Antibacterial efficacy and remineralization capacity of glycyrrhizic acid added casein phosphopeptide‐amorphous calcium phosphate

The aim was to evaluate remineralization capacity and antibacterial efficiency of Tooth Mousse and various amounts of glycyrrhizic acid added Tooth Mousse on primary tooth enamel. Three groups were formed; Group 1 (CPP‐ACP), Group 2 (CPP‐ACP + 5% glycyrrhizic acid), and Group 3 (CPP‐ACP + 10% glycyrrhizic acid) in order to evaluate remineralization capacity. Enamel samples were immersed in demineralization solution and then remineralization agents were applied. Surface microhardness and SEM analyses were performed at the beginning, after demineralization and remineralization. For antibacterial tests, four groups were formed; Group 1, Group 2 and Group 3 and Group 4 (control). Biofilms were then exposed to 10% sucrose eight times per day for 7 days. After biofilm growth period, samples were treated with materials to evaluate antibacterial efficiency except control group. After application of materials, samples were incubated 2 more days at 37°C and at the end of this period, absorbance values of biofilms were determined and data were analyzed. An increase in microhardness values was Group 2 > Group 3 > Group 1, respectively, but there were no significant differences. After remineralization, microhardness values showed significant increases when compared to demineralized groups, but there was no significant difference. All groups showed decreased absorbance value of biofilm when compared with control group but they were insignificant. It was observed that both in Group 2 and Group 3, glycyrrhizic acid did not have a negative effect on remineralization and although they have an increase, it was insignificant. Although glycyrrhizic acid added CPP‐ACP groups showed increased antibacterial activity, they were not statistically significant.     

Efficacy of calcium‐ and fluoride‐containing materials for the remineralization of primary teeth with early enamel lesion

The aim of the study was to determine the efficacy of different products containing fluoride, calcium and phosphate for enamel remineralization in eroded primary teeth. A total of 90 sound primary canine teeth were randomly divided into 5 groups of 18 teeth each: 1) control (polished enamel), 2) 5% DuraShield sodium fluoride varnish, 3) 500 ppm fluoridated toothpaste, 4) casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) cream, and 5) Clinpro White varnish containing functionalized tri‐calcium phosphate (fTCP). Enamel microhardness (EMH) was measured in all samples before and after demineralization and after 28 days of remineralization. Also 8 samples in groups 2 to 5 and four samples of sound and demineralized enamel were examined with atomic force microscopy (AFM). All data were analyzed with one‐way ANOVA (p<0.05). Mean microhardness of demineralized enamel was significantly lower than in enamel at baseline (p<0.001). Remineralization significantly increased microharness in groups 2 to 5 compared to the control group (p<0.001). Percent EMH after remineralization with CPP‐ACP was significantly higher than after fTCP (p=0.029), toothpaste (p< 0.001) or fluoride varnish (p<0.001); however, there was no significant difference between toothpaste and fluoride varnish (p=0.062). Microhardness increased more after fTCP treatment than after treatment with sodium fluoride varnish (p<0.001) or fluoridated toothpaste (p=0.045). AFM images showed that enamel roughness decreased most after treatment with fTCP, followed by CPP‐ACP, toothpaste and fluoride varnish. The efficacy of CPP‐ACP cream for remineralizing eroded enamel was greater than fluoride toothpaste, fluoride varnish or fTCP varnish. Microsc. Res. Tech. 78:801–806, 2015. © 2015 Wiley Periodicals, Inc.     

Remineralization effects of self-assembling peptide P11-4 associated with three materials on early enamel carious lesions: An in vitro study

The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P₁₁-4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P₁₁-4, (3) fluoridate toothpaste (FT), (4) P₁₁-4 + FT, (5) casein phosphopeptide–amorphous calcium phosphate (CPP–ACP), (6) P₁₁-4 + CPP–ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P₁₁-4 + BT. The surface enamel microhardness (EMH) and energy-dispersive X-ray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05). EMH after demineralization was significantly lower than the baseline value (p < .001). The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P₁₁-4 was significantly lower than the others (p < .001). The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.     

