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Amelogenesis imperfecta: a scanning electron microscopic and microradiographic study.

The aim of the present study was to use scanning electron microscopy (SEM) to visualize the morphology of the enamel surface in 12 primary teeth from children with amelogenesis imperfecta (AI). The observations were correlated to genetic, clinical and microradiographic data from the same teeth and to non-affected control teeth. SEM showed similar disturbances in teeth with a clinical predominance of hypoplasias and in teeth with a predominance of hypomineralization. In the microradiographs the enamel of most teeth showed both hypoplasias and areas of hypomineralization, independently of the predominant clinical manifestation. In the one boy with an X-linked inheritance pattern, both SEM and microradiography showed the morphology of the enamel to be unique in the present study. In the other teeth, similar manifestations were found in cases with AI as an AD trait and in the sporadic cases.

Amelogenesis Imperfecta↗

Brushite in the pulp of primary molars.

This study was undertaken to investigate the mineral phase of spherulitic calcifications discovered in the pulpous mesenchyme of human primary molars by microradiography. Analytical scanning electron microscopy and x-ray diffraction disclosed that well-crystallized brushite is the major compound of the spherulites. The mechanism leading to the crystallization of brushite is far from well understood. Histologically, on decalcified sections, inflammatory cells and capillaries can be seen trapped in the spherulites. In the light of these findings, it could be suggested that metabolic conditions may promote the crystallization of brushite in the pulp of primary molars.

Adolescent↗

Scanning electron microscopic, light microscopic and microradiographic study of giant tubules in bovine dentin.

Giant tubules (GT) in the axiomesiodistal plane of the incisal dentin of 21 unerupted permanent incisors of 1/2-2-yr-old calves were studied by scanning electron microscopy, light microscopy and contact microradiography. A technique is described by which the incisal dentin was split along the axiomesiodistal plane exposing the GT lumina longitudinally for SEM study. The luminal organic content was carefully removed mechanically or chemically. The GT originated 50-250 microns underneath the incisal dentino-enamel junction and converged pulpally, terminating in the incisal edge of the pulp. A confluence of adjacent tubules towards the pulp was seen. Each GT had a relatively constant diameter along its length, in the range of 10-50 micron. The dentinal tubules circumvented the GT origins and pursued a straight course pulpally, parallel to the characteristic wall zone surrounding each GT. Very few dentinal tubules entered the GT lumen at any level. The luminal lining along the larger part of the GT consisted of collagen fibrils forming a criss-cross pattern, while the most pulpal part was lined by a smooth organic sheath. The GT walls at any transversal level within one tooth had a lower mineral content than the circumpulpal dentin between them. It was concluded that the GT formation is not caused by crowding of the odontoblasts.

Animals↗

Influence of glutardialdehyde on dentin demineralization in vitro and in vivo.

In this paper the results are presented on the action of glutardialdehyde (GDA) on the in vitro demineralization of human dentin and on the in vivo demineralization of dentin using the Ogaard orthodontic banding system. The results show that a 2 min application of a 2% GDA solution at pH = 3.6 reduces dentin demineralization in vitro and in vivo substantially. Microradiography shows a percentage reduction of lesion depth and mineral loss in vitro of 20 and 36%, respectively. After 2 wk in vivo demineralization the same percentage reductions are 60 and 44%, respectively. The mechanism of action of GDA on dentin is not certain yet. Presumably the in vitro action is due to surface cross-linking of the dentin matrix causing reduced Ca and phosphate transport out of the dentin. In vivo an additional effect may be a rather short term influence of GDA on plaque or on plaque accumulation. The results of this paper indicate that glutardialdehyde is an interesting agent to consider in the reduction of root caries.

Aldehydes↗

Column-like structures following the course of tubules in human dentin.

