Enamel Of Primary Teeth Research Articles

Effect of various remineralising agents on human eroded enamel of primary teeth

To determine the effect of three remineralising agents on human primary anterior teeth, i.e. CPP-ACP, CPP-ACPF, fluoridated toothpaste and artificial saliva as control. Forty primary maxillary anterior teeth were divided into four groups: Group I: CPP-ACP, Group II: CPP-ACPF and Group III: fluoridated toothpaste as experimental and Group IV: artificial saliva as control. The samples were immersed in cola soft drink and artificial saliva for 10 cycles of 5s each. After erosive procedure, a thin layer of CPP-ACP, CPP-ACPF or fluoridated toothpaste were applied to the tooth surfaces for 3min, and kept in artificial saliva for 8h. Samples in the control group were directly kept in artificial saliva without any treatment. The Knoop microhardness of the labial surface of enamel was measured at baseline, after erosion and after the remineralisation procedures. No significant differences were observed among the different groups at pre-erosion and post-erosion intervals. However, after remineralisation, mean microhardness in different groups was significantly higher in Group II as compared to all the other groups (p<0.001). Group IV had significantly lower mean microhardness as compared to all the other groups (p<0.001). The collected data were statistically analysed using ANOVA test followed by Tukey's HSD test as the post-hoc tests to compare the differences in mean microhardness at different time intervals. Paired t test was used to assess the change in mean microhardness within a group. CPP-ACPF showed the best remineralisation potential.

Effect of a sugar-free pediatric antibiotic on primary tooth enamel hardness when exposed to different sucrose exposure conditions in situ

This in situ study aimed to investigate the effect of a sugar-free antibiotic suspension containing amoxicillin and clavulanic acid on enamel hardness of human primary teeth simulating different conditions of cariogenic challenge. A crossover, partially double-blind study was conducted in three phases of 14 days each, during which 11 volunteers wore palatal devices containing six dental enamel blocks covered with plastic meshes to allow biofilm formation. Dental blocks were extraorally submitted to treatment with a 20 % sucrose solution at three different daily frequencies of exposure (0, 3, and 8 times/day), and to the antibiotic suspension or its excipients at an 8-h time interval application regimen. On the 14th day of each phase, the blocks were removed for enamel analysis (surface and cross-sectional microhardness--SMH and CSMH). The antibiotic suspension showed significant higher SMH and CSMH values than the excipients (p < 0.05; Wilcoxon), regardless of the frequency of sucrose exposure. Sucrose exposure did not account for further enamel demineralization both for antibiotic and excipients (p > 0.05; Friedman). A protective effect of the antibiotic suspension on enamel demineralization was verified because its excipients alone promoted more pronounced surface and subsurface enamel demineralization, even in the absence of sucrose exposure. The use of a sugar-free amoxicillin/clavulanic acid suspension may promote a protective effect on primary enamel demineralization probably due to its topical effect on dental biofilm.

Dental Enamel Irradiated with a Low-Intensity Infrared Laser and Photoabsorbing Cream: A Study of Microhardness, Surface, and Pulp Temperature

The aim of this study was to assess the effect of low-intensity infrared laser light (λ=810 nm, 100 mW/cm(2), 90 sec, 4.47 J/cm(2), 9 J) with or without indocyanine green cream fluorinated or not fluorinated, using Knoop surface microhardness analysis. Lasers can be used as tools for the prevention of tooth enamel demineralization. The surface and pulp temperatures of the human deciduous tooth enamel were measured. For the analysis of surface hardness, a total of 48 specimens were prepared and randomly assigned into six groups (n=8/group): C (+), which received laser light; C(-), which received no treatment; cream (IV); cream and fluoride (IVF); cream and light (IVL); and cream and fluoride and light (IVFL). The specimens were subjected to treatment before demineralizing challenge by pH cycling. To analyze the surface and pulp temperatures, the samples were divided into the following groups (n=10): C(+), IVL, and IVFL. The hardness analysis indicated that the groups that received irradiation had less hardness reduction following the demineralizing challenge (p<0.001), with IVFL and IVL presenting the lowest percentages of surface microhardness loss at 3.98% and 9.3%, respectively. Surface temperature analysis indicated a maximum increase of 74°C and a mean of 45.25°C and 45.95°C for the IVL and IVFL groups, respectively. Pulp temperature analysis indicated a higher mean increase of 2.40°C±0.65 in the IVL group. These results suggest that the combination of cream and laser light possibly promoted protein denaturation of the tooth enamel organic matrix, which possibly decreased the loss of hardness without causing pulp damage.

