic beverages and foods as well as initial caries lesions can be covered and remineralized by the deposition of calcium phosphate, i.e., tooth mineral. This remineralization effect is characterized by the presence of calcium and phosphate ions in saliva that form hydroxyapatite on the enamel surface. Although it is apparently a simple crystallization, it turns out that remineralization under in vivo conditions is actually a very complex process. Calcium phosphate can form a number of solid phases of which hydroxyapatite is only one. Precipitation involves the formation of metastable phases like amorphous calcium phosphate that convert into biological apatite in a number of steps. Nanoscopic clusters of calcium phosphate that can attach on the enamel surface are also present in saliva. Thus, remineralization under strictly controlled in vitro conditions (e.g., pH, ion concentrations, no additives) is already complex, but it becomes even more complicated under the actual conditions in the oral cavity. Here, biomolecules are present in saliva, which interact with the forming calcium phosphate mineral. For instance, there are salivary proteins which have the function of inhibiting crystallization to avoid overshooting remineralization. Finally, the presence of bacteria and an extracellular matrix in plaque and the presence of proteins in the pellicle have strong influences on the precipitation on the enamel surface. The current knowledge on the remineralization of the enamel is reviewed from a chemical perspective with a special focus on the underlying crystallization phenomena and the effects of biological compounds that are present in saliva, pellicle, and plaque. Basically, the remineralization of enamel follows the same principles as calculus formation. Notably, both processes are far too complex to be understood on a microscopic basis under in vivo conditions, given the complicated process of mineral formation in the presence of a plethora of foreign ions and biomolecules.

ASPECTS OF SURFACE ENAMEL MINERALIZATION IN PERMANENT TEETH OF CHILDREN FROM DIFFERENT AGE GROUPS

The purpose of our study was the examination of external surface enamel mineralization in permanent teeth of children from different age groups. We examined sections of 50 extracted for orthodontic indications premolars in patients from different age groups. A study of 16 teeth was conducted in 11-13 years old children, 8 teeth were investigated in each group of 13-15 years old, as well as 9 teeth in 15-16-year-old patients. All patients were appointed with remineralization therapy during the first six months after tooth eruption fallowed by application of “Tooth Mousse” ones a day for 2 weeks every six months with appropriate monitoring. The comparison group, on the other hand, consisted from extracted teeth taken from children who were not subjected to any preventive remineralization measures. The distribution by age and the studied material was identical to the main group. Segmentation of the teeth was carried out after the tooth extraction with separation of the crown structure and further polishing of the crown using polishing brushes without pastes. Sections 0.3-0.5 mm thick were formed with a diamond disc. The enamel samples were cleaned and degreased and then examined in a polarizing microscope (Optika B-150POL-B 40x-640x Bino) at a magnification in 500 times. The description of the enamel microscopic surface was carried out according to the following parameters: surface heterogeneity, surface opaqueness/shininess, surface roughness/smoothness. The surface homogeneity was assessed by calculating the ratio of identified surface areas that visually differed from the overall enamel texture, which was characteristic of the predominant investigated surface enamel. There were criteria for evaluating the enamel surface heterogeneity according to the research data in a polarizing microscope : the presence of numerous well-defined cracks, the visualization and number of areas from which the enamel prisms extend, the presence and number of enamel surface irregularities confirmed by a change in the direction of the light beam, the percentage of surface homogeneity, which was calculated as the ratio of the area of ​​the visually homogeneous enamel surface to the area with ​​any microscopically detected changes. To assess the opacity of the enamel surface by the microscopic polarization study, the criteria of visual assessment of shiny and dark areas of interest were used. The study suggested that microscopic changes are characterized by a decrease of total number in enamel surface irregularities and an increase of its glossiness and smoothness at the approach of structural compositional stabilization at 15-16 years. The analysis also revealed that there were marked microscopic differences observed in enamel of 15-16 years old after remineralization with the "Tooth Mousse" gel and a comparison group (without remineralization therapy).The difference between them is reliable (p<0.01) according to the indicators of the relative average level of surface heterogeneity, and also statistically different from similar indicators that were registered in the age groups 11-13 and 13-15 years old (p<0.01). The gained results can be considered as the expediency grounds for implementation of dental caries prevention at the early stages of secondary mineralization (immediately after eruption) and throughout the entire period of its intensive phase, which will further contribute to the stabilization of the caries-resistant enamel.

