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PubMed1992

Dental composites/glass ionomers: the materials.

Most commercial dental composites contain liquid dimethacrylate monomers (including BIS-GMA or variations of it) and silica-containing compositions as inorganic reinforcing filler particles coated with methacrylate-functional silane coupling agents to bond the resin to the filler. They also contain initiators, accelerators, photo-initiators, photosensitizers, polymerization inhibitors, and UV absorbers. Durability is a major problem with posterior composites. The typical life-span of posterior composites is from three to 10 years, with large fillings usually fewer than five years. Polymerization shrinkage and inadequate adhesion to cavity walls are remaining problems. Some pulp irritation can occur if deep restorations are not placed over a protective film. Some have advocated the use of glass-ionomer cement as a lining under resin composite restorations in dentin. The concept of glass-ionomer cements (GICs) was introduced to the dental profession in the early 1970's. Current GICs may contain poly(acrylic acid) or a copolymer. Higher-molecular-weight copolymers may also be used to improve the physical properties of some GICs. Stronger and less-brittle hybrid materials have been produced by the addition of water-soluble compatible polymers to form light-curing GIC formulations. The ion-leachable aluminosilicate glass powder, in an aqueous solution of a polymer or copolymer of acrylic acid, is attacked by the hydrated protons of the acid, causing the release of aluminum and calcium ions. Salt bridges are formed, and a gel matrix surrounds the unreacted glass particles. The matrix is adhesive to mineralized tissues. Provisions must be made for maintenance of the water balance of restorations for the first 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Bisphenol A-Glycidyl Methacrylate↗
PubMed2001

Potential synergies between matrix proteins and soluble factors on resorption and proteinase activities of rabbit bone cells.

Human growth hormone (GH) has recently been found to stimulate osteoclastic resorption, cysteine-proteinase and metalloproteinase activities (MMP-2 and MMP-9) in vitro via insulin-like growth factor-I (IGF-I) produced by stromal cells. The present study investigated the effects of two extracellular matrix components (vitronectin and type-I collagen) on hGH- and hIGF-1-stimulated osteoclastic resorption and proteinase activities in a rabbit bone cell model. After 4 days of rabbit bone cell culture on dentin slices with vitronectin coating, hGH and hIGF-1 stimulated bone resorption and hIGF-1 upmodulated cysteine-proteinase activities. MMP-2 expression (but not resorption, cathepsin or MMP-9 activities) was upmodulated by hGH and hIGF-1 on dentin slices coated with type I collagen as compared to those without coating. Then, vitronectin was synergistic with hIGF-1 in the regulation of cysteine-proteinase production whereas collagen showed synergy with hGH and hIGF-1 in the regulation of MMP-2 production. Anti-alphavbeta3 totally abolished the effects of hGH and hIGF-1 on metalloproteinase release, but had no influence on cathepsin release. The results suggest that cysteine-proteinase modulation is not mediated by alphavbeta3 integrin (strongly expressed on osteoclastic surface) whereas the resorption process and metalloproteinase modulation are clearly mediated by this integrin. Our finding about the collagen coating also suggests that hGH- and hIGF-1-stimulated MMP-2 activity are mediated, along with alphavbeta3 integrin, by another adhesion molecule.

Animals↗
PubMed2005

Confocal laser scanning microscopic observations of secondary caries inhibition around different types of luting cements.

PURPOSE: To analyze in vitro artificial secondary caries inhibition around conventional luting cements and resin cements using a confocal laser-scanning microscope (CLSM). METHODS: Box shape cavities (approximately 3 mm long, 4 mm wide, and 1.5 mm deep) were prepared in bovine root dentin. One of five cements: Elite Cement 100 (EL) zinc phosphate cement, HY-Bond Carbo Cement (CA) polycarboxylate cement, Fuji I (FI) glass-ionomer cement, Fuji Luting (FL) GIC-based resin cement and Panavia F (PA) fluoride-releasing resin cement, was placed in the cavity. After polishing, the center of the cement surface was covered with an adhesive to preserve the original cement solubility. The specimens were stored in distilled water at 37 degrees C for 1 week, and stored in an artificial demineralizing solution for 3.5 days. Following this, each specimen was sectioned into two halves, trimmed, and polished. Thickness of inhibition zone, depth of outer lesion and cement solubility around each cement were determined by a CLSM. RESULTS: Inhibition zones were not seen in EL and CA, while they were found in FI, FL and PA. The depths of the outer lesions of CA and FI were significantly lower than those of EL, FL and PA (P< 0.05). The highest and the second-highest cement solubility were obtained in EL and CA, respectively. FI and FL indicated significantly lower cement solubility than EL and CA. PA tended to show the lowest cement solubility.

