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Objectives: This study aims to evaluate the effectiveness of topical fluoride application and diode laser-irradiation on the hardness of demineralized enamel and to evaluate the esthetic improvement of the white spot lesions (WSLs) using a visual analog scale (VAS). Materials and Methods: Artificial WSLs (3x3 mm) were created on the enamel surface of 45 human third molars. The teeth were randomly assigned into three groups (n = 15): group A, fluoride only; group B, combined therapy of fluoride and diode laser; and group C, control. Vicker’s hardness number (VHN) was measured at baseline, after demineralization and after treatment. To evaluate the esthetic improvement after treatment, 14 raters evaluated each group’s photographs using a 100-millimeter VAS. A one-way ANOVA or Brown-Forsythe and Games-Howell post hoc procedure were performed for statistical analysis. The level of significance was set at α = 0.05 for all tests. Results: Group A mean VHN was significantly higher than groups B and C, and group B was significantly higher than group C (P

OBJECTIVES: To evaluate the effects of different polyphenols and solvents on dentin collagen’s crosslinking interactions and biostabilization against MMPs and collagenase degradation. METHODS: Two polyphenols [proanthocyanidin (PA) and quercetin (QC)] with different water solubility were prepared as treatment solutions using ethanol (EtOH) or dimethyl sulfoxide (DMSO) as solvents. 6-um-thick dentin films were microtomed from dentin slabs of third molars. Following demineralization, films or slabs were subject to 60-s treatment (PA or QC) or no treatment (control) with subsequent extended-rinse with original solvent (EtOH or DMSO) or distilled water (DW). Collagen crosslinking interactions were assessed by FTIR. Biostability was assessed through endogenous MMPs activity via confocal laser scanning microscopy, and exogenous collagenase degradation via weight loss, hydroxyproline release and SEM. Finally, direct collagenase inactivation was also evaluated. Data were analyzed by three-way ANOVA and post-hoc tests (α=0.05%). RESULTS: Distinct effects of two polyphenols and solvents on collagen crosslinking and biostabilization were observed. Higher crosslinking and biostability efficacy occurred with PA than QC (p < 0.001) that demonstrated negligible collagen interactions. With DMSO solvent, efficacy results were significantly reduced with both polyphenols (p < 0.05). DMSO-rinse further weakened interactions of PA with collagen, diminishing biostability (p < 0.05). Low biostability was detected with QC and DW-rinse, suggesting direct enzymatic inhibition due to physical presence in collagen. SIGNIFICANCE: Collagen crosslinking interactions and biostability depend on polyphenol chemical characteristics. Treatment-solution solvents may affect interactions between polyphenols and collagen, specifically, DMSO showed detrimental effects on collagen crosslinking and biostability and should be used with caution.

Background: The denture-base acrylic resins used by partially edentulous patients can cause local demineralization of teeth. Alkali ions released from the bioactive materials that were added to acrylic resins can increase the pH of the oral environment and slow down the demineralization process. Aim of the study: This study aimed to create a new denture-base acrylic resin that can release ions. Materials and methods: A total of 222 samples with different fillers (calcium hydrogen phosphate, hydroxyapatite, two kinds of bioactive glasses, and a product obtained by reaction between bioactive glass formed from glass ionomer cement and polyacrylic acid) were prepared for the study. All the materials were tested for mechanical properties and their use as phosphate donors for 3 weeks. The measurements were presented as mean ± SD error of the mean. Data were analyzed by two-way analysis of variance, with a p-value of

Intrafibrillar mineralization of type I collagen fibrils is of great significance in dental remineralization, which is the key of caries prevention and treatment. Herein, two substances that have the remineralization ability, carboxylated polyamidoamine dendrimer (PAMAM-COOH) and nano-sized amorphous calcium phosphate (n-ACP) were combined to synthesize a novel nanomaterial, carboxylated polyamidoamine dendrimer/amorphous calcium phosphate nanocomposite (PAMAM-COOH/ACP). This article aims to evaluate the remineralization effect of PAMAM-COOH/ACP of dentin type I collagen fibrils in vitro. Fluorescence labeling technique was innovatively used to observe and evaluate the remineralization effect. PAMAM-COOH/ACP showed superior remineralization ability of human dentin type I collagen fibrils, especially the intrafibrillar remineralization. Therefore, the novel nanomaterial PAMAM-COOH/ACP is promising to prevent and treat various diseases caused by dentin demineralization and to improve various dental materials.

