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Biomedical subjects

L C Chow

Publications and source records attributed to L C Chow.

At least 19 recordsLinked to original sources

Effect of a calcium prerinse on salivary fluoride after a 228-ppm fluoride rinse.

The objective of this study was to determine if a concentrated calcium prerinse given before a fluoride rinse would cause an increase in the post rinse sali vary fluoride (F). A panel of 5 subjects used a 30, 150 or 300 mmol/l calcium lactate prerinse followed by a 1-min NaF rinse. All calcium prerinses significantly increased the 1-hour saliva F relative to the NaF control without a prerinse. The maximum increase was produced by the 150 mmol/l calcium lactate prerinse and was about ninefold higher than the NaF control.

Calcium Compounds↗

Salivary fluoride from fluoride dentifrices or rinses after use of a calcium pre-rinse or calcium dentifrice.

The low concentration of available calcium (Ca) in oral fluids limits the formation of Ca-mediated fluoride deposits that maintain oral fluoride (F) after a topical F treatment. The purpose of this study was to examine if a high concentration of Ca would increase salivary F when used before a F rinse or dentifrice. We found that a Ca pre-rinse (150 mmol/l Ca lactate) or Ca dentifrice (0.084 g Ca glycerolphosphate per gram dentifrice) used immediately before a 60 s 228-ppm F rinse (12 mmol/l NaF) produced a 4.6x or 3.6x increase (p < 0.05) respectively in the 1 h salivary F concentrations over the F rinse alone. Reducing the post-Ca F rinse to 10 s still produced a significant 2.2x increase in salivary F compared to the 60 s F rinse alone. Used with a conventional 1,100 ppm F (i.e. 1,100 microg F per gram) NaF dentifrice (Crest), the above Ca pre-rinse increased 1 h salivary F levels by 2.3x over the F dentifrice alone. However, a F rinse given before a Ca rinse produced no increase in 1 h salivary F concentrations. Although the persistence of these increases requires further study, these results suggest that a moderately high concentration of Ca given shortly before a F rinse or F dentifrice may increase the cariostatic effect of the F product.

Biological Availability↗

Nano DCPA-whisker composites with high strength and Ca and PO(4) release.

The main challenges facing composite restorations are secondary caries and bulk fracture. The objective of this study was to develop nano DCPA (dicalcium phosphate anhydrous)-whisker composites with high strength and Ca and PO(4) ion release to combat caries. Flexural strength for the nano DCPA-whisker composites at a nano DCPA:whisker mass ratio of 1:2 ranged from (148 +/- 9) MPa to (167 +/- 23) MPa, significantly higher than the (103 +/- 32) MPa of an inlay/onlay commercial control composite without Ca-PO(4) release. The nano DCPA-whisker composite released PO(4) to a concentration of (1.95 +/- 0.13) mmol/L and Ca of (0.68 +/- 0.05) mmol/L. Compared with previous conventional Ca- and PO(4)-releasing composites, the nano DCPA-whisker composites had strengths two-fold higher, and released comparable or higher levels of Ca and PO(4). In conclusion, combining nano-DCPA with whiskers yielded novel composites that released high levels of Ca and PO(4) requisite for remineralization. These high-strength composites may provide a unique combination of stress-bearing and caries-inhibiting capabilities.

Analysis of Variance↗

A water setting tetracalcium phosphate-dicalcium phosphate dihydrate cement.

The development of a calcium phosphate cement, comprising tetracalcium phosphate (TTCP) and dicalcium phosphate dihydrate (DCPD), that hardens in 14 min with water as the liquid or 6 min with a 0.25 mol/L sodium phosphate solution as the liquid, without using hydroxyapatite (HA) seeds as setting accelerator, is reported. It was postulated that reduction in porosity would increase cement strength. Thus, the effects of applied pressure during the initial stages of the cement setting reaction on cement strength and porosity were studied. The cement powder comprised an equimolar mixture of TTCP and DCPD (median particle sizes 17 and 1.7 microm, respectively). Compressive strengths (CS) of samples prepared with distilled water were 47.6 +/- 2.4 MPa, 50.7 +/- 4.2 MPa, and 52.9 +/- 4.7 MPa at applied pressures of 5 MPa, 15 MPa, and 25 MPa, respectively. When phosphate solution was used, the CS values obtained were 41.5 +/- 2.3 MPa, 37.9 +/- 1.7 MPa, and 38.1 +/- 2.3 MPa at the same pressure levels. Statistical analysis of the results showed that pressure produced an improvement in CS when water was used as liquid but not when the phosphate solution was used. Compared to previously reported TTCP-DCPD cements, the greater CS values and shorter setting times together with a simplified formulation should make the present TTCP-DCPD cement a useful material as a bone substitute for clinical applications.

