Prevention Of Demineralization Research Articles

Edible thermosensitive chitosan/hydroxypropyl β-cyclodextrin hydrogel with natural licoricidin for enhancing oral health: Biofilm disruption and demineralization prevention

Dental caries, a widespread and significantly detrimental health condition, is characterized by demineralization, pain, compromised tooth functionality, and various other adverse effects. Licoricidin (LC), a natural isoflavonoid, demonstrates potent antimicrobial properties for maintaining oral health. However, its practical application is significantly hindered by its limited water solubility and susceptibility to removal within the oral environment. To tackle this issue, we developed a delivery oral system by an edible thermosensitive chitosan- disodium beta-glycerol phosphate pentahydrate (CS/β-GP) hydrogel to load LC/Hydroxypropyl beta-cyclodextrin (HP-β-CD) inclusion complexes. These hydrogels (LC/HP-β-CD/CS/β-GP) could solidify rapidly at oral temperature and sustainably release LC, thereby preventing its rapid clearance from the oral cavity. We confirmed the significant antibacterial activity of this hydrogel against Streptococcus mutans and Staphylococcus aureus. Additionally, the HP-β-CD combination enhanced LC to penetrate bacterial biofilms and inhibit biofilm growth, leading to leakage of cellular proteins and DNA. Additionally, we studied the effect of LC/HP-β-CD/CS/β-GP on intracellular ROS levels and MMP, comprehensively exploring its antimicrobial mechanism. Furthermore, LC/HP-β-CD/CS/β-GP exhibited the ability to inhibit demineralization and demonstrated excellent biocompatibility. In summary, this study presented a safer approach to oral delivering bioactive substances, offering a promising strategy for enhanced oral health and safety.

Novel orthodontic adhesives with antibacterial, mineralization and fluorescence properties for enamel demineralization prevention

Enamel demineralization is one of the most common adverse effects of fixed orthodontic treatment, mainly because the appliances affect oral hygiene maintenance, potentially leading to plaque accumulation and oral flora dysbiosis. Adhesives are essential for fixed orthodontic treatment, but excessive adhesives on tooth surfaces might be stained aesthetically and serve as additional sites for plaque accumulation. Some research gaps exist for simultaneously addressing orthodontic enamel demineralization and proper adhesive removal. In this study, novel multifunctional orthodontic adhesives (MFOAs) were developed using amino-silane functionalized zinc oxide quantum dots (AF-ZnOQDS) with fluorescence property, antibacterial agent dimethylaminohexadecyl methacrylate (DMAHDM), and mineralizing material 45S5 bioactive glass (BG-45S5) as the modifiers. The three were incorporated into Transbond XT adhesive at different mass fractions and relevant properties were evaluated in vitro and in vivo. The results indicated that the MFOA-3 with 3 wt% AF-ZnOQDS, 5 wt% DMAHDM, and 7.5 wt% BG-45S5 possessed long-term antibacterial ability, dual-mineralization activity, and strong fluorescence properties. It had clinically acceptable physicochemical properties and good biocompatibility, providing a desirable anti-demineralization effect. Therefore, MFOA-3 provides a new strategy to solve the two major challenges of enamel demineralization and proper removal of adhesives during fixed orthodontics, and thus has great value in clinical application.

Efficacy of peptide-based enamel coatings in the prevention of demineralization using fixed orthodontic brackets in a rat model