Morphology of sealant/enamel interface after surface treatment with bioactive glass

The purpose of this study was to analyze, by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), the morphology of sealant/enamel interface after surface treatment with Biosilicate. Before pits and fissures sealing, the occlusal surfaces of 10 sound human molars were sectioned perpendicularly at the fissures in order to obtain three slices for each tooth. Slices were randomly assigned into three groups (n = 10) according to sealing protocol: Group 1‐ Acid etching + Biosilicate + glass ionomer‐based sealant (Clinpro XT Varnish, 3M ESPE); Group 2‐ Acid etching + glass ionomer‐based sealant (Clinpro XT Varnish, 3M ESPE); Group 3‐ No sealing. All slices were subjected to thermal cycling (5,000 cycles; 5–55°C; dwell time: 30s). Half of the slices from each group (n = 5) were analyzed by CLSM and the other half by SEM. Groups 1 and 2 were also submitted to EDS analysis and their data were evaluated by Two‐Way ANOVA e Tukey's test (α=5%). EDS data analysis showed higher amounts of silicon (Si) ions than calcium (Ca) ions in Group 1 (P < 0.05); Group 2 presented higher amounts (P < 0.05) of Ca ions than Si ions. It may be concluded that the use of Biosilicate for surface treatment did not affect the morphology of glass ionomer‐based sealant/enamel interfaces. Microsc. Res. Tech. 78:1062–1068, 2015. © 2015 Wiley Periodicals, Inc.     

Effects of Galla chinensis on the surface topography of initial enamel carious lesion: an atomic force microscopy study

To investigate the effect of Galla chinensis on the surface topography of initial enamel carious lesion, atomic force microscope (AFM) was used, and it was a new AFM application in enamel de‐/remineralization research. Bovine sound enamel slabs were demineralized to produce initial carious lesion in vitro. Then, the lesions were exposed to a pH‐cycling regime for 12 days. Each daily cycle included 4×1 min applications with one of three treatments: negative control group: deionized water; positive control group: 1 g/L aqueous solutions of NaF; experimental group: 4 g/L aqueous solutions of G. chinensis extract (GCE). The surface topography and roughness were investigated on the enamel slabs before and after pH‐cycling by AFM. 3D AFM images revealed the surface topographical changes of GCE‐treated enamel. Significant difference existed before and after the pH‐cycling among the groups. AFM offers a powerful tool for enamel de‐/remineralization research. The surface roughness results provide the evidences to remineralization of carious lesion, and indicate the potential of G. chinensis in promoting the remineralization. G. chinensis may become one more promising agent for caries prevention. SCANNING 31: 195–203, 2009. © 2010 Wiley Periodicals, Inc.     

Chemical and crystallographic study of remineralized surface on initial carious enamel treated with Galla chinensis

To investigate the morphologic, chemical and crystallographic characters of remineralized surface on initial carious enamel treated with Galla chinensis, scanning electron microscopy equipped with energy dispersive analysis spectroscopy were used, and X‐ray microdiffraction (microzone XRD) was used for the first time to analyze in situ the microzone crystallite of remineralized surface on carious enamel. Bovine sound enamel slabs were demineralized to produce initial carious lesion in vitro. Then, the lesions were exposed to a pH‐cycling regime for 12 days of remineralization. Each daily cycle included 4×1 min applications with one of the three treatments: distilled and deionized water (DDW); 1 g/L NaF; 4 g/L G. chinensis extract (GCE). After the treatments, some rod‐like deposits and many irregular prominences were found on GCE‐treated enamel surface, and the intensities of Ca and P signals showed a tendency to increase; Ca:P ratio was significantly higher than that of DDW‐treated enamel. X‐ray microdiffraction showed hydroxyapatite was still the main component of GCE‐treated enamel, and the crystallinity was increased, the crystal lattice changed gently with decreased lattice parameter a. These results indicated the potential of GCE in promoting the remineralization of initial enamel carious lesions, and supported the previous hypothesis about GCE mechanism. Combined with the anti‐bacteria and demineralization inhibition properties of GCE, the natural G. chinensis may become one more promising agent for caries prevention. SCANNING 31: 236–245, 2009. © 2010 Wiley Periodicals, Inc.     

