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Sample records for enamel caries lesions

  1. Infrared Methods for Assessment of the Activity of Natural Enamel Caries Lesions

    PubMed Central

    Lee, Robert C.; Staninec, Michal; Le, Oanh; Fried, Daniel

    2016-01-01

    New diagnostic methods are needed for the accurate assessment of caries lesion activity to establish the need for surgical treatment. Detection of the highly mineralized surface layer that forms near the surface of the lesions as a result of remineralization is important for diagnosis of the lesion activity. Previous studies have demonstrated that novel imaging methods can be used to detect remineralization of artificial enamel caries lesions. In this paper, the activity of natural enamel caries lesions was assessed in-vitro via detection of the surface layer with PS-OCT and dehydration rate measurements with NIR reflectance and thermal imaging modalities. An automated approach for detecting the surface layer with PS-OCT yielded high sensitivity (= 0.79) and high specificity (= 0.93) with moderate correlation (R2 = 0.5920) with histology. Significant differences in dehydration rate measurements were found between the active and the arrested lesions using both the NIR reflectance and thermal imaging modalities. These results demonstrate that these novel imaging methods are ideally suited for nondestructive, noninvasive and quantitative measurement of lesion activity during a single clinical examination in real-time. PMID:27642246

  2. Assessment of enamel-dentin caries lesions detection using bitewing PSP digital images

    PubMed Central

    TORRES, Marianna Guanaes Gomes; SANTOS, Aline da Silva; NEVES, Frederico Sampaio; ARRIAGA, Marcel Lautenschlager; CAMPOS, Paulo Sérgio Flores; CRUSOÉ-REBELLO, Iêda

    2011-01-01

    Objectives The aim of this study was to evaluate the detection of enamel-dentin occlusal caries using photostimulable phosphor plates. Material and Methods The ability to detect enamel-dentin occlusal caries in 607 premolars and molars from 47 patients between 10 and 18 years old, referred to the School of Dentistry of the Federal University of Bahia, Brazil, was evaluated based on clinical and radiographic examinations, using the criteria proposed in a previous study. A total of 156 bitewing digital images were obtained using Digora® (Soredex Medical Systems, Helsinki, Finland) phosphor plates. The plates were scanned and the images were captured and displayed on a computer screen. Image evaluation was done using Digora® for Windows 2.1 software, Soredex®. The radiologists were allowed to use enhancement tools to obtain better visibility during scoring of the teeth based on the radiographic criteria proposed in a previous study. Descriptive analysis and chi-squared proportion tests were done at 5% significance level. Results The results of clinical examination showed a higher prevalence of teeth with a straight dark line or demineralization of the occlusal fissure (score 1) and a lower prevalence of sealed teeth (score 5). In the bitewing digital images, 47 teeth presented visible radiolucency, circumscribed, in dentin under occlusal enamel (enamel-dentin caries lesions). Conclusions Correlating the clinical and radiographic findings, it was found that in the majority of teeth diagnosed by radiographic images as having enamel-dentin caries, no caries could be detected by clinical examination. PMID:21986650

  3. Surface Roughness of Initial Enamel Caries Lesions in Human Teeth After Resin Infiltration

    PubMed Central

    Arnold, Wolfgang H.; Meyer, Ann-Kathrin; Naumova, Ella A.

    2016-01-01

    Background: Low viscosity resin infiltration of initial caries lesions is a modern microinvasive method to treat initial cries lesions. However, only scarce information is available about the long-term surface alterations of infiltrated lesions. Methods: Twenty-eight premolar teeth exhibiting non-cavitated initial caries lesions (International Caries Detection and Assessment System (ICDAS code 1&2)) were divided into two groups, one of which was infiltrated with resin, and the other remained untreated. The teeth underwent two thermocycling procedures. The surface roughness was determined quantitatively, and the results were evaluated statistically. In addition, the surfaces of the lesions were investigated by scanning electron microscopy (SEM), and the surface was analyzed visually with respect to surface irregularities. Results: The results showed a reduction in the surface roughness that was significant after 2500 thermocycles compared to the untreated surface. In the control specimens, no change in the surface roughness was found. The qualitative SEM data also showed a smooth surface after thermocycling, which supported the statistical findings. Conclusion: After thermocycling, resin-infiltrated enamel surfaces become smoother and had no additional risk for plaque accumulation. PMID:27733877