12472 Clinical Features Of Adult Hypophosphatasia And Correlation Between Laboratory Findings And Patient’s Symptomatology: A Retrospective Review At The Penn Bone Center

Abstract Disclosure: J. Ocampo Mascaro: None. R. Tran: None. S. Kallish: Consulting Fee; Self; Sanofi, Amicus. Research Investigator; Self; Ipsen, Sanofi, Incyte, Idorsia. Speaker; Self; Sanofi, Amicus. J. Berman: None. M. Al Mukaddam: Grant Recipient; Self; Ipsen, Incyte Research Funding. Hypophosphatasia (HPP) is an inborn error of metabolism resulting in low activity of the enzyme tissue non-specific alkaline phosphatase (ALP). It primarily involves bone and teeth mineralization. HPP has a wide clinical spectrum. It may present with rickets, fractures, failure to thrive, weakness, respiratory complications, and seizures in its more severe perinatal/infantile forms. Childhood forms tend to be milder but may have substantial musculoskeletal complications and early teeth loss. The clinical picture in adults is extremely variable too. It is usually mild with stress fractures and/or teeth loss in most individuals but can be debilitating in others due to musculoskeletal pain and recurrent fractures. This retrospective study describes the characteristics of 35 adult patients (ages 22-74 years) with HPP based on clinical presentation +/- molecular testing at the Penn Bone Center, located at a US-based large academic hospital. Out of 35 patients, 26 had an ALPL variant in genetic testing (12 pathogenic, 5 likely pathogenic, and 9 of uncertain significance), 3 were negative, and 6 did not undergo testing yet. ALP values ranged from 11 to 39 U/L (N: 38-126). Serum fasting vitamin B6 levels (off supplements) ranged from normal range to 18 times the upper limit of normal. Main symptoms reported were fractures (74%), arthralgias/myalgias (51%), diffuse bone pain (29%), atraumatic teeth loss (20%), muscle weakness (14%), and nephrolithiasis (9%). We found no significant negative correlation between ALP levels and number of symptoms (rs -0.026) or age of first symptom occurrence (rs 0.205). We also found no significant positive correlation between B6 elevation and number of symptoms (rs 0.236) or age of first symptom occurrence (rs -0.175). Six patients within our cohort had previous or current treatment with asfotase alfa. This is an FDA-approved therapy for the treatment of perinatal, infantile, and childhood HPP and has been used in adult patients if one of the presenting symptoms was before age 18 years. Response to therapy in our patient cohort was mixed. Three out of six patients discontinued treatment due to lack of clinical benefit. Continued research of the clinical characteristics of adult HPP is needed to better understand its natural history, markers of severity of disease, and how to determine who may potentially benefit from asfostase alfa therapy. Presentation: 6/1/2024

Application of the Raman fluorescence method to study the effects of chemical, physical and radiation factors on the mineralization of hard dental tissues

Objective. To study the effect of physical, chemical and radiation factors on the degree of mineralization of the hard dental tissues surface using spectroscopy. Materials and methods. The degree of mineralization of hard dental tissues was studied by the Raman spectroscopy using hardware-software complex InSpectrum M on the teeth removed according to clinical indications (in vitro): in varying degrees of moisture (dry and wet); before and after exposure to acid and remineralizing drug; before and after exposure to radiation Results. The data obtained demonstrated the difference in the indicators in dry (1801 [1800; 1802]) relative units, and moistened (591.5 [591; 592]) teeth. The mineralization of teeth according to Raman Intensity before exposure to citric acid, was (602 [601; 602]) rel. units, and after the exposure it was (152 [152; 153]) rel. units, after application of the cm-2 plate it was (423 [422; 423]) rel. units. The identified differences are reliable (p 0.001). Thus, it is confirmed that organic acids (citric acid) contribute to the enamel demineralization by more than two times, and the use of calcium-containing plates contributes to remineralization almost to the initial state. At the same time, there were no significant differences in the level of mineralization (according to the Raman method of fluorescence spectroscopy) in teeth before and after direct radiation exposure, regardless of dose (2 Gy, 70 Gy, 110 Gy) in any of the functional groups (incisors, canines, premolars, molars). Conclusions. 1. Raman-fluorescence spectroscopy has a high sensitivity and is capable of detecting mineralization, de- and re-mineralization of hard dental tissues. 2. It is recommended to determine the hard tooth tissues mineralization by Raman-fluorescence spectroscopy in a moistened rather than a dry form. 3. Organic acids contribute to the demineralization of enamel, and the use of calcium-containing plates promotes its remineralization. 4. Direct radiation exposure does not have a direct effect on the mineralization of the surface of the hard dental tissues. regardless of the dose applied in all functional groups (incisors, canines, premolars, molars), in all areas of the teeth (equator, cutting edge, gum border).