Comparison of total‐etch,self‐etch,and selective etching techniques on class V composite restorations prepared by Er:YAG laser and bur: a scanning electron microscopy study

The purpose of this study was to compare total‐etch, self‐etch, and selective etching techniques on the marginal microleakage of Class V composite restorations prepared by Er:YAG laser and bur. Class V cavities prepared on both buccal and lingual surfaces of 30 premolars by Er:YAG laser or bur and divided into six groups. The occlusal margins were in enamel, and the cervical margins were in cementum. Group‐1: bur preparation(bp)+Adper Single Bond 2 (ASB)+Filtek Z550 (FZ); Group‐2: laser preparation(lp)+(ASB)+(FZ); Group‐3: bp + Clearfil S3 Bond Plus (CSBP)+(FZ); Group‐4: lp+(CSBP) (FZ); Group‐5: bp + acid etching+(CSBP)+(FZ); Group‐6: lp + acid etching+(CSBP)+(FZ). All teeth were stored in distilled water at 37°C for 24 hr, and then thermocycled 1000 times (5–55°C). Five teeth from each group were chosen for the microleakage investigation, and two teeth for the scanning electron microscope evaluation. Teeth which were prepared for the microleakage test were immersed in .5% methylene blue dye for 24 hr. After immersion, the teeth were sectioned and observed under a stereomicroscope for dye penetration. Data were analyzed using Kruskal–Wallis and Mann–Whitney U tests (p < .05). More microleakage was observed in the cervical regions compared to the occlusal regions in Groups 3, 5, and 6, respectively (p < .05). There is no statistically significant difference in Groups 1, 2, and 4, in terms of cervical regions versus occlusal regions (p > .05). No significant differences were observed among any groups in terms of occlusal and cervical surfaces, separately (p > .05). Different etching techniques did not influence microleakage of Class V restorations prepared by Er:YAG laser and bur.     

Morphological and immunohistochemical analysis of the biocompatibility of resin‐modified cements

The aim of this double‐blind randomized study was to evaluate the biocompatibility of resin‐modified glass ionomer cements (RMGIC) by means of morphological and immunohistochemical analyses. RMGICs were selected and divided into four groups: Group CK (Crosslink Orthodontic Band Cement); Group RS (Resilience Light Cure Band Cement) Group RMO (RMO Band Cement), Group TP (Transbond Plus Light Cure Band), and Group C (Control‐polyethylene). The materials were implanted in rat subcutaneous tissues, randomly selected for this study. After time intervals of 7, 15, and 30 days the tissues were submitted to morphological analysis. In immunohistochemical analysis, the immuno‐marking of antibody CD68 was evaluated. The results obtained were statistically analyzed by the Kruskal–Wallis and Dunn tests (p < .05). In the morphological analysis after 7 days, Groups RS, RMO and TP showed more intense inflammatory infiltrate (p = .004) and only Group RMO presented greater intensity of multinucleated giant cells (p = .027). In the immunohistochemical analysis, Groups RMO and RS were observed to present a larger quantity of CD68+ (p = .004) in the time interval of 7 days and only Group RMO presented statistically significant difference for this parameter after 15 days (p = .026). In the time interval of 30 days, Group RMO presented the largest quantity of multinucleated giant cells (p < .004). The RMGICS Crosslink and Transbond Plus provided significantly better tissue biocompatibility than the Resilience and RMO Cements.     