  4. Surface Roughness of Initial Enamel Caries Lesions in Human Teeth After Resin Infiltration.

    PubMed

    Arnold, Wolfgang H; Meyer, Ann-Kathrin; Naumova, Ella A

    2016-01-01

    Low viscosity resin infiltration of initial caries lesions is a modern microinvasive method to treat initial cries lesions. However, only scarce information is available about the long-term surface alterations of infiltrated lesions. Twenty-eight premolar teeth exhibiting non-cavitated initial caries lesions (International Caries Detection and Assessment System (ICDAS code 1&2)) were divided into two groups, one of which was infiltrated with resin, and the other remained untreated. The teeth underwent two thermocycling procedures. The surface roughness was determined quantitatively, and the results were evaluated statistically. In addition, the surfaces of the lesions were investigated by scanning electron microscopy (SEM), and the surface was analyzed visually with respect to surface irregularities. The results showed a reduction in the surface roughness that was significant after 2500 thermocycles compared to the untreated surface. In the control specimens, no change in the surface roughness was found. The qualitative SEM data also showed a smooth surface after thermocycling, which supported the statistical findings. After thermocycling, resin-infiltrated enamel surfaces become smoother and had no additional risk for plaque accumulation.

  5. Remineralization effects of gum arabic on caries-like enamel lesions.

    PubMed

    Onishi, T; Umemura, S; Yanagawa, M; Matsumura, M; Sasaki, Y; Ogasawara, T; Ooshima, T

    2008-03-01

    Gum arabic is a natural polysaccharide exudate from Acacia senegal and other related African species of Acacia. Gum arabic is considered to have an ability to enhance remineralization, because of its high concentration of Ca(2+). However, the caries preventive capacity of gum arabic has been scarcely investigated. We evaluated the cariostatic activities of gum arabic using histopathological methods to determine its effects on remineralization. Following incubation in demineralization solution, human third molars were exposed to 10 mg/ml of gum arabic, sodium fluoride at 1000 ppm (NaF), or double distilled water (DW, negative control), then subjected to demineralization-remineralization cycles. Before and after demineralization-remineralization cycles, contact microradiographs of each sample were taken and mineral distribution quantities were calculated. The remineralization ratio of the molars exposed to gum arabic was similar to that of those exposed to NaF, while the ratios of both were significantly greater than that of those exposed to DW. Gum arabic enhanced the remineralization of caries-like enamel lesions in vitro, suggesting its inhibitory effects towards dental caries.

  6. Remineralizing efficacy of a CPP-ACP cream on enamel caries lesions in situ.

    PubMed

    Meyer-Lueckel, Hendrik; Wierichs, Richard J; Schellwien, Timo; Paris, Sebastian

    2015-01-01

    The aim of this double-blind, randomized, cross-over in situ study was to compare the remineralizing effects induced by the application of casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP)-containing cream (without fluoride) after the use of fluoride toothpaste with the prolonged use of fluoride toothpaste on enamel caries lesions in situ. During each of three experimental legs of 4 weeks, 13 participants wore intra-oral mandibular appliances with 8 pre-demineralized bovine enamel specimens in the vestibular flanges mimicking either 'easily cleanable' or 'proximal' surfaces (n = 312). The three randomly allocated treatments were as follows: (1) application of CPP-ACP-containing cream (GC Tooth Mouse, non-fluoride) after the use of fluoride toothpaste (1,400 ppm NaF; TM), (2) prolonged application of fluoride toothpaste (1,400 ppm NaF; positive control, PC) and (3) prolonged application of fluoride-free toothpaste (negative control, NC). Additionally, one of each of the two flanges was brushed twice daily with the respective toothpaste. The differences in integrated mineral loss as assessed by transversal microradiography were calculated between values before and after the in situ period. Changes in mineral loss were analysed for those pairs of subgroups differing in only one of the three factors (intervention, brushing and position). The PC treatment induced a significantly higher mineral gain compared with the TM and NC treatments. No significant differences between TM and NC for both positions were observed. In conclusion, the additional use of a CPP-ACP-containing cream seems to be less efficacious in remineralizing caries lesions than the prolonged application of fluoride toothpaste.