White spot lesions (WSLs) represent a prominent pathology encountered during orthodontic treatment, originating from enamel demineralization induced by the accumulation of bacterial biofilms. The previously developed bioinspired enamel coating form of self-assembling antimicrobial peptide D-GL13K exhibited antimicrobial activity and enhanced acid impermeability, offering a potential solution to prevent demineralization. The primary aim of this investigation is to assess the invivo anti-demineralization properties and biocompatibility of the D-GL13K coating. A rat model was developed to assess the antimicrobial enamel coating during fixed orthodontic treatment. The anti-demineralization efficacy attributed to the D-GL13K coating was evaluated by employing optical coherence tomography, Vickers microhardness testing, and scanning electron microscopy. The biocompatibility of the D-GL13K coating was investigated through histologic observations of vital organs and tissues using hematoxylin and eosin. The D-GL13K coating demonstrated significant anti-demineralization effects, evidenced by reduced demineralization depth analyzed through optical coherence tomography and enhanced Vickers hardness than in the noncoated control group, showcasing the coating's potential to protect teeth from WSLs. Scanning electron microscopy analysis further elucidated the diminished enamel damage observed in the group treated with D-GL13K. Importantly, histologic examination of vital organs and tissues using hematoxylin and eosin staining revealed no overt disparities between the D-GL13K coated group and the noncoated control group. The D-GL13K enamel coating demonstrated promising anti-demineralization and biocompatibility properties in a rat model, thereby suggesting its potential for averting WSLs after orthodontic interventions. Further research in human clinical settings is needed to evaluate the coating's long-term efficacy.

Effectiveness of fluoride mouthrinse in prevention of demineralization during fixed orthodontic treatment: A systematic review and meta-analysis.

Enamel demineralization is a very common occurrence around bonded brackets in an orthodontic practice. Fluoride (FLR) applications have been used to prevent decalcification and further progression of white spot lesions. The purpose of this systematic review and meta-analysis was to systematically appraise available literature on the effectiveness of fluoride mouthrinse in the prevention of demineralization around fixed orthodontic appliances. A search was conducted for randomized controlled clinical trials among four electronic databases (MEDLINE, Google Scholar, PubMed, and Cochrane Review) through MeSH terms and keywords. Studies were excluded if random allocation was not conducted, or if they were animal or in vitro studies. About 146 articles were screened and 5 studies were selected for the present review. Only two studies were selected for MA due to variations in the measurement of outcomes among studies. This review concluded that rinsing with FLR in the course of the fixed orthodontic treatment lessens demineralization around the bracket. Using FLR mouthrinse to inhibit the formation of white spot lesions or dental caries in patients with multiple cavities or restoration can be considered in clinical practice.

A Comprehensive Narrative Review of Nanomaterial Applications in Restorative Dentistry: Demineralization Inhibition and Remineralization Applications (Part I).

Nanotechnology is extensively employed in various aspects of dentistry, including restorative dentistry, because of its substantial improvement and promising potential in the clinical efficacy of restorative materials and procedures. The main purpose of this review is to explore the different uses of nanomaterials in restorative dentistry. The review is divided into two parts: the current review (Part 1) focuses on the prevention of demineralization and promotion of remineralization, while the upcoming review (Part 2) will discuss the reinforcement of restorative materials and their therapeutic applications. Nanofillers are added to dental materials to boost their antibacterial, anticaries, and demineralization inhibitory capabilities. Additionally, they improve remineralization and enhance both mechanical properties and therapeutic features. The nanoparticles (NPs) used to increase antibacterial and remineralization inhibitions can be classified into two main groups: inorganic and organic NPs. Examples of inorganic NPs include silver, zinc oxide, titanium oxide, and gold. Examples of organic NPs include silica, quaternary ammonium salt monomers, and chitosan NPs. Furthermore, the nanofillers utilized to enhance the process of remineralization include various types such as metals, nano-hydroxyapatite, nano-amorphous calcium phosphate (ACP), dicalcium phosphate NPs, casein phosphopeptide-ACP (CPP-ACP), and calcium fluoride NPs. These uses underscore the potential applications of NPs in restorative dentistry, although there are still some limitations to address.