Adhesives↗

Reduction in dentin permeability using mildly supersaturated calcium phosphate solutions.

Treatments that obturate dentin tubules have been used for reducing dentin hypersensitivity. The objective of this study was to determine the effects of multiple treatments with a mildly supersaturated calcium phosphate solution on the hydraulic conductance (Lp) of partially occluded dentin discs in vitro. The treatment solution contained 6.5 mmoll(-1) each of calcium and phosphate, 0.25 mmoll(-1) fluoride, 30 mmoll(-1) KCl, and 50 mmoll(-1) HEPES buffer (pH adjusted to 7.0). The mean baseline Lp (in microlcm(-2)min(-1) H(2)O cm(-1)) was 0.108+/-0.041 (mean +/- S.D.; n=9, microlcm(-2)min(-1) H(2)O cm(-1) = 10.20 microlcm(-2)min(-1)KPa(-1)) and after five consecutive treatments, the mean relative Lp, presented as percentage of baseline, were 71+/-11, 58+/-10, 46+/-18, 40+/-14, and 25+/-10, respectively. The Lp values of the baseline and treatment groups were significantly (P<0.05) different. Consecutive treatments appeared effective in further reducing Lp of dentin discs.

Calcium Phosphates↗

Processing and properties of strong and non-rigid calcium phosphate cement.

A calcium phosphate cement (CPC) sets to form hydroxyapatite and has been used in dental and craniofacial applications. However, when CPC was used in periodontal repair, tooth mobility resulted in the fracture and exfoliation of the brittle implants. The aim of this study was to develop CPC-chitosan lactate composites with higher strength and increased strain before failure. It was hypothesized that the incorporation of chitosan lactate would render CPC non-rigid with improved properties. Two-way ANOVA showed significant effects of chitosan lactate and powder:liquid ratio (p < 0.001) on flexural strength, strain-at-peak-load, work-of-fracture, and elastic modulus. At powder:liquid = 2, the strength (mean +/- SD; n = 6) at 20% chitosan lactate was 15.7 +/- 1.3 MPa, higher than 4.9 +/- 1.4 MPa of CPC without chitosan lactate. At powder:liquid = 1, the strain-at-peak-load was 0.2% for CPC without chitosan lactate; it increased to 15.8% for CPC containing 15% chitosan lactate. The work-of-fracture was increased by more than ten times. The novel strong and non-rigid CPC may provide compliance for tooth mobility without fracturing the implant, and may also extend the use of CPC into the repair of larger defects in stress-bearing locations.

Analysis of Variance↗

Strong and macroporous calcium phosphate cement: Effects of porosity and fiber reinforcement on mechanical properties.

Because of its excellent osteoconductivity and bone-replacement capability, self-setting calcium phosphate cement (CPC) has been used in a number of clinical procedures. For more rapid resorption and concomitant osseointegration, methods were desired to build macropores into CPC; however, this decreased its mechanical properties. The aims of this study, therefore, were to use fibers to strengthen macroporous CPC and to investigate the effects of the pore volume fraction on its mechanical properties. Water-soluble mannitol crystals were incorporated into CPC paste; the set CPC was then immersed in water to dissolve mannitol, producing macropores. Mannitol/(mannitol + CPC powder) mass fractions of 0, 10, 20, 30, and 40% were used. An aramid fiber volume fraction of 6% was incorporated into the CPC-mannitol specimens, which were set in 3 mm x 4 mm x 25 mm molds and then fractured in three-point flexure to measure the strength, work of fracture, and modulus. The dissolution of mannitol created well-formed macropores, with CPC at 40% mannitol having a total porosity of a 70.8% volume fraction. Increasing the mannitol content significantly decreased the properties of CPC without fibers (analysis of variance; p < 0.001). The strength (mean +/- standard deviation; n = 6) of CPC at 0% mannitol was 15.0 +/- 1.8 MPa; at 40% mannitol, it decreased to 1.4 +/- 0.4 MPa. Fiber reinforcement improved the properties, with the strength increasing threefold at 0% mannitol, sevenfold at 30% mannitol, and nearly fourfold at 40% mannitol. The work of fracture increased by 2 orders of magnitude, but the modulus was not changed as a result of fiber reinforcement. A scanning electron microscopy examination of specimens indicated crack deflection and bridging by fibers, matrix multiple cracking, and frictional pullout of fibers as the reinforcement mechanisms. Macroporous CPCs were substantially strengthened and toughened via fiber reinforcement. This may help extend the use of CPCs with macropores for bony ingrowth to the repair of larger defects in stress-bearing locations.