Human genetic diseases of phosphate and pyrophosphate metabolism

In humans, physiological bone and tooth mineralization is a complex cell-mediated process. Prerequisites for proper mineralization include sufficient amounts of minerals (calcium and phosphate [Pi]) to initiate the formation and the growth of apatite crystals and adequate amounts of mineralization inhibitors, such as pyrophosphate (PPi), to prevent uncontrolled extraskeletal mineralization.In this review, we provide an overview of the genetics of human disorders of mineralization, focusing on Pi and PPi metabolism and transport diseases, as the Pi/PPi ratio is an important determinant of crystal production in vivo. Variants in genes implicated in the homeostasis of this ratio may lead to a systemic or local increased Pi/PPi ratio, either by increasing the Pi concentration or by decreasing the PPi concentration, resulting in ectopic calcifications; conversely, variants may lead to a decreased Pi/PPi ratio, resulting in defective mineralization.Owing to the implication of common pathways and, occasionally, to some extent of clinical overlap, an accurate diagnosis and understanding of the pathophysiology of these disorders may be challenging. However, precise molecular characterization of these conditions not only facilitates their diagnosis, but also helps to gather evidence regarding the pathophysiology and phenotype–genotype correlation to improve medical care and develop innovative therapeutics.

Association between flavonoids intake and dental caries in children and adolescents: a cross-sectional study from the NHANES database

BackgroundWorldwide, dental caries is a bacterial biofilm-mediated condition with a high morbidity in children and adolescents. Flavonoids are a class of active natural products with antibacterial and anti-inflammatory effect. In vivo and in vitro studies have shown that they can promote tooth mineralization and reduce inflammation. However, the association of flavonoids intake and dental caries in children and adolescents remain unclear.AimThis study was to evaluated the association of flavonoid and its subclass intake and dental caries in children and adolescents.MethodsData of participants aged 2-17 years were extracted from the National Health and Nutrition Examination Survey (NHANES) database (2017-2018). Dental caries was measured via the decayed or filled surfaces in primary teeth or permanent teeth (dfs/DFS) index. The weighted univariable and multivariable logistic regression models were utilized to explore the association of flavonoids intake with dental caries in children and adolescents, with odds ratios (ORs) with 95% confidence intervals (CIs). Subgroups analyses based on age, and overweight/obesity were further assessed the association. Subgroup analysis were further performed to explore whether the association between subclasses of anthocyanidins and catechins with dental caries was robust stratified by age and individual with overweight/obesity.ResultsAmong totally 1,818 children and adolescents, 786 (43.2%) had dental caries. High intake of anthocyanidins (OR=0.69, 95%CI: 0.52-0.92) and catechins (OR=0.64, 95%CI: 0.44-0.92) were associated with lower odds of dental caries. Similar results were discovered in individuals aged ≥6 years (anthocyanidins, OR=0.62, 95%CI: 0.43-0.90; catechins, OR=0.62, 95%CI: 0.40-0.96), and without overweight/obesity (anthocyanidins, OR=0.58, 95%CI: 0.37-0.90; catechins, OR=0.51, 95%CI: 0.31-0.84). Further investigation found that high intake of cyanidin, petunidin, malvidin, peonidin, (+)-Catechin, (-)-Epigallocatechin, and (-)-epicatechin were associated with lower odds of dental caries in children and adolescents.ConclusionHigh intake of anthocyanidins and catechins were associated with lower odds of dental caries in children and adolescents and are a promising intervention to be further explored in children and adolescents.