  7. Fluoride dose-response of human and bovine enamel artificial caries lesions under pH-cycling conditions.

    PubMed

    Lippert, Frank; Juthani, Kalp

    2015-11-01

    This laboratory study aimed to (a) compare the fluoride dose-response of different caries lesions created in human and bovine enamel (HE/BE) under pH-cycling conditions and (b) investigate the suitability of Knoop and Vickers surface microhardness (K-SMH/V-SMH) in comparison to transverse microradiography (TMR) to investigate lesion de- and remineralization. Caries lesions were formed using three different protocols (Carbopol, hydroxyethylcellulose-HEC, methylcellulose-MeC) and assigned to 24 groups using V-SMH, based on a 2 (enamel types) × 3 (lesion types) × 4 (fluoride concentrations used during pH-cycling-simulating 0/250/1100/2800 ppm F as sodium fluoride dentifrices) factorial design. Changes in mineral content and structural integrity of lesions were determined before and after pH-cycling. Data were analyzed using three-way ANOVA. BE was more prone to demineralization than HE. Both enamel types showed similar responses to fluoride with BE showing more remineralization (as change in integrated mineral loss and lesion depth reduction), although differences between tissues were already present at lesion baseline. Carbopol and MeC lesions responded well to fluoride, whereas HEC lesions were almost inert. K- and V-SMH correlated well with each other and with the integrated mineral loss data, although better correlations were found for HE than for BE and for MeC than for Carbopol lesions. Hardness data for HEC lesions correlated only with surface zone mineral density data. BE is a suitable surrogate for HE under pH-cycling conditions. The in vitro modeling of dental caries is complex and requires knowledge of lesion behavior, analytical techniques, and employed hard tissues.

  8. Effects of dentifrices differing in fluoride compounds on artificial enamel caries lesions in vitro.

    PubMed

    Wierichs, R J; Zelck, H; Doerfer, C E; Appel, P; Paris, S; Esteves-Oliveira, M; Meyer-Lueckel, H

    2017-01-01

    The aim of this study was to compare the caries-preventive effect of a stabilized stannous fluoride/sodium fluoride dentifrice containing sodium hexametaphosphate with those of a regular, solely sodium fluoride-containing and amine fluoride-containing dentifrice on pre-demineralized bovine enamel specimens using a pH-cycling model. Bovine enamel specimens with two artificial lesions each were prepared. Baseline mineral loss of both lesions was analyzed using transversal microradiography (TMR). Eighty-five specimens with a mean (SD) baseline mineral loss of 3393 (683) vol% × µm were selected and randomly allocated to five groups (n = 13/15). Treatments during pH-cycling (28 days and 2 × 20 min demineralization/day) were: brushing twice daily with slurries of AmF (1400 ppm F(-)), NaF (1450 ppm F(-)), SnF2/NaF (1100 ppm F(-)/350 ppm F(-)), and fluoride-free (FF) dentifrices or they were immersed in distilled water and remained unbrushed (NB). Subsequently, from each specimen one lesion was covered with acid-resistant varnish, while the remaining lesion was demineralized for another 14 days. Differences in integrated mineral loss (∆∆Z) were calculated between values before and after pH-cycling (∆∆Z E1) as well as before pH-cycling and after second demineralization (∆∆Z E2) using TMR. Treatments AmF and NaF induced a significantly higher mineral gain (∆∆Z E1/∆∆Z E2) compared to treatments FF and NB (p < 0.05; ANOVA test). Except for treatments AmF and NaF no significant differences in mineral loss between before and after pH-cycling could be observed (p < 0.05; t test) [∆∆Z E1: AmF:1563 (767); NaF:1222 (1246); SnF2/NaF:258 (1259); FF:-52 (1223); NB:-151 (834)]. Both dentifrices with either AmF or NaF promoted remineralization, whereas SnF2/NaF dentifrice did not promote remineralization in a biofilm-free pH-cycling model.

  9. Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study.

    PubMed

    Charone, Senda; Portela, Maristela Barbosa; Martins, Karol de Oliveira; Soares, Rosangela Maria; Castro, Gloria Fernanda

    2017-01-01

    This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.

  10. Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study

    PubMed Central

    CHARONE, Senda; PORTELA, Maristela Barbosa; MARTINS, Karol de Oliveira; SOARES, Rosangela Maria; CASTRO, Gloria Fernanda

    2017-01-01

    Abstract Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro. PMID:28198976

  11. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides.