The tooth cavity is the common problem in the enamel surface due to the predominance of the demineralization process. It can be controlled with different factors like sufficient salivation in remineralization agents, antibacterial protection, and pathologic factor. Fluoride ion (F−) is the oral hygiene active ingredient and best choice for control caries, prevent decay, crumbling of the bone tooth. F−. In general forms fluorapatite (FA) on the enamel surface, which inhibits mineral loss during the demineralization process. However, recommended optimum deposition of FA on the enamel surface, otherwise, FA leads to inhibit full remineralization. However, regularly consume fluoride causes dental fluorosis during tooth development. Hence, need for an alternative non-fluoride agent for dental caries, which can include effective remineralization without risks associated with F−. This review described fluoride release and re-release ability with application of dental materials, remineralizing potential of fluoridated and non-fluoridated products in dentistry such as casein phosphopeptides, nanohydroxyapatite, tricalcium phosphate, dicalcium phosphate dehydrate, polyols, SensiStat, trimetaphosphate, and herbal products. Lastly, dental perspectives are described. Based on literature results and discussion, nanohydroxyapatite, fluoride, and tricalcium phosphate are best among toothpaste to enhance the remineralization process. Recently, the focus of restorative dentistry is shifted toward more conservative approaches. Hence, F− releasing filling materials with different fluoride-releasing abilities like GIC, giomers, cermets, compomers, and composite materials proved beneficial for the patient. The presence of fluoride anions in the oral cavity has added advantage of being a potent antibacterial and antifungal agent.

To improve the specific surface area (SSA) of steam activated carbon that has been prepared from spent coffee grounds (SCG), a demineralization of the SCG was conducted. As the ash content of the SCG decreased, fine micropores developed during the activation, leading to a significant increase in the SSA. An electric double layer capacitor was assembled and then evaluated, with the evaluation results indicating that the capacitance per electrode weight, the capacitance retention in relation to the current density, and the internal resistance were superior for activated carbon with a higher SSA. However, the capacitance per electrode volume had a maximum value under certain conditions, which were considered well balanced in terms of the SSA and electrode density.

Chitosan films containing distilled pyroligneous extracts of Eucalyptus grandis (DPEC), characterized and developed by Brazilian Agricultural Research Corporation—Embrapa Temperate Agriculture (EMBRAPA-CPACT), were evaluated for antimicrobial activity against Candida albicans, Streptococcus mutans, and Lactobacillus acidophilus by direct contact test. Further, their capacity for the prevention of teeth enamel demineralization and cytotoxicity in vitro were also determined. The natural polymers were tested at different concentrations (1500–7500 µg mL−1) and the formulation of an experimental fluoride varnish with antimicrobial activity was evaluated by direct contact test, whereas cytotoxicity was analyzed through the colorimetric MTT assay. Preliminary data showed no statistically significant differences in cytotoxicity to NIH/3T3 cell line when DPEC is compared to the control group. On the other hand, the antimicrobial capacity and demineralization effects were found between the test groups at the different concentrations tested. Chitosan films containing distilled pyroligneous extracts of E. grandis may be an effective control strategy to prevent biofilm formation related to dental caries when applied as a protective varnish. They may inhibit the colonization of oral microorganisms and possibly control dental caries through a decrease in pH and impairment of enamel demineralization.

We evaluate the effects of the new Dentine matrix protein 1 (DMP-1) biomimetic system composed of phosphorylated polyamidoamine dendrimer (PAMAM-PO3H2) and carboxylated polyamidoamine dendrimer (PAMAM-COOH) on the mineralization of type I collagen fibrils. PAMAM-PO3H2 and PAMAM-COOH were observed to have the ability to induce internal and external mineralization of type I collagen fibrils in vitro through non-classical mineralization crystallization pathway, which has become a hopeful biomimetic system of biomimetic remineralization and demineralization of dentin type I collagen fibrils and has great potential in inducing biomimetic remineralization of demineralized dentin.

Purpose Sweptsource optical coherence tomography (SS-OCT) permits cross-sectional observation of surface/subsurface characteristics of enamel including early carious lesions (ECL) or remineralization non-invasively.This study aimed to visually compare the cross-sectional remineralizing efficacy of various agents on ICDAS-II scores-1&2 by using SS-OCT and histology. Methods Baseline SS-OCT (grey-scale/false-colour) and histology was performed on the randomly selected two samples with scores-1&2. Four remineralizing agents [fluoride-varnish (FV), CPP-ACP, nanohydroxy-paste (NHP) and silver-diamine-fluoride (SDF)]were evaluated for 2-or 6-weeks post-remineralization using SS-OCT and histology. Results Score-1&2 baseline SS-OCT images showed a linear-shaped demineralization with dentino-enamel junction (DEJ) visible; and bowl-shaped demineralization with DEJ invisible respectively. Remineralizing agents were assessed on the basis of their ability to remineralize the surface, subsurface and made visualize the DEJ in score-2. SS-OCT showed an outer growth layer in post-remineralization score-1, 2-weeks samples with FV and NHP. All the agents showed progressive subsurface remineralization in 6 weeks. Active lesions showed rapid uptake of minerals on surface. Subsurface mineralization in pigmented score-2 matched sound enamel with NHP and SDF. Surface remineralization was comparable in FV and SDF followed by NHP. SDF demonstrated deeper subsurface remineralization followed by NHP and CPP-ACP. Conclusion SS-OCT images correlated to histology. SS-OCT could monitor surface/subsurface in-situde/remineralization activity non-invasively.