Analysis of Variance↗
PubMed1993

Induction of mononuclear precursor cells with osteoclastic phenotypes in a rat bone marrow culture system depleted of stromal cells.

The importance of bone stromal cell involvement in osteoclast differentiation has been suggested. However, the detailed mechanism of its regulation is unclear. We investigated whether the soluble factors from osteoblastic cells influence osteoclast lineage cells in a population of rat bone marrow cells depleted of stromal cells. We show here that hematopoietic progenitor cells differentiate into mononuclear precursor cells, the preosteoclasts, that strongly express certain osteoclastic phenotypes in the absence of stromal cells. The multinucleation of the preosteoclasts occurred only in the presence of 1,25 dihydroxyvitamin D3 and stromal cells. The preosteoclasts themselves did not have dentine-resorbing activity, but they could differentiate into multinucleate osteoclast-like cells having such activity in the presence of rat primary osteoblasts. This culture system is a unique differentiation system for preosteoclast induction.

Animals↗
PubMed1979

The hydrolysis rates of ATP and phosphoserine in the odontoblast-predentin region of intact and carious human teeth.

Coronal odontoblast-predentin tissue was taken from intact teeth and from teeth with carious lesions of varying depths, and the samples (20, 200 x g, saline-soluble fractions) were studied for their ability to hydrolyze adenosine triphosphate (ATP) and phosphoserine. A significantly higher rate of ATP hydrolysis at pH 9.8 was detected in enamel caries and a significantly lower rate in advanced caries than in intact teeth. The rates of the hydrolysis of phosphoserine at pH 9.8 did not differ between the various tooth groups, and the only clear trend indicating elevated enzyme activity was seen in the group of initial dentin caries. The ATP and phosphoserine hydrolysis at pH 9.8 were considered to have been due to the nonspecific alkaline phosphatase (EC 3.1.3.1) activity. In the presence of both levamisole and ouabain, maximal enzyme-dependent ATP hydrolysis was observed at pH 7.9. The remaining ATP-cleaving activity was thought to have been due to the Ca2+Mg2+-dependent ATPase (EC 3.6.1.3). The Ca2+Mg2+-dependent ATPase activities at pH 7.9 remained at constant levels in both the intact and carious groups. The parameters studied in vitro were thought to reflect changes in the mineralization rate of reparative dentin as a response to caries in vivo.

Adenosine Triphosphatases↗
PubMed2005

In vitro and in vivo biological responses to a novel radiopacifying agent for bone cement.

Iodixanol (IDX) and iohexol (IHX) have been investigated as possible radiopacification agents for polymethylmethacrylate (PMMA) bone cement, to replace the currently used barium sulphate and zirconia. IDX and IHX are both water-soluble iodine-based contrast media and for the last 20 years have been used extensively in clinical diagnostic procedures such as contrast media enhanced computed tomography, angiography and urography. One of the major reasons to remove the current radiopacifying agents is their well-documented cytotoxicity and their potential to increase bone resorption. Using in vitro bone resorption assays, the effect of PMMA particles plus IDX or IHX to induce osteoclast formation and lacunar resorption on dentine slices has been investigated. These responses have been compared with the in vitro response to PMMA particles containing the conventional radiopacifying agents, that is, barium sulphate and zirconia. In parallel, the in vivo reaction, in terms of new bone formation, to particles of these materials has been tested using a bone harvest chamber in rabbit tibiae. In vitro cell culture showed that PMMA containing IHX resulted in significantly less bone resorption than PMMA containing the conventional opacifiers. In vivo testing, however, showed no significant differences between the amounts of new bone formed around cement samples containing the two iodine-based opacifying agents in particulate form, although both led to fewer inflammatory cells than particles of PMMA containing zirconia. Our results suggest that a non-ionic radiopacifier could be considered as an alternative to the conventional radiopacifying agents used in biomaterials in orthopaedic surgery.

