Search

Objectives: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. Method and materials: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. Results: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). Conclusions: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements. [ABSTRACT FROM AUTHOR]

Purpose: To compare bone substitutes composed of glycated collagen with synthetic micro-sized (1 to 10 µm) hydroxyapatite (OB) vs non-cross-linked collagen matrix with large-particle (250 to 1,000 µm) bovine-derived hydroxyapatite (BOC). Materials and Methods: The P1 to P4 premolars were bilaterally extracted from the mandibles of 19 Beagle dogs. After 21 days, osteotomies were created in each dog that received OB or BOC and were covered with a collagen membrane or were left untreated. The animals were randomly divided into three groups based on sacrifice time (4, 12, or 24 weeks). The right and left hemimandibles were trimmed to facilitate imaging and histology, and all tissues were placed in 10% neutral-buffered formalin. Microcomputed tomography (MicroCT 40 Scanner, Scanco) was used to analyze bone sections. Bone volume, residual material volume, and bone mineral density were determined for each treatment site (OB and BOC) based on a volume of interest that encompassed the original defect. Additionally, blinded histopathologic assessment (based on the ISO 10993-6 scoring system) and histomorphometry were performed on sections ground to < 100 µm thick and stained with Stevenel's blue. Results: No clinical side effects were noted. No statistical differences were observed for OB vs BOC regarding the mineral volume percentage. Compared to OB, BOC had significantly higher mean mineralization densities at 12 weeks (P < .01), but this difference did not extend to 24 weeks. For residual grafting material, bone maturation, alveolar ridge restoration, and inflammatory response, OB showed a residual amount of bone graft and no statistical differences compared to BOC. Conclusion: Both OB and BOC represent valid treatment options for critically sized bone defects. Both bone fillers outperformed the sham-operated, ungrafted (empty) control, demonstrating statistically improved bone growth and ridge restoration. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the remineralization efficacy of casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro‐CT analysis. Methodology: On extracted impacted third molars, artificial enamel lesions were prepared. Twenty‐eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP‐ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro‐CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro–Wilk test, repeated measures two‐way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established. Results: SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01). Conclusion: All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization. Clinical Significance: Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long‐term. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusions Clinical Relevance To evaluate the effects of dentifrices containing sodium fluoride (NaF) combined with NovaMin (Sensodyne Repair & Protect—SRP), NaF combined with stannous fluoride (SnF2, Oral‐B Pro‐Gengiva—OBP), and amine fluoride (AmF, Colgate Elmex—ELM) on enamel subjected to simulated erosive cycling.Bovine enamel‐dentin discs (n = 10/group) were subjected to erosive cycling with orange juice (pH = 3.29, 5 min, 3x/day), artificial saliva (SA–2 h, 3x/day and overnight) and treated with dentifrice (2 min, 2x/day) or without treatment (CONT). Surface microhardness (SMH) was evaluated at baseline (T0), on the first (T1) and fifth (T5) days. SMH loss (%SHL) was calculated. Surface roughness (Ra, μm) was determined at T0 and T5. Morphology and mineral content were evaluated under scanning electron microscopy and energy‐dispersive x‐ray spectroscopy. Data were analyzed using ANOVA/Tukey or Bonferroni (α = 5%).No differences in %SHL were detected among groups at T1. At T5, OBP promoted %SHL, Ra, and ΔRa significantly lower than all the other groups (p < 0.05). All groups exhibited morphological changes in topography and similar Ca/P means before and after treatments.Dentifrice containing SnF2 minimized the negative effects on the SMH and Ra caused by exposure to orange juice after 5 days of simulated cycling.Patients who are more exposed to risk factors for dental erosion could benefit from the use of dentifrice containing SnF2. [ABSTRACT FROM AUTHOR]

Background: Tyrosine-rich amelogenin peptide (TRAP) is the main amelogenin digestion product in the developmental enamel matrix. It has been shown to promote remineralization of demineralized enamel in our previous study. However, direct evidence of the effect of TRAP on the morphology and nanostructure of crystal growth on an enamel surface has not been reported. This study aimed to examine the effect of TRAP on the morphology of calcium phosphate crystals grown on early enamel erosion using a pH-cycling model. Methods: Eroded lesions were produced in human premolars by 30-second immersion in 37% phosphoric acid. Forty-five samples of eroded human premolar enamel blocks were selected and randomly divided into 3 groups: deionized water (DDW, negative control); 100 µg/mL TRAP, and 2 ppm sodium fluoride (NaF, positive control group). For 14 days, the specimens were exposed to a pH-cycling model. Using scanning electron microscopy (SEM) and atomic force microscopy (AFM) methods, the surface morphology, calcium-phosphorus ratio, and enamel surface roughness were examined. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR) were used to assess crystal characteristics. Results: After pH-cycling, compared to the two control groups, the surface of the eroded enamel of the peptide TRAP group shows a large number of new, densely arranged rod-like crystals, parallel to each other, regularly arranged, forming an ordered structure, with crystal morphology similar to that of natural enamel. The crystals are mostly hydroxyapatite (HA). Conclusion: This study demonstrates that the peptide TRAP modulates the formation of hydroxyapatite in eroded enamel and that the newly formed crystals resemble natural enamel crystals and promote the remineralization of enamel, providing a promising biomaterial for remineralization treatment of enamel lesions. [ABSTRACT FROM AUTHOR]

Background: White spot lesions are a widespread undesirable effect, especially prevalent during fixed orthodontic treatments. The study compared the in vitro enamel remineralization potential of undemineralized dentin matrix (UDD) versus chicken eggshell powder (CESP) for artificially induced enamel lesions. Methods: 100 caries-free and sound maxillary premolars were randomly divided into four groups each contain 25 teeth: Group I (Baseline): No treatment was done to the enamel surface. Group II (Negative control): The enamel surface of the teeth underwent demineralization using demineralizing solution to create artificial carious lesions then kept in artificial saliva. Group III (CESP treated): After demineralizing the tooth surface, the teeth have been suspended in the CESP remineralizing solution. Group IV (UDD treated): After enamel demineralization, the teeth were suspended in UDD remineralizing solution. The remineralization potential was assessed by Vickers microhardness testing, scanning electron microscopic examination (SEM), and energy dispersive X-ray (EDX). Results: The current study demonstrated an increase in the mean microhardness of CESP and UDD-treated groups; however, It was nearer to the baseline level in the UDD group. SEM imaging revealed greater enamel remineralization in the UDD group compared to the remaining groups. The UDD group disclosed complete coverage for the prismatic enamel compared to the CESP group, which revealed a partially remineralized enamel surface. Interestingly, the Ca/P ratio increased significantly in the CESP group compared to the negative control group. In contrast, a higher significant increase in the mean Ca/P ratios was recorded in the UDD group compared to the test groups. Conclusion: biomimetic UDD and CESP powder should be utilized to treat enamel early carious lesions. However, UDD demonstrated the most significant remineralization potential. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Dental caries are among the most common oral and dental diseases affecting adults and children. To prevent caries, either the factors that cause caries should be reduced or the host resistance should be increased. Several compounds, such as bioglass, chitosan, and silver diamine fluoride (SDF), can enhance enamel remineralization. Purpose: This study was conducted to investigate the effects of chitosan, bioglass, chitosan-bioglass, and SDF compounds on remineralizing primary enamel lesions. Materials and Method: In this in vitro study, seventy-two primary canine teeth were collected. The teeth were exposed to a demineralization solution for 72 hours to create primary caries lesions. The primary Vickers microhardness test (VMT) was conducted to measure the initial values. The samples were randomly divided into six groups (n=12): Group 1: bioglass-chitosan solution; Group 2: chitosan; Group 3: bioglass solution; Group 4: SDF; Group 5: remineralization solution; Group 6: distilled water. The solutions of Groups 1, 2, and 3 were applied to the samples for 7 days, while the SDF solution was applied only once. The samples were immersed in an artificial saliva solution, which was refreshed daily. After the treatment, the final Vickers microhardness test (VMT) values were recorded. The data were analyzed statistically using a two-way ANOVA and Tukey's test (p< 0.05). Results: The results indicated a statistically significant effect of remineralizing compounds on both pre-treatment and post-treatment microhardness (p< 0.0001). However, no significant difference in microhardness was observed between the groups studied (p= 0.225). Conclusion: All the compounds utilized in this study demonstrated a significant remineralizing effect on enamel lesions caused by primary caries in primary teeth. The chitosan-bioglass and bioglass groups exhibited the highest levels of remineralization, respectively. However, the comparison between the groups yielded insignificant results due to the dispersion of the samples. Therefore, further studies with larger sample sizes are recommended. [ABSTRACT FROM AUTHOR]

