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At least 19 recordsLinked to original sources

Experimental study of phosphopeptide in promoting tooth remineralization.

OBJECTIVE: To explore a new method for effective and safe prevention and treatment of caries. METHODS: Following the theory of tooth remineralization, we searched for the mechanism and clinical application of tooth remineralization with phosphopeptide. RESULTS: Phosphopeptide, with calcium and phosphorus, had a high affinity for hydroxyapatite and could enhance tooth remineralization. CONCLUSION: Phosphopeptide was effective in the prevention and treatment of tooth decay. Clinically, it could be safely applied.

Animals↗

Increased remineralization of tooth enamel by milk containing added casein phosphopeptide-amorphous calcium phosphate.

Casein phosphopeptide amorphous calcium phosphate nano-complexes (CPP-ACP) in chewing gum, lozenges and mouthrinses have been shown to re-mineralize enamel subsurface lesions in human in situ experiments. The aim of this double-blind, randomized clinical study was to investigate the capacity of CPP-ACP added to bovine milk to re-mineralize enamel subsurface lesions in situ. Ten subjects drank milk containing either 2.0 or 5.0 g CPP-ACP/l or a control milk whilst wearing removable appliances with enamel slabs containing subsurface demineralized lesions. Each 200 ml milk sample was consumed once a day for each weekday over three consecutive weeks. After each treatment and one weeks rest the subjects crossed over to the other treatments. At the completion of the treatments the enamel slabs were removed and remineralization determined using microradiography and microdensitometry. The results demonstrated that all three milk samples re-mineralized enamel subsurface lesions. However, the milk samples containing CPP-ACP produced significantly greater remineralization than the control milk. The re-mineralizing effect of CPP-ACP in milk was dose-dependent with 2.0 and 5.0 g CPP-ACP/l producing an increase in mineral content of 70 and 148%, respectively, relative to the control milk. The differences in remineralization following exposure to the three milk samples were all statistically significant (P<0.001). In conclusion, this study shows that the addition of 2.0-5.0 g CPP-ACP/l to milk substantially increases its ability to re-mineralize enamel subsurface lesions.

Administration, Buccal↗

Enamel remineralization on teeth adjacent to Class II glass ionomer restorations.

PURPOSE: To examine the in vitro remineralization of incipient carious lesions on teeth adjacent interproximally to teeth with Class II glass ionomer cement restorations. MATERIALS AND METHODS: Artificial carious lesions were created at the contact area of 30 teeth. Ten teeth had Class II glass ionomer cement/resin composite restorations placed, 10 teeth had Class II glass ionomer silver cermet restorations placed and 10 teeth had Class II amalgam restorations placed. Sections 100 microns thick were obtained longitudinally through the caries sites and polarized photomicrographs were taken in imbibition media of water and Thoulet's (R.I. 1.41 and 1.47) solutions, representing 5%, 10% and 25% pore volume respectively. Varnish was placed on the section, leaving only the external section site exposed, then sections were situated back into the original tooth. The restored teeth were abutted to the carious tooth so that the restorations came into contact with the adjacent restoration. The specimens were placed into closed environments of artificial saliva for 14 days, then were photographed again under polarized light and areas of the carious lesions were quantitated. RESULTS: An ANOVA indicated significant variance in adjacent tooth remineralization, when comparing the experimental groups, in imbibition media of water (P < 0.05), Thoulet's 1.41 solution (P < 0.008) and Thoulet's 1.47 solution (P < 0.006). Duncan's multiple range test demonstrated the glass ionomer cement/resin composite group to have significantly greater decrease in pore volume (P < 0.05) than the amalgam control group in water imbibition media and Thoulet's 1.47 media. There was no statistically significant difference between the glass ionomer cement/resin composite and glass ionomer silver cermet groups in these two imbibition media. The glass ionomer cement/resin composite group demonstrated significantly more (P < 0.05) decrease in pore volume than both the glass ionomer silver cermet group and amalgam control group in Thoulet's 1.47 imbibition media.

Analysis of Variance↗

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.

Animals↗

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.

Bicuspid↗

Solution activity product (KFAP) and simultaneous demineralization-remineralization in bovine tooth enamel and hydroxyapatite pellets.

The effects of changing the ion activity product of the remineralization solution at pH 4.5 (pKFAP 108-118) on the remineralization behavior of demineralized bovine tooth enamel and hydroxyapatite pellets have been studied. Solutions containing calcium-4.5, phosphate, and fluoride in acetate buffers were used. The 45Ca/F molar ratios indicated the formation of fluoridated hydroxyapatite in the enamel or the pellet when the pKFAP values for remineralizing solutions were less than 112. When the pKFAP values were greater than 112, the 45Ca/F ratios were found to be much less than 5. Also, when the pKFAP values were large (greater than 112), the remineralization patterns based on the fluoride distribution in the tooth (or pellet) were found to be different than when the pKFAP values were small (less than 112). The hypothesis that a pKFAP value of 112 is the demarcation between remineralization only and simultaneous dissolution-remineralization has been proposed based on these results.