Animals↗
PubMed1999

The permeability of human cementum in vitro measured by electron paramagnetic resonance.

The structure and permeability of cementum are changed during the course of periodontal disease. In this study, the transport of water-soluble, spin-labelled molecules through cementum was studied by electron paramagnetic resonance (EPR). Cementum samples cut from different parts of the root were classified into four different groups: (A) samples exposed to the oral environment, (B) samples exposed to the periodontal-pocket environment; (C) samples cut from periodontally involved teeth but not exposed to saliva or periodontal pocket and (D) samples from sound young teeth extracted for orthodontic reasons. In order to obtain undamaged cementum, a dentine layer was left on each sample. Two methods were used to measure the diffusion coefficients of spin-labelled molecules in cementum dentine samples. First, the method of one-dimensional EPR imaging (EPRI) was used to evaluate the penetration of spin-labelled molecules into the cementum/dentine structure. Second, the diaphragm-cell method was used to determine the diffusion coefficients of the labelled molecules through the cementum under steady-state conditions. The results indicate that the interface between cementum and dentine is a barrier to diffusion. A set of diffusion (D) and partition (K) coefficients to describe the molecular transport in cementum, barrier and dentine was generated from the experimental data of both methods. For cementum (c), the barrier (b) and dentine (d) these coefficients were: Dc= 10(-8)cm2/s, Db= 10(-10)cm2/s, Dd= 10(-6)cm2/s and K=0.1. For the particular periodontally involved and uninvolved teeth the value of the rate-limiting barrier was DbA= 0.3 +/- 0.03 x 10(-10)cm2/s, DbB= 1 +/-0.3 x 10(-10)cm2/s, DbC= 0.3 +/- 0.03 x 10(-10)cm2/s, DbD= 0.4 +/- 0.05 x 10(-10)cm2/s. The largest diffusion flux across the dental hard tissue was found in the samples that had been exposed to the pocket environment (3.1 +/- 0.2) x 10(-9)cm2/s (p < 0.01), which coincided with the permeability calculated from the data evaluated by EPRI. The transport of the labelled molecules into and through the cementum dentine samples depends on the structure of the dental hard tissues, which changes during the course of periodontal disease. Knowledge of molecular diffusion across the tooth cementum/dentine structure is likely to be important for planning new treatments for periodontal disease.

Adolescent↗
PubMed2004

The caries balance: the basis for caries management by risk assessment.

Dental caries progression or reversal depends upon the balance between demineralization and remineralization. The 'Caries Balance' is determined by the relative weight of the sums of pathological factors and protective factors. Minimally invasive dentistry aims at the least possible removal of enamel or dentin, including reducing pathological factors and enhancing remineralization to avoid any removal of hard tissues. A structured caries risk assessment should be carried out based upon the concept of the caries balance. Following the risk assessment a treatment plan is devised which leads to the control of dental caries for the patient. The balance between pathological and preventive factors can be swung in the direction of caries intervention and prevention by the active role of the dentist and his/her auxiliary staff. Much is now understood about the mechanism of dental caries. We have known for a long time that demineralization of enamel, dentin or cementum is caused by organic acids that are generated by so-called acidogenic bacteria in the plaque when these bacteria feed upon fermentable carbohydrates (Silverstone, 1973; Featherstone, 2000; Loesche, 1986). The natural repair process is remineralization, which occurs when the pH rises again and calcium and phosphate from saliva together with fluoride enter the subsurface region of the lesion and form a new veneer on the existing crystal remnants in the lesion (Ten Cate and Featherstone, 1991). This veneer is less soluble than the original mineral and resists further acid attacks. The key to improved dental health for all is now for the dental profession to embrace this knowledge and put it into practice in the real world, to inhibit caries formation and progression, and to enhance the natural repair process.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Morphology evaluation of primary enamel exposed to antihistamine and fluoride dentifrice--an in vitro study.

This in vitro study sought to evaluate the action of a pediatric medication with low pH and high acidity in primary enamel submitted (or not) to daily applications of fluoride dentifrice. For this study, 70 blocks of primary molars (n = 10 per subgroup) were analyzed using scanning electron microscopy. Six subgroups (two control and four experimental) were submitted to different treatments for 10 days. Microscopically, the enamel blocks of the subgroups that received medication and fluoride demonstrated the largest areas of partially or totally conditioned superficial enamel. The opposite was observed in the subgroups that were not exposed to fluoride; erosions in the internal enamel and in the transition zone between deep enamel and dentine showed superior percentiles. It was concluded that the medication modified the morphology of the primary enamel and that the use of fluoride was able to reduce the erosive effect of the formulation.