Does laser etching have an effect on application mode of a universal adhesive?—A microleakage and scanning electron microscopy evaluation

This study aimed to evaluate the microleakage of a universal adhesive's different application modes incorporated with Er,Cr:YSGG laser on Class V resin composite restorations. Sound human molar teeth (n = 30) were used for microleakage evaluations. Specimens with 60 standardized Class V cavities were divided into five groups according to the adhesive modes of universal adhesive, Adhese Universal (n = 12). Group 1‐etch‐and‐rinse mode with phosphoric acid; Group 2‐etch‐and‐rinse mode with Er,Cr:YSGG laser; Group 3‐selective‐etch mode with phosphoric acid; Group 4‐selective‐etch mode with Er,Cr:YSGG laser; Group 5‐self‐etch. After restorations were performed with a resin composite, Tetric N‐Ceram, the specimens were polished and subjected to thermocycling (10,000X). Following immersion in 0.5% basic fuschin for a day, the teeth were sectioned and the degree of microleakage was determined along the tooth‐resin composite interface using a light microscopy(40X). Five specimens from each group were examined by scanning electron microscopy. The Kruskal–Wallis, Siegel Castello, and Wilcoxon tests were used for statistical analyses (α = .05). At the enamel margins, significant differences were obtained among the groups (p < .05). Significantly higher microleakage scores were detected in Group 5 in comparison with Groups 1, 2, and 3. There were no significant differences between different adhesive strategies at the dentin margins (p > .05). While analyzing enamel and dentin microleakage scores, no statistically significant differences were observed in Groups 4 and 5 (p > .05). The laser application time and the adhesive modes of universal adhesives could affect the microleakage at the enamel margins. Different adhesive modes of universal adhesives combined with laser etching had no influence on the microleakage scores of dentin margins.     

Stress and strain distribution in demineralized enamel: A micro‐CT based finite element study

Physiological oral mechanical forces may play a role on the progression of enamel carious lesions to cavitation. Thus, the aim of this study was to describe, by 3D finite element analysis, stress, and strain patterns in sound and carious enamel after a simulated occlusal load. Micro‐CT based models were created and meshed with tetrahedral elements (based on an extracted third molar), namely: a sound (ST) and a carious tooth (CT). For the CT, enamel material properties were assigned according to the micro‐CT gray values. Below the threshold corresponding to the enamel lesion (2.5 g/cm³) lower and isotropic elastic modulus was assigned (E = 18 GPa against E₁ = 80 GPa, E₂ = E₃ = 20 GPa for sound enamel). Both models were imported into a FE solver where boundary conditions were assigned and a pressure load (500 MPa) was applied at the occlusal surface. A linear static analysis was performed, considering anisotropy in sound enamel. ST showed a more efficient transfer of maximum principal stress from enamel to the dentin layer, while for the CT, enamel layer was subjected to higher and concentrated loads. Maximum principal strain distributions were seen at the carious enamel surface, especially at the central fossa, correlating to the enamel cavity seen at the original micro‐CT model. It is possible to conclude that demineralized enamel compromises appropriate stress transfer from enamel to dentin, contributing to the odds of fracture and cavitation. Enamel fracture over a dentin lesion may happen as one of the normal pathways to caries progression and may act as a confounding factor during clinical diagnostic decisions. Microsc. Res. Tech. 78:865–872, 2015. © 2015 Wiley Periodicals, Inc.     