Objectives In this in vitro study, a bioluminescent marker was investigated for its potential to illuminate the assessment of dental caries and dental erosion, which are significant clinical and public health problems, through its binding of those ions, notably Ca2+, known to be released during the process of demineralization. Materials and Methods The light output from the selected bioluminescent marker was investigated in several experiments, including: (a)contact with a range of Ca2+ ion concentrations; (b) treatment of extracted teeth with solutions of differing pH, followed by application of the bioluminescence marker to assess Ca2+ ion release; and (c) application of the marker to freshly extracted teeth with natural and artificially created caries lesions on occlusal and smooth surfaces to image the Ca2+ ion distribution. Results The results of: experiment (a) showed that the light output from the marker increases with increasing Ca2+ concentration and of experiment (b) showed increases in light being observed as increasingly acidic solutions were applied. The results of experiment (c) showed the bioluminescence images of the extracted teeth produced “demineralization maps” of the imaged surfaces. Conclusions These results demonstrate the ability of a novel bioluminescence technology to image Ca2+ ions on tooth enamel surfaces which has potential in dental caries and dental erosion applications and provides the scientific basis for the ongoing development of that novel technology.

Objective: To investigate the effect of a novel mineral containing toothpaste in comparison to a fluoride toothpaste in children with white spot lesions. Method: The clinical study was conducted from 2016 to 2018 at Marmara University Department of Pediatric Dentistry Clinic after approval from the ethics review committee of Yeditepe University, Istanbul, Turkey, and comprised children of either gender aged 4-5 years having white spot lesions. They were randomly allocated into two groups. The FT ( Fluoridated Toothpaste ) group was given a 500ppm fluoridated toothpaste, while the Mineral Containing Toothpaste (MCT) group was given toothpaste containing calcium glycerophosphate, magnesium chloride, and 12% xylitol. The white spot lesions were examined using Laser Fluorescence (LF) at baseline and after a month of usage. The two readings were compared. Stimulated saliva was collected for measuring the salivary potential of hydrogen, buffering capacity, and streptococcus mutans. Data was analysed using SPSS 19. Results: Of the 26 children, 10(38%) were girls and 16(62%) were boys. The overall mean age was 4.77+/-0.54 years. There were 13(50%) subjects in each of the two groups. Of the 381 measurements done, 198(52%) were in the MCT group and 183(48%) in the FT group. LF scores decreased in both the groups (p=0.001). The remineralising potential was not significantly different (p=0.866), while salivary buffering capacity and potential of hydrogen increased in both the groups but the change was not significant (p>0.05). The number of children positive for streptococcus mutans decreased in both the groups (p>0.05). ---Continue

Aim Aim of the current study was to assess the anticariogenic effectiveness of different fluoride varnishes on artificially induced enamel lesions employing scanning electron microscope. Materials and methods Eighty healthy, normal premolars without dental caries that were extracted in course of orthodontic therapy with all the surfaces intact were included in this study. A window, 4 × 4 mm, was made discernible on the buccal surface of each sample tooth. A demineralizing solution at 37°C was used to immerse the teeth for 48 hours to induce artificial lesions on the surface of the enamel. Following preparation of the artificial enamel lesions, the 80 premolar teeth were allocated into the four groups (20 each) depending on the fluoride varnish system used as Group I: control, Group II: Duraphat varnish, Group III: MI Varnish, and Group IV: Clinpro White Varnish. The anticariogenic effectiveness of different fluoride varnishes was evaluated employing a scanning electron microscope (SEM). Results The MI Varnish (fluoride varnish) group exhibited slightly greater (127.20 ±0.14) mean demineralized lesions, pursued by Clinpro White Varnish use (126.88 ±0.09), the control group (126.36 ±0.10) and the Duraphat varnish (124.14 ±0.08) in that order. Greater mean areas of remineralization were found with use of MI Varnish (92.40 ±0.09), pursued by the Duraphat varnish use (106.68 ±0.12), use of Clinpro White Varnish (112.36 ±0.08), and then the control group (123.08 ±0.18) in that order. Statistically significant differences were noted between the experimental groups employing the various fluoride varnishes (p Conclusion The current research concluded that the MI Varnish group presented a superior protective potential in comparison with Duraphat varnish and Clinpro White Varnish groups. Clinical significance Mineral exchanges among teeth and saliva render incipient enamel lesions reversible. A 5% sodium fluoride varnish is the MI Varnish that is composed of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to provide an excellent fluoride varnish that makes available additional bioavailable fluoride, calcium, and phosphate. Therefore, it may be fruitfully utilized in remineralization of initial carious lesions. CPP-ACP may be employed in clinical practice for drawing back or ceasing initial carious lesions. Rani KBS, Ramanna PK, Mailankote S, et al. Evaluation of Anticaries Efficacy of Various Fluoride Varnishes on Artificial Enamel Lesion: An In Vitro Study. J Contemp Dent Pract 2021;22(7):774-777.