Systematic Review of the Relationship between Vitamin D Deficiency and Delayed Teething in Children and Infants

Background: In oral health, there has been an increasing focus on vitamin D (VD) levels. VD deficiency (VDD) is linked to a broad range of oral health issues during growth and maturity, and reduced VD synthesis may hasten the onset of some of these illnesses. Severe VDD in children can lead to poor tooth mineralization, which can lead to dentin and enamel abnormalities. Consequently, there's a chance that these flaws will raise the chance of dental caries developing and spreading. Objectives: This study's main goal was to determine how vitamin D insufficiency affects children's and newborns' delayed teething. Methodology: We conducted a thorough search of PubMed, SCOPUS, Web of Science, and Science Direct to find pertinent literature. The Rayyan QRCI was utilized during the whole operation. Results: The timing of the eruption and the amounts of vitamin D were shown to be significantly correlated (P < 0.001). Compared to infants with sufficient-to-optimal values of 25(OH)D (≥50.0 nmol/L) at birth, children with vitamin D deficiency at birth showed greater dental ages, higher developmental stages of the mandibular second premolar, and higher developmental stages of the mandibular second molar. Furthermore, compared to children with appropriate levels of vitamin D, those with a deficiency were 2.5 times more likely to have delayed teething. Additionally, the usual teething group had a mean blood vitamin D level of 26.8 ng/mL, whereas the delayed teething group had a mean level of 20.3 ng/mL. Conclusion: Studies from Saudi Arabia, India, Brazil, the United States, and Egypt have all underlined the effect that vitamin D insufficiency has on delayed teething in newborns and children. These findings emphasize the significance of maintaining appropriate vitamin D levels for healthy dental development by showing a continuous link between low levels of the vitamin and delayed teething eruption. Moreover, studies indicate that vitamin D concentrations in mothers and newborns may also influence how children's teeth develop. Promoting children's oral health outcomes requires addressing vitamin D insufficiency through suitable therapies and public health policies.

Synthesis of novel silver-loaded clay AgF@Hec for the prevention of dental caries in vitro

Dental caries, a chronic infectious disease characterized by tooth mineral loss caused by plaque, is one of the major global public health problems. Silver diamine fluoride (SDF) has been proven to be a highly effective anti-caries drug due to its high bacterial inhibition and remineralization ability. However, the SDF solution is unstable, which immensely limits its clinical application. Therefore, new silver-load clay named AgF@Hec was designed by replacing the NH3 with hectorite in this study. Fourier transform infrared spectroscopy and x-ray diffraction spectroscopy were employed to confirm the structure of AgF@Hec. Dynamic light scattering analysis was used to reveal the effect of different hectorite concentrations on the stability of AgF@Hec. Moreover, AgF@Hec exhibits significant remineralization and hardness recovery of the initial carious lesions. Bacteriostatic experiments also proved that it has a significant inhibitory effect on A. Viscosus, S. mutans, S. sanguinis, S. salivarius, Lactobacillus sp. and both gram-positive and gram-negative bacteria. We therefore believed that AgF@Hec should be a promising biomaterial that can be applied in the prevention of dental caries.

Hypophosphatasia Presenting as a Chronic Diffuse Pain Syndrome with Extra-Articular Calcifications.

Hypophosphatasia is a rare genetic disease characterized by abnormal alkaline phosphatase activity and deficiency of bone and teeth mineralization. Hypophosphatasia is well known in pediatrics with typical presentations in children, but mild forms can also be present in adults and are difficult to detect. We present the case of a 50-year-old woman referred for pain management, with a previous diagnosis of fibromyalgia. The association of clinical features (diffuse pain syndrome, early dental loosening, personal history of two fractures with osteoporosis, and family history of osteoporosis) with radiographic (heterotopic calcifications of the yellow and interspinous lumbar ligaments) and biological (low levels of total alkaline phosphatase) indices was suggestive of hypophosphatasia, which was confirmed by genetic analysis. We review and discuss the association between hypophosphatasia, musculoskeletal pain, and calcium pyrophosphate deposition and the importance of raising the diagnosis of adult-onset hypophosphatasia when facing these two rheumatologic entities.

Orthodontic treatment in children and adolescent patients with X-linked hypophosphatemia: A case-control study.