Sections, 60-180 microns thick, of permanent teeth, intact or with minor fillings, were cut parallel or transversal to the course of the dentinal tubules. Some teeth were demineralized, embedded in paraffin wax, cut in series, and stained with toluidine blue pH 5.6, hematoxylin-eosin, or PAS. Altogether, sections of 90 teeth were examined by ordinary and polarized light microscopy and contact microradiography. Alternating light and dark bands, usually 8-30 microns wide, extended from the pulpal border along the course of the tubules, gradually increasing in width, fading in the mantle dentin. Cross-sectioned bands appeared as dark and light "discs". This was the background for the term "columns". In the dark columns, usually exhibiting crowding of tubules, the intertubular dentin was dark and radiolucent; in the light columns, light and radiopaque. Dark columns contained a high amount of GAGs, assumed to have exerted an inhibitory effect on their mineralization. The columns probably represent structural elements in the architecture of dentin, possibly offering resistance against mechanical stress. It was suggested that the columns might depict functional differences in the matrix secretion and mineralization capacities of odontoblasts.

Adult↗

Column-like structures of human dentin in carious and artificial lesions.

Serial sections of 36 human teeth with minor to medium-sized carious lesions, adequate sections from previous studies of artificial lesions adjacent to fillings of amalgam (AM), silicate cement (SI) and glass ionomer cement (GI) were studied by ordinary light microscopy and microradiography. Six artificial primary root lesions were included. In carious lesions, dentin columns were visible in the demineralization zone and partly also in the translucent/radiopaque zone. A typical feature of the artificial lesions adjacent to SI fillings was highly radiopaque columns alternating with radiolucent ones. In the GI group such columns were seen at the cavity wall and the advancing front of the outer lesion. In the AM group dark columns were unveiled as pegs in the latter localization. The findings led to the assumption that the dark columns of intact dentin are preferred pathways of acid diffusion in artificial and, possibly, carious lesions. Increased radiopacity of columns in the SI and GI groups is explained by continued exposure of the tooth surface to fluoride dissolved from these fluoride-rich filling materials.

Dental Amalgam↗

Effect of fluoride mouthrinsing on caries lesion development in shark enamel: an in situ caries model study.

Shark enamel consists of nearly pure fluorapatite and has been shown to demineralize in an in situ caries model. The present study was conducted to investigate whether additional fluoride supplementation in the form of mouthrinsing would inhibit lesion development in shark enamel. The study slabs of shark enamel were mounted in dental appliances. Six individuals wore the appliances while rinsing daily with a neutral 0.2% NaF solution for 4 wk. The specimens were analyzed by means of quantitative microradiography, and the data compared with a previous study using untreated shark enamel and the same participants. It was found that fluoride rinsing did not measurably inhibit enamel demineralization in 4 wk. Scanning electron microradiographs showed that calcium fluoride-like material was not formed on shark enamel after neutral fluoride treatment, supporting a previous study. The present study indicates, therefore, that formation of a calcium fluoride-like material on the enamel surface may be essential for the cariostatic effect of topical agents.

Adolescent↗

Effect of a combined chlorhexidine and NaF mouthrinse: an in vivo human caries model study.

Chlorhexidine (CHX) is probably the most widely used and the most potent chemical plaque inhibitory agent, whereas fluoride (F-) is the only truly accepted anticaries agent available at present. As they have discrete mechanisms of action, a combination effect of these agents on human dental caries may exist. The inhibitory effect of CHX on the formation of, and acid production in, plaque may reduce a relatively extreme cariogenic challenge sufficiently for it to be overcome by the local F- concentrations achieved by brushing or rinses. The aim of this study was to evaluate the possible caries inhibitory effect of combining 2.2 mM CHX mouthrinses used twice daily with daily 11.9 mM NaF rinses in an in vivo human caries model using plaque-retaining bands on premolars scheduled for extraction. Nine subjects (a total of 28 teeth) were fitted with the bands for 4 wk. Saliva and plaque samples were collected before and after the study period for bacterial cultures, and the tooth surfaces were analyzed by microradiography after careful tooth extractions. The combination of CHX and F- rinses resulted in enamel mineral loss only slightly higher than that observed in "sound" enamel and clearly less than with F- rinses alone. Both total plaque bacteria and Streptococcus mutans were reduced by CHX rinses, confirming the discrete mechanisms of action.