Some features of prevention of demineralization of hard tissues of teeth during orthodontic treatment of children with dental anomalies

Aim. To study the effectiveness of remineralization and hygienic measures in the prevention of demineralization of hard tissues of teeth when using a fixed orthodontic structure in children and teenagers with dentoalveolar anomalies. Materials and methods. We examined 150 children and adolescents with anomalies of the dentition at the age of 12 to 16 years with fixed orthodontic structures. When starting orthodontic treatment of anomalies of the dentoalveolar system in children, we proceeded from the fact that the treatment and prophylactic methods of education consisted of two stages: 1st stage – general, where they explained in detail how to carry out an individual hygienic procedure in the oral cavity with controlled brushing of the teeth; Stage 2 – specialized, which includes the features of oral care in children with orthodontic appliances in these specific conditions, in accordance with the new dental clinical situation of the oral cavity. Results. The data obtained necessitate the conditions for successful prevention of orthodontic complications during corrective therapy of dentoalveolar anomalies are remineralizing therapy, the correct choice of methods and means of individual oral hygiene.

Effect of composite resin containing antibacterial filler on sugar-induced pH drop caused by whole saliva bacteria

Secondary caries around restorations is a major problem and can be attributed to bacteria invading microgaps formed at the tooth-restoration interface. An antibacterial composite resin containing quaternary ammonium silica (QASi) filler has been reported to inhibit enamel demineralization in situ. However, whether the prevention of enamel demineralization by QASi-containing composite resin is because of the reduced metabolic activity of acid-producing saliva bacteria is unclear. The purpose of this study was to compare the effects of QASi-containing composite resin and 2 other restorative materials on the viability of salivary bacteria and sugar-induced acid production. Whole saliva from each of the 30 study participants, 14 at high risk and 16 at low risk for caries, was brought into contact with quadruplicate specimens of 3 restorative materials, Infinix Flowable Composite, an anti-bacterial composite resin containing 1.5% QASi filler (Nobio), Filtek Supreme Flowable Restorative (3M), a conventional flowable composite resin, and dental amalgam (Silmet). Bacterial growth and sugar-induced acid production on each restorative material were measured every 20 minutes for 18 hours. Caries risk groups were compared using the t test and repeated measures analysis of variance (α=.05). When significant, Bonferroni multiple comparisons were used. On average, the saliva with the QASi-containing composite resin specimens maintained a near-neutral pH, not dropping below pH 6.0. The saliva associated with both conventional restorative materials exhibited a pH drop below 5.5 (P<.001), the critical threshold for tooth demineralization according to the Stephan curve. Virtually no growth was measured on the surface of the antibacterial composite resin, whereas bacteria grew on the conventional composite resin and dental amalgam (P<.001). No differences were observed between participants at high and low risk of caries. Unlike amalgam and conventional composite resin, the QASi-containing composite resin showed a near-complete shutdown of the metabolic activity of salivary bacteria upon contact and virtually no bacterial viability. This suggests that the prevention of tooth demineralization by QASi-containing restoratives is associated with a significant reduction in bacterial metabolic activity.

In Vitro Evaluation of the Bond Strength of Metal Brackets Adhered to Different Dental Restorative Materials using Different Orthodontic Adhesives

ABSTRACT Background: During orthodontic treatment, teeth with brackets may sometimes be restored with different restorative materials. In this case, the content of the orthodontic adhesive selected for bracket bonding may also be important. Aim: This study compared the bond strength of metal orthodontic brackets adhered to different resin composite and glass ionomer cement (GIC) restoration surfaces with glass ionomer-based and resin-based orthodontic adhesives to determine the best orthodontic adhesive for use in restored teeth. Material and Methods: This study prepared 80 discs. Four material groups of 20 discs were created: reinforced high-viscosity GIC, high-viscosity GIC, flowable bulk-fill resin composite, and nanohybrid resin composite. Specimens in each material group were divided into two subgroups that differed in the orthodontic adhesive used to bond the brackets to the prepared specimens. After 24 hours, the specimens were shear bond strength (SBS) tested at 1 mm/min using a universal tester. Results: The SBS of glass ionomer-based orthodontic adhesive differed significantly between metal brackets adhered to different bases (P &lt; 0.001). The highest SBSs were observed between metal brackets and high-viscosity glass ionomer restorations (6.79 ± 2.38). The highest SBSs observed with a resin-based orthodontic adhesive were between metal brackets adhered to nanohybrid resin composite restorations (8.84 ± 2.10; P = 0.030). Conclusions: Glass ionomer-based orthodontic adhesive provided safer bond strength and demineralization prevention when applying metal brackets to teeth with glass ionomer restorations.