Algorithms↗

Morphological and phase characterizations of retrieved calcium phosphate cement implants.

A self-hardening calcium phosphate cement (CPC), consisting of equimolar amounts of tetracalcium phosphate and dicalcium phosphate anhydrous, hardens when mixed with water and forms a resorbable hydroxyapatite (HA) as the end-product. The objective of this study was to investigate the changes of the phase and morphology of the CPC during hardening and aging under in vivo conditions. CPC samples retrieved 12 h after hardening in vivo had already contained carbonated HA (type B), even though the initial cement mixture did not contain carbonate as one of the solid components. The mass fraction of carbonate in the 12-h sample was about 1%. The results suggested that under in vivo conditions carbonate is readily available and this allows formation of carbonated HA in favor of carbonate-free HA. The carbonate content of the CPC samples retrieved 3 months after implantation was similar to that of the 12-h samples, and the exterior surfaces of the 3-month samples appeared less crystalline than that of the 12-h samples.

Animals↗

Formation of macropores in calcium phosphate cement implants.

A calcium phosphate cement (CPC) was shown to harden at ambient temperatures and form hydroxyapatite as the only end-product. Animal study results showed that CPC resorbed slowly and was replaced by new bone. For some clinical applications, it would be desirable to have macropores built into the CPC implant to obtain a more rapid resorption and concomitant osseointegration of the implant. The present study investigated the feasibility of a new method for producing macropores in CPC. Sucrose granules, NaHCO3, and Na2HPO4 were sieved to obtain particle sizes in the range of 125 microm to 250 microm. The following mixtures of CPC powder (an equimolar mixture of tetracalcium phosphate, Ca4(PO4)2O, and dicalcium phosphate anhydrous, CaHPO4) and one of the above additive granules were prepared: control-no additive; mixture A-0.25 mass fraction of sucrose; mixture B-0.25 mass fraction of NaHCO3; mixture C-0.25 mass fraction of Na2HPO4, and mixture D-0.33 mass fraction of Na2HPO4. Cement samples were prepared by mixing 0.3 g of the above mixtures with 0.075 ml of the cement liquid (1 mol/l Na2HPO4). After hardening, the specimens were placed in water for 20 h at about 60 degrees C to completely dissolve the additive crystals. Well-formed macropores in the shapes of the entrapped crystals were observed by scanning electron microscope (SEM). The macroporosities (mean+/-standard deviation; n = 6) expressed as volume fraction in % were 0, 18.9 +/- 1.7, 26.9 +/- 1.6, 38.3 +/- 4.4 and 50.3 +/- 2.7 for the control, A, B, C and D, respectively. The diametral tensile strengths (mean+/-standard deviation; n = 3) expressed in MPa were 10.1 +/- 0.7, 3.7 +/- 0.3, 2.4 +/- 0.2, 1.5 +/- 0.5 and 0.4 +/- 0.1, respectively, for the five groups. The results showed that macropores can readily be formed in CPC implants with the use of water-soluble crystals. The mechanical strength of CPC decreased with increasing macroporosity.

Journal Article↗

In vitro evaluation of a calcium phosphate cement root canal filler/sealer.

An in vitro dye leakage study was performed to compare the apical leakage of a fill with injectable calcium phosphate cement (CPC) filler/sealer and a master silver cone with leakage from a fill of Sealapex sealer and laterally condensed gutta-percha. Ten instrumented, extracted, single-rooted human teeth were obturated with either laterally condensed gutta-percha and Sealapex as the sealer or with a single master cone and the CPC paste sealer. Additional teeth were included in the study to serve as controls. The teeth were placed in 1% poly-R dye solution (pH 7.0) for 5 days. After the teeth were longitudinally sectioned apical leakage of dye was measured. There were no significant differences between the CPC and Sealapex groups. The single cone CPC procedure provided an adequate apical seal against dye penetration. Should retreatment become necessary the single cone may be removed to provide access for instrumentation.