Bond Durability of Er:YAG Laser-Prepared Primary Tooth Enamel

This study evaluated in vitro the influence of thermocycling and water storage (WS) on the shear bond strength (SBS) of composite resin in cavities prepared in primary tooth enamel with conventional bur or Er:YAG laser. The test surfaces were obtained from 48 primary molars and randomly assigned to 2 groups (n=24), according to cavity preparation: A: bur-preparation and B: Er:YAG laser irradiation. The specimens were restored with an etch-and-rinse adhesive system and composite resin. Each group was divided into 4 subgroups (n=6) according to WS duration and number of thermal cycles (TCs): I: 24 h WS/no thermocycling; II: 7 days WS/500 TCs; III: 1 month WS/2,000 TCs; IV: 6 months WS/12,000 TCs. The specimens were tested to failure in shear strength at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by two-way ANOVA and Tukey's test. SBS means (S.D.) in MPa were: AI: 17.45 (2.03), AII:16.38 (1.49), AIII: 6.88 (0.66), AIV: 7.77 (1.53), BI: 12.32 (0.99), BII: 15.37 (2.24), BIII: 15.05 (2.01) and BIV-5.51 (1.01). WS duration and number of TCs influenced significantly the SBS values only for BIV (p<0.05). AI presented the highest SBS value, which was statistically similar to those of AII, BII and BIII. In conclusion, the adhesion of an etch-and-rinse adhesive to Er:YAG laser-irradiated primary tooth enamel was affected by the methods used to simulate degradation of the adhesive interface only when 6 months WS/12,000 TCs were employed.

Perinatal factors associated with developmental defects of enamel in primary teeth: a case-control study

The present study was designed to evaluate associations between developmental defects of enamel (DDE) in the primary dentition and aspects related to mothers and preschoolers in the city of Diamantina, Brazil. A case-control study was carried out involving children aged three to five years. The case group was composed of 104 children with at least one dental surface affected by DDE. The control group comprised 105 children without DDE, matched for gender and age. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel Index. Information was collected through interviews investigating socio-demographic aspects, gestation, birth weight, prematurity and breastfeeding. Simple and multiple regression analyses were performed, providing unadjusted and adjusted prevalence ratios (Poisson regression). DDE were more prevalent among children who had not been breastfed (PR=1.57; 95% CI: 1.1-2.2) and those whose mothers were under 24 years of age at the birth of the child (PR=1.41; 95% CI: 1.1-1.9). The prevalence of DDE in the primary dentition was higher among children who had not been breastfed and those whose mothers were under 24 years of age at the birth of the child.

Developmental defects of enamel in primary teeth and association with early life course events: a study of 6–36 month old children in Manyara, Tanzania

BackgroundChildren with low birth weight show an increased prevalence of developmental defects of enamel in the primary dentition that subsequently may predispose to early childhood caries (ECC).Focusing 6–36 months old, the purpose of this study was to assess the frequency of enamel defects in the primary dentition and identify influences of early life course factors; socio-demographics, birth weight, child’s early illness episodes and mothers’ perceived size of the child at birth, whilst controlling for more recent life course events in terms of current breastfeeding and oral hygiene.MethodsA cross-sectional study was conducted in the high fluoride area of Manyara, northern Tanzania including 1221 child-mother pairs who attended Reproductive and Child Health (RCH) clinics for immunization and/or growth monitoring. After the primary caregivers had completed face to face interviews at the health care facility, children underwent oral clinical examination whereby ECC and developmental defects of enamel were recorded using field criteria. All erupted teeth were examined and the enamel defects were assessed on buccal surfaces according to the modified DDE Index.ResultsThe prevalence of enamel defects was 33.3%. Diffuse opacities were the most common defects identified (23.1%), followed by hypoplasia (7.6%) and demarcated opacities (5.0%). The most frequently affected teeth were the upper central incisors (29.0% - 30.5%), whereas lower central incisors (4.3% to 4.5%) were least frequently affected. Multiple logistic regression analysis, adjusting for confounding the factors revealed that having normal birth weight (equal or more than 2500 g) associated with lower odds of having enamel hypoplasia [OR 0.2 (95% CI 0.1-0.7)]. No statistically significant association occurred between birth weight and diffuse opacities, demarcated opacities or combined DDE.ConclusionChildren with the history of low birth weight were more likely than their normal birth weight counterparts to present with enamel hypoplasia. In view of the frequent occurrence of enamel defects and the fact that hypoplasia may constitute a risk factor for future ECC, enamel defects should be included as a dental health indicator in epidemiological studies of children in northern Tanzania.