Bacteria in the oral cavity have a great impact on caries formation by demineralizing tooth enamel. Bacterial infection should be prevented before restorative treatments. Rather than invasive treatment of existing caries, arresting bacterial activity in carious lesion and remineralizing dental tissue have become the goal of contemporary caries management philosophy. Silver compounds with antimicrobial effects have been developed over time and have taken their place in dentistry. 'Silver Diamine Fluoride' was created by combining the remineralizing effect of fluoride with the cariostatic effect of silver. Its popularity has increased because it appeals to the general population. It's application is painless, simple, and affordable. Our aim in this review is to provide a general perspective on the usage areas of Silver Diamine Fluoride from past to present and to create a guide for its use in pediatric patients. [ABSTRACT FROM AUTHOR]

The article offers a perspective on principles and care pathways for caries management in children. Topics discussed include advances in the science of cariology, evidence-based care pathway for caries management, prevention and restorative strategies, caries risk/susceptibility assessment, shared decision-making in oral healthcare, and active surveillance as part of restorative dental care, advances in clinical caries management for children, improvements for oral health systems.

Objectives: The main purpose of this study was to compare the remineralizing effects of casein phosphopeptide amorphous calcium phosphate fluoride (CPPACPF) and tricalcium phosphate (TCP) on artificially induced enamel white spot lesions (WSLs). Materials and Methods: In this in vitro study, 45 sound extracted premolars were immersed in a demineralizing solution (pH=4.5) for 96 hours, and were randomly divided into 3 groups of TCP, MI Paste Plus, and control. They were exposed to the remineralizing agents for 5 minutes once a day for 30 days. After mounting the teeth in resin blocks and polishing, they underwent a microhardness test at 3 different depths from the enamel surface. Data were analyzed by Prism software, two-way ANOVA, and Tukey's test (α=0.05). Results: The volume percentage of mineral content (VPM) was significantly different among the three groups at 30-, 60- and 90µm depths (P<0.0001). At 30µm depth, CPP-ACPF was significantly more effective than TCP (P<0.0001). At 60- and 90µm depths, there was no significant difference between CPP-ACPF and TCP (P>0.05). Conclusion: Both CPP-ACPF and TCP had significant efficacy for remineralization of artificially induced enamel WSLs under in vitro conditions. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to evaluate the remineralization potential of primary teeth enamel after being exposed to different laser diode therapies. Methods: Ninety-six vestibular primary teeth enamel samples were divided into eight groups (n = 12) with varying treatments: control (G1), CPP-ACP-fluoride varnish (G2), diode lasers at 980 nm (G3), 808 nm (G4), 450 nm (G5), 980 nm + CPP-ACP-fluoride varnish (G6), 808 nm + CPP-ACP-fluoride varnish (G7), and 450 nm + CPP-ACP-fluoride varnish (G8). Each sample was assessed using a DIAGNOdent® (KaVo Dental, Biberach, Germany), at baseline, post-treatment, and post-pH cycle remineralization. SEM imaging was performed before and after treatment and following the pH cycle. Results: The results indicated that the 980 nm and 808 nm diode lasers, both alone and in combination with CPP-ACP-fluoride varnish, either maintained or increased the calcium (Ca) weight percentage (Wt%) in the enamel. The 980 nm diode laser combined with CPP-ACP-fluoride varnish (G6) showed a significant increase in Ca Wt%, suggesting a strong remineralization effect. Similarly, the 808 nm diode laser alone (G4) also promoted a substantial increase in Ca Wt%. In contrast, the 450 nm diode laser, whether applied alone or in combination with CPP-ACP-fluoride varnish, resulted in a lower Ca Wt% and an increase in phosphorus (P) Wt%. Most groups, except for the CPP-ACP-fluoride varnish alone (G2), demonstrated an increase in P Wt%, indicating a complex interaction between laser therapy and enamel remineralization. Conclusions: The combined use of laser therapy with CPP-ACP-fluoride varnish significantly enhanced the remineralization of temporary teeth enamel. The 980 nm diode laser + CPP-ACP-fluoride varnish showed the most pronounced improvement in remineralization, while the 808 nm diode laser alone also effectively increased calcium solubility. These findings suggest that higher-wavelength diode lasers, particularly when combined with remineralizing agents, can effectively enhance the mineral content of primary teeth and promote enamel remineralization. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of neutral 10-methacryloyloxydecyl dihydrogen phosphate salt (MDP-Na) on the dentin bond strength and remineralization potential of etch-&-rinse adhesive. Methods: Two experimental etch-&-rinse adhesives were formulated by incorporating 0 wt% (E0) or 20 wt% (E20) neutral MDP-Na into a basic primer. A commercial adhesive, Adper Single Bond 2 (SB, 3 M ESPE), served as the control. Sixty prepared teeth were randomly allocated into three groups (n = 20) and bonded using either one of the experimental adhesives or SB. Following 24 h of water storage, the bonded specimens were sectioned into resin-dentin sticks, with four resin-dentin sticks obtained from each tooth for microtensile bond strength (MTBS) test. Half of the sticks from each group were immediately subjected to tensile loading using a microtensile tester at a crosshead speed of 1 mm/min, while the other half underwent tensile loading after 6-month incubation in artificial saliva (AS). The degree of conversion (DC) of both the control and experimental adhesives (n = 6 in each group) and the adsorption properties of MDP-Na on the dentin organic matrix (n = 5 in each group) were determined using Fourier-transform infrared spectrometry. Furthermore, the effectiveness of neutral MDP-Na in promoting the mineralization of two-dimensional collagen fibrils and the adhesive-dentin interface was explored using transmission electron microscopy and selected-area electron diffraction. Two- and one-way ANOVA was employed to assess the impact of adhesive type and water storage on dentin bond strength and the DC (α = 0.05). Results: The addition of MDP-Na into the primer increased both the short- and long-term MTBS of the experimental adhesives (p = 0.00). No difference was noted in the DC between the control, E0 and E20 groups (p = 0.366). The MDP-Na remained absorbed on the demineralized dentin even after thorough rinsing. The intra- and extra-fibrillar mineralization of the two-dimensional collagen fibril and dentin bond hybrid layer was confirmed by transmission electron microscopy and selected-area electron diffraction when the primer was added with MDP-Na. Conclusions: The use of neutral MDP-Na results in high-quality hybrid layer that increase the dentin bond strength of etch-&-rinse adhesive and provides the adhesive with remineralizing capability. This approach may represent a suitable bonding strategy for improving the dentin bond strength and durability of etch-&-rinse adhesive. [ABSTRACT FROM AUTHOR]