In today’s time tooth/teeth whitening has become the most common requested procedure from the clinician. As per the increasing demand by the patient for whiter teeth, there are various home based products are available like gels, tooth pastes and some other products are also available that can be applied by the dentist and it contains high amount of bleaching agent with in it. Some of the aware risk of tooth whitening procedure was also known such as, sensitivity of the tooth, irritation of the gingiva, demineralization of the tooth surface along with roughening of the superficial layer of the tooth. Keywords: Tooth whitening, Home bleaching procedure, In office bleaching procedure, Post bleaching sensitivity, Post bleaching gingival irritation

To evaluate the differences in the pullout strength and displacement of pedicle screws in cadaveric thoracolumbar vertebrae with or without artificial demineralization.Five human lumbar and five thoracic vertebrae from one cadaver were divided into two hemivertebrae. The left-side specimens were included in the simulated osteopenic model group and the right-side bones in a control group. In the model group, we immersed each specimen in HCl (1 N) solution for 40 minutes. We measured bone mineral density (BMD) using dual-energy X-ray absorptiometry and quantitative computerized tomography. We inserted polyaxial pedicle screws into the 20 pedicles of the cadaveric lumbar and thoracic spine after measuring the BMD of the 2 hemivertebrae of each specimen. We measured the pullout strength and displacement of the screws before failure in each specimen using an Instron system.The average pullout strength of the simulated osteopenic model group was 76% that of the control group. In the control and model groups, the pullout strength was 1678.87±358.96 N and 1283.83±341.97 N, respectively, and the displacement was 2.07±0.34 mm and 2.65±0.50 mm, respectively (p.05). We detected positive correlations between pullout strength and BMD in the control group and observed a negative correlation between displacement and BMD in the model group.By providing an anatomically symmetric counterpart, the human cadaveric model with or without demineralization can be used as a test bed for pullout tests of the spine. In the simulated osteopenic model group, pullout strength was significantly decreased compared with the untreated control group.Decreased bone mineral density may significantly reduce the pullout strength of a pedicle screw, even though the range is osteopenic rather than osoteoporotic.

Clinicians always face a challenge in selecting the appropriate material for clinical use. Presently, the term bioactive is being used judiciously and unquestionably in the field of dental materials. The introduction of nanotechnology brought about a revolution in material science leading to the development of bioactive materials for caries prevention and management. This review comprehensively evaluates the use of bioactive materials for modification of the oral biome, prevention of dental caries, and the management of dental caries as restorative materials. Six online database (PubMed, Scopus, Science Direct, Embase, Web of Science, and Cochrane library) were systematically searched using broad keywords. Published articles were scrutinized, analyzed and the full-text articles were selected. Data reveals relatively limited application of tissue engineering and regeneration for enamel and dentin due to their limited ability to remodel. However, many steps are being taken in biomimetic approach for the modification of dentin. The path to overcoming any challenges will require active collaboration among clinicians, a material scientist and pulp biologist.

To investigate the anti-demineralization potential of a newly developed surface reaction-type pre-reacted glass-ionomer (S-PRG) filler containing self-adhesive resin cement against acidic attacks on the dentin surface. A total of 32 bovine teeth were used. Cavities were prepared on crown dentin slaps and filled with three self-adhesive resin cement: (1) S-PRG-based cement, (2) Si-based cement, and (3) RelyX cement. Specimens were then subjected to pH cycling for 28 days, and the depth of demineralization was assessed using swept-source optical coherence tomography (SS-OCT) after 7, 14, 21, and 28 days. Sixty-four root dentin blocks were divided into four groups and then subjected to a pH cycling procedure with the aforementioned three material blocks and one negative control. The mineral loss was observed using transverse microradiography (TMR), and the surface microhardness (SMH) test was conducted to investigate the mechanical properties of treated dentin surfaces. The depth of demineralization for the S-PRG-based cement was significantly lower than that of the Si-based cement after 7, 21, and 28 days. Conversely, the RelyX cement was not significantly different from the Si-based cement after 7, 14, and 21 days (p

Summary Background The highly prevalent white spot lesions around orthodontic brackets necessitate introducing preventive materials without relying on patient compliance. Objective To evaluate the antidemineralizing effect of two concentrations of xylitol varnish. Trial design Triple-blind, four-arm, parallel-group, single-center, randomized controlled clinical trial. Methods A total of 120 orthodontic patients were randomly assigned to four groups (n = 30), using a computer-generated randomized block list. The treatment groups were: 10% xylitol, 20% xylitol, 5% fluoride, and placebo. Tooth demineralization was measured with DIAGNOdent at T1 (before treatment), followed by varnish application. At T2 (third month), the varnish was re-applied, and at the third (T2) and sixth (T3) months, and after treatment (T4), the demineralization was measured. The white spot lesion frequency was assessed visually after treatment. The participants, the clinician, and data assessors were all blinded to group assignments. Results A total of 115 patients underwent per-protocol analyses. At T2, the mean DIAGNOdent numbers in the fluoride and 10% xylitol groups were significantly lower than the placebo group (P = 0.00), with a mean difference of 0.63 (95% CI, 0.15–1.10) and 0.5 (95% CI, 0.04–0.95), respectively. At T3, the fluoride and 10% xylitol groups had significantly lower mineral loss than the placebo group (P=0.046) with a mean difference of 0.52 (95% CI, 0.14–0.89) in the fluoride and 0.45 (95% CI, 0.03–0.86) in the 10% xylitol groups, respectively. However, at T4, only the mean for the 10% xylitol group was significantly different (P=0.049) from the placebo group, with a mean difference of 1.18 (95% CI, 0.42–1.93). Visual assessment showed that after treatment, the prevalence of white spot lesions in the fluoride (P=0.03) and 10% xylitol (P=0.00) groups was less than the placebo group with the odds ratio of 0.67 (95% CI, 0.46–0.96) and 0.43 (95% CI, 0.28–0.64), respectively. Conclusion The 10% xylitol varnish short-term effects on caries control were significantly greater than 20% xylitol varnish and placebo but similar to fluoride varnish. However, the 10% xylitol long-term effect was almost better than fluoride varnish. Trial registration The protocol was registered at IRCT.ir under the code IRCT20180913041032N1.