Photodynamic nano hydroxyapatite with biofilm penetration capability for dental plaque eradication and prevention of demineralization

Dental caries represents one of the most prevalent diseases worldwide, characteristic of the growth of dental plaque and demineralization of tooth enamel. Current medications for eradication of dental plaques and prevention of demineralization suffer from several limitations to overcome, calling for novel strategies with great potency in eliminating cariogenic bacteria and dental plaque that forms, as well as in inhibiting the demineralization of enamel, into an integrated system. Considering the potency of photodynamic therapy in bacteria inactivation and the composition of enamel, we herein report that the novel photodynamic nano hydroxyapatite (nHAP), named Ce6 @QCS/nHAP, was useful for this purpose. Ce6 @QCS/nHAP, comprised of quaternary chitosan (QCS)-coated nHAP loaded with chlorin e6 (Ce6), exhibited good biocompatibility and non-compromised photodynamic activity. In vitro studies revealed that Ce6 @QCS/nHAP could effectively associate with cariogenic Streptococcus mutans (S. mutans), leading to a significant antibacterial effect through photodynamic killing and physical inactivation against the planktonic microbe. Three-dimensional fluorescence imaging suggested that Ce6 @QCS/nHAP exhibited a superior S. mutans biofilm penetration capacity to free Ce6, resulting in effective dental plaque eradiation when light irradiation was applied. The number of surviving bacteria in biofilm was at least 2.8 log units lower in the Ce6 @QCS/nHAP group compared to that in the free Ce6 group. Further, in the S. mutans biofilm-infected artificial tooth model, treatment with Ce6 @QCS/nHAP also resulted in the significant prevention of hydroxyapatite disks from demineralization, with lower percentage of fragmentation and weight loss These data suggest that our photodynamic nanosystem can effectively eradicate dental plaque while also significantly protecting artificial tooth from demineralization, opening up new possibilities in treating bacterium-associated dental caries.

Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study

BackgroundThis study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth.MethodsForty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey’s post hoc test were used at p ≤ 0.05 to identify significant differences.ResultsInsignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish.ConclusionsIn primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.

Regenerative biomineralization potential of commercially available remineralizing agents as a preventive treatment approach for tooth erosion - An in vitro laser-induced breakdown spectroscopy analysis.

In today's era, erosion is the most prevalent type of tooth wear. The prevention of demineralization with biomineralization is the most desired treatment. The aim of this study is to evaluate and compare the surface remineralization potential of two remineralizing agents - self-assembling peptide P11-4 (SAP P11-4) and calcium silicate plus sodium phosphate (CSSP) salts on intact and demineralized enamel using laser-induced breakdown spectroscopy (LIBS). Sixteen maxillary premolars were decoronated and split into buccal and palatal halves embedded in acrylic resin with a total sample size of 32 designated into Group 1 (intact teeth) and Group 2 (demineralized teeth). Further subdivision into Groups 1a and 2a (SAP P11-4 group [n = 8]); Groups 1b and 2b (CSSP group [n = 8]), Group 2 was first exposed to Coca-Cola. Then, all groups were subjected to experimental LIBS. Groups 1a and 2a were treated with SAP P11-4 based product, i.e., CURODONT™ PROTECT gel. Groups 1b and 2b were treated with CSSP-based products regimen, i.e., REGENERATE Enamel Science™ Advanced Toothpaste and Advanced Enamel Serum. The LIBS assessment was redone for all groups to attain a change in Ca and P values. Inferential statistics were done using Wilcoxon signed-rank test (Before-After product application) and Mann-Whitney U-test (between the groups). According to the statistical evaluation there was a statistically significant difference (P < 0.05), in Ca and P values in demineralized teeth when both SAP P11-4 and CSSP groups were evaluated. Although Ca values exhibited a significant difference in intact teeth, P did not exhibit a significant difference on the application of both remineralizing agents. The remineralizing potential between the two agents, SAP P11-4 and CSSP groups. There was no statistically significant difference ( P <0.05) observed between the two agent's remineralization potential for intact and demineralized teeth. SAP P11-4 and CSSP have the potential to remineralize both intact and demineralized enamel. There was increased remineralization in demineralized samples subjected to erosion.