Different bacterial models for in vitro induction of non‐cavitated enamel caries‐like lesions: Microhardness and polarized light miscroscopy analyses

The aim of this study was to compare different bacterial models for in vitro induction of non‐cavitated enamel caries‐like lesions by microhardness and polarized light microscopy analyses. One hundred blocks of bovine enamel were randomly divided into four groups (n = 25) according to the bacterial model for caries induction: (A) Streptococcus mutans, (B) S. mutans and Lactobacillus acidophilus, (C) S. mutans and L. casei, and (D) S. mutans, L. acidophilus, and L. casei. Within each group, the blocks were randomly divided into five subgroups according to the duration of the period of caries induction (4–20 days). The enamel blocks were immersed in cariogenic solution containing the microorganisms, which was changed every 48 h. Groups C and D presented lower surface hardness values (SMH) and higher area of hardness loss (ΔS) after the cariogenic challenge than groups A and B (P < 0.05). As regards lesion depth, under polarized light microscopy, group A presented significantly lower values, and groups C and D the highest values. Group B showed a higher value than group A (P < 0.05). Groups A and B exhibited subsurface caries lesions after all treatment durations, while groups C and D presented erosion‐type lesions with surface softening. The model using S. mutans, whether or not it was associated with L. acidophilus, was less aggressive and may be used for the induction of non‐cavitated enamel caries‐like lesions. The optimal period for inducing caries‐like lesions was 8 days. Microsc. Res. Tech. 78:444–451, 2015. © 2015 Wiley Periodicals, Inc.     

Comparison between the use of thermoplasticized gutta‐percha and a polydimethyl siloxane‐based material in filling internal resorptive cavities using spiral computed tomography

To evaluate the fill of internal resorption cavities obturated with thermoplasticized gutta‐percha and GuttaFlow2 using CT scan. Twenty human maxillary anterior teeth were selected and root canals were prepared using ProTaper system to size F3. Irrigation was performed with 5 ml of 2.5% sodium hypochlorite (NaOCl) and 5 ml of 17% ethylenediaminetetraacetic acid (EDTA). Each root was then sectioned horizontally into two halves and semicircular cavities were prepared around the periphery of the root canal opening of each root half, using a round bur. Both the root halves were then fixed using cyanoacrylate glue. All the specimens were subjected to preoperative CT scan analysis to determine the volume of internal cavities. The samples were then randomly divided into two groups. In Group 1, the specimens were obturated with thermoplasticized gutta‐percha (E&Q system) and specimens in Group 2 were obturated using GuttaFlow2. All specimens were then subjected to postoperative CT scan analysis. The volume of voids in internal resorptive cavities were calculated, which was then used to estimate the amount of gutta‐percha filled. There was no significant difference in volume of internal resorptive cavities between thermoplasticized gutta‐percha and GuttaFlow2 groups before obturation (p = 0.466). However, after obturation there was a significant difference between both the groups, in which GuttaFlow2 demonstrated better fill (p = .014). Thermoplasticized gutta‐percha filled 81% of internal resorptive cavity while GuttaFlow2 filled 91%, respectively. GuttaFlow2 showed better fill than thermoplasticized gutta‐percha in the filling of internal resorptive cavities.     

Ultrastructural changes in the cemento‐enamel junction caused by acidic beverages: An in vitro study

The present in vitro study was aimed at evaluating the morphological changes in the cemento‐enamel junction (CEJ) after exposure to acidic beverages using the scanning electron microscopy (SEM). The initial pH and titratable acidity (TA) was analyzed from follow groups: (I) Coca cola, (II) orange juice, (III) Cedevita, (IV) Red Bull, (V) Somersby cider, and (VI) white wine. The CEJ samples (n = 64), obtained from unerupted third molars, were allocated to one control (artificial saliva, n = 16) and six experimental groups (n = 8). The experimental samples were immersed in beverages (50 ml) for 15 min, three times daily, 10 days, and in artificial saliva between immersions. SEM analysis was performed in a blind manner, according to scoring scale. One‐way ANOVA and Tukey's post hoc tests, as well as Kruskal–Wallis and Mann–Whitney U test used for statistical analysis. The pH values of the acidic beverages ranged from 2.65 (Coca cola) to 3.73 (orange juice), and TA ranged from 1.90 ml (Coca cola) to 5.70 ml (orange juice) of NaOH to reach pH 7.0. The SEM analysis indicated statistically significant differences between the control samples and those immersed in acidic beverages. The Groups IV, I, and II, showed the highest CEJ damage grade while those of the Group VI were the lowest. All the tested acidic beverages caused morphological changes in the CEJ with a smaller or larger exposure of dentine surface, and were not always related to the pH or TA of acidic beverages.     