There are only a few studies about the effects of toothpastes for children on remineralization and surface roughness of primary teeth. The aim of this study was to examine the remineralization capacity of five different toothpastes for children on primary tooth enamels with artificial initial caries, their effects on enamel surface roughness, and the relationship between their abrasive effects and remineralization. Sixty of 74 samples were allocated for microhardness and AFM analyses (after initialization, demineralization, and pH cycling), and 14 samples were evaluated by SEM. Sixty samples were divided into five groups, with each group representing a different toothpaste brand, as follows: Group 1: Splat; Group 2: Logodent; Group 3: Eyup Sabri Tuncer; Group 4: Naturalive; and Group 5: Buccotherm. Fourteen samples were divided into seven groups, each representing a different processing stage, with two samples in each group, for the initial (sound enamel surface) stage, post demineralization, and after applying the five remineralizing toothpastes. Toothpastes were applied to samples in a 7-day pH cycle. Data were analyzed statistically. Each toothpaste showed increased microhardness values; however, this increase was significant only for Group 4 (Naturalive) and Group 5 (Buccotherm). The highest surface roughness values were obtained after demineralization. The toothpastes reduced surface roughness, but these reductions were not statistically significant among the different types of toothpastes. The correlation analysis revealed that the toothpastes affected surface roughness according to their remineralization potential. The results were supported by SEM images. All toothpastes recovered primary tooth enamels with artificial initial caries, but only two had significant values. [ABSTRACT FROM AUTHOR]

On a global note, oral health plays a critical role in improving the overall human health. In this vein, dental-related issues with dentin exposure often facilitate the risk of developing various oral-related diseases in gums and teeth. Several oral-based ailments include gums-associated (gingivitis or periodontitis), tooth-based (dental caries, root infection, enamel erosion, and edentulous or total tooth loss), as well as miscellaneous diseases in the buccal or oral cavity (bad breath, mouth sores, and oral cancer). Although established conventional treatment modalities have been available to improve oral health, these therapeutic options suffer from several limitations, such as fail to eradicate bacterial biofilms, deprived regeneration of dental pulp cells, and poor remineralization of teeth, resulting in dental emergencies. To this end, the advent of nanotechnology has resulted in the development of various innovative nanoarchitectured composites from diverse sources. This review presents a comprehensive overview of different nanoarchitectured composites for improving overall oral health. Initially, we emphasize various oral-related diseases, providing detailed pathological circumstances and their effects on human health along with deficiencies of the conventional therapeutic modalities. Further, the importance of various nanostructured components is emphasized, highlighting their predominant actions in solving crucial dental issues, such as anti-bacterial, remineralization, and tissue regeneration abilities. In addition to an emphasis on the synthesis of different nanostructures, various nano-therapeutic solutions from diverse sources are discussed, including natural (plant, animal, and marine)-based components and other synthetic (organic- and inorganic-) architectures, as well as their composites for improving oral health. Finally, we summarize the article with an interesting outlook on overcoming the challenges of translating these innovative platforms to clinics. [ABSTRACT FROM AUTHOR]

Introduction: In community settings with limited dental personnel and equipment, and in an era when the aerosol transmission of infectious agents is on the rise, a non‐invasive approach to caries management is critical. To provide information on non‐invasive material selection, the aim of this study was to compare the remineralization effect of commonly used fluoride‐containing materials, adjunctive to the everyday use of fluoride toothpaste (F‐toothpaste), on primary tooth natural dentin caries. Methods: Fifty‐five specimens were randomly divided into five groups: 38% silver diamine fluoride (SDF), 5% fluoride varnish (F‐varnish), glass‐ionomer cement (GIC), deionized water (DW) with F‐toothpaste slurry, and DW as a control group (n = 11). The lesion depth and mineral density were measured before and after bacterial pH‐cycling using micro‐computed tomography. The percentage of mineral density change (%MDchange) was quantified. The dependent t‐test, Wilcoxon‐Signed‐Rank Test, and one way ANOVA with Bonferroni correction were used to analyse the data. Results: SDF application reduced lesion depth from 844.6 to 759.1 μm (p < 0.045) while increasing mineral density from 551.4 to 763.0 mgHA/cm3 (p < 0.003). Only mineral density rose from 600.2 to 678.4 mgHA/cm3 (p < 0.013) when GIC was used. The other groups showed no difference. The highest %MDchange was also found after SDF treatment (49.7%, p < 0.05), whereas GIC (17.2%, p < 0.05) presented a higher percentage than the F‐varnish (2.0%), F‐toothpaste (−1.1%) and no‐treatment groups (−1.4%). Conclusion: In this in vitro study, where the pH of cycling was almost neutral, using SDF as an adjunct to F‐toothpaste resulted in the highest remineralization compared with other remineralizing materials. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the remineralization effect of NaF, NaF with TCP, NaF with CPP‐ACP and NaF with CXP varnishes on newly erupted first permanent molars using laser fluorescence (LF) method. The study was a randomized, double‐blind, controlled trial with four parallel groups. Methods: The study was carried out in 48 high caries‐risk children (DMFS >8), aged 6–7 years with newly erupted permanent first molars (initial lesion with 13 < LF value<30). A total of 140 teeth were divided randomly into four groups (n = 35): G1.Duraphat Varnish containing 5% NaF, G2. Clinpro™ White Varnish containing 5% NaF with TCP, G3.Embrace™ Varnish containing 5% NaF with CXP, G4. MI Varnish containing 5% NaF with CPP‐ACP. All dental treatments of the patients were completed before the varnish application. The varnishes were applied to the targeted teeth at baseline, 1 and 3 months. Patients were called for follow‐up appointments at 1, 3 and 6 months, and LF scanning was used to monitor mineralization changes. Data were analysed statistically by Wilcoxon signed‐rank and Mann–Whitney U‐tests. Results: In total, 40 children (122 teeth) completed the trial. At the end of 6 months, the amount of reduction in LF values (indicating remineralization) are as follows: NaF with CXP(6.87 ± 4.32) < NaF with TCP(7.36 ± 7.05) < NaF(7.40 ± 7.03) < NaF with CPP‐ACP(8.33 ± 4.90). All of the varnishes resulted in significant decrease in LF measurements and there was no significant difference between control (NaF alone) group and other groups. Only MI varnish had a significantly greater remineralization effect than Embrace™ Varnish (p < 0.05). Conclusion: As a non‐invasive approach, CPP‐ACP, TCP and CXP containing NaF varnishes have the potential to remineralize initial caries lesions on permanent first molars in high caries‐risk children. [ABSTRACT FROM AUTHOR]

Objective: In this study, dentine surface was analysed through Environmental‐scanning‐electron‐microscopy (ESEM) with energy‐dispersive‐X‐ray‐spectrometry (EDX) and Fourier‐transform‐infrared‐spectroscopy (FTIR) with attenuated total‐reflectance (ATR) to assess the morpho‐chemical changes and variations in mineralization degree after demineralizing treatment, after five toothpastes application (HA & Citrate toothpaste, Zinc‐HA toothpaste, Calcium Sodium Phosphosilicate toothpaste, Arginine & Calcium carbonate toothpaste, Colgate‐Triple‐Action, and Control toothpaste), after soaking in artificial saliva and after citric acid attack. Methods: Ca/P, Ca/N and P/N ratios were calculated from EDX atomic data to evaluate the mineralization degree of dentine surface. The IR calcium phosphate (CaP)/collagen and carbonate/collagen ratios has been evaluated to assess the remineralization changes in dentine; the carbonate/collagen IR ratio was calculated to identify the nucleation of B‐type‐carbonated apatite and calcium carbonate. Results: ESEM–EDX and ATR–FTIR showed residuals of toothpastes after the treatments in all cases, with a general increase in the mineralization degree after soaking in artificial saliva and a decrease after acid attack. Treatment with Arginine & Calcium carbonate toothpaste showed the highest Ca/P value after treatment (Ca/P 1.62) and acid attack (Ca/P 1.5) in confirmation, IR showed the highest amount of carbonate after treatment and soaking in artificial saliva. Arginine and calcium carbonate toothpaste and HA and citrate toothpaste remained to a higher extent on the dentine surface and revealed a higher remineralization activity. These formulations showed higher resistance to demineralization attack, as demonstrated by a higher ICaP/IAmide II intensity ratio than those obtained after EDTA treatment. Conclusions: Toothpastes that remained to a higher extent on dentine surface (arginine and calcium carbonate toothpaste in particular) were more able to promote remineralization. The formed calcium phosphate (CaPs) phase was intimately bound to dentine rather than a simple deposit. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the effect of the use of remineralization agents before the application of resin infiltration on the treatment of initial enamel lesions. Materials and methods: Eighty buccal enamel samples were prepared from human molars, and artificial initial lesions were formed after 96 h of incubation with a demineralizing solution. The samples were randomly divided into 8 groups (n = 10) including a remineralizing agent (Tooth Mousse, Medical Mineral Gel, Remin Pro), resin infiltration (ICON), and a combined treatment of both. Remineralizing agents were applied in pH cycle for 7 days. Baseline, demineralization, and after-treatment fluorescence (FluoreCam and DIAGNOdent Pen), surface microhardness (HMV-2T), surface roughness (M300C), OCT (Maestro-2) and ultrasonic system (Novascope 4500) data were obtained for all groups. The sample surfaces were examined under SEM/EDX (SU3500) at x1000. Data were statistically analyzed using the Two-Way Robust ANOVA and Bonferroni tests (p < 0.05). Results: There was no statistically significant difference between the groups for microhardness, roughness, OCT, DIAGNOdent Pen, ultrasound, and FluoreCam size/intensity values (p = 0.582; p = 0.963; p = 0.884; p = 0.923; p = 0.051; p = 0.268; p = 0.793 respectively). The effect of the treatment procedure showed a significant difference (p < 0.001), except for the roughness values (p = 0.984). The lowest Calcium (Ca) ratio (%atomic) was observed in the RI group in the EDX analysis. Conclusion: Remineralizing agents and resin infiltration methods may be used in combination or alone in the treatment of initial enamel lesions. Combining remineralizing agents with resin infiltration does not alter the efficacy of the treatment. Highlights: The use of remineralizing agents before resin infiltration does not alter the effectiveness of treatment for the start of demineralization located on the outer half of the enamel. [ABSTRACT FROM AUTHOR]