X-linked hypophosphatemia (XLH) is a rare genetic disease that disturbs bone and teeth mineralization. It also affects craniofacial growth and patients with XLH often require orthodontic treatment. The aim of this study was to describe changes in the dental health of XLH children during orthodontic treatment compared with those in matched controls undergoing similar orthodontic procedures. For this retrospective case-control study, we included all individuals less than 16 years old diagnosed with XLH, orthodontically treated in our centre from 2016 to 2022 and pair-matched them to patients with no chronic or genetic conditions. Clinical and radiological parameters concerning their malocclusion, craniofacial discrepancy and the characteristics and iatrogenic effects of their orthodontic treatment were analysed. Fifteen XLH patients (mean age: 11.3 ± 2.1), pair-matched to 15 control patients were included. Orthodontic treatment was successfully conducted in XLH patients with slightly shorter duration and similar iatrogenic effects as in the control group, except for the occurrence of dental abscess during and after orthodontic tooth movement. XLH patients did not show more relapse than the controls. Despite the presence of oral manifestations of XLH such as spontaneous abscesses, XLH patients can undergo orthodontic treatment with no obvious additional iatrogenic effects.

Evaluation of the Effectiveness of Three Interventions on Mineralization of Young Permanent Teeth Using DIAGNOdent™ Pen: A Double-Blind Randomized Controlled Trial

Background: The occurrence of dental caries is influenced by the interplay of host factors, microbial factors, and environment factors collectively forming the epidemiological triad of dental caries. Modification of the caries epidemiological triad limits the caries progression by shifting the equilibrium toward re-mineralization. Aim: The aim of this study was to evaluate the effectiveness of dietary sugar intake modification, plaque control measures, and fluoride toothpaste on the mineralization of enamel using DIAGNOdent™ pen scores. Methodology: 108 children aged 13–15 years, qualified the preset inclusion and exclusion criteria were randomly allocated into one among the three interventional groups such as Group 1: Diet counseling; Group 2: Educational intervention of toothbrushing and oral rinsing; and Group 3: Fluoride toothpaste. The sugar scores from 1 week’s diet history, plaque index scores, the weight of the fluoride toothpaste, and DIAGNOdent™ pen scores were recorded at the baseline visit and subsequently at 6- and 12-week intervals. Statistical analysis was done using Chi-square, repeated measure analysis of variance, and Tukey’s post hoc tests to determine the relationship between the variables. Results: The percentage reduction in DIAGNOdent pen score at 12-week time interval in Group 1 was 25.37%, Group 2 was 6.77%, and Group 3 was 13.37%. Intergroup comparison revealed that Group 1 showed a statistically significant difference (P < 0.05) as compared to Group 2 and Group 3, but Group 2 was as effective as Group 3 in teeth remineralization. Conclusion: the results suggest that among the abovementioned interventions, the dietary sugar restriction group is related to improved mineralization when compared to the instructed toothbrushing, oral rinsing, and fluoride toothpaste groups.

Presence of K+ in solution acts as a protectant against dissolution of biomimetic apatites compared to Na+

Tooth mineral is constantly exposed to saliva. Based on many factors including diet and chronic disease, salivary composition can vary in pH and potassium (K+) and sodium (Na+) concentrations. Tooth mineral is composed of bioapatite with an ability for ionic exchange between the mineral and the surrounding fluid. Na+ and K+ are known to integrate into biomimetic apatites during crystallization and affect crystallization growth/rate and morphology of calcium phosphates. However, it is unknown how exogenous Na+ and K+ in the solution affect carbonated apatite after formation. Therefore, we investigated the mechanistic differences between Na+ and K+ on biomimetic apatite dissolution/recrystallization. To do so, biomimetic carbonated apatites with 3 or 7 wt% CO32− were exposed to NaCl or KCl solutions at various concentrations and pHs seen in saliva. Powder mass, Raman, FTIR, and XRD were used to determine the weight, composition, and structure of the mineral while the solution was characterized for pH and ionic variations. After mineral-solution exposure, significant differences were seen between NaCl and KCl solutions. The apatites exposed to NaCl underwent a classical dissolution/recrystallization mechanism exhibiting more loss in mass and carbonate during dissolution with modifications of A-, B-, and labile CO32− amounts during recrystallization which were dependent on the initial apatite CO32− content. Meanwhile, apatites exposed to KCl had less mass loss during dissolution and retained the crystal structure, A-, B-, and labile CO32− amounts during recrystallization, suggesting that K+ may shield apatites from dissolution. To our knowledge, this is the first study to parse out mechanistic differences between Na+ and K+ on biomimetic carbonated apatite dissolution/recrystallization. Overall, this study will provide insight on how fluctuating Na+ and K+ in saliva may affect tooth mineral composition and structure.