    PubMed

    Schmidlin, Patrick; Zobrist, Katja; Attin, Thomas; Wegehaupt, Florian

    2016-01-01

    To assess the re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles. Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control). The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control), while the last third was left open for three test and one control treatments: (A) Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann), (B) self-assembling peptides (SAP, Curodont), or (C) amine fluoride solution (Am-F, GABA) for 5 min each. Untreated samples (D) served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase) and microhardness (Knoop) depth profiles (25-300 µm) were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening). Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D). A significant re-hardening up to 125 µm was observed in the EMD and SAP groups. This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect.

  12. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides

    PubMed Central

    Schmidlin, Patrick; Zobrist, Katja; Attin, Thomas; Wegehaupt, Florian

    2016-01-01

    ABSTRACT Objectives To assess the re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles. Material and Methods Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control). The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control), while the last third was left open for three test and one control treatments: (A) Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann), (B) self-assembling peptides (SAP, Curodont), or (C) amine fluoride solution (Am-F, GABA) for 5 min each. Untreated samples (D) served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase) and microhardness (Knoop) depth profiles (25-300 µm) were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening). Results Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D). A significant re-hardening up to 125 µm was observed in the EMD and SAP groups. Conclusions This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect. PMID:27008255

  13. Presence and distribution of dental enamel defects, recurrent aphthous lesions and dental caries in children with celiac disease.

    PubMed

    Cantekin, Kenan; Arslan, Duran; Delikan, Ebru

    2015-01-01

    To determine presence and distribution of enamel defects, recurrent oral aphthous lesions (RAS) and dental caries in children with Celiac Disease (CD) and compare the results with a healthy control group. Twenty- five CD patients age between 4- 16 years with no other systemic disease, were examined in Pediatric Gastroenterology Clinic of Erciyes University, Faculty of Medicine (Kayseri, Turkey) and then referred to Department of Pediatric Dentistry, Faculty of Dentistry for dental examination and treatment. The control group (25 patients) consisted healthy patients referred to the Department of Pediatric Dentistry, Faculty of Dentistry, Erciyes University for restorative treatment. Both the CD group and control group was examined by the same investigator for the following; (1) enamel defects, (2) recurrent aphthous stomatitis, (3) dental caries. The mean dmft values for the CD group and control group were 3.25±3.25 and 4.56±2.87 respectively. The difference was not statistically significant.(P>0.05). The mean DMFT values for the CD and the control group were 3.75±2.62 and 1.83±1.7, respectively. There was a significant difference between the two groups (P<0.01). The prevalence of enamel defects and recurrent apthous stomatitis (RAS) was greater in celiac patients than in the control group. Enamel defects (in at least one permanent tooth) were observed in 12 out of 25 (48%) children in the CD group and four out of 25 children (16%).(P =0.01). Recurrent apthous stomatitis was found in 11/25 (44%) CD group, while no RAS was detected in the control group. Celiac Disease (CD) has adverse effects on oral health in term of enamel defect, recurrent aphthous stomatitis and caries score. Pediatricians and dentists especially pediatric dentists should be knowledgeable about oral symptoms of CD. Increased awareness can provide an early diagnosis and prevent long- term complications of this disease. On the other hand, further comprehensive investigations of CD patients can

  14. Bond Strength of Experimental Low-viscosity Resin Materials to Early Enamel Caries Lesions: Effect of Diluent/Solvent Addition.

    PubMed

    Araújo, Tatiany Gabrielle Freire; Sfalcin, Ravana Angelini; de Araújo, Giovana Spagnolo Albamonte; Alonso, Roberta Caroline Brusch; Puppin-Rontani, Regina Maria