Agreement between photographic and clinical examinations in detecting developmental defects of enamel in infants

This study assesses the reliability of photographic method with clinical examinations in detecting developmental defects of enamel (DDE) in the anterior primary teeth of infants. The study sample was a part of an ongoing longitudinal study to assess risk factors for early childhood caries, and consisted of 138 and 238 infants who had scheduled follow-up visits at approximately 8 and 18-20 months corrected age, respectively. The modified DDE Index was used to record enamel defects (opacity, hypoplasia, and all types of defects) on anterior primary teeth by trained dentist examiners. Photographs of the teeth were taken using a digital camera. Statistical analysis included Cohen's Kappa for reliability, and McNemar test and paired t-test for comparison between photographic and clinical examinations. The level of agreement between clinical and photographic methods was fair to moderate with Kappa values ranging from 0.252 to 0.514. The photographic examination detected significantly more DDE than the clinical examination regardless of age group and type of DDE. The intra- and inter-examiner reliability of the photographic method was excellent with Kappa values ranging from 0.638 to 0.927. Within the limitation of this study, the photographic method can be a sound approach for verifying the diagnosis of DDE.

Deproteinization Treatment on Bond Strengths of Primary, Mature and Immature Permanent Tooth Enamel

The aim of this study was to examine the effect of pre-post deproteinization treatment with 5% sodium hypochloride on shear bond strength (sbs) of adhesive resin to primary, immature and mature permanent teeth enamel. 30 teeth were used for each of primary, immature and mature permanent teeth groups. (totally 90). In control groups, enamel was etched for 60s with 37% phosphoric acid (3M) and rinsed for 10s (Procedure A). In experimental groups, deproteinization was applied with 5% NaOCI solution for 120s before (Procedure D+A) and after acid-etching (Procedure A+D). Gluma Comfort Bond (Heraeus-Kulzer) and Charisma (Heraeus-Kulzer) composite resin were applied to etched enamel surfaces. Data were determined with Two-Way ANOVA and LSD Multiple Comparison Test (p < 0.05). SBS was significantly lower in primary and immature permanent teeth than mature permanent teeth (p < 0.05). "Procedure A+D" statistically increased sbs values in primary and immature permanent teeth (p < 0.05). Deproteinization after acid etching significantly enhanced the shear bond strength values in primary and immature permanent teeth.

Microstructures and Mechanical Characteristics of Enamel and Dentin of Primary and Permanent Teeth

Objective: To investigate the microstructures and mechanical characteristics of enamel and dentin of primary and permanent teeth by AFM, analyze their relationships and provide information for bionics and designs of dental materials. Methods: After embedding, cutting and grinding, 10 primary teeth and 10 permanent teeth were randomly divided into four groups. The morphology of samples was obtained by AFM and the roughness and Young’s modulus were calculated by JPK DP Data processing version 4.0 software. Results: In permanent teeth groups, the enamel rods arrange more tightly than those in primary teeth groups. The roughness of primary enamel （1203±39.5nm）was higher than permanent teeth（954.6±30.5nm）.The Young′s modulus of enamel in primary teeth（80.4±7.7GPa）was lower than permanent teeth（90.8±2.2GPa）. The roughness of dentin in primary teeth （1695±67.6nm）is higher than permanent teeth （1210±45.3nm）and the Young′s modulus of dentin in primary teeth（19.8±1.9 GPa）was lower than the permanent teeth （23.1±1.0 GPa）. Conclusions: The mechanical characteristics of primary and permanent teeth are closely related to their microstructures.

The Effect of the Addition of Tricalcium Phosphate to 5% Sodium Fluoride Varnishes on the Microhardness of Enamel of Primary Teeth

Aim. The aim of this study was to compare the effect of pH cycling on the microhardness of the enamel of primary human teeth treated with a conventional brown Sodium Fluoride (5% NaF) Varnish to those treated with a white Fluoride Varnish (5% NaF) enhanced with functionalized tricalcium phosphate (fTCP). Materials and Methods. Ninety extracted caries-free primary incisors were washed in a detergent and divided into three groups; group A received no treatment, teeth in group B were coated with Sodium Fluoride (5% NaF) Varnish, while teeth in group C were coated with 5% NaF varnish enhanced with functionalized tricalcium phosphate (fTCP). After ten days of pH cycling, the surface microhardness of the teeth was measured using a Knoop indenter. Results. The mean Knoop hardness number (KHN) of 5% NaF with fTCP was greater than that of 5% NaF alone while the control group had the lowest mean KHN. Conclusion. The results of this study suggest that the use of an additive such as fTCP to a fluoride varnish significantly improves the protective ability of the varnish on primary teeth in vitro.

