Tooth Remineralization Research Articles

Nutrition, diet and dental health — de- and remineralisation of teeth

There is little if any evidence that nutrition during the time of tooth formation has any clinically significant effect on caries susceptibility of erupted teeth in man. Caries, erosion and demastication are not nutritional diseases. They are, however, diet-related diseases because erupted teeth are subject to local chemical and mechanical effects of the diet contacting the teeth. Caries is the result of a chronic undermining demineralisation of the teeth by organic acids that are produced by the bacteria of the dental biofilm while fermenting carbohydrates from the human diet. Dental erosion is the result of a chronic localised loss of dental hard tissue etched away from the surface by acids derived from the diet or from gastric reflux. The physicochemical grounds of de- and remineralisation of teeth are explained using detailed diagrams. Initial caries lesions without cavitation of the surface can remineralise (heal) under conditions of low cariogenic diet and good oral hygiene. However, once the surface has broken and cavitation occurred, there is no alternative to restorative dental therapy because remineralisation is no more possible.

Ernährung, Nahrungsmittel und Zahngesundheit – De- und Remineralisation der Zähne

There is little if any evidence that nutrition during the time of tooth formation has any clinically significant effect on caries susceptibility of erupted teeth in man. Caries, erosion and demastication are not nutritional diseases. They are, however, diet-related diseases because erupted teeth are subject to local chemical and mechanical effects of the diet contacting the teeth. Caries is the result of a chronic undermining demineralisation of the teeth by organic acids that are produced by the bacteria of the dental biofilm while fermenting carbohydrates from the human diet. Dental erosion is the result of a chronic localised loss of dental hard tissue etched away from the surface by acids derived from the diet or from gastric reflux. The physicochemical grounds of de- and remineralisation of teeth are explained using detailed diagrams. Initial caries lesions without cavitation of the surface can remineralise (heal) under conditions of low cariogenic diet and good oral hygiene. However, once the surface has broken and cavitation occurred, there is no alternative to restorative dental therapy because remineralisation is no more possible.

Effects on Hardness and Elastic Modulus for DSS-8 Peptide Treatment on Remineralization of Human Dental Tissues.

Dental remineralization may be achieved by mediating the interactions between tooth surfaces with free ions and biomimetic peptides. We recently developed octuplet repeats of aspartate-serine-serine (DSS-8) peptide, which occurs in high abundance in naturally occurring proteins that are critical for tooth remineralization. In this paper, we evaluated the possible role of DSS-8 in enamel remineralization. Human enamel specimens were demineralized, exposed briefly to DSS-8 solution, and then exposed to concentrated ionic solutions that favor remineralization. Enamel nano-mechanical behaviors, hardness and elastic modulus, at various stages of treatment were determined by nanoindentation. The phase, microstructure and morphology of the resultant surfaces were characterized using the grazing incidence X-ray diffraction (GIXD), variable pressure scanning electron microscopy (VPSEM), and atomic force microscopy (AFM), respectively. Nanoindentation results show that the DSS-8 remineralization effectively improves the mechanical and elastic properties for demineralized enamel.

Ozone Therapy in Medicine and Dentistry

The purpose of this review is to present the potential for the incorporation of ozone therapy into the practice of dentistry. Ozone gas has a high oxidation potential and is 1.5 times greater than chloride when used as an antimicrobial agent against bacteria, viruses, fungi, and protozoa. It also has the capacity to stimulate blood circulation and the immune response. Such features justify the current interest in its application in medicine and dentistry and have been indicated for the treatment of 260 different pathologies. It can be used for the treatment of alveolitis as a replacement for antibiotic therapy, as a mouthwash for reducing the oral microflora, as well as the adherence of microorganisms to tooth surfaces. Ozone has been shown to stimulate remineralization of recent caries-affected teeth after a period of about six to eight weeks. The future of ozone therapy must focus on the establishment of safe and well-defined parameters in accordance with randomized, controlled trials to determine the precise indications and guidelines in order to treat various medical and dental pathologies. Scientific support, as suggested by demonstrated studies, for ozone therapy presents a potential for an atraumatic, biologically-based treatment for conditions encountered in dental practice.

