Search Results (13)

Dental caries is an avoidable and complex condition impacting billions of individuals worldwide, posing a specific concern among younger generations, despite the progress of oral hygiene products. This deterioration occurs due to the acid demineralization of tooth enamel, leading to the loss of minerals from the enamel subsurface. The remineralisation of early enamel carious lesions could prevent the cavitation of teeth. The enamel protein amelogenin constitutes 90% of the total enamel matrix protein and plays a key role in the bio mineralisation process. The aim of this study is to investigate the self-assembly microstructure and reticulation behaviour of a newly developed bioactive hydrogel with leucine-rich amelogenin peptide (LRAP) intended for enamel remineralisation. SEM, AFM, UV-VIS, and FTIR analyses emphasize the ability of peptides to promote cell adhesion and the treatment of early carious lesions. In conclusion, short-chain peptides can be used in hydrogels for individual or professional use. Full article

Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious solution for alleviating WSLs, but studies with long-term monitoring are scarce. The aim of this clinical study is to assess the color change stability of the lesion after four years of implementing the resin infiltration technique. Materials and Methods: Forty non-cavity and unrestored white spot lesions (WSLs) were treated with the resin infiltration technique. The color of the WSLs and adjacent healthy enamel (SAE) was assessed using a spectrophotometer at T0 (baseline), T1 (after treatment), T2 (1 year after) and T3 (4 years after). The Wilcoxon test was utilized to determine the significance of the variation of color (ΔE) between WSLs and SAE over the observed time periods. Results: When comparing the color difference ΔE (WSLs-SAE) at T0-T1, the Wilcoxon test demonstarated a statistically significant difference (p < 0.05). For ΔE (WSLs-SAE) at T1-T2 and T1-T3, the color variation was not statistically significant (p = 0.305 and p = 0.337). Conclusions: The study’s findings indicate that the resin infiltration technique is an effective solution for resolving the appearance of WSLs, and the results have demonstrated stability for a minimum of four years. Full article

In the current study, we sought to evaluate the effects of phosphoryl-oligosaccharides of calcium (POs-Ca) and/or fluoride-containing toothpaste on enamel. Six groups of experimental toothpaste were prepared by adding various concentrations of POs-Ca and/or fluoride. A 5 × 10-mm window on the enamel of the bovine incisor was immersed in resin and divided into three areas for “sound”, “demineralized (DEM)”, and “after pH cycle (aft. pH cycle)”. All specimens were subjected to pH cycling, including soaking in a slurry with toothpaste diluted threefold for 5 min. Transverse microradiography was employed to evaluate the mineral recovery, and the pH values of each demineralization solution were measured. The high fluoride concentration group showed a significantly better mineral recovery rate than the others, with no statistical differences between before and after pH cycling among the POs-Ca with low fluoride, POs-Ca only, low fluoride only, and control groups. In the low-concentration fluoride groups, the group containing POs-Ca tended to have a higher remineralization effect than the non-POs-Ca group. After pH cycling, the demineralization solution showed no pH changes in any group. The addition of POs-Ca and fluoride to toothpaste may recover the mineral density in enamel subsurface lesions at low-fluoride concentrations, but the high-fluoride concentrations did not show a meaningful difference in the two groups with and without POs-Ca. Full article

Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F); casein phosphopeptide-amorphous calcium phosphate (CPP–ACP) and with fluoride (CPP–ACFP); and self-assembling oligopeptide P11-4 (SAP). The aim of this study was to compare the remineralisation of ESLs in vitro using these technologies. Human enamel slabs with ESLs were cut into two half-slabs; one half-slab was untreated (control), and the other half was treated by exposure to one of the four technologies with artificial saliva (AS) or AS alone for 14 days at 37 °C. The technologies were applied to the ESL surface according to the manufacturer’s instructions. At the completion of each treatment, the treated half-slabs and their paired control half-slabs were embedded, sectioned and the mineral content was determined using transverse microradiography. The change in mineral content (remineralisation) between treatments was statistically analysed using one-way ANOVA. The order from highest to lowest remineralisation was CPP–ACFP (52.6 ± 2.6%) > CPP–ACP (43.0 ± 4.9%) > BG/F (13.2 ± 2.5%) > SAP (5.8 ± 1.6%) > AS (2.1 ± 0.5%). Only CPP–ACFP and CPP–ACP produced remineralisation throughout the body of the lesions. All four biomimetic technologies had some effect on the remineralisation of ESLs; however, CPP–ACFP with calcium, phosphate and fluoride ions stabilised by CPP was superior in the level and pattern of remineralisation obtained. Full article

Background: Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions. Conclusions: Despite the fact that organic–inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry. Full article