Background: White-spot lesions are considered an initial carious stage characterized by an outer enamel layer with significantly reduced mineralization. This study was conducted to assess the combined effect of Biomin F toothpaste and Diode laser on remineralization of white spot lesions. Materials and methods: An invitro study conducted on a total of 30 premolars divided into three groups; Group A (Biomin F Tooth paste), Group B (Biomin F with laser application for 30 sec), Group C (Negative control). The three groups were submitted to three stages; stage 1:Baseline,stage 2:After demineralization ,and stage 3:After remineralization. In each stage, elemental analysis(calcium, phosphorus, and fluoride)was measured quantitatively using Energy Dispersive X-ray (EDX) analysis and qualitatively by micrographs using scanning electron microscope. The data were tested to find significant difference between mineral changes during stages by using (ANOVA) test and Bonferroni test. Results: Calcium, phosphorus and fluoride ions decreased in all groups after demineralization. In stage 3, after application of remineralizing agents, Calcium ions increased significantly in groups A and B where p<.05. As regards to the phosphorus ions, a significant increase was observed in all groups with group A showed the highest gain as phosphorus level percentage change (%mass) was 56.52±18.02. Fluoride ions increased significantly in groups A and B (p<0.05) but decreased significantly in group C. There was no statistical significant difference between group A and B (p ≥.05) in calcium, phosphorus, and fluoride level after remineralization. Conclusion: Within the limitation of the present study, we concluded that Biomin F toothpaste is promising in the repairing of white spot lesions on the surface of the demineralized enamel. Diode laser did not affect the remineralizing ability of Biomin F toothpaste. [ABSTRACT FROM AUTHOR]

Objectives: This study pursued two main purposes. The first aim was to expound on the microscopic factors of radiation-related caries (RRC). Further, it aimed to compare the remineralization effect of different remineralizing agents on demineralized teeth after radiotherapy. Methods: The enamel and dentin samples of bovine teeth were irradiated with different doses of radiation. After analysis of scanning electron microscope (SEM), X-Ray diffraction (XRD), and energy dispersive spectrometer (EDS), the samples irradiated with 50 Gy radiation were selected and divided into the demineralization group, the double distilled water (DDW) group, the Sodium fluoride (NaF) group, the Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group, the NaF + CPP-ACP group, and the Titanium tetrafluoride (TiF4) group. After demineralization, remineralizing agents treatment, and remineralization, the samples were evaluated using SEM, atomic force microscope (AFM), EDS, and transverse microradiography (TMR). Results: A radiation dose of 30 Gy was sufficient to cause damage to the dentinal tubules, but 70 Gy radiation had little effect on the microstructure of enamel. Additionally, the NaF + CPP-ACP group and the TiF4 group significantly promoted deposit formation, decreased surface roughness, and reduced mineral loss and lesion depth of demineralized enamel and dentin samples after radiation. Conclusions: Radiation causes more significant damage to dentin compared to enamel. NaF + CPP-ACP and TiF4 had a promising ability to promote remineralization of irradiated dental hard tissues. Advances in knowledge: This in vitro study contributes to determining a safer radiation dose range for teeth and identifying the most effective remineralization approach for RRC. [ABSTRACT FROM AUTHOR]

Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups. Materials and Methods: In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05). Results: All samples' microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm2] and ibuprofen [75.1 kgf/mm2]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499). Conclusion: As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure. [ABSTRACT FROM AUTHOR]

Background.: This study evaluated the efficacy of grape seed extract (GSE) on the remineralization of primary tooth enamel alone or in combination with remineralizing agents. Methods.: The initial microhardness value of 90 primary tooth enamel samples was calculated; then, the samples were demineralized. The post-demineralization hardness of the samples was measured and the samples were randomly divided into 6 groups as follows: G1: negative control, G2: GSE, G3: NaF, G4:Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), G5: GSE+NaF, and G6: GSE+CPP-ACP (n=15). Oral environment pH cycle was applied and hardness measurements were repeated after treatments. The samples were stained with 1% rhodamine B dye and sectioned, and the lesion depth was measured. Statistical significance was set at P <0.05.> Results.: The hardness decrease of the GSE and GSE+NaF groups was less than the other groups (P <0.05).>P>0.05). GSE showed a positive effect when combined with NaF in maintaining microhardness but did not show the same effect when combined with CPP-ACP (P <0.05).>P<0.05).>P<0.05).> Conclusion.: The lowest hardness decrease was observed in the GSE and GSE+NaF groups, and the lowest penetration rates were observed in the GSE+NaF and GSE+CPP-ACP groups. It has been determined that a 15% GSE solution might be used as an alternative to fluoride in primary tooth remineralization and can increase the effectiveness of fluoride when used together. [ABSTRACT FROM AUTHOR]

This article discusses recent advancements in dental biomedicine and technologies aimed at improving oral health outcomes. It highlights the potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in remineralizing teeth affected by molar-incisor hypomineralization (MIH), as well as the antibacterial properties of silver diamine fluoride (SDF) in preventing carious lesion progression. The article also explores other innovative approaches in dental care, such as laser-induced pre-emptive pulpal laser analgesia (PPLA) for pain management and the use of biomimetic hydroxyapatite as an alternative to fluoride for enamel restoration. Additionally, it discusses the role of digital technology in enhancing dental diagnostics and treatment planning, the importance of interprofessional collaboration, and the inclusion of patient-centered research in improving treatment experiences and outcomes. The article concludes by mentioning recent advancements in diagnostic imaging and the efficacy of desensitizing toothpastes for managing dentin hypersensitivity. [Extracted from the article]