Adolescent↗

Effects of aluminum (III) and fluoride on the demineralization of bovine enamel: a longitudinal microradiographic study.

Longitudinal microradiography has been used to determine inhibiting effects of aluminum (III), Al, and fluoride on mineral loss from slices of bovine enamel exposed to a demineralizing solution 4 h daily for 35 days. Inhibitor treatment was 5 min four times daily. For the remaining time, the samples were immersed in a neutral calcium phosphate solution which allowed neither remineralization nor demineralization. This study indicates that a 1-mM (27 ppm) solution of Al in a 0.1-M lactate solution, pH 5, has an inhibitory effect on the in vitro demineralization of bovine enamel. Application of this solution alternating with 20 mM (380 ppm) fluoride gave the same total inhibition as treatment with 20 mM fluoride alone.

Alum Compounds↗

The effects of a sodium hypochlorite treatment on demineralized root dentin.

The effects of a 10% NaOCl treatment for 2 min on demineralized human root dentin were investigated by means of: microradiography (MR), scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM) and secondary ion mass spectroscopy (SIMS). MR measurements revealed that NaOCl caused a tissue contraction not related to water loss but to removal of organic substance(s), resulting in reductions of the lesion depth and mineral loss values by 15% and 42%, respectively. CLSM observations on wet dentin showed that the dentinal tubules underneath the surface are clearly observable and not deformed substantially by the NaOCl, except near the outermost surface. This indicates the importance of wet as well as of dried (high vacuum) observations. SEM micrographs (high vacuum) showed definite changes in the outer dentin surface structure; 85% of the originally open dentinal tubules were closed after NaOCl treatment. No marked changes were observed in the dentin ultrastructure inside lesions, as shown by SEM on fractured surfaces. SIMS data, pertaining to samples in high vacuum, showed a remarkable increase of chlorine (Cl) content in the entire lesion due to the NaOCl, indicating deep penetration of the original OC1 ions. The results suggest that the 2-min treatment of demineralized dentin by NaOCl solutions removes and/or changes part of the dentin matrix in nearly the whole lesion. As a consequence the mineral is somewhat redistributed, the outermost surface of a few mu m is changed, but the main dentin structure and element composition are still intact. These findings indicate that NaOCl treatments are of interest in remineralization and hyper-remineralization studies of dentin.

Adolescent↗

Scanning microradiographic study on the influence of diffusion in the external liquid on the rate of demineralization in hydroxyapatite aggregates.

Subsurface demineralization in enamel caries is known to entail diffusion of reagents and products both within the lesion and within the plaque biofilm external to the lesion. However, development of a predictive mathematical model for subsurface demineralization is hindered by limited quantitative understanding of the effects of these diffusion processes. The purpose of this quantitative study was to investigate and understand the effect of external diffusion length on the rate of demineralization in a simple model system. Ten, 500-microm thick sections cut from a porous hydroxyapatite (HAP) pellet were inserted in scanning microradiography (SMR) cells. The exposed thin edges of the sections were initially separated by columns of water (diffusion lengths) of 0-0.9 cm from a 1-l reservoir of demineralizing buffer (pH 4). Buffer was found to diffuse from the reservoir through the increasing diffusion lengths to the exposed HAP surface, whilst dissolved product diffused along the reverse path. Rates of HAP loss (from SMR measurements) decreased as the diffusion length increased. Experimental data were fitted to a general diffusion-reaction model. This showed that the solution near the HAP surface was almost completely saturated with HAP, and that the diffusion of dissolution products, rather than of buffer species, was rate limiting.

Acetic Acid↗

Establishing quantitative light-induced fluorescence cut-offs for the detection of occlusal dentine lesions.