Protection against Dental Erosion and the Remineralization Capacity of Non-Fluoride Toothpaste, Fluoride Toothpaste and Fluoride Varnish

Introduction: The oral cavity and the teeth are frequently subjected to numerous physiological pH variations, mainly due to the type of diet. These changes are the main cause of enamel demineralization and consequent breakage under mechanical forces. This causes severe sensitivity and sometimes pain, which endures unless the hard tissue is remineralized. Since enamel does not self-repair, the application of alloplastic materials that have the property of releasing remineralizing ions is strongly recommended. The aim of this in vitro study is to evaluate the effectiveness of two different toothpastes and a fluoride varnish in the prevention of demineralization, and their ability to remineralize enamel after it has undergone several acidifications. Methods: Eight human teeth with no caries or defects were prepared. The acid attack simulations were performed using a commercial cola carbonated drink. Samples were immersed in 5 mL of soft drink for two minutes at room temperature, and then were rinsed with distilled/deionized water. The immersion process lasted about 2 min, and was repeated four times for a total of eight minutes. Then, two different types of toothpaste, one with and one without fluoride, and a fluoride varnish were applied to the surfaces of the samples and rinsed off with demineralized water. A second acidification cycle was then carried out, with the subsequent reapplication of the three different products to evaluate their ability to protect against demineralization. SEM and profilometer analysis were then carried out to evaluate the results. Results: The statistical analysis showed a good remineralization capacity for all three products, especially in the fluoride-varnish-treated samples. However, regarding protection from demineralization, non-fluoride toothpaste was found to be ineffective, while fluoride toothpaste and varnish produced positive results. Conclusions: Dental professionals should advise fluoride toothpastes and varnishes over non-fluoride toothpastes. Fluoride toothpastes and varnishes represent a valid treatment for surface remineralization after a first acid attack and for protection from subsequent demineralization in an acid environment, such as that which can develop in the oral cavity.

Resin-modified glass ionomer enriched with BIOGLASS: Ion-release, bioactivity and antibacterial effect.

Developing dental materials for the prevention of remineralization or demineralization is important for high-risk caries patients. This study aimed to evaluate the physicochemical and microbiological effects of adding 45S5 bioglass to resin-modified glass ionomer cement (RMGIC). Samples belonged to the following groups: GIC: conventional glass ionomer cement (Vitro Fil), RMGIC: resin-modified GIC (Vitro Fil LC), and RMGIC/45S5: RMGIC with 10% (wt%) of 45S5. Changes in pH and release of fluoride, calcium, and phosphorus ions under acidic (pH4) and neutral (pH7) pH conditions were evaluated. Antibacterial activity was verified based on colony-forming units. Material sorption and solubility were analyzed after bacterial exposure. After 28 days, the bioactivity of the materials was evaluated using scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS). Analysis of variance, post hoc Scheffe, and Tukey (α=0.05) tests were employed for statistical analysis. RMGIC/45S5 showed higher alkalization activity, calcium release at pH4 and 7, and sorption than GIC and RMGIC (p < .05). Release of phosphorus and fluoride at pH4 and 7 was higher for GIC than that for RMGIC and RMGIC/45S5 (p < .05). RMGIC/45S5 showed higher values than RMGIC (p < .05). However, antibacterial activity did not differ among the groups. Precipitates of calcium and phosphorus were visualized in RMGIC/45S5 samples via SEM/EDS. These results indicate that the RMGIC/45S5 promotes alkalization and increases the release of calcium, phosphorus, and fluoride ions, resulting in precipitate deposition rich in calcium and phosphorus, thereby being a promising option to improve the bioactivity of RMGIC.