Animals↗

Micromorphological and micronanalytical characterization of stagnating and progressing root caries lesions.

Root caries is the predominant disease of the tooth tissues in the elderly population and differs in progression and micromorphology from coronal dentin caries. Therefore, different clinical concepts are needed for the treatment of these progressing and arrested lesions. It was the aim of this study to investigate the three-dimensional structure and volume of stagnating and progressing root caries lesions and to determine the mineral composition of the different lesion zones to achieve a better understanding of the natural history of root caries lesion formation. Of 21 extracted human teeth of patients between 42 and 77 years of age with stagnating and progressing root caries lesions serial sections were cut and investigated with polarized light and scanning electron microscopy. From the polarized light micrographs 3D reconstructions were made to determine the volumes of the lesion zones and their relations expressed in a demineralization index (DI). With increasing size of the demineralizing zone the DI increased indicating an increase in the size of the translucent zone. The 3D reconstructions showed distinct differences between stagnating and progressing root caries lesions. In the hypermineralized translucent dentin not all dentin tubules were obliterated by intratubular dentin and within the translucent dentin scattered dead tracts were found. Electron dispersive X-ray (EDX) analysis showed that the intertubular dentin of the translucent dentin was also demineralized to a certain extent. The results indicate distinct morphological differences between progressing and stagnating root caries lesions which may have consequences for treatment strategies.

Adult↗

Cervical tooth wear and sensitivity: erosion, softening and rehardening of dentine; effects of pH, time and ultrasonication.

BACKGROUND: Cervical dentine wear is commonly observed and may be associated with dentine hypersensitivity. Erosion is thought to play a part in both conditions but compared to enamel has been little studied in dentine. AIM: The aims of these studies in vitro were to: (i) determine the effects of citric acid on dentine at different pH values and over time; (ii) measure the depth of dentine demineralisation or softening using ultrasonication; (iii) determine whether softened dentine can be remineralised or rehardened using artificial saliva. METHODS: Groups of flat dentine specimens prepared from unerupted human third molar teeth were: (a) exposed to citric acid at pH 3.2 for periods up to 4 h with mineral water as control; (b) exposed to citric acid at pH 2.54, 3.2, 4.5, 5.5 and 6.0 for 2 h and then subjected to ultrasonication stepwise up to 480 s; (c) exposed to citric acid at pH 2.54, 3.2, and 4.5, placed into artificial saliva for 24 h and then subjected to ultrasonication as in (b). Loss of dentine was measured by profilometry, after, each phase of erosion, ultrasonication and immersion in artificial saliva. RESULTS: Depth of erosion significantly increased non-linearly with time and significantly decreased with increasing pH. Ultrasonication had minimal albeit significant effects on control specimens. Removal of softened dentine increased with ultrasonication time. Depth of softening significantly increased with increasing erosion time to 2 h, plateauing at 2 microm. Depth of softening increased to 2 microm from pH 2.54 to pH 3.2 and decreased at higher pH values thereafter. 24 h in artificial saliva provided no protection to the soften zone against ultrasonicaion. Citric acid at all pH values and exposure times removed the dentine smear layer to expose tubules. Ultrasonication did not remove the smear layer on control specimens but removed all deposits formed after exposure to artificial saliva. CONCLUSION: It is concluded that dentine is susceptible to erosion even at relatively high pH, the tubule system is readily exposed and dentine, unlike enamel, shows little propensity to remineralise.

Analysis of Variance↗

Effects of chelating agents and sodium hypochlorite on mineral content of root dentin.

Effects of combined and single use of EDTA, RC-Prep, and NaOCl on mineral content of root dentin were evaluated in vitro using energy dispersion spectrometric microanalysis. Thirty-six standardized midroot dentin specimens obtained from human anterior teeth were used. Specimens were polished and divided into six experimental groups. The first two groups were treated with EDTA or RC-Prep followed by NaOCl irrigation. Groups 3 to 5 were treated with EDTA, RC-Prep, and NaOCl, respectively. The last group was irrigated with saline solution as a control. Levels of calcium, phosphorus, and magnesium were measured in the root dentin after treatments. The results showed that (i) EDTA combined with NaOCl irrigation as final flush and NaOCl alone changed the calcium/phosphorus ratio of root dentin significantly (p < 0.05); and (ii) there was a significant increase in the magnesium level after the use of chelating agent combined with NaOCl (p < 0.05). It was concluded that using NaOCl irrigation as final flush altered the effectiveness of chelating agents on root dentin.

Calcium↗

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↗

A proposal for a new classification of lesions of exposed tooth surfaces.