    2015-04-01

    To evaluate the effect of different concentrations of monomers and solvents/diluents on the microtensile bond strength (μTBS) bond strength of experimental low-viscosity resins (infiltrants) to enamel caries-like lesions (ECLL). Flat enamel blocks obtained from sound human third molars were submitted to ECLL formation and randomly distributed into 9 groups (n = 10): G1: TEG-DMA 100%; G2: TEG-DMA 80%, ethanol 20%; G3; TEG-DMA 80%, HEMA 20%; G4: TEG-DMA 75%, UDMA 25%; G5: TEG-DMA 60%, UDMA 20%, ethanol 20%; G6: TEG-DMA 60%, UDMA 20%, HEMA 20%; G7: TEG-DMA 75%, bis-EMA 25%; G8: TEG-DMA 60%, bis-EMA 20%, ethanol 20%; G9: TEG-DMA 60%, bis-EMA 20%, HEMA 20%. After etching with 37% phosphoric acid for 60 s, experimental infiltrants were actively applied and photocured for 60 s, then stored in 100% humidity (24 h, 37°C). Hourglass-shaped specimens were obtained and the μTBS test performed (MPa). The fracture patterns were assessed by SEM. Data were submitted to two way-ANOVA and Tukey's tests (α = 0.05). The highest μTBS value was observed for G4 (TEG-DMA/UDMA, 19.18 MPa) and the lowest for G5 (TEG-DMA/UDMA/ethanol, 9.00 MPa). A significant decrease in μTBS was observed for all groups containing ethanol (G2, G5, and G8). The addition of HEMA did not affect μTBS values. Most groups showed a high frequency of mixed failure between infiltrant and enamel. The addition of bis-EMA or UDMA to TEG-DMA-based infiltrants did not improve bond strength to carious enamel. The ethanol addition negatively affected the bonding strength of infiltrants to enamel caries-like lesions, regardless of the resin matrix composition of the infiltrant.

  15. Remineralization of early enamel caries lesions using different bioactive elements containing toothpastes: An in vitro study.

    PubMed

    Wang, Yu; Mei, Li; Gong, Lin; Li, Jialing; He, Shaowei; Ji, Yan; Sun, Weibin

    2016-09-14

    Demineralization can be arrested or reversed when remineralization agents are applied to incipient carious or non-cavitated carious lesions. A large number of therapeutic agents including non-fluoridated products have been developed to promote enamel remineralization. This study aims to evaluate the efficacy of different bioactive elements containing toothpastes in remineralization of artificial enamel lesions. Artificial carious lesions were created on 40 human enamel slabs, and were randomly divided into four groups: (1) control group (no treatment), (2) casein phosphopeptide-amorphous calcium phosphate group (CPP-ACP, GC Tooth Mousse), (3) 8% arginine and calcium carbonate group (ACC, Colgate Sensitive Pro-Relief), (4) calcium sodium phosphosilicate group (CSP, NovaMin®). All samples were subjected to 15 days of pH-cycling. Subsequently, a one-hour acid resistance test was carried out. Surface hardness of the samples was assessed using the Knoop hardness test, and surface morphology and roughness were assessed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Data were analyzed using one-way ANOVA, Tukey's test and paired t test. The three tested toothpastes exhibited a significantly higher remineralization efficacy compared with the control group (P< 0.05 for all). After pH-cycling, the specimens treated with Colgate Sensitive Pro-Relief and NovaMin® showed a significant higher surface hardness (P< 0.001 and P= 0.03, respectively) and lower surface roughness (P< 0.05 for both) compared those treated with GC Tooth Mousse. While after the acid resistance test, all groups showed a significant loss of surface hardness (P< 0.001 for all) and significant increase of surface roughness (P< 0.05). The specimens treated with Colgate Sensitive Pro-Relief and NovaMin® still showed a significant higher surface hardness and lower surface roughness in comparison with those treated with GC Tooth Mousse (P< 0.05 for all). No significant difference was

  16. Lasers effects on enamel for caries prevention

    NASA Astrophysics Data System (ADS)

    Ana, P. A.; Bachmann, L.; Zezell, D. M.

    2006-05-01

    The aim of this study was to ascertain whether laser irradiation is able to reduce caries incidence. For this purpose, the effects of laser on enamel and on fluoride uptake were discussed. Current literature regarding the preventive effect of laser irradiation on dental hard tissue has been reviewed. An evaluation of the results of the available in vitro and in vivo studies on the efficacy of anticaries and induced changes on enamel by laser irradiation were also performed. Articles were selected using the Medline, Web of Science, Embase, and Cochrane databases, and the results of these studies were described. The most common lasers employed for caries prevention on enamel are Nd:YAG; CO2; Er:YAG; Er,Cr:YSGG; and argon. The percentage of inhibition of dental caries varied from 30 to 97.2%, and the association with fluoride has demonstrated the best results on inhibition of caries development. Laser irradiation under specific conditions can change the crystallographic properties of apatite crystals, increasing the acid resistance of lased enamel. The combined treatment of laser irradiation with fluoride propitiates an expressive fluoride uptake, reducing the progression of carieslike lesions, and this treatment is more effective than laser or fluoride alone. Available data suggest that lasers combined with fluoride is a promising treatment in caries prevention.