Objective: This study aimed to compare the remineralization effects of a calcium silicate-based cement (Biodentine) and of a glass ionomer cement (GIC: Fuji IX) on artificially demineralized dentin. Methods: Four standard cavities were prepared in dentin discs prepared from 34 extracted sound human third molars. In each disc, one cavity was covered with an acid-resistant varnish before demineralization (Group 1). The specimens were soaked in a chemical demineralization solution for 96 h to induce artificial carious lesions. Thereafter, one cavity each was filled with Biodentine (Group 2) and GIC (Group 3), respectively, and one carious lesion was left unrestored as a negative control (Group 4). Next, specimens were immersed in simulated body fluid (SBF) for 21 days. After cross-sectioning the specimens, the Ca/P ratio was calculated in each specimen by using scanning electron microscopy–energy-dispersive X-ray spectroscopy (SEM-EDX). Finally, data were analyzed using repeated-measures ANOVA with post-hoc Bonferroni correction. Results: Both cement types induced dentin remineralization as compared to Group 4. The Ca/P ratio was significantly higher in Group 2 than in Group 3 (p < 0.05). Conclusion: The dentin lesion remineralization capability of Biodentine is higher than that of GIC, suggesting the usefulness of the former as a bioactive dentin replacement material. Clinical relevance: Biodentine has a higher remineralization ability than that of GIC for carious dentin, and its interfacial properties make it a promising bioactive dentin restorative material. [ABSTRACT FROM AUTHOR]

In dentistry, hydroxyapatite (HAp) plays pivotal role for remineralization and protecting the teeth and helping to restore cavities. It is a combination of calcium and phosphorus salt, which is naturally available mineral from various sources. In the present study, HAp was extracted from fish scale and poultry eggshell by wet chemical methods. Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), and Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) were adopted for the characterization of synthesized HAp from fish scales and poultry eggshell. The synthesized HAp of Ca/P molar ratio ranges from 1.58 to 1.75. It was formulated toothpaste and applied on demineralized teeth for 15 days. The cross sections of teeth showed the formation of tubular enamel. It showed irregular tubular to regular arrangment tubular appeared in HAp formulated tooth paste than fluoride toothpastes. [ABSTRACT FROM AUTHOR]

Purpose: The main objective of this study was to investigate the efficacy of S-PRG filler-containing gel application in promoting dentin remineralization using ultrasonic velocimetry. Methods: Root dentin slabs of bovine teeth were sliced and formed into rectangles, treated with 0.1 M lactate buffer (pH 4.75) for 10 min, and then immersed in artificial saliva (pH 7.0). This treatment was repeated three times a day for 28 days. S-PRG filler-containing gel (PRG) and high-fluorine concentration silver diamine fluoride (SDF) solution were used. The treatment methods were: 1) untreated group, 2) PRG one-off application group, 3) SDF oneoff application group, 4) PRG frequent-time application group, and 5) SDF frequent-time application group. After treatment, dentin slabs were soaked in 0.1 M lactate buffer solution and dipped in artificial saliva. This treatment was repeated 3 times a day for 28 days. Results: The ultrasonic velocity of the untreated samples decreased slightly during the experimental period. In the one-off application group, ultrasonic velocities of SDF and PRG increased rapidly on day 7 and then decreased slightly during the experimental period. In the frequent-time application group, ultrasonic velocities of SDF and PRG increased during the experimental period; specimens treated with SDF had significantly higher ultrasonic velocities on each measurement day compared to specimens treated with PRG. Conclusion: From the results of this experiment, it was concluded that the S-PRG filler-containing gel and silver diamine fluoride solution appear to promote remineralization and inhibit dentin demineralization. [ABSTRACT FROM AUTHOR]

Background: The formation of white spots, which represent early carious lesions, is a major issue with fixed orthodontics. The addition of remineralizing agents to orthodontic adhesives may prevent the formation of white spots. The aim of this study was to produce a composite orthodontic adhesive combined with nano-bioactive glass-silver (nBG@Ag) for bracket bonding to enamel and to investigate its cytotoxicity, antimicrobial activity, remineralization capability, and bond strength. Methods: nBG@Ag was synthesized using the sol-gel method, and characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy with an attenuated total reflectance attachment (ATR-FTIR). The cytotoxicity test (MTT) and antimicrobial activity of adhesives containing 1%, 3%, and 5% (wt/wt) nBG@Ag were evaluated, and the shear bond strength of the adhesives was measured using a universal testing machine. Remineralization was assessed through microhardness testing with a Vickers microhardness tester and scanning electron microscopy (SEM). Statistical analyses were conducted using the Shapiro-Wilk test, Levene test, one-way ANOVA, Robust-Welch test, Tukey HSD method, and two-way ANOVA. Results: The biocompatibility of the adhesives was found to be high, as confirmed by the lack of significant differences in the cytotoxicity between the sample and control groups. Discs made from composites containing nBG@Ag exhibited a significant reduction in the growth of Streptococcus mutans (p < 0.05), and the antibacterial activity increased with higher percentages of nBG@Ag. The shear bond strength of the adhesives decreased significantly (p < 0.001) after the addition of nanoparticles, but it remained above the recommended value. The addition of nBG@Ag showed improvement in the microhardness of the teeth, although the differences in microhardness between the study groups were not statistically significant. The formation of hydroxyapatite deposits on the tooth surface was confirmed through SEM and energy-dispersive X-ray spectroscopy (EDX). Conclusion: Adding nBG@Ag to orthodontic adhesives can be an effective approach to enhance antimicrobial activity and reduce enamel demineralization around the orthodontic brackets, without compromising biocompatibility and bond strength. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the quality of bone regeneration in fresh sockets using four different materials at different time points. Materials and Methods: A split-mouth randomized clinical trial was designed to evaluate the histologic and histomorphometric characteristics of 82 fresh sockets from 30 patients. One socket per patient healed spontaneously (control), and at least one fresh socket was grafted with a material chosen randomly from a sealed envelope: platelet- rich growth factor (PRGF; n = 20 sites), PRGF + autologous bone (n = 9 sockets), autologous bone (n = 10 sites), or PRGF + demineralized freeze-dried bone allograft (DFDBA; n = 13). Biopsy specimens were taken at different time points divided into three assessment groups: short duration (2 to 4 months), intermediate duration (5 to 6 months), and long duration (7 to 12 months). The histologic findings were assessed to quantify the trabeculae pattern, the degree of mineralization, and the quality of bone regeneration. Results: A total of 26 patients with 73 sockets completed the study. Mineralization after a short duration was found to be significantly higher among sockets treated only with autologous bone (47.3% ± 3.6%) or with PRGF+autologous bone (45.1% ± 13.6%). During the intermediate time point, this difference was not observed; also, the control sites were found to have the highest amount of mineralization (37.7% ± 14.9%). After a long duration of wound healing, the PRGF+DFDBA group had the greatest percentage of mineralized tissue (54.7% ± 28.7%), which was significantly higher than the sites treated only with PRGF (30.0% ± 13.2%). Conclusion: From a histologic point of view, the use of autologous graft with or without PRGF seems to be the best strategy for socket regeneration within a short period of time (2 to 4 months). However, the application of PRGF alone inside fresh sockets may interfere with normal bone healing compared with control sites healed spontaneously. [ABSTRACT FROM AUTHOR]

Objectives: Exosomes derived from stem cells are a potential cell‐free tool for tissue regeneration with therapeutic potential. However, its application in cementum repair is unclear. This study aimed to investigate the effect of human periodontal ligament stem cell‐derived exosomes on the biological activity of cementoblasts, the main effector cells in cementum synthesis. Materials and Methods: OCCM‐30 cementoblasts were cultured with various human periodontal ligament stem cell‐derived exosome concentrations. OCCM‐30 cells proliferation, migration, and cementogenic mineralization were examined, along with the gene and protein expression of factors associated with cementoblastic mineralization. Results: Exosomal promoted the migration, proliferation, and mineralization of OCCM‐30 cells. The exosome‐treated group significantly increased the expression of cementogenic‐related genes and proteins. Furthermore, the expression of p‐PI3K and p‐AKT was enhanced by exosome administration. Treatment with a PI3K/AKT inhibitor markedly attenuated the gene and protein expression of cementoblastic factors, and this effect was partially reversed by exosome administration. Conclusions: Human periodontal ligament stem cell‐derived exosomes can promote the activity of cementoblasts via the PI3K/AKT signaling pathway, providing a scientific basis for promoting the repair process in orthodontically induced inflammatory root resorption. [ABSTRACT FROM AUTHOR]