The aims of this in vitro study were, first, to define suitable cut-off values for the detection of occlusal dentine lesions by means of quantitative light-induced fluorescence (QLF), and, second, to compare the validity of light microscopy (LM) and microradiography (MR) as reference standards. Fifty-four third molar occlusal fissures with sound sites or non-cavitated lesions were examined. Standard QLF equipment was used to capture, display, store, and analyze fluorescence images. Each tooth was cut into sections in the bucco-lingual direction using a microtome saw, and the caries levels were subsequently assessed with the two reference methods. The histological examination with LM indicated that 46% of the specimens had carious lesions progressing into the dentine compared with 41% measured using MR (D3-4 level). Using optimal cut-off levels for the detection of dentine lesions, the sensitivity and specificity values were > 80%. The area under the receiver operating characteristic curve was slightly higher for MR (0.91-0.93) than for LM (0.88-0.89). The results of this study give a good idea of suitable cut-off points for the detection of occlusal dentine lesions using QLF. Owing to the small number of specimens in this study, further studies should be carried out before establishing definite cut-offs.

Area Under Curve↗

Congenital hypothyroidism and changes in the enamel of deciduous teeth.

Deciduous teeth from children with congenital hypothyroidism were collected and ground sections were prepared. The sections were analysed by means of polarized light and microradiography. The enamel in ground sections of deciduous teeth from children with congenital hypothyroidism showed an increase in areas with elevated pore volume distribution in both the pre- and postnatal enamel. The findings suggest that thyroid hormone influences enamel maturation. Further, alterations in enamel structure, presumably due to prenatal thyroid deficiency, were found to be more common among children with neurological abnormalities at the age of 7 to 9 years.

Child, Preschool↗

Effect of 2% plain and fluoridated milk on root surface caries in vitro.

The caries-protective effect of milk and fluoridated milk on enamel has been reported; however, few data are available concerning the role of milk and/or fluoridated milk on root surfaces. The aim of this study was to compare the effect of plain and fluoridated milk on root surface caries. Artificial root surface lesions were created, sectioned and analyzed using polarized light microscopy (PLM) and microradiography (MRG). The sections were covered except for the original surface and assigned to a treatment group. The samples were immersed in 2% plain milk or fluoridated milk for 40 hours and re-evaluated. Changes were measured and mean differences were compared with an unpaired t-test. Both techniques revealed a reduction in lesion depth for each milk group; however, a significantly greater reduction (p<0.05) was observed with the fluoridated milk. These results suggest that fluoridated milk may have a beneficial effect on the remineralization of root surface caries.

Animals↗

Nuclear vacuoles in nuclear cataract.

The human lens nucleus has always been described as a homogeneous part of the lens, and if any distinct opacities are found, these are considered to be congenital. However, in lenses with nuclear cataract, both of senile type and those induced by hyperbaric oxygen, we have found relatively transparent vacuoles in the nucleus of similar appearance as cortical vacuoles. In cataracts induced by hyperbaric oxygen the vacuoles were reversible to some extent. The vacuoles have been investigated with slit-lamp photography and quantitative microradiography. Nuclear vacuoles were found in 11 out of 25 patients treated with hyperbaric oxygen compared to 19 out of 100 pre-operatively examined senile nuclear cataracts. In the microradiographs the vacuoles appeared as dark rounded areas with a lower dry mass content (approximately 0.30 g X cm-3) than the surroundings (approximately 0.50 g X cm-3).

Adult↗

Remineralization of enamel subsurface lesions in situ by sugar-free lozenges containing casein phosphopeptide-amorphous calcium phosphate.