Effect of calcium fluoride nanoparticles in prevention of demineralization during orthodontic fixed appliance treatment: a randomized clinical trial.

White spot lesions (WSLs) are the most common complications of fixed appliance orthodontic treatment. To evaluate the effectiveness of calcium fluoride nanoparticles-containing orthodontic primer (nCaF2-primer) in preventing the incidence of WSLs during orthodontic treatment. Single-centre, double-blinded, split-mouth, randomized clinical trial. The sample involved 31 orthodontic patients (≥12 years). Participants were recruited using a simple nonstratified randomization. Data collection, measurements, and analysis were performed blindly. Outcome measures included comparing the effect of nCaF2-primer with control primer (Transbond) regarding the degree of demineralization (DIAGNOdent pen), Streptococcus mutans (S. mutans) bacterial counting [real-time polymerase chain reaction device (PCR)], and WSLs incidence (pre- and post-operative photographs). The measurements were performed before bonding, 1, 3, and 6 months after bonding and after appliance removal. A two-way repeated measure analysis of variance test (for DIAGNOdent pen scores), and Wilcoxon signed-rank test (for the difference between bacterial counting and WSLs incidence) were used (P < 0.05). Thirty-one patients were recruited and randomized (mean age 17.9 ± 2.45 years). For the primary outcome (DIAGNOdent pen scores) and secondary outcome of S. mutans counting: 31 patients (310 teeth for each group) were included in scoring at T1 and T3, and 30 patients (300 teeth) were included at T6. While for the photographic scores, 26 patients were included after bracket bonding. The demineralization scores showed significant differences at all-time intervals within the 6 months after bracket bonding which was more noticeable after the first month. There was a significant difference in bacterial count between the two primer groups at the T1 only. Regarding photographic scores, there were no significant differences in the WSLs incidence between the two primers groups after brackets removal. No harm was detected during treatment, except the usual pain/gingival irritation. nCaF2-primer effectively decreased demineralization scores within the 6 months after bracket bonding. Moreover, it significantly reduced S. mutans colonization after the first month. However, the tested primer did not have an extra advantage in preventing WSLs development at the clinical level after appliance removal. The trial was registered with ClinicalTrials.gov on 8 May 2021 (registration number: NCT04994314).

Dual Action Nitric Oxide and Fluoride Ion-Releasing Hydrogels for Combating Dental Caries.

Demineralization and breakdown of tooth enamel are characterized by a condition called dental caries or tooth decay, which is caused by two main factors: (1) highly acidic food intake without proper oral hygiene and (2) overactive oral bacteria generating acidic metabolic byproducts. Fluoride treatments have been shown to help rebuild the hydroxyapatite structures that make up 98% of enamel but do not tackle the bacterial overload that continues to threaten future demineralization. Herein, we have created a dual-function Pluronic F127-alginate hydrogel with nitric oxide (NO)- and fluoride-releasing capabilities for the two-pronged treatment of dental caries. Analysis of the hydrogels demonstrated porous, shear-thinning behaviors with tunable mechanical properties. Varying the weight percent of the NO donor S-nitrosoglutathione (GSNO) within the hydrogel enabled physiologically actionable NO release over 4 h, with the fabricated gels demonstrating storage stability over 21 days. This NO-releasing capability resulted in a 97.59% reduction of viable Streptococcus mutans in the planktonic state over 4 h and reduced the preformed biofilm mass by 48.8% after 24 h. Delivery of fluoride ions was confirmed by a fluoride-sensitive electrode, with release levels resulting in the significant prevention of demineralization of hydroxyapatite discs after treatment with an acidic demineralization solution. Exposure to human gingival fibroblasts and human osteoblasts showed cytocompatibility of the hydrogel, demonstrating the potential for the successful treatment of dental caries in patients.