Preparation and properties of nano-sized calcium fluoride for dental applications

Objectives The aim of the present study was to prepare nano-sized calcium fluoride (CaF 2) that could be used as a labile F reservoir for more effective F regimens and as an agent for use in the reduction of dentin permeability. Methods Nano-sized CaF 2 powders were prepared using a spray-drying system with a two-liquid nozzle. The properties of the nano-CaF 2 were studied and the effectiveness of a fluoride (F) rinse with nano-CaF 2 as the F source was evaluated. The thermodynamic solubility product of the nano-CaF 2 solution was determined by equilibrating the nanosample in solutions presaturated with respect to macro-CaF 2. Reactivity of the nano-CaF 2 was assessed by its reaction with dicalcium phosphate dehydrate (DCPD). F deposition by 13.2 mmol/L F rinse with the nano-CaF 2 as the F source was determined using a previously published in vitro model. Results X-ray diffraction (XRD) analysis showed pattern of low crystalline CaF 2. BET measurements showed that the nano-CaF 2 had a surface area of 46.3 m 2/g, corresponding to a particle size of 41 nm. Transmission electron microscopy (TEM) examinations indicated that the nano-CaF 2 contained clusters comprising particles of (10–15) nm in size. The nano-CaF 2 displayed much higher solubility and reactivity than its macro-counterpart. The CaF 2 ion activity product (IAP) of the solution in equilibrium with the nano-CaF 2 was (1.52 ± 0.05) × 10 −10, which was nearly four times greater than the K sp (3.9 × 10 −11) for CaF 2. The reaction of DCPD with nano-CaF 2 resulted in more F-containing apatitic materials compared to the reaction with macro-CaF 2. The F deposition by the nano-CaF 2 rinse was (2.2 ± 0.3) μg/cm 2 ( n = 5), which was significantly ( p < 0.001) greater than that ((0.31 ± 0.06) μg/cm 2) produced by the NaF solution. Significance The nano-CaF 2 can be used as an effective anticaries agent in increasing the labile F concentration in oral fluid and thus enhance the tooth remineralization. It can also be very useful in the treatment for the reduction of dentin permeability.

Milk Helps Build Strong Teeth and Promotes Oral Health

A great deal of research into the benefits of milk consumption has gone largely under the radar for many decades. There is a wealth of studies both in the United States and abroad to suggest that milk consumption is largely anti-cariogenic when combined with a typical routine of oral hygiene. This effect can be mostly attributed to several factors: tooth remineralization, inhibition of bacterial colonization, and biofilm inhibition. These abilities have been studied in detail and are likely due to numerous proteins found in milk. An attractive feature of milk from the community health perspective is its widespread consumption throughout the world. For this reason, studies have been initiated to investigate the possibilities of using milk to deliver fluoride and antibacterial antibodies to high-risk populations worldwide. This review will focus on the various components of milk, which promote oral health, and will also discuss common approaches to improve upon the oral health benefits of milk consumption.

ADJUNCTIVE INFRARED DIODE LASER THERAPY ACCELERATES HEALING IN APICAL GRANULOMAS: A CASE REPORT STUDY

The final stage of severe infection round the apex of a tooth is granuloma formation, the treatment of which can be a major problem in clinical dentistry. Although granulomas in the early stages can respond to conservative conventional therapy, such as the application of calcium hydroxide, many in the later stage require surgical intervention with the risk of postoperative sequelae and patient downtime. Low reactive-level laser therapy (LLLT) has been shown to reduce inflammation and accelerate wound healing. The present study was designed to assess the role of 830 nm diode laser therapy in conjunction with conservative conventional therapy in the treatment of severe apical granulomas. Thirty-three young male patients with severe apical granulomas participated in the study, 19 of whom were treated with conventional treatments, and 14 with calcium hydroxide combined with 0.5 J/cm2 - 2 J/cm2 intra- and extraoral diode laser therapy. Significant improvements were seen in the LLLT combination group compared with the control group in the time taken for the resolution of acute postoperative pain (100 vs 500 min) and inflammation (1.6 vs 5.6 days), and long-term tooth remineralization and alveolar bone regeneration (15 vs 33 months). LLLT with the 830 nm diode laser was shown to be safe and effective in combination with conservative conventional therapy in the treatment of severe apical granulomas and was superior to the conventional approach on its own for granulomas of similar severity.