BACKGROUND: The anticariogenic potential of casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP) has been demonstrated using laboratory, animal and human in situ caries models. The aim of this study was to determine the effect of CPP-ACP incorporation into a sugar-free lozenge (pressed mint tablet) on enamel remineralization in a human in situ model. METHODS: The study utilized a double-blind, randomized, cross-over design with four treatments: (i) a lozenge containing 56.4mg (3 per cent w/w) CPP-ACP; (ii) a lozenge containing 18.8mg (1 per cent w/w) CPP-ACP; (iii) a lozenge not containing CPP-ACP; and (iv) a no lozenge nil-treatment control. Ten subjects wore removable palatal appliances with four, human-enamel, half-slab insets containing subsurface lesions. Lozenges were consumed, without chewing, four times per day for 14 days duration. After each treatment period the enamel slabs were removed, paired with their respective demineralized control, embedded, sectioned and subjected to microradiography and computer-assisted densitometric image analysis to determine the level of remineralization. RESULTS: The incorporation of CPP-ACP into the lozenge significantly increased enamel subsurface lesion remineralization with 18.8 and 56.4mg of CPP-ACP increasing remineralization by 78 and 176 per cent respectively, relative to the control sugarfree lozenge. CONCLUSION: This study demonstrates that lozenges are a suitable vehicle for the delivery of CPP-ACP to promote enamel remineralization.

Administration, Buccal↗

The effect of different commercial dentifrices on enamel lesion progression: an in vitro pH-cycling study.

AIMS/OBJECTIVES: To evaluate and compare the de/remineralization effects of dentifrices manufactured locally in some developing countries. DESIGN: Utilisation of the in vitro single-section and the pH-cycling model. SETTING: Laboratory. TEST MATERIALS: Dentifrices: Maxam DFP, Maxam Tartar Control, First, Tianqi Medicated from China; Vicco Vajradenti from India; Colgate MFP2, Crest Tartar Control from USA; and one non-fluoride dentifrice as control. METHODS: Sound molars were painted, leaving a 1 mm wide 'window' on the buccal and/or lingual surface and placed in a demineralisation solution for 96 h to produce artificial caries lesion approximately 80-100 mm deep. The teeth were then longitudinally sectioned (approximately 100 mm thick), and randomly divided into 8 groups (22 sections/group). The pH cycling model was utilised for 10 days. OUTCOME MEASURES: Polarised light microscopy and microradiography were used to evaluate the lesion progression before and after treatment. RESULTS: The control group showed an increase in lesion depth of 70 per cent and was statistically different from some test groups which ranged from -2 per cent to 68 per cent (P < 0.01, t-test). Statistically significant differences were also observed among some of the fluoride containing groups. CONCLUSIONS: This study suggests that, when compared to 'multinational dentifrices', Chinese and Indian dentifrices manufactured locally failed to show 'healing' efficacy even though they claimed to contain varying levels of fluoride.

China↗

The effects of child formula toothpastes on enamel caries using two in vitro pH-cycling models.

AIMS/OBJECTIVES: To compare, using two pH-cycling models, the de/remineralisation effects of children's toothpastes on primary teeth. DESIGN: In vitro single-section and pH-cycling models. METHODS: Primary teeth were placed in demineralising solution for 96 hours to produce artificial carious lesions 60-100 microm deep. They were cut into 100 microm thick sections and assigned to 6 groups. Sections in Groups A and D were exposed to a non-fluoridated toothpaste, those in Groups B and E to half-pea-sized (0.16g) and those in Groups C and F to pea-sized portions (0.32g) of a 500ppm F toothpaste. pH-cycling Model I (Groups A, B, C), without added fluoride, ran for 7 days, while Model II (Groups D, E, F), with 0.25ppm F, ran for 10 days. OUTCOME MEASUREMENTS: Lesions were evaluated using polarised light microscopy and microradiography. RESULTS: Lesions in Groups B and E progressed by 64% and 61%, respectively, while those in Groups C and F progressed by only 19% and 23% respectively. CONCLUSIONS: Both 10-day and 7-day pH-cycling models were suitable for studying carious lesion progression in primary teeth (the demineralising and remineralising solutions of the 10-day cycling model contained 0.25ppm F). A pea-sized portion (0.32g) of 500ppm F toothpaste slowed down the demineralisation progression better than a half-pea-sized portion.

Cariostatic Agents↗