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Keywords = white spot lesions

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15 pages, 1418 KB  
Article
Characterization of Newly Synthesized Nanobiomaterials for the Treatment of White Spot Lesions
by Andra Clichici, Diana Dudea, Cristina Gasparik, Camelia Alexandra Coadă, Ioana Bâldea, Stanca Cuc and Mărioara Moldovan
Biomolecules 2026, 16(1), 112; https://doi.org/10.3390/biom16010112 - 8 Jan 2026
Viewed by 134
Abstract
Background: White spot lesions (WSLs) are characterized by enamel demineralization. Minimally invasive treatments using infiltrating resins, such as the commercially available Icon®, are recommended. The need for such treatments justifies ongoing research into developing materials that can address existing limitations regarding [...] Read more.
Background: White spot lesions (WSLs) are characterized by enamel demineralization. Minimally invasive treatments using infiltrating resins, such as the commercially available Icon®, are recommended. The need for such treatments justifies ongoing research into developing materials that can address existing limitations regarding strength, durability, and biocompatibility. Objectives: This study aimed to synthesize and characterize four novel nanobiomaterials by evaluating their physicochemical properties and biocompatibility compared to the commercial material Icon®. Materials and methods: The recipes for the experimental nanobiomaterials NB3, NB6, NB3F, and NB6F contain varying proportions of TEGDMA, UDMA, HEMA, Bis-GMA, and HAF-BaF2 glass. Mechanical and physicochemical characteristics were evaluated, such as flexural strength, measured using the three-point test; water absorption and solubility; fluoride release; polymerization conversion; and residual monomers, assessed using High-Performance Liquid Chromatography (HPLC). In vitro cell viability was assessed via colorimetry using human dysplastic oral keratinocytes (DOKs). Results: NB6 and NB6F demonstrated the greatest polymerization potential. NB3 exhibited the lowest water absorption and solubility due to its hydrophobic nature. Additionally, the inclusion of UDMA enhanced the strength and elasticity of NB3 when compared to NB6. Among the samples with fluoride additives (NB3F and NB6F), the highest fluoride release on day 7 occurred with the material lacking UDMA. In contrast, the NB3F sample containing UDMA released the least amount of fluoride on the same day. In quantitative terms, NB3 and NB6F exhibited the lowest levels of residual monomers, whereas NB6 showed the highest levels. Both NB3 and NB6 were significantly better tolerated by the cells, showing higher cell viability compared to the commercial material Icon®. Conclusions: The materials’ mechanical and physicochemical properties varied with component proportions, enabling identification of a suitable formulation for targeted clinical applications. Biocompatibility tests showed that the experimental NB3 and NB6 were better tolerated than Icon®. Furthermore, the incorporation of filler particles improved the mechanical strength of the experimental nanobiomaterials. Full article
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26 pages, 2623 KB  
Article
Deletion of sRNA0024 Reduces Virulence of Pseudomonas plecoglossicida and Alleviates Host Immune Injury in Epinephelus coioides
by Lingmin Zhao, Yihai Ouyang, Jiang Zheng, Yujia Sun, Yingxue Qin and Meiqin Mao
Animals 2025, 15(24), 3623; https://doi.org/10.3390/ani15243623 - 17 Dec 2025
Viewed by 324
Abstract
Visceral white spot disease caused by Pseudomonas plecoglossicida severely threatens marine aquaculture, highlighting the need for effective control strategies. To clarify the role of a novel small RNA, sRNA0024, in bacterial pathogenicity, we constructed an sRNA0024 deletion mutant (ΔsRNA0024) and compared its phenotype [...] Read more.