A presença do chumbo na composição química do esmalte dentário pode gerar hipoplasias, aumentar o risco de desmineralização e cárie. A partir de um grupo original de 17 participantes, foram determinados e comparados os resultados de níveis prévios de chumbo no esmalte dentário superficial saudável e no esmalte afetado por hipoplasia em 2 casos. Foram realizadas microbiópsias ácidas in vivo de esmalte dentário superficial, analisadas por espectrometria de emissão óptica com plasma indutivamente acoplado (ICP OES) para determinação do fósforo (P) e espectrometria de absorção atômica de forno de grafite (GF AAS) para determinação do chumbo (Pb). Caso 1: O teor de P na solução ácida referente ao esmalte saudável foi 25.200 mgP/L ± 0.200 e na solução referente à hipoplasia foi 16.400 mgP/L ± 0.100. O nível de chumbo na área de esmalte saudável foi de 20.02 ppm e 18.04 ppm na área de hipoplasia. Caso 2: O teor de P na solução ácida referente ao esmalte saudável foi 35.800 mgP/L ± 0.300 e na solução referente à hipoplasia foi 2.720 mgP/L ± 0.030. O nível de chumbo na área de esmalte saudável foi de 4.37 ppm e 236.69 ppm na área de hipoplasia. Houve diferença estatisticamente significativa em relação ao teor de fósforo e profundidade da biópsia na comparação das médias entre os dois casos de hipoplasia e esmalte saudável do grupo de origem dos casos.

Background: Enamel as the hardest layer of teeth is susceptible to acid attack which can cause demineralization. This triggers a chemical reaction to release calcium ions from the tooth enamel which causes a decrease in the hardness of the enamel sur-face. Calcium and phosphate ions are minerals that can inhibit demineralization and increase remineralization. The 5% calcium and 20% phosphate content in jackfruit seeds has the potential to be used as a tooth remineralization material. Objective: To determine the effectiveness of the application of jackfruit seed paste (Artocarpus heterophyllus Lamk) as an alternative remi-neralization agent to increase enamel surface hardness. Method: This experimental laboratory study was conducted using 32 maxillary first premolar teeth. All samples were immersed in cola carbonated drink (2 minutes). Samples in each group were treated (30 minutes) with the application of jackfruit seed paste (group I) and CPP-ACP paste (group II). The Vickers Hardness Number (VHN) test was performed on the surface of the initial tooth enamel, after soaking in cola carbonated drinks and after treatment. Results: The enamel surface hardness significantly increased after treatment in groups I and II. Conclusion: The application of jackfruit seed paste was effective in increasing enamel surface hardness.

Introduction: Adolescence age group has significant impact of advertizing industry for use of soft drink and junk food. Present study is aimed to find out the alteration in the bone markers in medical and dental students, who regularly consume soft drinks. Materials and Methods: Students from our institute were divided (n = 200) in two groups. Group A – Students who consume 200 ml or less than 200 ml of soft drink in a week. Group B -Students consuming more than 200 ml of either ‘regular’ soft drink (B1) or ‘diet’ soft drink (B2) per day. Results: There is a significant decrease in the levels of bone density, calcium, phosphorous, vitamin D and increase in the activity of alkaline phosphatase in Group B2 than group A as well as B1. Conclusion: Diet soft drinks are consumed instead of regular soft drinks, the decrease in the pH due to phosphoric acid and aspartame; may lead to bone demineralization resulting into decreased bone density. Inhibition of 1alpha hydroxylase may get inhibited due to acid pH caused by phosphoric acid from soft drinks. These changes may lead to develop tendency of bone fractures in the future life. Keywords: Soft drinks, Bone density.