Energy dispersive X‐ray spectrometry study of the protective effects of fluoride varnish and gel on enamel erosion

Background: Dental erosion is a risk factor for dental health, introduced by today's lifestyle. Topical fluoride applications in the form of varnishes and gel may lead to deposition of fluoride on enamel. Purpose: This in vitro study aimed to evaluate the effect of two fluoride varnishes and one fluoride gel on the dissolution of bovine enamel by acids. Methods: Enamel samples (72) were divided (n = 8): artificial saliva (control‐G1), Pepsi Twist® (G2), orange juice (G3), Duraphat® + Pepsi Twist® (G4), Duraphat® + orange juice (G5), Duofluorid® + Pepsi Twist® (G6), Duofluorid® + orange juice (G7), fluoride gel + Pepsi Twist® (G8), and fluoride gel + orange juice (G9). Fluoride gel was applied for 4 min and the varnishes were applied and removed after 6 h. The samples were submitted to six cycles (demineralization: Pepsi Twist® or orange juice, 10 min; remineralization: saliva, 1 h). Samples were analyzed by energy‐dispersive X‐ray fluorescence (144 line‐scanning). Results: The amount of Ca and P decreased significantly in the samples of G2 and G3, and the Ca/P ratio decreased in G3. Mineral gain (Ca) was greater in G9 samples than in G4 > G3 > G5 > G1, and (P) greater in G7 samples than in G9 > G4‐6 > G2‐3. Conclusions: The protective effect of Duofluorid® was significantly lower than fluoride gel against orange juice. The fluoride varnishes can interfere positively with the dissolution of dental enamel in the presence of acidic beverages. Fluoride gel showed the best protection level to extrinsic erosion with low costs. Microsc. Res. Tech., 2011. © 2010 Wiley‐Liss, Inc.     

Active application of primer acid on acid‐treated enamel: Influence on the bond effectiveness of self‐etch adhesives systems

Aim: Evaluate the composite‐to‐enamel bond after passive or active application of self‐etching primer systems on polished or pre‐etched enamel with phosphoric acid. Materials and Methods: Two self‐etch adhesives systems (SEAS) were used: Clearfil SE Bond and Easy Bond. Third human molars were divided into 8 groups (N = 10). The crown of each tooth was sectioned into halves and the mesial/distal surfaces were used. The adhesives were actively or passively applied on enamel with or without prior phosphoric‐acid etching. Resin composite cylinders were built after adhesive application. After stored in relative humidity for 24 hr/37°C the specimens were subjected to microshear test in universal testing a machine at a crosshead speed of 0.5 mm/minute. The results were analyzed with three‐way ANOVA and the Tukey test. The enamel‐etching pattern was evaluated under SEM. Results: The 2‐step SEAS system presented significantly higher adhesive bond strength means (47.37 MPa) than the 1‐step (36.87 MPa). A poor enamel‐ etching pattern was observed in active mode showing irregular and short resin tags, however there was not compromised the bond strength. Conclusion: Active or passive application produced similar values of bond strength to enamel regardless of enamel pretreatment and type of SEAS.     