Cariostatic Agents↗
PubMed1983

Matrix sialoprotein of developing bone.

Using nondegradative isolation procedures, we purified and characterized a glycoprotein from fetal calf bone that is rich in sialic acid. This bone sialoprotein (BSP) has an apparent Mr = 70,000-80,000 and stains with Alcian blue and Stains All on sodium dodecyl sulfate gels but does not stain with Coomassie blue without prior treatment with neuraminidase. This glycoprotein contains 50% protein, 12% sialic acid, 7% glucosamine, and 6% galactosamine. Fetal calf BSP is rich in glutamate (19%), aspartate (15.4%), and glycine (11.8%) but, in contrast to osteonectin and the bone proteoglycan, has relatively low amounts of leucine (4.3%). Antisera raised against fetal calf BSP localized the glycoprotein by indirect immunofluorescence to developing bone trabeculae with an overall tissue distribution identical with that of osteonectin. On competition enzyme-linked immunosorbent assay analysis, BSP was 11.5% (+/-2.4%, S.E.) of mineral-bound (guanidine-EDTA-soluble) calf bone protein. Immunoreplicas (Western blots) of calf bone extracts suggest that more than 95% of the antigenicity resided in the Mr = 70,000-80,000 region with the remaining cross-reactivity in Alcian blue positive, Mr = approximately 20,000 and approximately 30,000 bands. Brief treatment of the Mr = 70,000-80,000 species with trypsin produced lower molecular weight, Alcian blue-staining products of similar size. No BSP was detected in guanidine extracts of various soft or unmineralized connective tissues, but dentin contained small amounts (0.4%) of the protein. Rat and fetal human bone were also observed to contain a sialoprotein with similar properties and a certain degree of cross-reactivity with the bovine BSP.

Amino Acids↗
PubMed2006

Antibacterial effect of selected root-end filling materials.

The purpose of this study was to evaluate the antibacterial activity of leachable components of selected root-end filling materials: amalgam, ProRoot MTA (mineral trioxide aggregate), Intermediate Restorative Material (IRM), Super Bond C&B, Geristore, Dyract, Clearfil APX composite with SE Bond, or Protect Bond. The direct contact test (DCT) with Staphylococcus aureus, Enterococcus faecalis, and Pseudomonas aeruginosa, was used. The materials were tested immediately after application to the microtiter wells (fresh samples) and after setting for 3 days (set samples). Ten microliters of bacterial suspension was added to each well for direct contact with each material for 1 h at 37 degrees C. Growth of surviving bacteria was then measured in a microplate spectrophotometer hourly at 620 nm for 15 h. Twelve uncoated wells using identical inoculum size served as positive controls. The data obtained at the end of 15 h was subjected to one-way ANOVA and post hoc comparisons were done using Tamhane's T2 test. Fresh samples of all materials showed a 3-h delay in exponential growth of both E. faecalis and S. aureus, and a 5-h delay in growth of P. aeruginosa. Set samples of IRM and ProRoot MTA cements showed generally greater antibacterial activity than the other materials: both completely inhibited P. aeruginosa, and both delayed or limited growth of E. faecalis. The DCT, by being quantitative and virtually independent of solubility and diffusion, was found suitable to assay solid root-end filling materials. IRM and ProRoot MTA were generally more potent inhibitors of bacterial-growth than the other tested materials.

Aluminum Compounds↗
PubMed2006

Bone sialoprotein enhances migration of bone marrow stromal cells through matrices by bridging MMP-2 to alpha(v)beta3-integrin.