In the presence of improved methods of identification and treatment of lesions on the exposed surfaces of teeth, it should now be acknowledged that the GV Black "classification of carious cavities" is out of date. This paper describes a new system, proposed in 1997, discussed broadly throughout the profession, and eventually modified. The system has been adopted in several regions around the world as being a useful corollary to the current developing concept of minimal intervention dentistry. It is now desirable to adopt a new approach to the identification and recording of the lesions caused by both caries and non-carious tooth loss. A major advantage arising from its adoption would be that it would encourage the profession to minimise the amount of normal healthy tooth structure that is often sacrificed in pursuit of the cavity designs as suggested by Black. The authors are members of a Project Group of the FDI Science Committee, and this paper explains the concept and offers justification for the adoption of the system.

Dental Caries↗

Fluoride distribution in sound and carious root tissues of human teeth.

Proton probe analysis has been used to provide for the first time quantitative F concentration data in carious root tissues from subjects consuming water containing 1 ppm F. In small lesions at the neck of the tooth with minimal tissue loss the F concentration was significantly higher at the outer lesion edge than at the outer edge of adjacent sound root tissue. In one sample with high F values the lesion edge had 19,000 ppm F and the adjacent sound root surface 5,400 ppm F microg F/g apatite). In large lesions with extensive cavitation F was again concentrated in the outer edge of the lesion and was significantly higher (1,800-4,100 ppm) than in adjacent sound inner dentine (190-290 ppm). Fluoride concentrations varied markedly along the outer edge of both normal and carious root tissues. Fluoride increase at the lesion edge is not an effect of tissue shrinkage but probably a result of remineralisation events during caries. This additional F may be expected to increase tissue resistance to further acid attacks.

Acids↗

Tooth-surface progression and reversal changes in fluoridated and no-longer-fluoridated communities over a 3-year period.

OBJECTIVE: To compare permanent tooth surface-specific progression/reversal changes between fluoridation-ended (F-E) and still-fluoridated (S-F) communities in British Columbia, Canada, over a 3-year period. METHODS: D1D2MFS examinations were contrasted for 2,964 schoolchildren in 1993/94 (grades 2, 3, 8 and 9) and 1996/97 (grades 5, 6, 11 and 12). Generalized Estimating Equation (GEE) models explored the relation between progression/reversal changes and fluoridation status, age, gender, socioeconomic status, and dietary/fluoride histories. RESULTS: Within a scenario of low levels of caries overall, few children had multiple surfaces progressing. At least one smooth surface progressed in 31.4% of subjects; at least one pit-and-fissure (PF) surface progressed in 43.1% of subjects. At least one smooth surface reverted in 89% of subjects who had reversible stages; at least one PF surface reverted in 23.8% of subjects who had reversible stages. GEE (smooth) indicated that odds ratios of progression were twice as large in the F-E site compared to the S-F site, and slightly increased in older participants and in participants exposed to more fluoride technologies. GEE (PF) also indicated that progression was slightly more common in the F-E site; more frequent snacking and lower parental educational attainment had modest associations with increased progression in PF surfaces. For the two types of surfaces, GEE models demonstrated that unerupted surfaces were less likely to progress than sound surfaces. No associations were found between reversals and independent variables. CONCLUSION: Progressions were found to be weakly linked to socio-demographic factors; baseline surface statuses were better predictors of progression. Using the current definitions for disease transitions, F-E communities had more frequent progressions than a S-F community.

Adolescent↗

Human root caries: microbiota in plaque covering sound, carious and arrested carious root surfaces.

The plaque microbiota covering sound or carious root surfaces were studied and compared with that covering arrested root caries lesions. From each of these categories five extracted teeth were examined. The experimental design of the study allowed us to relate the qualitative and quantitative microbial composition to the degree of integrity of the root surface. Plaque was sampled by a newly developed 'mowing' technique. Plaque samples were cultured anaerobically on nonselective Columbia blood agar plates supplemented with 5% hemolyzed human blood and on media selective for Lactobacillus spp. and streptococci of the mutans group. The cultivable microbiota were quantitatively speciated using Rapid ID 32A, Rapid ID 32 Strep, API 20 Strep, API ZYM, and API 50 CH tests and SDS-PAG electrophoresis. Regardless of the state of mineralization, the microbiota on all surfaces resembled marginal plaque associated with gingivitis. In addition to the gram-positive predominant facultative anaerobic genera Streptococcus, Staphylococcus, Lactobacillus and Actinomyces, gram-negative anaerobes, predominantly Bacteroides, Prevotella, Selenomonas, Fusobacterium, Leptotrichia, and Capnocytophaga, showed the highest isolation frequencies. On all surfaces Actinomyces spp. predominated, with streptococci and lactobacilli forming a minor part of the microbiota. With respect to the detected proportions of anaerobes, microaerophiles, Actinomyces naeslundii, Prevotella buccae and Selenomonas dianae, significant differences were observed between the three categories of root surfaces. The total CFU's on both caries-free and caries-active surfaces were significantly higher than on arrested lesions. In general, the results support a polymicrobial etiology for caries initiation on root surfaces, with A. naeslundii, Capnocytophaga spp., and Prevotella spp. making specific contributions to the processes of cementum and dentin breakdown.

Actinomyces↗