Visceral white spot disease caused by Pseudomonas plecoglossicida severely threatens marine aquaculture, highlighting the need for effective control strategies. To clarify the role of a novel small RNA, sRNA0024, in bacterial pathogenicity, we constructed an sRNA0024 deletion mutant (ΔsRNA0024) and compared its phenotype and virulence with those of the wild-type strain NZBD9. In vitro assays showed that deletion of sRNA0024 did not affect bacterial growth but significantly reduced biofilm formation and adhesion. In vivo infection experiments in orange-spotted grouper (Epinephelus coioides) demonstrated that the ΔsRNA0024 mutant had a 3.8-fold higher 50% lethal dose (LD50), improved host survival, and milder splenic lesions than the wild type. Histopathology and host transcriptome analyses revealed weakened activation of complement–coagulation cascades, neutrophil extracellular traps, leukocyte migration, and inflammatory signaling pathways, indicating a lower-intensity immune response. Bacterial transcriptomics showed that deletion of sRNA0024 was associated with reduced luxR expression and attenuated quorum-sensing–associated virulence traits, supporting a possible role for this small RNA in modulating luxR expression and QS-related host immunopathology. These findings identify sRNA0024 as an important contributor to the virulence of P. plecoglossicida and highlight the sRNA0024–luxR module as a potential antivirulence target for controlling visceral white spot disease in aquaculture. Full article
(This article belongs to the Section Aquatic Animals)
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13 pages, 2269 KB  
Article
The Effect of Different White Spot Lesion Treatments on the Enamel Microhardness—An In Vitro Pilot Study
by Milena Milanović, Miloš Beloica, Zoran Mandinić, Jelena Juloski, Miloš Petrović, Dušan Kosanović, Miloš Todorović, Maja Dimitrijević, Aleksandar Jakovljević, Miloš Vorkapić and Dragan Stanimirović
Dent. J. 2025, 13(11), 496; https://doi.org/10.3390/dj13110496 - 27 Oct 2025
Viewed by 931
Abstract
Background/Objectives: Dental caries, one of the most common oral diseases worldwide, represents a major public health concern. Contemporary dentistry has established several non-invasive approaches and resin infiltration, as a micro-invasive path, in the treatment of white spot lesions (WSLs). This study aimed to [...] Read more.
Background/Objectives: Dental caries, one of the most common oral diseases worldwide, represents a major public health concern. Contemporary dentistry has established several non-invasive approaches and resin infiltration, as a micro-invasive path, in the treatment of white spot lesions (WSLs). This study aimed to evaluate the effect of different WSL treatments on enamel surface microhardness. Materials and Methods: Seventy-five intact human premolars extracted upon orthodontic indication and the demineralizing solution composed of acetic acid, monopotassium phosphate and calcium chloride with pH = 4.4 and exposure time 96 h were used. The samples were randomly divided into five groups (n = 15): I—intact enamel (control group); II—artificial white spot lesion; III—artificial WSL treated with fluoride varnish; IV—artificial WSL treated with casein phosphopeptide—amorphous calcium phosphate (CPP-ACP) paste; V—resin-infiltrated artificial WSL. The surface microhardness was determined using the Oliver–Pharr method and a spherical indenter (Shimadzu Indenter, Kyoto, Japan). One-way analysis of variance (ANOVA) followed by a Post Hoc test (Bonferroni) was used with a level of significance set at p < 0.05. Results: Resin-infiltrated white spot lesions showed comparable microhardness mean value as the control group: 68.23 (±21.45) and 63.57 (±18.89), respectively (p > 0.05). Also, resin infiltration increased enamel microhardness compared to WSL values, with a statistically significant difference (p < 0.05). Fluoride varnish and CPP-ACP treatment resulted in equivalent values (50.84 ± 14.35 and 50.99 ± 15.31, respectively). Conclusions: Different WSL treatments (fluoride varnish, CPP-ACP and resin infiltration) produced comparable enamel microhardness values. Among the tested agents, resin infiltration resulted in higher microhardness values, while fluoride varnish and CPP-ACP demonstrated equivalent outcomes. Full article
(This article belongs to the Section Dental Materials)
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16 pages, 1982 KB  
Article
Oral Microbiome Analysis and Caries Risk Classification Using the Caries Management by Risk Assessment System in Pre-Orthodontic Patients
by Isamu Kado, Ryo Kunimatsu, Yuma Koizumi, Yuki Yoshimi, Tomohiro Ogasawara, Fumika Abe, Shintaro Ohgashira, Shangwu Tsai, Kanako Okazaki and Kotaro Tanimoto
J. Clin. Med. 2025, 14(18), 6464; https://doi.org/10.3390/jcm14186464 - 13 Sep 2025
Cited by 2 | Viewed by 1495
Abstract
Background/Objectives: This study aimed to classify pre-orthodontic patients using the Caries Management by Risk Assessment (CAMBRA) system and clarify their oral characteristics and microbiome. Methods: At the Department of Orthodontics, Hiroshima University Hospital, 68 patients were included in this study. Clinical parameters, [...] Read more.