  17. Effects of carbamide peroxide whitening agents on enamel surfaces and caries-like lesion formation: an SEM and polarized light microscopic in vitro study.

    PubMed

    Flaitz, C M; Hicks, M J

    1996-01-01

    Whitening enamel with carbamide peroxide (CP) to remove cosmetically displeasing stains has become common-place in dental practice. This in vitro study evaluated CP treatment effects on enamel surface morphology and caries-like lesion susceptibility. Tooth quarters were prepared from 10 caries-free human molars following a fluoride-free prophylaxis. The tooth quarters were assigned to the following treatment groups: 1) Distobuccal-10 percent NW gel (Nite White, Discus Dental); 2) Distolingual-10 percent PL paste (Platinum, Colgate); 3) Mesiobuccal-16 percent NW gel; and 4) Mesiolingual-Control. Following the manufacturers' recommended treatment, each quarter was sectioned with one portion prepared for SEM and the other portion for caries-like lesion formation. Intact enamel surfaces were present with all treatments. Enamel prism markings with exaggerated prism peripheries and mild to moderate prism core loss were seen with both 10 percent NW and 16 percent NW gels, but was more prominent with 16 percent NW gel. Amorphous surface layers with occasional exposure of indistinct prism markings occurred with 10 percent PL paste. Body of lesion mean depths were 135 microns control, 159 microns 16 percent NW, 144 microns 10 percent NW, and 122 microns 10 percent PL. Lesion depths were significantly different (p < 0.05 DMR paired design) between 10 percent PL and 16 percent NW, and between control and 16 percent NW. Whitening enamel surfaces in vitro with 10 percent carbamide peroxide paste containing dicalcium phosphate dihydrate (Colgate-Platinum) produced an amorphous surface layer and reduced caries susceptibility when compared with 16 percent carbamide peroxide gel (Nite White).

  18. In vitro effects of several surface preparation methods on shear bond strength of orthodontic brackets to caries-like lesions of enamel.

    PubMed

    Shahabi, M; Moosavi, H; Gholami, A; Ahrari, F

    2012-09-01

    The aim of this study was to evaluate the efficiency of several surface preparation methods for improving shear bond strength of brackets to demineralised enamel. in vitro study. Eighty premolars were selected and divided into 5 groups. Group 1 served as the control, while the remaining 4 groups were immersed in a demineralising solution (pH 4.8) for 12 weeks. In groups 1 (control) and 2 (demineralised/control) conventional acid etching was used. In group 3, a solution of 5% sodium hypochlorite (NaOCl) was applied on enamel surface for one minute after acid etching. The brackets in group 4 were bonded with Transbond Plus self-etching primer, and group 5 underwent treatment with a 2% sodium fluoride (NaF) gel, which was applied on the enamel surface for 4 minutes before etching. Shear bond strength (SBS) and adhesive remnant index (ARI) were determined in all groups, and surface morphology was examined under scanning electron microscope (SEM). The mean SBS of acid-etched demineralised enamel was significantly lower than that of acid-etched sound enamel (p<0.05). Treatment of caries-like lesions with 5% NaOCl or self-etching primer failed to improve the bond strength. After NaF treatment and acid etching of demineralised enamel, both type 1 and type 2 etching patterns were observed and the resulting SBS was comparable to that of sound enamel (p>0.05). The application of 2% NaF on enamel caries before bracket bonding is an effective way for enhancing the bond strength.

  19. CO2 laser and topical fluoride therapy in the control of caries lesions on demineralized primary enamel.

    PubMed

    Valério, R A; Rocha, C T; Galo, R; Borsatto, M C; Saraiva, M C P; Corona, S A M

    2015-01-01

    This study evaluated the effect of CO2 laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3 × 3 × 2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n = 10): L: CO2 laser (λ = 10.6 μm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2 laser was applied with 0.5 W power and 0.44 J/cm(2) energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 μm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P ≤ 0.05) that showed the lowest microhardness values. It was concluded that CO2 laser can be an additional resource in caries control progression on primary teeth enamel.