Adverse effects of respiratory disease medicaments and tooth brushing on teeth: A scanning electron microscopy,X‐ray fluorescence and infrared spectroscopy study

The present study aims to evaluate the effect of brushing with fluoride dentifrice on teeth severely affected by erosion due to respiratory medicaments. Enamel (n = 50) and dentin (n = 50) bovine specimens were prepared and treated with artificial saliva (S‐control), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS) and subjected to cycles of demineralization (immersing in 3 mL, 1 min, three times a day at intervals of 1 hr, for 5 days) followed by remineralization (saliva, 37°C, 1 hr). Simulated brushing with fluoridated toothpaste was performed using 810 strokes in a reciprocal‐action brushing simulator. Scanning electron microscopy, micro energy dispersive X‐ray fluorescence (μ‐EDXRF) spectroscopy and attenuated total reflection Fourier transform infrared (ATR FTIR) spectroscopy were then performed. μ‐EDXRF images showed extensive erosion after treatment with all medicaments. SEM images showed enamel erosion in order SS > BR > AC = AM > S after brushing and fluoridation. FTIR results were in agreement. In case of dentin, μ‐EDXRF measurements showed significant difference in mineral content (percent weight of calcium and phosphate) in SS + brushing + fluoridation treated enamel compared to control, while μ‐EDXRF images showed erosive effects in the order SS > AM>BR > AC = S post brushing + fluoridation. SEM images showed erosion in the order SS > AM = BR > AC > S post brushing + fluoridation. Again, FTIR multivariate results were in agreement. Overall, our study shows that proper oral care is critical when taking certain medication. The study also demonstrates the possible use of FTIR for rapid clinical monitoring of tooth erosion in clinics.     

Comparison of methods for quantifying dental wear caused by erosion and abrasion

Various methods have been applied to evaluate the effect of erosion and abrasion. So, the aim of this study was to check the applicability of stylus profilometry (SP), surface hardness (SH) and focus‐variation 3D microscopy (FVM) to the analysis of human enamel and dentin subjected to erosion/abrasion. The samples were randomly allocated into four groups (n = 10): G1‐enamel/erosion, G2‐enamel/erosion plus abrasion, G3‐dentin/erosion, and G4‐dentin/erosion plus abrasion. The specimens were selected by their surface hardness, and they were subjected to cycles of demineralization (Coca‐Cola®‐60 s) and remineralization (artificial saliva‐60 min). For groups G2 and G4, the remineralization procedures were followed by toothbrushing (150 strokes). The above cycle was repeated 3×/day during 5 days. The samples were assessed using SH, SP, and FVM. For each substrate, the groups were compared using an unpaired t‐test, and Pearson correlation coefficients were calculated (α = 5%). For enamel, both profilometry technique showed greater surface loss when the erosion and abrasion processes were combined (P <0.05). The correlation analysis did not reveal any relationships among SH, SP, and FVM to G2 and G4. There were significant correlation coefficients (–0.70 and –0.67) for the comparisons between the FVM and SH methods in enamel and dentin, respectively, in G1 and G3. Choosing the ideal technique for the analysis of erosion depends on the type of dental substrate. SP was not sufficiently sensitive to measure the effects on dentin of erosion or erosion/abrasion. However, SP, FVM and SH were adequate for the detection of tissue loss and demineralization in enamel. Microsc. Res. Tech., 2013. © 2012 Wiley Periodicals, Inc.     

Remineralization potential of P11-4 and fluoride on secondary carious primary enamel: A quantitative evaluation using microcomputed tomography

The aim of this study was to assess the ability of self-assembling peptide (P11-4) diffusion, assembly, and remineralization to effect artificial secondary caries-like lesions in human primary teeth in vitro. Enamel-dentin blocks obtained from extracted human primary molars were embedded into epoxy resin blocks. Cavities (approximately 1 × 1 × 2 mm) were prepared on the surface using a high-speed diamond bur under constant water cooling and filled with composite restorative material (Filtek Z250; 3 M ESPE). The samples were immersed in demineralizing solution (20 ml) for 96 h to produce secondary caries lesions and divided into two groups according to the testing materials: fluoride varnish (Duraphat; Colgate, UK) and P11-4 (Curodont Repair; Credentis, Switzerland). Except for the control areas, all samples were remineralized for 3–5 min using the remineralizing agents, and then all the sections were placed in a pH-cycling system for 5 days at 35°C. The pH cycling procedure was followed by micro-CT analysis for the qualitative evaluation of surface changes. The Mann–Whitney U test was used to compare two independent groups. In the comparison of more than two dependent groups, Bonferroni smoothed pairwise analyses were used to determine the source of the Kruskal–Wallis H test difference. The results of the study revealed that the remineralization depths of the peptide group were higher than those of the fluoride group (p < .01). There was a statistically significant difference in remineralization effects between the fluoride and peptide groups. P11-4 can be considered as an effective remineralizing agent for secondary caries lesions.     