Background/Objectives: This study aimed to classify pre-orthodontic patients using the Caries Management by Risk Assessment (CAMBRA) system and clarify their oral characteristics and microbiome. Methods: At the Department of Orthodontics, Hiroshima University Hospital, 68 patients were included in this study. Clinical parameters, such as plaque control record, DMF index, and number of white spot lesions (WSLs), were obtained. Medical interviews and oral examinations were conducted according to the CAMBRA system, and participants were classified into four risk groups (Low, Moderate, High, and Extreme). The supragingival plaques and stimulated saliva were collected. A saliva test was performed to measure the saliva secretion volume, pH, buffering capacity, and bacterial culture. Microbial DNA was extracted from the stimulated saliva and plaque samples, and 16S rRNA metagenomic analysis was performed. For statistical analysis, the Kruskal–Wallis test was used. Results: Participants were classified into four CAMBRA risk groups, with many classified as the High group. The number of DMF teeth and WSLs were the highest in the Extreme group, which tended to have the worst oral hygiene habits. The saliva test results revealed that the Extreme group had the worst saliva secretion volume, buffering capacity, and Streptococcus mutans score, with statistically significant differences. Bacterial 16S metagenomic sequencing revealed that the genus Fusobacterium had the highest relative abundance in the saliva samples of the Low group, whereas the genus Actinomyces had the highest relative abundance in the Extreme group. Conclusions: In this single-center, cross-sectional study, CAMBRA risk classification accurately reflected the oral condition of pre-orthodontic patients. Full article
(This article belongs to the Special Issue Oral Hygiene: Updates and Clinical Progress: 2nd Edition)
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19 pages, 5697 KB  
Article
Biomechanical and Morphological Analyses of Enamel White Spot Lesions Treated by Different Therapeutic Approaches (In Vitro Comparative Study)
by Lamis Abdul Hammed Al-Taee, Mohammad Talal Al-Hyazaie, Rabeia J. Khalil and Avijit Banerjee
Dent. J. 2025, 13(9), 408; https://doi.org/10.3390/dj13090408 - 5 Sep 2025
Viewed by 1734
Abstract
Background/Objectives: Within the minimum intervention oral care (MIOC) delivery framework, the management and improvement in the esthetics of enamel white spot lesions (WSLs) are recommended. This study evaluated the chemomechanical and morphological characteristics of WSLs treated by four therapeutic approaches using Raman [...] Read more.