Effect of CPP-ACP modified-GIC on prevention of demineralization in comparison to other fluoride-containing restorative materials.

This study evaluated the ability of a CPP-ACP-modified Glass-ionomer cement (GIC) to inhibit demineralization around the margins of cervical cavities in natural teeth in comparison with a Giomer and conventional GIC with and without coating. Thirty-two sound human molars were used. Box-shaped cavities were prepared along the CEJ. Teeth were randomly divided into four groups and restored with Equia Forte Fil, Coated Equia Forte Fil, Fuji VII EP or Beautifil II. Teeth were subjected to pH cycling. Micromorphological and elemental analyses were done using SEM and EDX. Polarized light microscope analysis and microhardness tests were also performed. Microhardness tests on enamel showed a significant difference between the coated Equia group, Equia and Beautifil II groups (P &lt; 0.05). Dentine results showed significant differences between the coated Equia group and all other groups (P &lt; 0.05). Elemental analysis showed significant differences in calcium weight percentage among the first and second observation levels in all groups (P &lt; 0.05). A significant difference was found between the coated Equia group and the other three groups (P &lt; 0.05). All tested materials showed some ability to resist demineralization at the restoration margins. The coated GIC restoration showed better outcomes compared with the other tested materials.

Prevention of demineralization during multi-bracketed fixed orthodontic treatment: An overview of systematic reviews.

Demineralization during multi-bracketed fixed orthodontic treatment is a well-known problem. To systematically evaluate the evidence for the prevention of enamel demineralization during multi-bracketed fixed orthodontic treatment. Systematic reviews (with or without meta-analysis) that have appraised the primary studies on the prevention of demineralization during multi-bracketed fixed orthodontic treatment were searched systematically and included as per pre-defined eligibility criteria. The risk of bias of the included reviews was assessed by two authors using the ROBIS tool and AMSTAR-2 tool. Twenty-nine reviews conducted on 128 exclusive primary studies were included for the present overview; 23 of these reviews were assessed to be of a high risk of overall bias, 5 were of low risk, and 1 review was of unclear risk of bias. Predominantly, the published reviews have focused on fluorides, whereas some reviews have also studied the role of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), reminder therapy, lasers, and sealants. Professional fluorides, sealants, reminder therapy, and lasers might be valuable interventions to prevent demineralization during orthodontic treatment based on the conclusions of reviews with high quality; however, further studies are required to elucidate the role of CPP-ACP, chlorhexidine varnish, and powered toothbrushes.

THE EFFECTIVENESS OF COMPOMER AND GIC AGAINST PREVENTION IN ENAMEL DEMINERALIZATION

Background: Several studies showed that fluoride interferes in the dynamics involved in the development of caries and could present an antimicrobial effect or provide demineralization inhibition or dental remineralization. The development of fluoride-releasing materials can contribute to a preventive of demineralization. GIC and Compomer are restorative materials containing fluoride which can prevent demineralization. Purpose: To analyze the effectiveness of Compomer and GIC against prevention in enamel demineralization. Method: The cavities were made on 18 bovine teeth which grouped into 3 groups, each group consisting of 6 bovine teeth. After the restorative procedures, the teeth were submitted to demineralization and remineralization cycling during 14 days. The sections of the teeth were examined under scanning electron microscope after undergoing pH cycling. The data were analyzed using the Kruskal-Wallis and Tukey Test (p&lt;0.05). Results: GIC group showed the lowest lesion depth of demineralization (10.9883 ± 0.74333) followed by Compomer group (25.4183 ± 3.44268) and Control group (88.9783 ± 3.02495). Conclusion: GIC restorative materials have a better enamel demineralization prevention effect than Compomer. Keywords: compomer, demineralization, fluoride, GIC, remineralization

Quantitative Analysis and Effect of SDF, APF, NaF on Demineralized Human Primary Enamel Using SEM, XRD, and FTIR.