Ex vivo detection and characterization of early dental caries by optical coherence tomography and Raman spectroscopy

Early dental caries detection will facilitate implementation of nonsurgical methods for arresting caries progression and promoting tooth remineralization. We present a method that combines optical coherence tomography (OCT) and Raman spectroscopy to provide morphological information and biochemical specificity for detecting and characterizing incipient carious lesions found in extracted human teeth. OCT imaging of tooth samples demonstrated increased light backscattering intensity at sites of carious lesions as compared to the sound enamel. The observed lesion depth on an OCT image was approximately 290 microm matching those previously documented for incipient caries. Using Raman microspectroscopy and fiber-optic-based Raman spectroscopy to characterize the caries further, spectral changes were observed in PO4 (3-) vibrations arising from hydroxyapatite of mineralized tooth tissue. Examination of various ratios of PO4 (3-) nu2, nu3, nu4 vibrations against the nu1 vibration showed consistent increases in carious lesions compared to sound enamel. The changes were attributed to demineralization-induced alterations of enamel crystallite morphology and/or orientation. OCT imaging is useful for screening carious sites and determining lesion depth, with Raman spectroscopy providing biochemical confirmation of caries. The combination has potential for development into a new fiber-optic diagnostic tool enabling dentists to identify early caries lesions with greater sensitivity and specificity.

Eating behaviour and food choices in children with Down’s syndrome, autistic spectrum disorder or cri du chat syndrome and comparison groups of siblings

High sugar foods and beverages consumed frequently are associated with increased dental caries and periodontal disease. Based on parental survey responses, the diets of children with Down’s syndrome, autistic spectrum disorder (ASD) and cri du chat syndrome and comparison groups of siblings were considered from an oral health perspective. In each group children who were frequent consumers of one high sugar food or beverage were likely to be high consumers of others, whilst other children were low consumers of high sugar foods and beverages. Children in middle and late childhood tended to consume more cariogenic foods and beverages than preschool children. For most children frequency of meal and snack consumption would allow little opportunity for remineralization of teeth.

Bioadhesive, rheological, lubricant and other aspects of an oral gel formulation intended for the treatment of xerostomia

Xerostomia is commonly known as ‘dry mouth’ and is characterised by a reduction or loss in salivary production. A bioadhesive gel for its localised treatment was formulated to help enhance the residence time of the product, based on the polymer Carbopol 974P. The bioadhesion of various formulations was evaluated on different mucosal substrates, as simulations of the oral mucosa of xerostomic patients. Depending on the type of model substrate used, the mechanism of bioadhesion could alter. When the rheology of various formulations was examined, changes in bioadhesion were more easily interpreted, as the presence of other excipients caused an alteration in the rheological profile, with a change from a fully expanded and partially cross-linked system to an entangled system. Improving the lubricity of the product was considered important, with optimum incorporation of vegetable oil causing a desirable lowering of the observed friction of the product. The final complex formulation developed also contained salivary levels of electrolytes to help remineralisation of teeth, fluoride to prevent caries, zinc to enhance taste sensation, triclosan as the main anti-microbial/anti-inflammatory agent and non-cariogenic sweeteners with lemon flavour to increase the palatability of the product while stimulating any residual salivary function.

Polymer electrolyte membrane for electrochemical applications

Mineralization of collagen fibrils using solution-based systems containing biomimetic analogs of matrix proteins to stabilize supersaturated calcium phosphate solutions have been predictably achieved in vitro. Solution-based systems have limitations when used for in-situ remineralization of human hypomineralized tissues because periodic replenishment of the mineralizing solution is infeasible. A carrier-based platform designed for delivering mineral precursors would be highly desirable. In the present work, mesoporous silica nanoparticles with expanded pores (eMSN; 14.8 nm) were synthesized. Polyacrylic acid–stabilized amorphous calcium phosphate (PA–ACP) was generated from a supersaturated calcium and phosphate ion-containing solution, and chosen as the model mineralizing phase. After amine functionalization (AF) of the eMSN through a post-grafting method, the positively-charged AF-eMSN enabled loading of PA–ACP by electrostatic interaction. In-vitro cytotoxicity testing indicated that PA–[email protected] was highly biocompatible. The release kinetics of mineralization precursors from PA–[email protected] was characterized by an initial period of rapid calcium and phosphate release that reached a plateau after 120 h. Intrafibrillar mineralization was examined using a 2-D fibrillar collagen model; successful mineralization was confirmed using transmission electron microscopy. To date, this is the first endeavor that employs expanded-pore mesoporous silica to deliver polymer-stabilized intermediate precursors of calcium phosphate for intrafibrillar mineralization of collagen. The carrier-based delivery system bridges the gap between contemporary solution-based biomineralization concepts and clinical practice, and is useful for in-situ remineralization of bone and teeth.Concepts of collagen biomineralization have been reasonably well established in the past few years and intrafibrillar mineralization of collagen fibrils can be predictably achieved with analogs of matrix proteins using solution-based systems. However, solution-based systems have their limitations in clinical applications that require direct application of mineralization precursors in-situ because periodic replenishment of the mineralizing solution is impossible. The present work presents for the first time, the use of amine-functionalized mesoporous silica with expanded pores for loading and release of polyacid-stabilized amorphous calcium phosphate mineralization precursors, and for intrafibrillar mineralization of type I collagen fibrils. This strategy represents an important step in the translational application of contemporary biomineralization concepts for in-situ remineralization of bone and teeth.