Background: Mineralization‐promoting peptide‐3 (MPP3) is a new biomimetic remineralization agent. Aim: To assess the remineralization efficiency of MPP3, either alone or in combination with fluoride gel. Design: The samples were divided into four groups: control, 1.23% fluoride gel, 10% MPP3 gel, and 1.23% fluoride gel + 10% MPP3. Following the application of remineralization agents (4 min), the samples remained in a pH‐cycling model (37°C, 4 weeks). Microhardness, microcomputed tomography (micro‐CT), polarized light microscopy (PLM), and field emission scanning electron microscopy (FE‐SEM) analysis were conducted. RM‐ANOVA, one‐way ANOVA, and intraclass correlation coefficient (ICC) were used for statistical analysis, and a significance level of p <.05 was employed. Results: Mineralization‐promoting peptide 3 and fluoride gel + MPP3 increased the microhardness of the enamel compared with initial values in each group (p <.05). Mineralization‐promoting peptide 3 successfully maintained the mineral density of enamel, although the cariogenic pH‐cycling and PLM results indicated that the lesion depth (μm) was significantly lower in the fluoride gel + MPP3 group (27.0336 ± 12.53650) than in the control group (37.3907 ± 12.76002, p <.05). Conclusion: The combined use of MPP3 with fluoride gel enhanced the caries‐protective and mineralization‐promoting effects of fluoride. Mineralization‐promoting peptide 3 may be a potential agent that can be employed to improve the physical properties of enamel. [ABSTRACT FROM AUTHOR]

Background: Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F. Materials and methods: The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19F Magic angle spinning nuclear magnetic resonance (19F-MAS-NMR) were also performed. Results: XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19F-MAS-NMR showed peaks between − 103 and − 104ppm corresponding to fluorapatite formation in Groups 3 and 4. Conclusion: Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate the effect of remineralizing agents on demineralized enamel intended for use as fluoride substitutes or supplements for oral hygiene applications. Methodology: Enamel samples were obtained from 30 bovine teeth. The enamel blocks were stored in 20 mL of demineralization solution for 72 h. They were then brushed with the following toothpaste for the remineralization protocol: NaF, NaF/SnF2 combination, NovaMin, or nano‐hydroxyapatite. SEM/EDX examinations and microhardness measurements of the samples were performed to investigate the remineralization efficacy of the studied toothpaste. One‐way analysis of variance (ANOVA) with post hoc Tukey's HSD test was used to analyze the change in microhardness values in different remineralization protocols (p < 0.05). Results: Differences in the mean remineralization (%RP) and hardness recovery (%HR) were determined between the groups (p < 0.05). Groups 1 and 4 showed significant differences in %RP (p < 0.05). In the SEM/EDX examinations, the samples treated with n‐HAp showed an accumulation of crystal deposits on the enamel surface, although at a lower density than those treated with NaF and NaF/SnF2 combination. Conclusion: The remineralization strategy in toothpaste plays an important role in enamel remineralization. NovaMin‐containing toothpaste showed positive effects on the enamel surface with better Ca/P ratio. Toothpastes containing n‐HAp triggered less change in the increase of microhardness values compared to other toothpastes. The use of SnF2 in toothpaste in combination with NaF significantly increased the binding of fluoride to demineralized enamel compared to toothpaste containing NaF alone. [ABSTRACT FROM AUTHOR]

Given the global prevalence of dental caries, impacting 2.5 billion individuals, the development of sophisticated prevention filling materials is crucial. Streptococcus mutans , the principal caries-causing strain, produces acids that demineralize teeth and initiate dental caries. To address this issue, we aimed to develop a synergistic resin-based composite for enhancing caries control. The synergistic resin composite incorporates fluorinated kaolinite and silanized Al 2 O 3 nanoparticle fillers into an epigallocatechin gallate (EGCG) immobilized urethane-modified epoxy acrylate (U-EA) resin matrix, referred to the as-prepared resin composite. The EGCG-modified TPGDA/U-EA network was synthesized by preparing methacrylate-functionalized isocyanate (HI), reacting it with EGCG to form HI-EGCG, and then incorporating HI-EGCG into the TPGDA/U-EA matrix. The lamellar space within the kaolinite layer was expanded through the intercalation of acrylamide into kaolinite, enhancing its capability to adsorb and release fluoride ions (F–). The layered structure of acrylamide/ kaolinite in the U-EA resin composite acts as a F– reservoir. The physico-mechanical properties of the as-prepared resin composites are comparable to those of commercial products, exhibiting lower polymerization shrinkage, substantial F– release and recharge and favorable diametral tensile strength. The immobilized EGCG in the composite exhibits potent antimicrobial properties, effectively reducing the biofilm biomass. Furthermore, the synergistic effect of EGCG and fluorinated kaolinite efficiently counteracts acid-induced hydroxyapatite dissolution, thereby suppressing demineralization and promoting enamel remineralization. Our innovative EGCG and fluoride synergistic composite provides enhanced antimicrobial properties, durable anti-demineralization, and tooth remineralization effects, positioning it as a promising solution for effective caries control and long-term dental maintenance. [Display omitted] [ABSTRACT FROM AUTHOR]

This study assessed the effect of nano-hydroxyapatite incorporation into resin infiltrant on the mineral content, surface tomography, and resin tag penetration of demineralized enamel. Forty specimens were exposed to a demineralized solution to form subsurface caries lesions. The lesions were treated with negative control, a resin infiltrant (ICON), ICON with 5% nano-hydroxyapatite (NHA, Sigma-Aldrich), or ICON with 10% NHA. Mineral density was assessed using microcomputed tomography scans at various stages of the experiment. Specimens were scanned by scanning electron microscope (SEM) for surface analysis and resin tag penetration. Analysis of variance was used to assess the difference among groups. Specimens treated with ICON and 5% or 10% NHA showed the most favorable mineral density regarding the percent change in mineral content (32.4% and 29.7%, respectively), compared to 8.8% in teeth treated with ICON alone and -1.8% in teeth in the control group. SEM showed that teeth treated with ICON or ICON with 5% or 10% NHA had a smooth surface. The resin penetration in all tested groups showed high-quality resin tags, regardless of the treatment protocol. NHA resin infiltrant (ICON with 5% or 10% NHA) effectively enhanced the artificial enamel caries surfaces in terms of smooth surfaces, mineral density, and resin penetration. [ABSTRACT FROM AUTHOR]