IntroductionTopical fluoride therapy has proven benefits in the prevention of demineralization. Tooth enamel has shown a great potential for remineralization with an application of topical fluorides if administered at an appropriate time. In an effort to find an effective remineralizing agent, a novel fluoride agent silver diamine fluoride (SDF) has emerged as a potent caries arresting as well as caries preventing agent.Aim and objectiveThe present study was aimed at determining the primary tooth enamel resistance to demineralization after topical application of three fluoride agents SDF, APF, and NaF.Materials and methodsEnamel specimens were prepared from 40 caries-free primary molars. These specimens were randomly allocated into three groups of 10 specimens each and they were treated by different topical fluorides namely: Group I–SDF, group II–Acidulated phosphate fluoride (APF), group III–Sodium fluoride. Three enamel specimens from each group were placed on custom-made acrylic blocks with 5 × 5 mm of an exposed window for scanning electron microscope (SEM) evaluation and rest of the specimens were ground into a fine powder for X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) analysis. The tooth blocks and treated samples were subjected to the demineralization process for 168 hours. They were then qualitatively assessed to evaluate their resistance to demineralization using SEM, XRD, and FTIR.Results and conclusionMorphologically, the enamel of all groups specimens was mostly smooth with some groves and microporosities. Chemically, the Ca/P molar ratios of all groups were similar with slight variations. Structurally, the crystalline phases found in enamel by powder XRD were hydroxyapatite and carbonate apatite; and there was a higher amount of incorporated type B carbonate than type A carbonate as evidenced by FTIR. The study concludes that topical application of a 38% SDF solution can inhibit demineralization of enamel.How to cite this articleJabin Z, Nasim I, Vishnu Priya V, et al. Quantitative Analysis and Effect of SDF, APF, NaF on Demineralized Human Primary Enamel Using SEM, XRD, and FTIR. Int J Clin Pediatr Dent 2021;14(4):537–541.

Effect of TiF4/NaF and chitosan solutions on biofilm formation and prevention of dentin demineralization

ObjectiveThis study evaluated the effect of experimental solutions containing TiF4/NaF and chitosan on bacterial species of microcosm biofilm and on dentin demineralization. DesignMicrocosm biofilm was produced from human saliva mixed with McBain medium (0.2% sucrose) on bovine dentin for 5 days, under 5% CO2 and 37 °C. From the 2nd day to 5th day, the treatments were applied (1×60s/day) as following: (1) NaF (500 ppm F−, positive control); (2) TiF4 and NaF (TiF4: 190 ppm Ti4+ and 300 ppm F-; NaF: 190 ppm F−); (3) similar to 2 plus 0.5% chitosan (Ch 500 mPa.s, 75% deacetylation); (4) phosphate buffer solution (negative control); and (5) 0.5% chitosan (Ch 500 mPa.s, 75% deacetylation). CFU counting was performed for total microorganism, total streptococci, total lactobacilli and mutans streptococci. Dentin demineralization was measured by transverse microradiography-TMR. The data were compared using ANOVA/Tukey or Kruskal-Wallis/Dunn tests (p < 0.05). ResultsNo differences were found between the treatments with respect to CFU counting (p > 0.05). Dentin treated with TiF4/NaF plus chitosan solution presented the lowest demineralization compared to the negative control and pure chitosan solution. On the other hand, this experimental solution did not significantly differ from TiF4/NaF solution, being both able to significantly reduce mineral loss. ConclusionTiF4/NaF plus chitosan solution, at suitable pH to be clinically applicable, had no antimicrobial effect, but it was able to reduce dentin caries development under this model.