Search Strategies for Independent Reviewers

1169 T o save space, the Caries Filter, which was duplicated in most of the searches, has been excerpted and is listed only once, at the beginning of this appendix. In the subsequent searches where the Caries Filter was used it is indicated as [insert caries filter here] in boldface. When inserting this filter, it is essential to maintain all other punctuation present in the rest of the relevent search, especially parentheses. It is not necessary to keep the brackets or any of the boldface text. Caries Filter: exp Tooth demineralization/ or Cariogenic agents/ or Tooth remineralization/ or cariogenic:.mp. or (caries-free or cariesfree).mp. or precavit:.mp. or demineralization.mp. or (caries or caires or craies or careis or carise).mp. or carious.mp. or cariology.ti,ab. or ((teeth or tooth or dental or dentin or enamel) adj3 cavit:).mp. or ((teeth or tooth or dental or dentin or enamel or rampant or recurrent) adj3 decay:).mp. or ((active adj decay) or (white adj spot:)).mp. or ((non-cavitated or noncavitated) adj3 lesion:).mp. or ((tooth or teeth) adj3 remineralization).mp. or ((dental or tooth or teeth) adj3 fissure:).mp. or ((tooth or teeth) adj3 fissure:).mp. or ((teeth adj3 fissure:) or (oral adj fissure:)).mp. or (filled adj3 (teeth or tooth)).mp. or (dft or dfs or dmf:).mp.

Position of the American Dietetic Association: The impact of fluoride on dental health

The appropriate use of fluorides, through topical application, water fluoridation, or exogenous supplementation, has been shown to be a positive factor in the prevention of dental caries and remineralization of teeth. This is true for individuals of all ages. The use of fluorides and fluoridation is endorsed by almost all professional health organizations as the most effective dental public health measure in existence.

Position of The American Dietetic Association: The impact of fluoride on dental health

The appropriate use of fluorides, through topical application, water fluoridation, or exogenous supplementation, has been shown to be a positive factor in the prevention of dental caries and remineralization of teeth. This is true for individuals of all ages. The use of fluorides and fluoridation is endorsed by almost all professional health organizations as the most effective dental public health measure in existence.

Novel Topical Fluoride Delivery System I: Remineralization of Ground Bovine Teeth

Laboratory studies were carried out on a newly conceived fluoride-containing re-mineralizing system with bovine teeth. The prototype fluoride delivery device involved micronized calcium fluoride maintained at the tooth surface with a cellulose film. Together with salivary calcium and phosphate (or simulated saliva), this system was able to generate and maintain the appropriate thermodynamic activity driving force for significant fluorapatite deposition in a reasonably short time (-48 hr).

Tooth enamel remineralization

In this paper a survey is given on tooth remineralization from remineralizing solutions and from saliva. The substrate, sound tooth enamel, is described from a chemical as well as from an ultrastructural point of view. Because saliva plays a crucial role in in vivo remineralizations, the most relevant properties of saliva, such as the thermodynamic stabilities with respect to calcium phosphates of interest, are considered. Tooth remineralization can be divided into three main types: lesion remineralization, surface softened remineralization and etched enamel remineralization. The main emphasis in this survey is given to lesion and surface softened remineralization which are the most important from a practical view point. In these two cases, the reaction order, the activation energy and the mechanism are discussed as well as the ultrastructure of remineralized material, the influence of various agents (especially F -)and differences between in vitro and in vivo data.