The limitations on the use of fluoride therapy in dental caries prevention has necessitated the development of newer preventive agents. This review focusses on the recent and significant studies on P11-4 peptide with an emphasis on different applications in dental hard tissue conditions. The self-assembling peptide P11-4 diffuses into the subsurface lesion assembles into aggregates throughout the lesion, supporting the nucleation of de novo hydroxyapatite nanocrystals, resulting in increased mineral density. P11-4 treated teeth shows more remarkable changes in the lesion area between the first and second weeks. The biomimetic remineralisation facilitated in conjunction with fluoride application is an effective and non-invasive treatment for early carious lesions. Despite, some studies have reported that the P11-4 group had the least amount of remineralised enamel microhardness and a significantly lower mean calcium/phosphate weight percentage ratio than the others. In addition, when compared to a low-viscosity resin, self-assembling peptides could neither inhibit nor mask the lesions significantly. Moreover, when it is combined with other agents, better results can be achieved, allowing more effective biomimetic remineralisation. Other applications discussed include treatment of dental erosion, tooth whitening and dentinal caries. However, the evidence on its true clinical potential in varied dental diseases still remains under-explored, which calls for future cohort studies on its in vivo efficacy. Full article

Subsurface enamel demineralization beneath an intact surface layer or white spots lesions (WSL) can and should be treated with non-invasive procedures to impede the development of a cavitated lesion. We aim to analyze if infiltrative resin improves enamel roughness, microhardness, shear bond strength, and penetration depth. MEDLINE [via Pubmed], Cochrane Central Register of Controlled Trials, Embase, Web of Science, Scholar, and LILACS were searched until May 2021. Methodological quality was assessed using the Joanna Briggs Institute Clinical Appraisal Checklist for Experimental Studies. Pairwise ratio of means (ROM) meta-analyses were carried out to compare the enamel properties after treatment with infiltrative resin on sound enamel and WSLs. From a total of 1604 articles, 48 studies were included. Enamel surface roughness decreased 35% in sound enamel (95%CI: 0.49–0.85, I² = 98.2%) and 54% in WSLs (95%CI: 0.29–0.74, I² = 98.5%). Microhardness reduced 24% in sound enamel (95%CI: 0.73–0.80, I² = 99.1%) and increased by 68% in WSLs (95%CI: 1.51; 1.86, I² = 99.8%). Shear bond strength reduced of 25% in sound enamel (95%CI: 0.60; 0.95, I² = 96.9%) and increased by 89% in WSLs (95%CI: 1.28–2.79, I² = 99.8%). Penetration depth was 65.39% of the WSLs (95%CI: 56.11–74.66, I² = 100%). Infiltrative resins effectively promote evident changes in enamel properties in sound and WSLs. Future studies with long-term follow-ups are necessary to corroborate these results from experimental studies. Full article

Background: Enamel mineral density is dependent on a balanced dynamic process of demineralization and remineralization. Objective: We evaluated the remineralization potential of experimental calcium- containing primer (CaP) application on enamel subsurface lesions. Methods: Demineralized enamel samples obtained from bovine incisor teeth were prepared and cut buccolingually. All samples were divided into 4 main groups according to the type of primer: CLEARFIL SE BOND 2 Primer (SEP), experimental calcium-containing primer (CaP) and bond: CLEARFIL SE BOND 2 Bond (SEB), CLEARFIL Protect Bond (PBB) treatment: (1) SEP-SEB (2) SEP-PBB (3) CaP-SEB (4) CaP-PBB. Each group was subdivided according to storage time in artificial saliva: immediately, 1 month and 6 months. Then, the samples were analyzed using transverse micro radiography (TMR). Additionally, the samples treated with each primer were prepared for scanning electron microscope (SEM) and energy dispersive X-ray spectroscopy (EDS) observation. Two-way ANOVA was used for the statistical analysis of mineral loss (ΔZ: vol%·µm). Results: CaP-PBB had the significantly lowest ΔZ at all storage times, while SEP-SEB had the highest ΔZ (p < 0.05). SEM observations revealed that new crystals were formed on the surface after 6 months, and the ratio of calcium on the enamel increased in the EDS analysis. Conclusion: Experimental calcium-containing primer can provide additional mineral deposition, with even further deposition when combined with a fluoride-containing bond. Full article

Dental caries or tooth decay is a preventable and multifactorial disease that affects billions of people globally and is a particular concern in younger populations. This decay arises from acid demineralisation of tooth enamel resulting in mineral loss from the subsurface. The remineralisation of early enamel carious lesions could prevent the cavitation of teeth. The enamel protein amelogenin constitutes 90% of the total enamel matrix protein in teeth and plays a key role in the biomineralisation of tooth enamel. The physiological importance of amelogenin has led to the investigation of the possible development of amelogenin-derived biomimetics against dental caries. We herein review the literature on amelogenin, its primary and secondary structure, comparison to related species, and its’ in vivo processing to bioactive peptide fragments. The key structural motifs of amelogenin that enable enamel remineralisation are discussed. The presence of several motifs in the amelogenin structure (such as polyproline, N- and C-terminal domains and C-terminal orientation) were shown to play a critical role in the formation of particle shape during remineralization. Understanding the function/structure relationships of amelogenin can aid in the rational design of synthetic polypeptides for biomineralisation, halting enamel loss and leading to improved therapies for tooth decay. Full article