UNLABELLED: BMSCs migrate through matrix barriers and differentiate into osteoblasts. BSP enhances osteogenic cell migration through basement membrane and collagen matrices in vitro by localizing MMP-2 on the cell surface through alpha(v)beta(3)-integrin. INTRODUCTION: The specific mechanisms by which bone marrow stromal cells (BMSCs) leave their primary sites, move through matrices encountered during homing to their site of final differentiation, and remove preexisting matrices in preparation for bone matrix production are not well understood. MATERIALS AND METHODS: The enhanced migration of human osteoblast precursor cells through matrix barriers by bone sialoprotein (BSP) was studied by a modified Boyden-chamber assay. The bridging of normally soluble matrix metalloproteinase 2 (MMP-2) to the cell surface receptor, alpha(v)beta(3)-integrin, by BSP was analyzed by flow cytometry. RESULTS: BSP enhanced the in vitro passage of BMSCs and pre-osteoblasts through matrix barriers (Matrigel and denatured type I collagen) in a dose-dependent manner. An intact ArgGlyAsp (RGD) was required in the BSP for enhanced migration through the barriers but was not sufficient, as shown by the inactivity of two other SIBLING (Small Integrin-Binding LIgand, N-linked Glycoprotein) family members, osteopontin and dentin matrix protein-1. The specificity of the BSP enhancement activity was apparently caused by this molecule's ability to bridge MMP-2 to the cell surfaces. CONCLUSIONS: Pre-osteoblasts and their BMSC precursors may use MMP-2/BSP/integrin complexes to disrupt matrix barriers during migration to their final destinations in vivo.

Bone Marrow Cells↗
PubMedDate not supplied

Rates of mineral loss in human enamel during in vitro demineralization perpendicular and parallel to the natural surface.

Human enamel is a structurally anisotropic material. The aim of this study was to investigate whether this structural anisotropy is reflected in the demineralization behaviour of enamel. Kinetics of demineralization of in vitro caries lesions with the direction of acid attack perpendicular to the natural surface of dental enamel from human premolar teeth were compared with kinetics when demineralized parallel to this surface. Pairs of enamel samples from the same tooth were demineralized under identical conditions. Loss of mineral with time was very nearly linear for both directions (consistent with the rate-controlling step being reaction at the advancing front rather than transport processes), but the perpendicular rate was, on average, about 14% higher than the parallel rate. The rate of demineralization parallel to the surface increased from the natural surface to the enamel-dentine junction by 10-25%, depending on sample. The origin of fine structure and slight departures from linearity in the loss of mineral with time plots are discussed. Mineral masses per unit area were determined from absorption of a 15-microm diameter X-ray beam using photon (AgKalpha) counting methods.

Anisotropy↗
PubMed1996

Fluoridation of hydroxyapatite powder by ammonium hexafluorosilicate.

Diamine silver fluoride [AgF: (NH3)2AgF] is a unique fluoride solution used clinically in Japan for primary teeth. AgF has been shown to reduce dental caries and dentine hypersensitivity. However, AgF also stains teeth black due to sulfide precipitation and thus is unacceptable for permanent teeth. In the present study, the potential value of ammonium hexafluorosilicate [SiF: (NH4)2SiF6], which has a formula similar to that of AgF but contains no Ag, was studied with respect to its ability to fluoridate apatite. Hydroxyapatite [HAP: Ca10(PO4)6(OH)2] powder was treated with several topical fluoride solutions, i.e. neutral sodium fluoride, acidulated phosphate fluoride (APF) along with AgF and SiF. Following treatment, the HAP powders were analyzed for their fluorine content, crystallinity changes, and solubility in acidic solution. The highest level of fluoridated HAP [FAP: Ca10(PO4)6(OH)xF2-x] was observed in HAP powder treated with SiF, even though more total fluorine in the form of FAP and CaF2 was observed in HAP powder samples treated with APF. Presumably as a consequence of this higher level of FAP formation after SiF treatment, the highest level of crystallinity along with the lowest solubility in acidic solution were observed in HAP powder treated with SiF solution. We concluded, therefore, that SiF may have potential value for use as a topical fluoride solution.

Acidulated Phosphate Fluoride↗
PubMed1998

Osteoclast differentiation factor (ODF) induces osteoclast-like cell formation in human peripheral blood mononuclear cell cultures.