Background/Objectives: Within the minimum intervention oral care (MIOC) delivery framework, the management and improvement in the esthetics of enamel white spot lesions (WSLs) are recommended. This study evaluated the chemomechanical and morphological characteristics of WSLs treated by four therapeutic approaches using Raman spectroscopy, Knoop microhardness (KH), and field-emission scanning electron microscopy (FESEM). Methods: Sixty human enamel slabs were divided into six groups: non-treated (baseline), WSLs (8% methylcellulose gel with 0.1 M lactic acid, pH 4.6 at 37 °C for 21 days), and four treated groups, namely bovine collagen supplement (Nutravita Ltd., Maidenhead, Berkshire, UK), Regenerate system (NR-5, Bordeaux, France), Sylc air abrasion (AquaCare, Denfotex Research Ltd., Edinburgh, UK), and CO2 laser (JHC1180, Jinan, China). Treatment lasted 28 days, followed by four weeks of storage in artificial saliva (pH = 7.0, 37 °C). Bovine collagen was analyzed using Fourier-Transform Infrared Spectroscopy (FTIR). The mineral content, including the phosphate peak intensities (PO4 ν1, ν2, and ν4) and carbonate (CO3), as well as tissue microhardness, were assessed at varying depths (50–200 µm), followed by morphological assessment. Results: The FTIR spectrum of bovine collagen powder confirms the presence of amide I, II, and III. It produced a statistically significant enhancement in the phosphate content and KHN compared to WSLs of up to 150 µm in depth (p < 0.001). Regenerate-treated surfaces recorded the highest phosphate content among groups at the superficial layer. All treatment interventions enhanced the morphology of lesions by covering the exposed prisms and inter-prismatic structure. Conclusions: Bovine collagen supplements can enhance the phosphate content and surface properties of enamel white spot lesions (WSLs) and could be considered a potential modality comparable to other micro-invasive approaches for addressing incipient enamel lesions. This could significantly impact dental care management. Full article
(This article belongs to the Special Issue Updates and Highlights in Cariology)
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14 pages, 1232 KB  
Article
Influence of Bioactive Glass Incorporation in Resin Adhesives of Orthodontic Brackets on Adhesion Properties and Calcium Release
by Ana Paula Valente Pinho Mafetano, Fernanda Alves Feitosa, Gabriela da Silva Chagas, Nathália Moreira Gomes, Marcella Batista Rocha, Mariane Cintra Mailart, Karen Cristina Kazue Yui and Cesar Rogério Pucci
Polymers 2025, 17(17), 2282; https://doi.org/10.3390/polym17172282 - 23 Aug 2025
Cited by 3 | Viewed by 1324
Abstract
This study evaluated a light-cure orthodontic adhesive with the incorporation of bioactive glass particles and its effects on shear bond strength (SBS), adhesive remnant index (ARI), degree of conversion (DC), calcium release, and particle size distribution. Bioactive glass was added to the Transbond [...] Read more.
This study evaluated a light-cure orthodontic adhesive with the incorporation of bioactive glass particles and its effects on shear bond strength (SBS), adhesive remnant index (ARI), degree of conversion (DC), calcium release, and particle size distribution. Bioactive glass was added to the Transbond XT Adhesive (3M ESPE), resulting in five groups: TXT (0% wt of bioactive glass-incorporated—negative control); TXT20 (20% wt of bioactive glass-incorporated); TXT30 (30% wt of bioactive glass-incorporated), TXT50 (50% wt of bioactive glass-incorporated), and FLB (positive control—FL BOND II adhesive system with S-PRG particles, SHOFU Inc.). Data were analyzed with one-way ANOVA followed by Tukey’s test (α = 0.05). Quantitative SEM analysis confirmed submicron particle agglomerates (median equivalent circular diameter 0.020–0.108 µm). The TXT20 exhibited the highest values of degree of conversion (p < 0.05) (73.02 ± 3.33A). For SBS (in MPa): Control Group TXT—19.50 ± 1.40A, Group TXT20 18.22 ± 1.04AB, Group FLB 17.62 ± 1.45B, Group TXT30 14.48 ± 1.46C and Group TXT50 14.13 ± 1.02C (p < 0.05). For calcium release the group TXT50 2.23 ± 0.11D showed higher values (p < 0.05). The incorporation of distinct bioactive glass particle concentrations influenced the shear bond strength, degree of conversion, and calcium release. While the 50 wt% bioactive glass group exhibited the highest calcium release, both 20 wt% of bioactive glass group and the positive control group exhibited the highest degree of conversion without compromising the bonding strength. Full article
(This article belongs to the Special Issue Designing Polymers for Emerging Applications)
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4 pages, 454 KB  
Interesting Images
Texture and Color Enhancement Imaging-Assisted Endocytoscopy Improves Characterization of Gastric Precancerous Conditions: A Set of Interesting Comparative Images
by Riccardo Vasapolli, Johannes Raphael Westphal and Christian Schulz
Diagnostics 2025, 15(15), 1925; https://doi.org/10.3390/diagnostics15151925 - 31 Jul 2025
Viewed by 801
Abstract
Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of [...] Read more.
Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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13 pages, 516 KB  
Systematic Review
The Role of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) in White Spot Lesion Remineralization—A Systematic Review
by Valentina Baccolini, Lígia Pereira da Silva, Liliana Teixeira, Raquel Teixeira de Sousa and Patrícia Manarte-Monteiro
J. Funct. Biomater. 2025, 16(8), 272; https://doi.org/10.3390/jfb16080272 - 25 Jul 2025
Cited by 2 | Viewed by 7737
Abstract
Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. [...] Read more.
Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article
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14 pages, 2892 KB  
Article
Green-Synthesized Nano-Silver Fluoride for Remineralization of Enamel Lesions in Primary Teeth: A Comparative In Vitro Study with SDF and SDF/KI
by Antonia Palankalieva, Plamen Katsarov and Ani Belcheva
Dent. J. 2025, 13(7), 331; https://doi.org/10.3390/dj13070331 - 21 Jul 2025
Viewed by 2123
Abstract
Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This [...] Read more.
Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article
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19 pages, 523 KB  
Review
Usage of Silver Nanoparticles in Orthodontic Bonding Reagents
by Janet Jisoo Lee, Meigan Niu, Zinah Shakir, Geelsu Hwang, Chun-Hsi Chung, Mark S. Wolff, Zhong Zheng and Chenshuang Li
J. Funct. Biomater. 2025, 16(7), 244; https://doi.org/10.3390/jfb16070244 - 3 Jul 2025
Cited by 3 | Viewed by 2066
Abstract
Fixed orthodontic appliances, which are cemented to tooth surfaces, complicate the maintenance of oral hygiene and create a rough surface that is favorable for bacteria attachment. Additionally, the presence of orthodontic appliances may conceive a unique environment that interacts with cariogenic microorganisms, fostering [...] Read more.
Fixed orthodontic appliances, which are cemented to tooth surfaces, complicate the maintenance of oral hygiene and create a rough surface that is favorable for bacteria attachment. Additionally, the presence of orthodontic appliances may conceive a unique environment that interacts with cariogenic microorganisms, fostering a distinct microbial ecosystem compared to that of the patients without orthodontic appliances, thus increasing the vulnerability of tooth surfaces to demineralization and caries formation. Silver (Ag) has shown strong antimicrobial effects and has been extensively investigated in the medical field. Here, we aim to review the antibacterial properties and potential side effects of silver nanoparticles (AgNPs) when incorporated into orthodontic bonding reagents. This valuation could contribute to the development of novel bonding reagents designed to prevent the formation of white spot lesions and caries during orthodontic treatments. Full article
(This article belongs to the Special Issue Dental Biomaterials in Implantology and Orthodontics)
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18 pages, 468 KB  
Review
Can New Remineralizing Agents Serve as Fluoride Alternatives in Caries Prevention? A Scoping Review
by Jekaterina Gudkina, Bennett T. Amaechi, Stephen H. Abrams and Anda Brinkmane
Oral 2025, 5(3), 47; https://doi.org/10.3390/oral5030047 - 2 Jul 2025
Viewed by 9935
Abstract
Background: Due to limitations of fluoride (F) treatment as a main caries preventive measure, it is important to consider the use of other dental caries preventive measures to reduce caries prevalence, especially in its early stages. Recently, new remineralizing agents appeared on the [...] Read more.