Effect of ammonium hexafluorosilicate application for arresting caries treatment on demineralized primary tooth enamel

Ammonium hexafluorosilicate (AHF) has been applied to arrest caries without discoloration. The purpose of this study was to observe structural and elemental changes of demineralized and AHF applied primary tooth enamel. Enamel from the labial surface of 20 primary canines was divided into an unground side and ground side at the center of the tooth, and demineralized with 35% phosphoric acid for 6 min. The teeth were divided into 4 groups according to a 3-min application of AHF and 1 week of soaking in artificial saliva, as follows: group A (neither AHF nor saliva), group B (only saliva), group C (only AHF), and group D (AHF and saliva), and then subdivided according to whether the enamel was ground or unground. Specimens were analyzed with scanning electron microscopy (SEM) and energy dispersive X-ray spectrometry (EDS). The data were statistically analyzed using ANOVA and Fisher's PLSD test at α = 0.05. In groups A and B, prism structures were seen, however, in groups C and D, enamel surfaces were covered with spherical particles. Ca/P ratio was significantly higher in groups C and D than in groups A and B. There was no significant difference between ground and unground enamel in the content of any element. The values for F, Na, Mg and Si persents and Ca/P ratio were significantly higher for the enamel surface than for points 10-30 µm beneath the surface. Results of this study suggest the possibility that AHF treatment arrests caries, although further study will be required to confirm this result.

Determination of bond strengths of a composite resin material polymerized with halogen and LED light sources which has bonded to enamel of primary teeth with total and self-etch bonding systems

Determination of bond strengths of a composite resin material polymerized with halogen and LED light sources which has bonded to enamel of primary teeth with total and self-etch bonding systems

The relation between enamel defects in deciduous teeth, nutritional status and the development of basic skills in children with small for gestational age

Introduction: Small for Gestational Age (SGA) babies are those whose birth weight are less than 2 SD or below the 10th percentile curve of Lubchenco intrauterine growth and development. The cause of SGA is due to an Intra-uterine growth restriction (IUGR). IUGR inhibits the development of various organs, including the enamel of deciduous teeth and the central nervous system (CNS). The research aims to analyzed correlation between enamel defects in deciduous teeth, nutritional status and the development of basic skills in children with SGA. Methods: A total of 28 SGA children aged between 3-6 years were obtained from Hasan Sadikin Hospital. The sample comprised of 20 boys and 8 girls to be studied for tooth enamel defects in deciduous teeth, weight, height and development basic capabilities. Study design was descriptive and analytical, with cross-sectional study. Scoring modification Developmental Defect of Enamel (DDE) of the FDI was used to assess the enamel defects in deciduous teeth. Enamel Defect Score (EDS) was calculated according to the Willyanti’s formula. The nutritional status was measured by measuring height, weight, and age and converted to the diagram of Body Mass Index (BMI) / Age of the WHO Child Growth Standards. While the development of SGA children basic skills was measured using pre- screening questionnaire development (KPSP). To determine the linkage between enamel defects in deciduous teeth and nutritional status with basic skills development in SGA children, the non-parametric statistical analysis of Kendall’s Coefficient of Concordance was performed. Results: Statistical test results showed that Kendall’s Coefficient of Concordance (W) = 1.00 is statistically significant with Chi-square value = 56.00 with p (value) &lt;0.01. Conclusion: There is a significant relationship between EDS and nutritional status with the SGA children development of basic skills as well as the development of the child’s ability.

Congenital Rubella Syndrome: Dental Manifestations and Management in a 5 year Old Child

Congenital Rubella Syndrome is a rare disorder comprised of a constellation of physical abnormalities that develop in infants as a result of maternal infection and subsequent fetal infection with rubella virus. The congenital lesions involve vital organs such as heart, eye, ear, brain and endocrine system and less frequently, teeth. The severity of systemic involvement depends on the stage of gestation at which maternal rubella infection occurs. With the implementation of immunization programs worldwide, its incidence has been dramatically reduced during the past half century. This article provides an insight into the prolonged effect of the virus on ameloblasts by highlighting the presence of hypoplastic enamel in primary teeth and erupting permanent teeth in a female child diagnosed with congenital rubella syndrome.

