Enamel alteration following tooth bleaching and remineralization

The purpose of this study was to compare the effects of professional tooth whitening agents containing highly concentrated hydrogen peroxide (with and without laser activation), on the enamel surface; and the potential of four different toothpastes to remineralize any alterations. The study was performed on 50 human molars, divided in two groups: treated with Opalescence^® Boost and Mirawhite^® Laser Bleaching. Furthermore, each group was divided into five subgroups, a control one and 4 subgroups remineralized with: Mirasensitive^® hap+, Mirawhite^® Gelle?, GC Tooth Mousse? and Mirafluor^® C. The samples were analysed by SEM/3D‐SEM‐micrographs, SEM/EDX‐qualitative analysis and SEM/EDX‐semiquantitative analysis. The microphotographs show that both types of bleaching cause alterations: emphasized perikymata, erosions, loss of interprizmatic substance; the laser treatment is more aggressive and loss of integrity of the enamel is determined by shearing off the enamel rods. In all samples undergoing remineralization deposits were observed, those of toothpastes based on calcium phosphate technologies seem to merge with each other and cover almost the entire surface of the enamel. Loss of integrity and minerals were detected only in the line‐scans of the sample remineralized with GC Tooth Mousse?. The semiquantitative EDX analysis of individual elements in the surface layer of the enamel indicates that during tooth‐bleaching with HP statistically significant loss of Na and Mg occurs, whereas the bleaching in combination with a laser leads to statistically significant loss of Ca and P. The results undoubtedly confirm that teeth whitening procedures lead to enamel alterations. In this context, it must be noted that laser bleaching is more aggressive for dental substances. However, these changes are reversible and can be repaired by application of remineralization toothpastes.     

Methods for Biomimetic Remineralization of Human Dentine: A Systematic Review

This study aimed to review the laboratory methods on biomimetic remineralization of demineralized human dentine. A systematic search of the publications in the PubMed, TRIP, and Web of Science databases was performed. Titles and abstracts of initially identified publications were screened. Clinical trials, reviews, non-English articles, resin-dentine interface studies, hybrid layer studies, hybrid scaffolds studies, and irrelevant studies were excluded. The remaining papers were retrieved with full texts. Manual screening was conducted on the bibliographies of remaining papers to identify relevant articles. A total of 716 studies were found, and 690 were excluded after initial screening. Two articles were identified from the bibliographies of the remaining papers. After retrieving the full text, 23 were included in this systematic review. Sixteen studies used analogues to mimic the functions of non-collagenous proteins in biomineralization of dentine, and four studies used bioactive materials to induce apatite formation on demineralized dentine surface. One study used zinc as a bioactive element, one study used polydopamine, and another study constructed an agarose hydrogel system for biomimetic mineralization of dentine. Many studies reported success in biomimetic mineralization of dentine, including the use of non-collagenous protein analogues, bioactive materials, or elements and agarose hydrogel system.     

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.     

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.     

Analysis of efficacy of the self‐assembling peptide‐based remineralization agent on artificial enamel lesions

The objective of this in vitro study was to analyze and compare the biomimetic remineralizing efficacy of the self‐assembling peptide (P11‐4) with agents containing casein phoshopeptide‐amorhous calcium phosphate fluoride (CPP‐ACFP) and sodium fluoride (NaF) on artificial caries lesions using DIAGNOdent and micro‐computed tomography (μCT). Artificial enamel lesions were prepared on extracted impacted sound mandibular third molars. The samples were randomly allocated to four groups (n = 8): Group 1, P11‐4 (Curodont Repair, Credentis AG, Switzerland); Group 2, CPP‐ACFP (MI Varnish, GCCo., Japan); Group3, NaF (Duraphat Varnish, Colgate, Colgate‐Palmolive, NY, USA); Group 4, artificial saliva (control). The agents were applied to demineralized surfaces according to manufacturers' instructions; all specimens were stored in artificial saliva for 1 month. Demineralization and remineralization on enamel surfaces were analyzed and quantified by DIAGNOdent (KaVo, Germany) and μCT (SkyScan1174, Belgium) for lesion depth/area/volume/mineral density (MD). The remineralization efficacy of the agents was evaluated by DIAGNOdent on 1st, 7th, 30th days and by μCT on 30th day. Data were statistically analyzed by ANOVA, Kruskal–Wallis, T test, and Wilxocon tests. The highest remineralization efficacy findings in all periods were determined in Group 1, followed by Groups 2, 3, and 4. The remineralization findings for fluorescence, MD, lesion depth in Group 1 were found significantly higher (p < 0.01) than Group 3; and no significant differences (p > 0.05) were found between Groups 1–2 and Groups 2–3. The area and volume change values in Groups 1, 2, and 3 have shown no significancy (p > 0.05). A significant correlation (p < 0.01) was found between μCT and DIAGNOdent methods. The data of this study have demonstrated that P11‐4 has showed the best remineralization efficacy, followed by CPP‐ACFP and NaF. It is concluded that self‐assembling peptide‐based remineralization agent can be used successfully for biomimetic remineralization of enamel subsurface lesions.     