AIM AND OBJECTIVE To evaluate and compare the ability of three commercially available remineralizing agents on the surface microhardness (SMH) of enamel after induction of white spot lesions (WSLs) by demineralization. MATERIALS AND METHODS About 80 sound mandibular human premolars that were later removed as a part of orthodontic treatment were employed in this research under the inclusion criteria. After cleaning and disinfecting the teeth, their crowns were mounted in acrylic resin and painted with nail varnish, not including a 3 mm × 3 mm window in the middle of the buccal surface. Each tooth was soaked in 15 mL of a demineralizing solution at a pH of 4.5 that was prepared for this study and left in a place for 10 subsequent days to permit the formation of WSLs after which the SMH was again assessed. The premolar teeth were then randomly allocated and equally divided into one of the four groups of 20 each depending on the treatment they received as Group 1: control group, Group 2: Colgate sensitive Pro-Relief toothpaste group, Group 3: Amflor group, and Group 4: Enafix group. After 15 days, the microhardness of all samples was estimated and alterations in the same were noted. Scanning electron microscopy (SEM) was used to evaluate the surface morphology. RESULTS Enhanced and highest mean SMH was present in the Colgate sensitive Pro-Relief group (53.26 ± 0.10) followed by Enafix group (47.72 ± 0.21), Amflor group (44.84 ± 0.66), and control group (39.52 ± 0.32), respectively after application of remineralizing agents. Except for Group 3 vs Group 4, statistically significant differences (p < 0.05) were noted in all the groups. CONCLUSION All the three agents employed in this study, that is, Colgate sensitive Pro-Relief toothpaste, Amflor, and Enafix improved the SMH of teeth after the therapy given over 15 days compared to the microhardness following demineralization. CLINICAL SIGNIFICANCE White spot lesions often occur on labial surfaces of teeth after orthodontic treatment. Hence, these lesions pose esthetic challenges thereby affecting treatment satisfaction perceived by the patient. As esthetics and appearance are of foremost significance after orthodontic treatment, elimination protocols for remineralization of WSLs are of utmost importance employing economic means. How to cite this article: Nalawade VA, Jeri SY, Dash BP, et al. Effectiveness of Various Remineralizing Agents on White Spot Lesions after Orthodontic Treatment: A Comparative Study. J Contemp Dent Pract 2021;22(5):545-548.

The high-ash low-grade coals of Indian origin are relatively more challenging to demineralize due to their unfavorable hydrophilic surface chemistry. Herein, we report castor oil as a potential bridging liquid, which efficiently agglomerated high-ash low-grade coals by 55-60% at lower concentration (10 wt%) compared to literature (20-25 wt%), without inclusion of surfactants. A blend of castor oil and turpentine oil proved further beneficial. Wet milling of coal was a crucial prerequisite for efficient agglomeration. Three low-grade coals, Bhubaneshwari (35.8% ash), Kaniha (35% ash), and Hingula (26% ash), were beneficiated in the present study. A detailed analysis of process parameters validated with structural characterization using FTIR, Petrography, zeta potential, and SEM analysis was performed. The chemistry between ricinoleic acid in castor oil with that of surface functionality of coal is speculated to be the reason behind the obtained agglomeration results. Castor oil, being non-edible, bio-based, non-toxic, and non-polluting in nature, provides a greener alternative to mineral oils toward the production of clean fuel.

Bennett Tochukwu Amaechi,1 Thais Santiago Phillips,1 Veronica Evans,1 Chidera Precious Ugwokaegbe,2 Minh Nguyet Luong,1 Linda Oge Okoye,3 Frederic Meyer,4 Joachim Enax4 1Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA; 2Department of Biology, University of Texas at San Antonio, San Antonio, TX, USA; 3Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria; 4Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, GermanyCorrespondence: Bennett Tochukwu AmaechiDepartment of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USATel +1 210 567 3185Email amaechi@uthscsa.eduPurpose: The effectiveness of a hydroxyapatite (HAP) toothpaste and a fluoride toothpaste in preventing root tissue demineralization (root caries) was compared using an established pH-cycling caries model.Materials and Methods: Sixty dentin blocks were produced from the root tissue of extracted human teeth and were assigned to 3 test groups (n=20/group): 10% hydroxyapatite toothpaste (HAP), 1450 ppm fluoride toothpaste (fluoride), and artificial saliva (artsaliva). Early root caries lesions were developed in each sample by 7-day demineralization using a pH-cycling caries model. The daily cyclic treatment regimen consists of two 2-minute toothpaste-slurry treatment periods, one 6-hour acid challenge using acidified gel (pH 4.5), and then storage in remineralizing solution (artsaliva) for the rest of the time. Demineralization was assessed as the amount of mineral loss (∆z) using transverse microradiography (TMR). Pairwise comparisons (between treatments) were performed using analysis of variance (ANOVA), and then Tukey’s HSD for multiple comparisons. All p-values are considered significant if p< 0.05.Results: Both ANOVA and Tukey’s HSD indicated no significant (ANOVA; n=20) difference in mean ∆z among the groups, with least ∆z (±Sd) in the HAP (1117± 366) compared to fluoride (1392± 334) and artsaliva (1406± 223). Relative to control, HAP and fluoride inhibited root demineralization by 21% and 6%, respectively.Conclusion: Within the limit of the present study, the tested toothpaste containing 10% HAP is an effective root caries control toothpaste. Toothpaste containing 10% HAP was slightly more effective in preventing tooth demineralization than 1450 ppm fluoride provided as sodium fluoride. Thus, this study shows that HAP toothpastes can serve as an effective alternative to fluoride toothpastes for root caries management.Keywords: hydroxyapatite, fluoride, pH cycling, artificial saliva, demineralization, toothpaste

Dental caries is a dynamic, preventable, reversible, complex biofilm-mediated, multifactorial disease that involves a series of demineralization/neutrality/remineralization of dental hard tissue in primary and permanent dentition. An imbalance in the continuum with a net demineralization over time results in the initiation of caries lesions. Visual inspection and intraoral radiographs are vital in caries detection, although they are of suboptimal sensitivity for early caries lesions. Shifting toward a conservative, noninvasive approach to caries management has resulted in the development of innovative-sensitive technologies. These newer techniques may serve as adjunct for the dental practitioner in detecting earliest changes in tooth structure.