Background: Due to limitations of fluoride (F) treatment as a main caries preventive measure, it is important to consider the use of other dental caries preventive measures to reduce caries prevalence, especially in its early stages. Recently, new remineralizing agents appeared on the market, with their commercial availability in a variety of oral care products. Objectives: The purposes include providing a scoping review that represents caries remineralizing efficacies of only commercially available products and their existing adverse effects (if it is presented) and ensuring that only evidence-based approved products are included. Methods: The following databases were used in searching scientific literature on 28 October 2024: PubMed, PubMed Advanced Search, MeSH database, and PubMed Clinical Queries. The study selection criteria were as follows: for laboratory, in vitro, and/or in situ—remineralization of enamel-scanning electron microscopy, spectroscopy, microhardness test, light microscopy, profilometry, transverse microhardness microradiography, integrated mineral loss, light microscopy, photothermal radiometry; if it was a randomized controlled trial—CONSORT protocol, ICDAS system (to detect dental caries), diagnostic additional devices; antibacterial ability-colony forming units, DNA-based sequencing, scanning electron microscopy, crystal violet staining, and confocal laser scanning microscopy. Results: This review includes 98 papers: 14 of them describing the current status of caries patterns in the world, 60 studies (45 laboratory studies and 15 RCTs), and 24 systematic reviews were analyzed in order to detect whether new remineralizing agents can replace fluoride in further caries prevention. Conclusions: All reviewed new remineralization agents could be used without additives to treat early caries lesions, but the combination with F promotes better remineralization. Only HAP demonstrated its potential to serve as an alternative to fluoride in oral care products. However, further clinical studies are needed to prove its role in the remineralizing process of initial caries lesions. One also needs to ensure that both the clinical trials and in vitro lab studies use the best gold standards to validate any changes in the tooth structure, both remineralization and demineralization. Full article
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14 pages, 671 KB  
Review
White Spot Lesion Treatment Options: A Systematic Review of Different Techniques for Masking These Lesions
by Michela Lamorgese, Nélio Veiga, Maria J. Correia, Ana T. P. C. Gomes, Sara Lopes, Lígia Lopes-Rocha, Rita Fidalgo-Pereira and Pedro C. Lopes
Gels 2025, 11(5), 371; https://doi.org/10.3390/gels11050371 - 19 May 2025
Cited by 3 | Viewed by 8275
Abstract
White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety [...] Read more.
White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability. Full article
(This article belongs to the Special Issue Functional Gels for Dental Applications)
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12 pages, 7852 KB  
Article
Remineralization Effects of Zinc-Containing Glass Ionomer Cement Restoratives on Demineralized Enamel Under pH Cycling Conditions
by Khin Myanmar, Go Inoue, Xuefei Chen and Yasushi Shimada
Crystals 2025, 15(4), 329; https://doi.org/10.3390/cryst15040329 - 29 Mar 2025
Cited by 1 | Viewed by 1502
Abstract
(1) Background: White spot lesions (WSLs) on enamel result from demineralization and are an early sign of dental caries. Glass ionomer cement (GIC) has been widely used for its remineralization potential, and zinc-containing GIC (zGIC) has been introduced to enhance this effect. However, [...] Read more.
(1) Background: White spot lesions (WSLs) on enamel result from demineralization and are an early sign of dental caries. Glass ionomer cement (GIC) has been widely used for its remineralization potential, and zinc-containing GIC (zGIC) has been introduced to enhance this effect. However, its efficacy compared to conventional GIC (cGIC) remains unclear. This study aimed to evaluate and compare the remineralization effects of cGIC and zGIC on WSLs. (2) Methods: Thirty-six bovine enamel specimens were prepared, demineralized for four days, and divided into three groups: control, cGIC, and zGIC. Half of each specimen’s treated window was covered with varnish, and a two-week pH cycling protocol was conducted. Mineral density (MD) changes were assessed using microcomputed tomography (Micro-CT) at five time points: pre-demineralization, after demineralization, immediately after treatment, and 1- and 2-weeks post-treatment. Scanning electron microscopy (SEM) was also performed. (3) Results: MD values in the zGIC and cGIC groups were significantly higher than in the control group throughout every post-treatment assessment (p < 0.05). zGIC demonstrated significantly higher MD than cGIC (p < 0.05), and SEM images revealed inferior mineral deposition. (4) Conclusions: These findings suggest that zGIC is more effective in remineralizing WSLs than cGIC over two weeks. Full article
(This article belongs to the Special Issue Bioinspired Mineralization of Dental Tissues)
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9 pages, 199 KB  
Article
Salivary Interleukin-6 and Interleukin-18 Levels and Their Association with Dental Health in Children with Idiopathic Nephrotic Syndrome
by Paula Piekoszewska-Ziętek, Natalia Korytowska-Przybylska, Małgorzata Pańczyk-Tomaszewska and Dorota Olczak-Kowalczyk
Int. J. Mol. Sci. 2025, 26(7), 3175; https://doi.org/10.3390/ijms26073175 - 29 Mar 2025
Cited by 1 | Viewed by 1256
Abstract
Idiopathic nephrotic syndrome (NS) is associated with immune dysfunction and increased susceptibility to infections. Oral health may influence systemic inflammation and disease progression. This study aimed to evaluate the salivary levels of interleukin-6 (IL-6) and interleukin-18 (IL-18) in children with NS and their [...] Read more.