Calcium Hydroxide↗

Diametral tensile strength and compressive strength of a calcium phosphate cement: effect of applied pressure.

The diametral tensile strength (DTS) and compressive strength (CS) of a calcium phosphate cement comprised of tetracalcium phosphate and dicalcium phosphate anhydrous were studied. Cement powder and water were mixed at a powder/liquid ratio of 4.0. The resulting cement pastes were placed in molds and a pressure ranging from 0-2.8 MPa was applied for various lengths of time (0.5-24 h). DTS and CS measurements were conducted on 24-h wet samples. The strength was found to be significantly (p<0.05) affected by the pressure but not by the time. Samples prepared under a pressure of 0.7 MPa had a mean DTS value of 10.8+/-1.0 MPa (n = 5), which is comparable to the values reported in the literature for the same cement prepared under similar conditions. In contrast, the mean CS value obtained in the present study, 66.1+/-5.0 MPa (n = 5), was significantly higher than the value (51+/-4.5 MPa) previously reported. The higher CS may be attributed to an improved mold design that may reduce sample damage during demolding, and to the use of a loading device that applied a constant pressure to the sample during setting. The average standard deviation of the mean for the 19 DTS sample groups (n = 5 in each group) was 1.1 MPa, corresponding to 9.6% of the mean DTS value. The average standard deviation of the 7 CS sample groups (n = 5 in each group) was 4.5 MPa, corresponding to 7.1% of the mean CS value. Published 2000 John Wiley & Sons, Inc.

Bone Cements↗

Effect of mixing ratio and pH on the reaction between Ca4(PO4)2O and CaHPO4.

The reaction of Ca(PO4)2O (TTCP) and CaHPO4 (DCPA) in an aqueous solution has been shown to be responsible for the hardening of a calcium phosphate cement. This reaction was investigated by monitoring pH changes and composition of solid phases. In the first set of experiments (no attempt to control pH), 2.5 g each of mixtures of TTCP/DCPA, molar ratio from 0.25 to 2, was placed in 12.5 mL of 0.15 mol/L KCl solution, at initial pH about 7, and the pH was allowed to drift for 24 h. Results show that at any time up to 24 h, the pHs were higher for slurries with higher TTCP/DCPA molar ratios. For the slurries with TTCP/DCPA molar ratio of >/= 0.83, the 24 h pHs of the slurries were 9 to 11, whereas for those with TTCP/DCPA of </= 0.67, the pHs were between 5.3 and 7. The slurries with TTCP/DCPA molar ratios between 0.5 and 1 (Ca/P molar ratio=1.5 to 1.67) reacted completely within 24 h to form hydroxyapatite (OHAp), Ca5(PO4)3. In the second set of experiments, 2 g of an equimolar TTCP and DCPA mixture was placed in 20 mL of 0.15 mol/L KCl solution. The pH values were kept constant (6, 8 or 10) by using H3PO4 and \Ca(OH)2 or HCl and KOH as titrant solutions. At pH 8, DCPA and TTCP dissolved at about the same rate, whereas at pH 10, DCPA was consumed more rapidly than TTCP. At both pHs, OHAp was the only product formed. However, at pH 6, the composition of reaction products depended on the types of the titrants used. Specifically when H3PO4 and Ca(OH)2 were used, hydrolysis of TTCP was the predominant reaction and both octacalcium phosphate and OHAp were formed. But, when HCl and KOH were used, only OHAp was formed. In this case hydrolysis of TTCP and DCPA appeared to proceed independently with TTCP hydrolysis beginning immediately and progressing slowly through 48 h while the DCPA hydrolysis began several hours after the reaction started but was completed in 24 h.

Journal Article↗

Composition of plaque and saliva following use of an alpha-tricalcium-phosphate-containing chewing gum and a subsequent sucrose challenge.