There is a remarkable interest in the dental area about the effect produced by the acidic agents contained in commercial non-alcoholic drinks on dental enamel due to their ability to produce caries or erosive lesions. The objective was to characterize the morphological and the chemical alterations of the adamantine structure exposed to the action of a flavored water. Human dental crowns sectioned in the buccolingual direction were embedded in polymer. Flat and highly polished surfaces were obtained by wear with descending granulation sandpaper. Observations and chemical analyses were performed on radial enamel before and after exposure to the beverage, at the ESEM FEI QUANTA 200-EDS (SeMFi-LIMF. FI- UNLP). For the morphological description, the etching patterns of the enamel were considered. The chemical elements sodium, magnesium, chlorine, and the calcium/phosphorus ratio were studied. The samples were immersed in 100 ml of a flavored water for 12 minutes. At the ESEM, the prisms presented different patterns of acid etching, which may affect the core or the profile. The chemical composition showed variations according to the area, before and after the treatment. Although the studied elements were present in the healthy enamel, both in the radial and in the Hunter Schreger bands, the percentage values were different. In the bands, sodium and magnesium increased while chlorine decreased. After the action of the flavored water, sodium and magnesium increased even more and the chlorine dropped markedly. A significant difference was found in Ca/P ratio before and after treatment. The beverage used contains acid agents in its composition that produce loss of minerals from the adamantine tissue. We conclude that the exposure of tooth enamel to flavored water produces demineralization compatible with erosion lesions.

Objective To evaluate preventive effects of S-PRG-filled resin-composites on surrounding tooth demineralization and interfacial bacterial penetration. Methods Cavities were prepared on enamel or dentin blocks and treated by BeautiBond Universal (Shofu) and filled by resin-composites containing S-PRG filler (Shofu) at 0 wt% (P0, control), 10 wt% (P10), 30 wt% (P30), 50 wt% (P50) or 70 wt% (P70). The specimens were demineralized by Streptococcus mutans biofilms for 12 days. Wall lesion depth (WL-depth) and outer lesion depth (OL-depth) were measured from fluorescence microscopy. Interfacial bacterial penetration area (BPA) was evaluated from confocal laser scanning microscopy. Wall lesion hardness (WL-hardness) and outer lesion hardness (OL-hardness) were measured with a Vickers microhardness tester. Elemental analysis of resins and surrounding lesions was conducted by scanning electron microscopy and energy dispersive X-ray spectrometry. Results Resin-composites in P70 contained significantly more F, Na and Al than that in P0 and P10. P70, P50 and P30 showed significantly lower WL-depth than P0. P70 showed significantly lower OL-depth, fewer Ca and P loss in lesions than P0. P70 showed significantly higher WL-hardness and OL-hardness in dentin specimens than P0. Enamel margins had a higher gap frequency than dentin margins. However, BPA did not show significant differences among the groups. Significance Resin-composites containing S-PRG fillers at ≥30 wt% can inhibit wall lesions and that at 70 wt% can further decrease outer lesions, reduce Ca and P loss in lesions and increase surrounding dentin hardness. However, S-PRG-filled resin-composites does not inhibit interfacial biofilm penetration after a short-term demineralization period.

Current adhesives bond to dentin via a micro-interlocking mechanism within the hybrid layer. Besides such mechanical retention, bonding to dentin would benefit from additional chemical interaction between collagen and resin. This study aims to synthesize a novel light-curable collagen crosslinker methacrylate (MA) functionalized grapeseed extract (GSE) and to assess MAGSE’s ability to crosslink dentin collagen in a clinically relevant setting as well as its role in light-cure as a resin. MA functionalization was accomplished by reacting GSE with methacryloyl chloride to obtain MAGSE, which was characterized by 1H-NMR and Fourier transformed infrared spectroscopy (FTIR). The 6-µm-thick dentin films were microtomed from dentin slabs of third molars. Following demineralization, they were treated for 30 s by 1% MAGSE. Collagen crosslinking and resistance to digestion of MAGSE were evaluated by FTIR, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) assay of films, and scanning electron microscopy (SEM)/transmission electron microscopy (TEM) on slabs. Meanwhile, 1% MAGSE or GSE was added to an experimental adhesive formulated with 2-hydroxyethyl methacrylate and a tricomponent photoinitiator system. Polymerization kinetics were monitored continuously in real time for 10 min using FTIR–attenuated total reflection. The results indicated that MAGSE could bind to dentin collagen and protect it from collagenase degradation as strong as GSE. Dentin collagen treated by 1% MAGSE for 30 s was scarcely digested (1.6 ± 1.6%) after 1 h in 0.1% collagenase, while untreated collagen was completely digested (100.9 ± 20.2%). SEM/TEM images indicated MAGSE efficiently crosslinked dentin collagen in 30 s and rendered it almost inert to digestion under clinically relevant settings. Unlike GSE that hindered light-curing of HEMA, MAGSE accelerated the rate of polymerization and exhibited typical traits of a resin monomer with multiple polymerizable units. In conclusion, a novel collagen crosslinking resin MAGSE is synthesized, which inherits collagen crosslinking ability from GSE and polymerization function from MA. Inclusion of this light-curable collagen crosslinker into adhesives might be a revolutionary way to improve durability of dentin bonding in composite restorations.