We have reported that osteoclast differentiation factor (ODF) expressed on the plasma membrane of osteoblasts/ stromal cells is a ligand for osteoclastogenesis inhibitory factor (OCIF). A genetically engineered soluble form of ODF (sODF) induced osteoclast-like multinucleated cells (OCLs) in the presence of M-CSF in mouse spleen cell cultures. Osteoblasts/stromal cells were not required in this process. To elucidate the mechanism of human osteoclastogenesis, human peripheral blood mononuclear cells (PBMCs) were cultured for 7 days with sODF and human M-CSF in the presence or absence of dexamethasone. Treatment of human PBMCs with sODF together with M-CSF induced OCLs, which expressed tartrate-resistant acid phosphatase and vitronectin receptors, produced cAMP in response to calcitonin, and formed resorption pits on dentine slices. OCLs were also formed from the adherent cell population of human PBMCs. Dexamethasone was required for human OCL formation in culture of whole PBMCs but not in culture of the adherent cell population. OCL formation was strongly inhibited by OCIF simultaneously added. These results clearly indicate that like in mouse osteoclastogenesis, ODF is a critical factor for human osteoclastogenesis. The present study also indicates that OCIF acts as a naturally occurring decoy receptor for ODF in inhibiting signal transduction in human osteoclast formation.

Animals↗
PubMed2002

Adhesion/decalcification mechanisms of acid interactions with human hard tissues.

In order to study adhesion/decalcification mechanisms of acid interactions with human hard tissues such as bones and teeth, the chemical interaction of five carboxylic acids (acetic, citric, lactic, maleic, and oxalic) and two inorganic acids (hydrochloric and nitric) with enamel and two synthetic hydroxyapatite (HAp) powders with, respectively, a high and a low crystallinity were analyzed using X-ray photoelectron spectroscopy (XPS), atomic absorption spectrophotometry (AAS), and spectrophotometry (S). X-ray diffraction revealed that the crystallinity of the highly crystallized HAp was considerably higher than that of enamel while the crystallinity of the poorly crystallized HAp was similar to that of dentin and bone. XPS of acid-treated enamel demonstrated for all carboxylic acids ionic bonding to calcium of HAp. AAS and S showed for both HAps that all carboxylic and inorganic acids except oxalic acid extracted Ca significantly more than P, leading to a Ca/P ratio close to that of synthetic HAp (2.16 w/w). Oxalic acid extracted hardly any Ca, but substantially more P, leading to a significantly smaller Ca/P ratio than that of HAp. AAS showed that the calcium salt of oxalic acid hardly could be dissolved, whereas the calcium salts of all the other acids were very soluble in their respective acid solution. These results confirm the adhesion/decalcification concept (AD-concept) previously advanced. Depending on the dissolution rate of the respective calcium salts, acids either adhere to or decalcify apatitic substrates. It is concluded that the AD-concept that originally dictated the interaction of carboxylic acids with human hard tissues can be extended to inorganic acids, such as hydrochloric and nitric acid. Furthermore, HAp crystallinity was found not to affect the adhesion/decalcification behavior of acids when interacting with apatitic substrates, so that the AD-concept can be applied to all human hard tissues with varying HAp crystallinity.

Acids↗
PubMedDate not supplied

Effects of tartar-control dentifrice on tooth sensitivity: a pilot study.

PURPOSE: The purpose of this three-week, double-blind pilot study was to assess the effects of a tartar-control dentifrice on tooth sensitivity. METHOD: Fifty-six volunteer dental hygiene students completed a 14-item questionnaire regarding their oral health. Eighteen students were excluded from the study due to prior tooth sensitivity. Thirty-eight students were randomly assigned to either the experimental group using a tartar-control dentifrice (containing tetrapotassium pyrophosphate, PEG-6, disodium pyrophosphate, and tetrasodium pyrosulphate in a 5.0% soluble pyrophosphate formulation) or the control group using a regular dentifrice. Participants brushed for three weeks twice daily and then completed a post-treatment questionnaire, which included questions about tooth sensitivity. Differences between groups in reported sensitivity were measured by Fisher's Exact Test. RESULTS: Fisher's Exact Test revealed a statistically significant difference in sensitivity experienced by the experimental group compared to the control group (p < 0.05), which reported no sensitivity. The phi coefficient, used to examine the strength of the relationship between tartar control paste and tooth sensitivity, was found significant at p < 0.02. CONCLUSION: These findings suggest that patients may experience dentinal hypersensitivity when using the tartar-control toothpaste tested. Further long-term studies are required to test various brands of tartar-control dentifrice with a larger, more diverse sample for clinical measures of sensitivity.

Adult↗
PubMed2005

Erosion--chemical and biological factors of importance to the dental practitioner.

The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.

Calcium↗