Previous studies demonstrated that the chewing of a 2.5% (mass fraction) alpha-tricalcium-phosphate-fortified (alpha-TCP) experimental chewing gum released sufficient calcium and phosphate to eliminate any fall in the tooth mineral saturation of plaque fluid after a sucrose rinse (Vogel et al., 1998). In contrast, the chewing of a conventional sugar-free gum did not eliminate this decrease in saturation. The purpose of this study was to examine if the release of ions from plaque calcium-phosphate pools induced by this gum could provide protection during subsequent exposure to cariogenic conditions. Fourteen subjects accumulated plaque for 48 hrs, fasted overnight, chewed a control or experimental gum for 15 min, and subsequently rinsed 1 min with a mass fraction 10% sucrose solution. Before gum chewing, and at 7 min and 15 min afterward, whole plaque, plaque fluid, and salivary samples were obtained and analyzed by micro-analytical techniques. Additional samples were collected and analyzed at 25 min (7 min after the sucrose rinse). Although the results confirmed the deposition of large amounts of calcium and phosphates in plaque seen in the previous study, only a small increase was seen in plaque-fluid-free calcium and phosphate before sucrose administration. This suggests that few of the mineral ions were mobilized under non-cariogenic conditions. However, 7 min after the sucrose rinsing, an increase in these concentrations was seen which, based on hydroxyapatite ion activity product calculations, indicated a decrease in the driving force for demineralization compared with that seen with the control gum. These results suggest that the chewing of the experimental gum deposits a labile mineral reservoir in plaque that can resist a subsequent cariogenic challenge.

Adult↗

Effect in vitro acidification on plaque fluid composition with and without a NaF or a controlled-release fluoride rinse.

Plaque fluid ion concentration changes, especially fluoride, in response to the pH decrease associated with a cariogenic episode are important components of the caries process. A "controlled-release" (CR) fluoride rinse, based on the controlled release of fluoride in the presence of calcium, has been shown to form large fluoride reservoirs in resting plaque. In this study, the in vitro acid-induced release of fluoride, and other ions, was examined in 48-hour-fasted plaque fluid from subjects (n = 11) who received no rinse, or who used a 228-ppm CR or NaF fluoride rinse 1 hr before being sampled. After collection, the plaque was centrifuged to yield plaque fluid, acidified (0.1 microL of 0.5 mol/L HCl per milligram plaque), and then re-centrifuged before a second sample was obtained. Although previous studies indicated a higher plaque fluid fluoride after the new rinse relative to NaF, no statistically significant difference was observed here. Average fluoride release after acidification (average pH, 5.2) was statistically greater following the use of the CR rinse (153 micromol/L) compared with the NaF rinse (17 micromol/L). No fluoride release was seen in the no-rinse samples. The pH, free calcium, phosphate, acetate, propionate, and buffer capacity were not affected by the different amounts of fluoride deposited in the plaque. However, following acid addition, an increase in free calcium and phosphate was observed, which was also independent of the rinse. The large release of fluoride following acidification suggests that the new rinse may provide an improved cariostatic effect.

Acetates↗

Remineralization effects of a two-solution fluoride mouthrinse: an in situ study.

Results from previous studies show that a two-solution fluoride (F) rinse is significantly more effective than a NaF rinse of the same F content of 250 microg/g (ppm) in remineralizing enamel and root lesions in an in vitro cyclic de- and remineralization model. In the present study, the two-solution rinse and two NaF rinses with F contents of 250 ppm and 1000 ppm were evaluated in an intra-oral remineralization model. Caries-like lesions were formed in the enamel of extracted human molars with the use of a pH 4 demineralizing solution. Thin sections of the enamel (approximately 120 microm) containing lesions were prepared, and the mineral contents of the lesions were assessed by quantitative microradiography. With the cut surfaces protected by nail varnish, 3 enamel specimens were mounted with wax in the lingual areas of a removable mandibular appliance. The study used a randomized, crossover design with seven subjects. In each of the 3 legs of the study, subjects wore the appliances continuously except when eating, drinking, and brushing their teeth. Twice daily (after breakfast and before bedtime), the subjects received a one-minute rinse with 20 mL of (1) 250-ppm-F NaF rinse, (2) 1000-ppm-F NaF rinse, or (3) 228-ppm-F two-solution F rinse. At the end of the 14-day experimental period, the sections were retrieved, and the mineral contents of the lesions were again assessed quantitatively. The results show that both the 1000-ppm-F NaF and 228-ppm-F two-solution rinses produced a greater (p < 0.05) remineralization than did the 250-ppm-F NaF rinse. The remineralization produced by the two-solution rinse was not statistically different (p > 0.05) from that produced by the NaF rinse with 4x the F content (1000 ppm F).

Analysis of Variance↗