Caries is a multifactorial disease that can negatively affect dental tissues through the demineralization process, which produces acids deriving from the metabolism of carbohydrates. Some strategies to prevent this process have been proposed, such as topical fluoride application, resin-based restorations, pit and fissures sealers, infiltrated resins, vaccines, mouthwashes, and several brushing techniques. Objective. To evaluate in vitro enamel hydrophobic modification as a method of prevention against demineralization. A descriptive and comparative study was carried out. Thirty premolars extracted for orthodontic reasons were obtained, encapsulated in epoxy resin, sectioned, and sanded to obtain specimens 3mm in thickness. The samples were pretreated with NaOCl and EDTA, incubated with 1 and 4% octadeyltrichlorosilane (OTS) or with 3 and 6% octadecyltriethoxysilane (TEOS) for 5min and for 8h. Subsequently, the samples were immersed in citric acid for 2 months. The samples were analyzed by their contact angle, infrared spectroscopy, scanning electron microscopy, atomic and confocal force, before and after treatment in citric acid. The samples coated with 1 and 4% OTS for 5min and 8h kept the silanizing agent on their surface after 2 months in citric acid. The treatment with TEOS was only effective at 6% with a reaction time of 5min. The modification with 1 and 4% OTS protects the surface of the tooth enamel from demineralization in acidic medium. The results indicate that treatment with 4% OTS is effective from 5min, which makes it appropriate in clinical practice. Resumen Introducción. Caries es una enfermedad multifactorial que destruye en tejido dental por la desmineralización de ácidos generados en el metabolismo de carbohidratos. Algunos métodos preventivos, como fluoruro, resinas, selladores de fosetas y fisuras, resinas infiltradas, vacunas, enjuagues bucales, y un sinfín de técnicas de cepillado, han sido empleadas. Objetivo. Evaluar in vitro la modificación hidrofoba del esmalte como método preventivo en contra de la desmineralización. Materiales y Métodos. Un estudio decriptivo y comparativo fue empleado. Se obtuvieron treinta premolares sanos extraidos por razones ortodónticas y encapsulados en resina epóxica, seccionados y pulidos hasta obtener especímenes de 3mm de grosor. Las muestras fueron pretratadas con NaOCl y EDTA, incubadas en octadeciltriclosorilano (OTS) al 1 y 4% y octadeciltrietoxisilano (TEOS) 3 y 6% por 5min y 8h. Después, las muestras fueron sumergidas en ácido cítrico por 2 meses. Las muestras fueron analizadas con ángulo de contacto, espectroscopía infrarroja, microscopía electrónica de barrido, atómica y confocal, antes y después de tratamiento con ácido cítrico. Resultados. Las muestras cubiertas con OTS 1 y 4% por 5min y 8h mantuvieron el agente silanizante sobre la superficie después de 2 meses en ácido cítrico. El tratamiento con TEOS fue efectivo al 6% y con un tiempo de reacción de 5min. Conclusiones. La modificación con 1 y 4% de OTS proteje la superficie del esmalte dental contra la desmineralización en un medio ácido. Estos resultados indican que el tratamiento con OTS 4% es efectivo desde 5min de aplicación, lo cual es apropiado en la práctica clínica.

Dentin bonding is a dynamic process that involves the penetration of adhesive resin monomers into the extrafibrillar and intrafibrillar demineralized collagen matrix using a wet-bonding technique. However, adhesive resin monomers lack the capacity to infiltrate the intrafibrillar space, and the excess water that is introduced by the wet-bonding technique remains at the bonding interface. This imperfectly bonded interface is inclined to hydrolytic degradation, severely jeopardizing the longevity of bonded clinical restorations. The present study introduces a dentin bonding scheme based on a dry-bonding technique, combined with the use of extrafibrillar demineralization and a collagen-reactive monomer (CRM)-based adhesive (CBA). Selective extrafibrillar demineralization was achieved using 1-wt% high-molecular weight (MW) carboxymethyl chitosan (CMCS) within a clinically acceptable timeframe to create a less aggressive bonding substance for dentin bonding due to its selectively extrafibrillar demineralization capacity. CMCS demineralization decreased the activation of in situ collagenase, improved the shrinking resistance of demineralized collagen, and thus provided stronger and more durable bonding than traditional phosphoric acid etching. The new dentin bonding scheme that contained CMCS and CBA and used a dry-bonding technique achieved an encouraging dentin bonding strength and durability with low technical sensitivity. This bonding scheme can be used to improve the stability of the resin-dentin interface and foster the longevity of bonded clinical restorations., Graphical abstract Image 1, Highlights • 1-wt% CMCS adjusting could form a 1μm partly demineralized zone with interfibrillar minerals in a clinically viable time. • The stability of dentin collagen and bonding could be enhanced by “selective demineralization” with 1-wt% CMCS in 30 s. • A user-friendly adhesion scheme achieved strong dentin bonding strength and durability with a strengthened interface. • A new bonding scheme can be used to improve the bonding interface stability and foster the longevity of restorations.