Background: Several methods were introduced for enamel biomimetic remineralization that utilize a biomimetic analogue to interact and absorb bioavailable calcium and phosphate ions and induce crystal nucleation on demineralized enamel. Amelogenin is the most predominant enamel matrix protein that is involved in enamel biomineralization. It plays a major role in developing the enamel's hierarchical microstructure. Therefore, this study was conducted to evaluate the ability of an amelogenin-inspired peptide to promote the remineralization potential of fluoride and a supersaturated calcium phosphate solution in treating artificially induced enamel carious lesions under pH-cycling regimen. Methods: Fifty enamel slices were prepared with a window (4*4 mm2) on the surface. Five samples were set as control healthy enamel and 45 samples were subjected to demineralization for 3 days. Another 5 samples were set as control demineralized enamel and 40 enamel samples were assigned into 8 experimental groups (n=5) (P/I, P/II, P/III, P/AS, NP/I, NP/II, NP/III and NP/AS) according to peptide treatment (peptide P or non-peptide NP) and remineralizing solution used (I; calcium phosphate solution, II; calcium phosphate fluoride solution, III; fluoride solution and AS; artificial saliva). Samples were then subjected to demineralization/remineralization cycles for 9 days. Samples in all experimental groups were evaluated using Raman spectroscopy for mineral content recovery percentage, microhardness and nanoindentation as healthy, demineralized enamel and after pH-cycling. Data were statistically analysed using two-way repeated measures Anova followed by Bonferroni-corrected post hoc test for pairwise multiple comparisons between groups. Statistical significance was set at p= 0.05. Additionally, XRD, FESEM and EDXS were used for crystal orientation, surface morphology and elemental analysis after pH-cycling. Results: Nanocrystals clumped in a directional manner were detected in peptide-treated groups. P/II showed the highest significant mean values in mineral content recovery (63.31%), microhardness (268.81±6.52 VHN), elastic modulus (88.74±2.71 GPa), nanohardness (3.08±0.59 GPa) and the best crystal orientation with I002/I300 (1.87±0.08). Conclusion: Despite pH changes, the tested peptide was capable of remineralizing enamel with ordered crystals. Moreover, the supplementary use of calcium phosphate fluoride solution with peptide granted an enhancement in enamel mechanical properties after remineralization. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of a formulated remineralizing gallic acid (GA) varnish in treating artificial enamel caries lesions. Fifty-five intact bovine incisors were collected. Enamel blocks (5 × 9 mm) were prepared. A third of each block's surface remained intact. Primary carious lesions were induced on the middle and bottom thirds of the blocks by immersing the samples in a demineralization solution for 6 h. The bottom third of the blocks were further remineralized by randomly applying 0.5%, 2%, or 8% GA varnishes and 2.26% fluoride varnish (V varnish, Vericom, Seoul, Korea), or the varnish base without active ingredients (n = 11 each). The specimens were immersed in a remineralizing solution for 4 h and then subjected to a 2-hour immersion in the demineralizing solution. After six days of pH cycling, the surface microhardness was measured at depths of 30, 75, and 120 μm. The percentage of surface microhardness recovery (SMHR%) was compared among the groups using the Shapiro-Wilk, ANOVA, and Tukey HSD post-hoc tests (α = 0.05). The SMHR% of all experimental groups was higher than the control group at 30 μm (p < 0.05). The 0.5% GA varnish showed the highest SMHR% at all depths; however, the difference with the other experimental groups was significant at a depth of 30 μm (p < 0.05). The SMHR% of the fluoride and the 2% and 8% GA varnishes was comparable at all depths. All treatments potentially remineralize enamel lesions, with 0.5% GA varnish having the greatest effect, particularly on the top surface layer. As such, this newly developed varnish may emerge as a promising alternative to fluoride varnish. [ABSTRACT FROM AUTHOR]

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host's natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Surface remineralization is recommended for the management of active non-cavitated interproximal carious lesions in primary teeth. According to the American Academy of Pediatric Dentistry, a recently recognized category of materials called bioactive restorative materials can be used for remineralization. This study aimed to evaluate the release of fluoride (F), calcium (Ca) and phosphate (P) ions from Predicta® Bioactive Bulk-fill composite compared with EQUIA Forte® and Filtek™ Z350 and to determine the remineralization effect of these 3 restorative materials on adjacent initial interproximal enamel carious lesions. Methods: The release of F, Ca and P ions from 3 groups ((n = 10/group) (Group 1- Predicta®, Group 2- EQUIA Forte® and Group 3- Filtek™ Z350)) was determined at 1st, 4th, 7th and 14th days. After creating artificial carious lesions, human enamel samples were randomly assigned into 3 groups (n = 13/group) which were placed in contact with occluso-proximal restorative materials and exposed to a 14-day pH cycling period. Surface microhardness was determined using a Knoop microhardness assay at baseline, after artificial carious lesions formation and after pH cycling. The difference in the percentage of surface microhardness recovery (%SMHR) among groups was compared. Mineral deposition was analyzed with energy-dispersive x-ray spectroscopy (EDS) and the enamel surface morphology was evaluated with scanning electron microscopy (SEM). Kruskal-Wallis's test with Dunn's post hoc test and one-way ANOVA with Tukey's post hoc test were used for data analysis. Results: EQUIA Forte® released the highest cumulative amount of F and P ions, followed by Predicta® and Filtek™ Z350. Predicta® released higher amount of Ca ions than EQUIA Forte® and Filtek™ Z350. Predicta® demonstrated the highest %SMHR, followed by EQUIA Forte® and Filtek™ Z350. There was a significant difference in the %SMHR between Predicta® and Filtek™ Z350 (p < 0.05). However, EQUIA Forte® demonstrated the highest fluoride content, followed by Predicta® and Filtek™ Z350. The SEM images of EQUIA Forte® and Predicta® revealed the greater mineral deposition. Conclusion: Predicta® demonstrated a marked increase in surface microhardness and fluoride content of adjacent initial interproximal enamel carious lesions in primary molars compared with Filtek™ Z350. Predicta® is an alternative restorative material to remineralize adjacent initial interproximal enamel carious lesions in primary molars, especially in high-risk caries patients. [ABSTRACT FROM AUTHOR]

With the phase-out of amalgam and the increase in minimally invasive dentistry, there is a growing need for high-strength composite materials that can kill residual bacteria and promote tooth remineralization. This study quantifies how antibacterial polylysine (PLS) and re-mineralizing monocalcium phosphate monohydrate (MCPM) affect Streptococcus mutans biofilms and the strength of dental composites. For antibacterial studies, the MCPM-PLS filler percentages were 0-0, 8-4, 12-6, and 16-8 wt% of the composite filler phase. Composite discs were immersed in 0.1% sucrose-supplemented broth containing Streptococcus mutans (UA159) and incubated in an anaerobic chamber for 48 h. Surface biomass was determined by crystal violet (CV) staining. Growth medium pH was measured at 24 and 48 h. Biofilm bacterial viability (CFU), exo-polysaccharide (water-soluble glucan (WSG) and water-insoluble glucan (WIG)), and extracellular DNA (eDNA) were quantified. This was by serial dilution plate counting, phenol-sulfuric acid microassay, and fluorometry, respectively. The biaxial flexural strengths were determined after water immersion for 1 week, 1 month, and 1 year. The MCPM-PLS wt% were 8-4, 8-8, 16-4 and 16-8. The normalized biomass, WSG, and WIG showed a linear decline of 66%, 64%, and 55%, respectively, as the PLS level increased up to 8%. The surrounding media pH (4.6) was all similar. A decrease in bacterial numbers with the 12-6 formula and a significant reduction with 16-8 compared to the 0-0 formulation was observed. The eDNA concentrations in biofilms formed on 12-6 and 16-8 formulations were significantly less than the 0-0 control and 8-4 formulations. Doubling MCPM and PLS caused a 14 and 19% reduction in strength in 1 week, respectively. Average results were lower at 1 month and 1 year but affected less upon doubling MCPM and PLS levels. Moreover, a 4% PLS may help to reduce total biomass and glucan levels in biofilms on the above composites. Higher levels are required to reduce eDNA and provide bactericidal action, but these can decrease early strength. [ABSTRACT FROM AUTHOR]

Background: White spot lesions (WSL) are caused by demineralisation on enamel tooth surfaces. The use of 5% concentrated sodium fluoride varnish (SFV) and casein phosphor-peptides amorphous calcium phosphate with sodium fluoride (CPP-ACPF) (delivered via MI Varnish™) has been seen to be effective in decreasing the progression of WSL. This literature review aims to compare the efficacy of SFV and CPP-ACPF on WSL as supported by current research. It will add to the body of theoretical clinical knowledge for dental professionals, highlighting how dental professionals can treat and prevent progression of WSL by topical application of SFV and CPP-ACPF. More clinical trials are needed to unequivocally state that CPP-ACPF is superior to SFV in preventing the progression of WSL. Hypothesis: CPP-ACPF topical application combined with SFV is more effective in decreasing WSL than SFV alone. Aim: To review the evidence regarding remineralisation properties of SFV and CPP-ACPF on WSL. Study design: Eligibility criteria included clinical trials focused on WSL remineralisation in primary and secondary teeth, including smooth surface lesions and orthodontics. The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Ovid), Scopus, Web of Science and Google Scholar titles and abstracts were screened. Systemic reviews, meta-analysis, and case reports and in vitro studies were excluded. Studies with participants aged between 3-26 years were included in the review and patients with medical conditions, enamel defects or milk allergies were excluded. Results: Seven of nine articles showed a decrease in progression of WSL when using CPP-ACPF, SFV or both. CCP-ACPF showed the greatest improvement when compared to SFV. Thus, the hypothesis is supported as CPP-ACPF (delivered via MI Varnish™) topical application was more effective than SFV (Duraphat™) alone, decreasing the progression of WSL. Conclusion: Based on limited literature in vivo studies, it is suggested that CPP-ACPF applied via MI Varnish™ is a competitive product, when compared with SVF alone, however requires extended in mouth clinical trials. Furthermore, a substantial body of evidence from in vitro studies suggests that MI Varnish™ is an effective product aiding remineralisation processes, with the addition of CPP-ACP complexes. [ABSTRACT FROM AUTHOR]