Influence of maternal cholesterol-enriched diet on chemical composition of teeth enamel in offspring of mice.

Aim: To determine the chemical composition of the tooth enamel of two-day-old mice from hypercholesterolemic mothers by energy dispersive X-ray spectroscopy. Materials and Methods: Forty mature female mice were randomly assigned (n = 20/group) to either a standard chow vivarium diet (control group) or a cholesterol-enriched chow diet (experimental group). After fertilization, pregnancy and birth, on postnatal day 2, the incisor segments of 6 pups form each group were used for energy dispersive X-ray spectroscopy. Results: Influence of maternal hypercholesterolemic diet on tooth development and mineralization was examined, which revealed changes in enamel chemical composition. First, the results indicate the presence of seven elements (Na, Cl, Ca, P, Mg, S, Fe) in the enamel of both the hypercholesterolemic and normal offspring, but the content of element Ca2+ decreased, the content of elements P5+, Na+, Cl- tended to increase in pups from hypercholesterolemic mice. Second, the initial level of mineralization according to the atomic (%) Ca / P in hypercholesterolemic pups ratio was 1.26, comparing with normal pups where level of mineralization was 1.34. Taking into account that irreversible changes in the structure of the enamel were observed when the Ca / P ratio was below 1.33, we can suggest that the eruption of teeth with an imperfect structure could be because of maternal hypercholesterolemic diet. Conclusions: Results of this study suggest that hypercholesterolemic diet during gestation and lactation leads to altered enamel mineralization in mice because of changes in chemical composition and may link to the early childhood caries.

Dental and skeletal maturation of Chinese male children with unilateral cleft lip and palate.

The aim of this study was to determine whether the relationship between dental age (DA), cervical stage (CS) and chronological age (CA) in Chinese male children with unilateral cleft lip and palate (UCLP) is similar to that of children without clefts. Panoramic and cephalometric radiographs of 105 male UCLP patients, aged from 8 to 16 years, were collected and compared to 210 age-matched healthy control males. The Demirjian and cervical vertebral maturation (CVM) methods were used to visually examine the radiographs and Spearman's correlation analysis was used to identify differences between the two groups with regards to CS, DA and CA. There was a significant positive correlation between DA and CA in both groups and the mean CA-DA difference was significantly higher in children with UCLP when compared to controls (0.319 vs. 0.003, p < 0.05). A significant delay in tooth development was detected in UCLP children from 10 to 12 years-of-age. Both the UCLP and control groups showed high correlations between CS and DA. Calcification stage D appeared only before CS3; however, from CS5 to 6, all teeth have almost completed their maturation phase. Chinese male UCLP patients are likely to experience delayed tooth development compared to healthy controls, especially during the fast-growing period. Evaluating the stages of tooth mineralization could represent a rapid method to assess growth potential.

An Exploration of Mineral Density, Elemental and Chemical Composition of Primary Teeth in Relation to Cord-Blood Vitamin D, Using Laboratory Analysis Techniques.

Postnatally, severe vitamin D deficiency commonly results in rickets as well as potential defects in tooth mineralization. The effects of milder deficiency on oral health outcomes later in life are still unclear. This study used micro-computed tomography (μCT), energy dispersive X-ray analysis (EDX), and Raman spectroscopy to investigate mineral density, total density, and elemental composition of enamel and dentine in 63 exfoliated primary incisors from participants with known 25-hydroxyvitamin D levels (25-OHD) at birth. No differences in mineralization and chemical composition using μCT and EDX analysis were observed irrespective of 25-OHD status. Subtle structural differences were observed via Raman spectroscopy, with more crystalline enamel observed in those with sufficient 25-OHD at birth. Although subtle, the differences seen suggest further attention should be given to children with known milder levels of vitamin D deficiency in early life. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).