Idiopathic nephrotic syndrome (NS) is associated with immune dysfunction and increased susceptibility to infections. Oral health may influence systemic inflammation and disease progression. This study aimed to evaluate the salivary levels of interleukin-6 (IL-6) and interleukin-18 (IL-18) in children with NS and their association with dental health, particularly caries prevalence and the consequences of untreated caries. A cross-sectional study was conducted on 86 children aged 5–17 years, including 40 NS patients and 46 healthy controls. Clinical dental examinations assessed caries prevalence using the dmft/DMFT index and the impact of untreated caries using the pufa/PUFA index. Unstimulated saliva samples were collected, and IL-6 and IL-18 concentrations were measured using enzyme-linked immunosorbent assay. NS patients exhibited a significantly lower prevalence of active carious lesions than controls (50% vs. 72%, p = 0.039). The DMFT index was lower in the NS group (p = 0.003). Salivary IL-6 levels were significantly reduced in NS patients compared to controls (p = 0.015), while IL-18 levels showed no significant difference. IL-6 positively correlated with decayed permanent teeth and pulp/periapical tissue diseases, whereas IL-18 correlated with white spot lesions and pulp infections. IL-6 and IL-18 could serve as potential non-invasive indicators of disease progression in NS patients. Full article
12 pages, 4551 KB  
Article
Identification and Characterization of Fusarium incarnatum Causing Leaf Spot and Fruit Rot on Luffa in China
by Xia Chen, Hao Liu, Lanlan Dong, Junrui Shi, Zhonghua Ma, Leiyan Yan and Yanni Yin
Plants 2025, 14(6), 845; https://doi.org/10.3390/plants14060845 - 8 Mar 2025
Cited by 3 | Viewed by 2179
Abstract
In 2022, an outbreak of fungal rot disease affected luffa crops in Shanghai and Zhejiang Province. Infected plants exhibited symptoms including yellowing, chlorosis, wilting, and water-soaked occurred on leaves and fruits. Dark brown, concave lesions developed, often accompanied by white or pale pink [...] Read more.
In 2022, an outbreak of fungal rot disease affected luffa crops in Shanghai and Zhejiang Province. Infected plants exhibited symptoms including yellowing, chlorosis, wilting, and water-soaked occurred on leaves and fruits. Dark brown, concave lesions developed, often accompanied by white or pale pink mold under moist conditions. Fourteen pathogen strains, morphologically resembling Fusarium species, were isolated. Molecular analysis confirmed Fusarium incarnatum as the causative agent. Pathogenicity tests on luffa plants fulfilled Koch’s postulates, with inoculated plants displaying the same symptoms. Re-isolation of the fungus from the inoculated plants confirmed its role in the disease. To our knowledge, this is the first report of F. incarnatum causing leaf spot and fruit rot on luffa in China. Moreover, the soil bacterial strain Bacillus velezensis BV171 displayed strong inhibition of F. incarnatum mycelia growth and promoted the growth of sponge gourd plants. These findings lay the foundation for the development of diagnostic tools, disease management strategies, and the breeding of resistant luffa varieties. Full article
(This article belongs to the Special Issue Pathogenesis and Disease Control in Crops—2nd Edition)
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