Developmental defects of enamel in primary teeth: prevalence and associated factors

Studies on the prevalence of enamel defects in the primary dentition as a whole are scarce, as most investigations examine specific population groups. The aim of this study was to evaluate the prevalence of enamel defects in primary teeth and determine whether prematurity, birthweight, and socio-demographic variables are associated with such defects. A cross-sectional study was carried out with 381 children aged 3-5 years. Data were collected through clinical examinations and interviews with parents during the National Immunisation Day. The diagnosis of enamel defects was performed using the Developmental Defects of Enamel (DDE) Index. Through interviews, information was collected on socio-demographic aspects, pregnancy, birthweight, prematurity, and breastfeeding. Statistical analysis was performed using the SPSS program for Windows and involved descriptive analysis, Fisher's exact test, the chi-square test, and Poisson regression. The prevalence of developmental defects of enamel was 29.9%. Demarcated opacity was the most frequent type of defect. Children with a history of very low birthweight had a greater prevalence of enamels defects (PR, 2.7; 95% CI, 1.66-4.61). Prematurity and socio-demographic variables were not associated with enamel defects. Children with a history of very low birthweight had a greater frequency of enamel defects in primary teeth.

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher's LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.

Nanostructural effect of acid-etching and fluoride application on human primary and permanent tooth enamels

This study examined the nanostructural effects of fluoride application and the acid-etching time with respect to the time elapsed after fluoride application on the primary and permanent tooth enamel layers using atomic force microscopy (AFM) and scanning electron microscopy (SEM). 192 non-carious teeth were assigned to sixteen experimental groups (n=12) including primary (1 to 8) and permanent (9 to 16) teeth, based on the timing of acid-etching with 37% phosphoric acid after an acidulated phosphate fluoride (APF) pre-treatment. The APF pre-treatment led to a decrease in surface roughness in both the primary and permanent teeth. After the APF treatment, the roughness in both primary and permanent teeth increased with the time elapsed. An acid-etching time of 40s led to increased nanostructural changes in the enamel surfaces compared to the conventional acid-etching time of 20s. This acid-etching process led to a higher roughness changes in the primary teeth than in the permanent teeth. To obtain proper enamel adhesion of a sealant after APF pre-treatment, it is important to apply acid-etching two weeks after pre-treatment. In addition, the acid-etching time should be prolonged to apply etching more quickly than two weeks, regardless of the primary and permanent teeth.

Distribution of fluoride and magnesium concentrations in deciduous tooth enamel of children with cerebral palsy and Down syndrome

Abstract Background Systemic disturbance during the fetal and postnatal periods in disabled children may affect the formation and mineralization of deciduous tooth enamel. Aim To reveal differences in the status of mineralization in the surface and inner layers of deciduous tooth enamel between children with cerebral palsy (CP), those with Down syndrome (DS), and controls. Methods Using extracted deciduous teeth obtained from CP children (5 teeth), DS children (5 teeth), and control children (11 teeth), fluoride and magnesium concentrations, used as mineralization parameters, were measured in three regions of the enamel at different depths: the enamel surface (ES), neonatal line (NL), and dentino-enamel junction (DEJ). Results Fluoride concentration was significantly higher in the ES region than in the NL or DEJ region in all three groups. There was no significant correlation between type of disability and fluoride concentration. Magnesium concentration was significantly higher in the DEJ region than in the NL or ES region. A significant correlation was seen between type of disability and magnesium concentration. Conclusions Magnesium concentration was significantly higher in DS children than in control children, suggesting that DS children undergo poorer mineralization. Magnesium concentration tended to be higher in CP children than in control children.

Effects of ammonium hexafluorosilicate application on demineralized enamel and dentin of primary teeth

Silver diamine fluoride (Ag(NH(3))(2)F) arrests caries but stains teeth black. To overcome this drawback, we applied ammonium hexafluorosilicate (AHF; (NH(4))(2)SiF(6)) and observed changes in the color and structure of demineralized enamel and dentin of extracted primary teeth. Enamel and dentin were demineralized in 10% EDTA solution for 90 s followed by 35% phosphoric acid gel for 60 s, then soaked in AHF solution for 60 s. Before analysis by scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS), enamel and dentin were demineralized in 10% EDTA for 90 s. Teeth were divided into 4 groups according to AHF application and artificial saliva immersion status and then examined. The data were statistically analyzed using one-way ANOVA and Fisher's PLSD test at a significance level of P < 0.05. AHF treatment did not cause visible discoloration. Enamel prisms and dental tubules appeared by demineralization were covered with precipitates by AHF application. A sphere-filled membranous structure was observed in the saliva immersion groups. EDS analysis showed that AHF application had no effect on enamel; however, F% and Ca/P ratio were significantly higher on dentin surfaces after AHF application without artificial saliva immersion. Further study on arresting caries treatment is required.

Demineralization analysis of deciduous tooth enamel after irradiation with LEDs and fluoride photoabsorbing cream using X-Ray dispersive energy

Demineralization analysis of deciduous tooth enamel after irradiation with LEDs and fluoride photoabsorbing cream using X-Ray dispersive energy