Reconfigurable Dual Peptide Tethered Polymer System Offers a Synergistic Solution for Next Generation Dental Adhesives

Resin-based composite materials have been widely used in restorative dental materials due to their aesthetic, mechanical, and physical properties. However, they still encounter clinical shortcomings mainly due to recurrent decay that develops at the composite-tooth interface. The low-viscosity adhesive that bonds the composite to the tooth is intended to seal this interface, but the adhesive seal is inherently defective and readily damaged by acids, enzymes, and oral fluids. Bacteria infiltrate the resulting gaps at the composite-tooth interface and bacterial by-products demineralize the tooth and erode the adhesive. These activities lead to wider and deeper gaps that provide an ideal environment for bacteria to proliferate. This complex degradation process mediated by several biological and environmental factors damages the tooth, destroys the adhesive seal, and ultimately, leads to failure of the composite restoration. This paper describes a co-tethered dual peptide-polymer system to address composite-tooth interface vulnerability. The adhesive system incorporates an antimicrobial peptide to inhibit bacterial attack and a hydroxyapatite-binding peptide to promote remineralization of damaged tooth structure. A designer spacer sequence was incorporated into each peptide sequence to not only provide a conjugation site for methacrylate (MA) monomer but also to retain active peptide conformations and enhance the display of the peptides in the material. The resulting MA-antimicrobial peptides and MA-remineralization peptides were copolymerized into dental adhesives formulations. The results on the adhesive system composed of co-tethered peptides demonstrated both strong metabolic inhibition of S. mutans and localized calcium phosphate remineralization. Overall, the result offers a reconfigurable and tunable peptide-polymer hybrid system as next-generation adhesives to address composite-tooth interface vulnerability.     

盐酸溶解石灰石法的海水淡化再矿化中试研究

针对反渗透海水淡化水低碱度和低硬度的特点,采用石灰石溶解法对淡化水进行再矿化.以盐酸对淡化水进行酸化,考察酸化水pH(2、2.3、3)及矿化塔内停留时间(3、8、12、24、36、48、60 min)对矿化效果的影响,并计算酸的利用效率.结果表明,酸化水pH应不大于3,且随酸化水pH减小,矿化水硬度、碱度越高;随停留时...     

Amorphous Calcium Phosphate-Based Bioactive Polymeric Composites for Mineralized Tissue Regeneration

Amorphous calcium phosphate (ACP), a postulated precursor in the formation of biological hydroxyapatite, has been evaluated as a filler phase in bioactive polymeric composites that utilize dental monomers to form the matrix phase on polymerization. In addition to excellent biocompatibility, these composites provided sustained release of calcium and phosphate ions into simulated saliva milieus. In an effort to enhance the physicochemical and mechanical properties and extend the utility of remineralizing ACP composites to a greater variety of dental applications, we have focused on: a) hybridizing ACP by introducing silica and/or zirconia, b) assessing the efficacy of potential coupling agents, c) investigating the effects of chemical structure and compositional variation of the resin matrices on the mechanical strength and ion-releasing properties of the composites, and d) improving the intrinsic adhesiveness of composites by using bifunctional monomers with an affinity for tooth structure in resin formulations. Si- and Zr-modified ACPs along with several monomer systems are found useful in formulating composites with improved mechanical and remineralizing properties. Structure-property studies have proven helpful in advancing our understanding of the remineralizing behavior of these bioactive composites. It is expected that this knowledge base will direct future research and lead to clinically valuable products, especially therapeutic materials appropriate for the healing or even regeneration of defective teeth and bone structures.