The prevalence of white spots on teeth has increased in recent years. Regardless of their etiology, these lesions are characterized by a reduction in the enamel’s mineral phase, which is replaced by organic fluids. This causes an alteration of its chemical composition that affects its optical characteristics. Subsurface demineralization increases the pore volume of enamel, which in turn changes its optical refraction and results in the opaque color of white spot lesions. Here, we examined a non-invasive clinical technique used for eliminating these white spot lesions from enamel via two HCl-based products at different concentrations (6.6% and 15%). We used a digital method for evaluating the volumetric changes produced in dental enamel by the application of both products, one of which involved chemical erosion and the other, abrasive erosion. The mean volume of the enamel eliminated was −0.042 mm in 15% HCl, and −0.12 mm in 6.6% HCl. Thus, both 15% HCl and 6.6% HCl are capable of eroding the surface of the tooth enamel without reaching dentin. Moreover, 6.6% HCl produced a greater erosion of the dental enamel and left the surface a texture typical of an abrasive chemical-erosive product. The 15% HCl, however, produced an etching pattern typical of an erosive chemical with open enamel prisms prepared for subsequent adhesive procedures and restorers. Full article

White-spot-lesions (WSL) are a common complication associated with orthodontic treatment. In the current study, the remineralization efficacy of a BiominF^® paste was compared to the efficacy of a fluoride gel. Methods: Orthodontic brackets were bonded to 60 human premolars buccal surfaces, which were covered with varnish, except a small treatment area (3 mm²). All specimens were challenged by a demineralization solution for 4 days. Specimens were assigned into 4 groups: BiominF^® paste, Fluoride (4-min application), fluoride (twenty four hours application), and the control (n = 15). After cross-sectioning, enamel slabs having a thickness of approximately 100–120 μm were obtained. A TMR (Transverse Micro Radiography) technique was used to observe the sub-surface enamel lesions’ depth and mineral density, and their response to the remineralization protocols. One way ANOVA was used to analyze the results (α = 0.05). The top and the cross-sectional surfaces were observed using SEM/EDS. Results: Specimens treated with BiominF^® paste showed significant decrease in delta z values, however lesion depth showed no significant difference when compared to the other three groups (p < 0.05). SEM/EDS observation showed the formation of crystal like structures on top of enamel demineralized surfaces, when treated with BiominF^® paste. In conclusion BiominF^® paste can be considered an effective remineralizing agent for white spot Lesions. Full article

This study evaluated the effects of fluoride on subsurface enamel demineralization induced by two commonly used chemical models. Forty-eight enamel blocks were demineralized at pH = 5.0 by an acetate buffer (Group 1), a lactate buffer (Group 2), an acetate buffer with 0.02 ppm fluoride (Group 3) and a lactate buffer with 0.02 ppm fluoride (Group 4) at 25 °C for 3 weeks. The surface destruction percentage (SDP), mineral loss and lesion depth of the blocks were studied using micro-computed tomography. An elemental analysis of the enamel surface was evaluated using an energy-dispersive X-ray spectroscopy. Surface micro-hardness was determined by the Knoop Hardness Test. The mean lesion depth of Groups 1 through 4 were 134.1 ± 27.2 μm, 96.1 ± 16.5 μm, 97.5 ± 22.4 μm and 91.1 ± 16.2 μm, respectively (p < 0.001; group 1 > 2, 3 > 4). The SDPs of groups 1 through 4 were 7.8 ± 8.93%, 0.71 ± 1.6%, 0.36 ± 1.70% and 1.36 ± 2.94% (p < 0.001; group 1 > 2, 3, 4). The fluoride in mean weight percentages of groups 1 through 4 were 1.12 ± 0.24%, 1.10 ± 0.20%, 1.45 ± 0.40% and 1.51 ± 0.51%, respectively (p < 0.001; group 3, 4 > 1, 2). The mean Knoop hardness values of groups 1 through 4 were 27.5 ± 13.3, 39.7 ± 19.3, 73.6 ± 44.2 and 91.0 ± 57.2, respectively (p < 0.001; group 4 > 3 > 2 > 1). The chemical model using an acetate buffer solution created significantly deeper zones of subsurface demineralization on enamel than the lactate buffer solution. An acetate buffer may damage the enamel surface, but the surface damage can be prevented by adding fluoride. Full article

Micro computed tomography has been combined with dedicated data analysis for the in vitro quantification of sub-surface enamel lesion mineralization. Two artificial white spot lesions, generated on a human molar crown in vitro, were examined. One lesion was treated with a self-assembling peptide intended to trigger nucleation of hydroxyapatite crystals. We non-destructively determined the local X-ray attenuation within the specimens before and after treatment. The three-dimensional data was rigidly registered. Three interpolation methods, i.e., nearest neighbor, tri-linear, and tri-cubic interpolation were evaluated. The mineralization of the affected regions was quantified via joint histogram analysis, i.e., a voxel-by-voxel comparison of the tomography data before and after mineralization. After ten days incubation, the mean mineralization coefficient reached 35.5% for the peptide-treated specimen compared to 11.5% for the control. This pilot study does not give any evidence for the efficacy of peptide treatment nor allows estimating the necessary number of specimens to achieve significance, but shows a sound methodological approach on the basis of the joint histogram analysis. Full article