Statement of the Problem: The prevalence of non-carious dentin lesions is on the rise mainly due to improved life expectancy. Successful management of these lesions is often challenging, and given that dentin can be remineralized, adverse consequences due to progression of these lesions can be prevented or minimized as such. Purpose: This study aimed to assess the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and Remin-Pro remineralizing agents on dentin microhardness of non-carious dentin lesions. Materials and Method: This in vitro, experimental study evaluated 36 extracted sound human premolars. The teeth were decoronated at the cementoenamel junction. Enamel was removed, and dentin was exposed at the cervical third of the buccal surface. The primary microhardness of dentin was then measured. The teeth, standardized in terms of dentin microhardness, then underwent demineralization by acid etching and were subjected to microhardness test again. They were then randomized into three groups for treatment with CPP-ACP, Remin-Pro, and artificial saliva (control), and dentin microhardness was measured for the third time after treatment. Data were analyzed using ANOVA. Results: Within group comparisons showed a significant difference in microhardness at the three time points in all three groups (p< 0.005). Between-group comparisons revealed that the microhardness of the three groups was not significantly different at baseline or after demineralization. However, the microhardness of the three groups was significantly different after the intervention (p= 0.000). Pairwise comparisons revealed significantly higher microhardness in the CPP-ACP group than the other two groups (p= 0.003). Remin-Pro and the control groups were not significantly different in this respect (p= 0.340). Conclusion: CPP-ACP can be used for remineralization of non-caries dentin lesions; however, Remin-Pro does not appear to be effective for this purpose. [ABSTRACT FROM AUTHOR]

The topic of fluoride release and uptake by glass-ionomer (glass polyalkenoate) dental cements is reviewed. The study was based on a literature search carried out using PubMed. The main key words used were glass-ionomer and fluoride, and further refinements were made by adding the keywords anti-microbial, anti-caries and remineralization. Papers were selected from the initial search, which concentrated on fundamental aspects of fluoride release, including kinetics and the influence of the cement composition, and resulting clinical performance against caries. Other relevant papers were cited where they added useful and relevant data. From these published papers, it was possible to explain the detailed mechanism of fluoride release by glass-ionomer cements and also its uptake. Fluoride release has been shown to be a two-step process. In neutral solutions, the steps can be divided into early wash-out and long-term diffusion. In acid conditions, the early wash-out remains, though with greater amounts of fluoride released, and the long-term release becomes one of slow dissolution. The effect of fluoride on the viability of oral micro-organisms has been described, and glass-ionomers have been shown to release sufficient fluoride to reduce the size and viability of adjacent populations of oral bacteria. The effect of low levels of fluoride on the remineralization of tooth tissue has been considered. Levels needed to increase remineralization are much lower than those needed to adversely affect oral bacteria, from which we conclude that glass-ionomers release sufficient fluoride to promote remineralization. Despite this, there remains uncertainty about their overall contribution to sound oral health, given the widespread use of other sources of fluoride, such as toothpastes. Glass-ionomer cements of both types (conventional and resin-modified) release fluoride for considerable periods of time after setting. They release sufficient fluoride to inhibit the growth of oral bacteria, and this level is more than sufficient to promote remineralization of tooth mineral. This shows that these materials provide sufficient fluoride to inhibit caries though, with the widespread use of fluoridated products such as toothpaste, this may have only limited benefit on the oral health of patients. [ABSTRACT FROM AUTHOR]

An introduction to articles published within the issue is presented, including one on the management of peri-implantitis by bonding a nanobiopolymer to a titanium (Ti) alloy surface tested for antimicrobial activity, another which demonstrated the feasibility to coat titanium with bioglass and that the treatment could promote a regenerative environment around dental implants, and another on the potential implications for clinical use of engineered nanotubules on Ti surfaces.

Background: The present study aimed to evaluate the flexural strength, degree of conversion, and demineralization-prevention ability of an experimental fissure sealant containing nano-calcium-phosphate compounds. Methods: An experimental sealant was formulated using silica and nano hydroxyapatite filler particles. The control group consisted of the DENU Seal (n = 10, each group). The flexural bond strength was evaluated by UTM. DC was evaluated by FTIR. To evaluate the demineralization-prevention ability, Cl V cavities in 10 third molar teeth restored with two sealant products, followed by an acid challenge then the Vickers microhardness test was carried out. Results: The mean flexural strength in the commercial group was higher than the experimental group. However, the mean flexural modulus was not significantly different between the two groups. In the experimental group, DC was significantly higher than the commercial group. Adjacent to the interface, the decrease in microhardness in the experimental group was significantly less than the commercial group. However, on the tooth surface, there were no significant differences between the two groups. In the experimental group, the decrease in microhardness at the interface was less than at the tooth surface, however the situation was opposite in the commercial group. Conclusions: Incorporating hydroxyapatite into the sealant structure might prevent demineralization, without adverse effects on flexural modulus and degree of conversion. [ABSTRACT FROM AUTHOR]

The tooth, including enamel and dentin, is a prominent biomineral that is produced by the biomineralization of living organisms. Although the mechanical performance of the tooth is outstanding, caries easily develop in a complex oral environment. The analysis of the chemical composition and the relationship between the mechanical properties and the structure is of great importance in solving caries. In this review, the multilevel structure and mechanical properties of enamel and dentin are briefly introduced, along with caries formation and the limitations of clinical dental restoration. Furthermore, the progress of the application of a wide range of biomimetic strategies for tooth remineralization is highlighted, including the use of calcium phosphate ionic clusters to construct the mineralization front, ensuring the oriented epitaxial growth of enamel crystals and replicating the complex structure of the enamel. Moreover, compared with the current clinical treatment, in which the resin composite and glass ionomer cement are the main repair materials and the high incidence of secondary caries leads to imperfect restorations, the remineralization tactics could achieve excellent repair effectiveness in reconstructing the complicated structure, restoring mechanical strength and gaining permanent repair. A basic understanding of enamel and dentin, their potential for restoration, and hopeful prospects for tooth repair that can be applied in the clinical setting, not just in the laboratory, is provided by this review. [ABSTRACT FROM AUTHOR]

Background: This study aims to synthesize and characterize hydroxyapatite nanoparticles (nano-HA) and evaluate their effects on the remineralization of demineralized enamel in the presence to Er,CR: YSGG laser irradiation. Materials and methods: Enamel specimens from 44 human molars were divided into four groups: control, demineralized enamel, demineralized enamel treated with nano-HA, and demineralized enamel treated with nano-HA followed by Er,Cr:YSGG laser irradiation (0.5, 20 Hz, 60 µs, 20 s). Vickers microhardness test was used to evaluate the enamel surface hardness. The morphology and chemistry of enamel surfaces were assessed using scanning electron microscopy (SEM) and Raman spectroscopy, respectively. Result: The result of this study showed that the application of Er,CR: YSGG laser irradiation to demineralized enamel treated with nano-HA had the highest impact on its microhardness. Conclusion: ER,CR: YSGG laser irradiation promotes enamel remineralization after treatment with nano HA. [ABSTRACT FROM AUTHOR]