Chemical and morphological evaluation of enamel and dentin near cavities restored with conventional and zirconia modified glass ionomer subjected to erosion‐abrasion

Microenergy dispersive X‐ray fluorescence (μ‐EDXRF) spectroscopy and scanning electron microscopy (SEM) were used to test the hypothesis that zirconia modified glass ionomer cement (GIC) could improve resistance to erosion‐abrasion to a greater extent than conventional cement. Bovine enamel (n = 40) and dentin (n = 40) samples were prepared with cavities, filled with one of the two restorative materials (GIC: glass‐ionomer cement or ZrGIC: zirconia‐modified GIC). Furthermore, the samples were treated with abrasion‐saliva (AS) or abrasion‐erosion cycles (AE). Erosive cycles (immersion in orange juice, three times/day for a duration of 1 min over a 5 day period) and/or abrasive challenges (electric toothbrush, three times/day for a duration of 1 min over a 5 day period) were performed. Positive mineral variation (MV%) on the enamel after erosion‐abrasion was observed for both materials (p < 0.05), whereas a negative MV% on the dentin was observed for both materials and treatments (p < 0.05). The SEM images showed clear enamel loss after erosion‐abrasion treatment and material degradation was greater in GIC_AE compared to those of the other groups. Toothbrush abrasion showed a synergistic effect with erosion on substance loss of bovine enamel, dentin, GIC, and ZrGIC restorations. Zirconia addition to the GIC powder improved the resistance to abrasive‐erosive processes. The ZrGIC materials may find application as a restorative material due to improved resistance as well as in temporary restorations and fissure sealants.     

Efficacy of in-office bleaching techniques combined with the application of a casein phosphopeptide-amorphous calcium phosphate paste at different moments and its influence on enamel surface properties

OBJECTIVES: The aim of this in vitro study was to investigate the efficacy of in‐office bleaching technique combined with the application of a casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) paste (MI Paste–MI) at different moments and its influence on enamel surface properties. METHODS: Eighty bovine dental crowns were randomly allocated into eight groups (n = 10), and bleached with either 35% hydrogen peroxide (HP) or 37% carbamide peroxide (CP). Four different protocols of application of MI were considered: without MI, MI applied before bleaching, MI applied after bleaching, and MI applied both before and after bleaching. Bleaching effectiveness was measured by the VITA EasyShade spectrophotometer utilizing the CIEL*a*b* system (ΔE, ΔL*, Δa*, and Δb*). Color readings were measured at baseline, 7, 14, and 21 days. Hardness and roughness were measured at baseline (T0) and immediately after bleaching (T14). Data were subjected to the two‐way ANOVA for repeated measurements and Tukey's test at 5%. RESULTS: HP groups achieved the greatest color change. The application of a CPP‐ACP paste did not reduce the efficacy of bleaching peroxides. Samples bleached with CP showed decreased hardness at T14. Samples bleached with HP that received the application of MI before and before/after bleaching did not present hardness decrease at T14. Samples bleached with peroxides only and received MI after bleaching showed increased roughness at T14. CONCLUSIONS: The use of CPP‐ACP was able to prevent negative changes in roughness and hardness of bovine enamel when associated to hydrogen peroxide, and might be applied before/after the bleaching protocol. Microsc. Res. Tech. 75:1019–1025, 2012. © 2012 Wiley Periodicals, Inc.