  20. CO2 Laser and Topical Fluoride Therapy in the Control of Caries Lesions on Demineralized Primary Enamel

    PubMed Central

    Valério, R. A.; Saraiva, M. C. P.; Corona, S. A. M.

    2015-01-01

    This study evaluated the effect of CO2 laser irradiation and topical fluoride therapy in the control of caries progression on primary teeth enamel. 30 fragments (3 × 3 × 2 mm) from primary canines were submitted to an initial cariogenic challenge that consisted of immersion on demineralizing solution for 3 hours and remineralizing solution for 21 hours for 5 days. Fragments were randomly assigned into three groups (n = 10): L: CO2 laser (λ = 10.6 μm), APF: 1.23% acidulated phosphate fluoride, and C: no treatment (control). CO2 laser was applied with 0.5 W power and 0.44 J/cm2 energy density. Fluoride application was performed with 0.1 g for 1 minute. Cariogenic challenge was conducted for 5 days following protocol previously described. Subsurface Knoop microhardness was measured at 30 μm from the edge. Obtained data were subjected to analysis the variance (ANOVA) and Duncan test with significance of 5%. It was found that the L group showed greater control of deciduous enamel demineralization and were similar to those of APF group, while being statistically different from C group (P ≤ 0.05) that showed the lowest microhardness values. It was concluded that CO2 laser can be an additional resource in caries control progression on primary teeth enamel. PMID:25874248

  1. The chemistry of enamel caries.

    PubMed

    Robinson, C; Shore, R C; Brookes, S J; Strafford, S; Wood, S R; Kirkham, J

    2000-01-01

    The chemical changes which occur during the process of carious destruction of enamel are complex due to a number of factors. First, substituted hydroxyapatite, the main component of dental enamel, can behave in a very complex manner during dissolution. This is due not only to its ability to accept substituent ions but also to the wide range of calcium phosphate species which can form following dissolution. In addition, the composition, i.e., the extent of substitution, changes throughout enamel in the direction of carious attack, i.e., from surface to interior. Both surface and positively birefringent zones of the lesion clearly illustrate that carious destruction is not simple dissolution. Selective dissolution of soluble minerals occurs, and there is the probability of reprecipitation. The role of fluoride here is crucial in that not only does it protect enamel per se but also its presence in solution means that rather insoluble fluoridated species can form very easily, encouraging redeposition. The role of organic material clearly needs further investigation, but there is the real possibility of both inhibition of repair and facilitation of redeposition. For the future, delivering fluoride deep into the lesion would appear to offer the prospect of improved repair. This would entail a delivery vehicle which solved the problem of fluoride uptake by apatite at the tooth surface. Elucidation of the role of organic material may also reveal putative mechanisms for encouraging repair and/or protecting the enamel mineral.

  2. Remineralization of initial enamel caries in vitro using a novel peptide based on amelogenin

    NASA Astrophysics Data System (ADS)

    Li, Danxue; Lv, Xueping; Tu, Huanxin; Zhou, Xuedong; Yu, Haiyang; Zhang, Linglin

    2015-09-01

    Dental caries is the most common oral disease with high incidence, widely spread and can seriously affect the health of oral cavity and the whole body. Current caries prevention measures such as fluoride treatment, antimicrobial agents, and traditional Chinese herbal, have limitations to some extent. Here we design and synthesize a novel peptide based on the amelogenin, and assess its ability to promote the remineralization of initial enamel caries lesions. We used enamel blocks to form initial lesions, and then subjected to 12-day pH cycling in the presence of peptide, NaF and HEPES buffer. Enamel treated with peptide or NaF had shallower, narrower lesions, thicker remineralized surfaces and less mineral loss than enamel treated with HEPES. This peptide can promote the remineralization of initial enamel caries and inhibit the progress of caries. It is a promising anti-caries agent with various research prospects and practical application value.

  3. The inhibitory effect of MI paste, fluoride and a combination of both on the progression of artificial caries-like lesions in enamel.

    PubMed

    Pulido, Maria Teresa; Wefel, James S; Hernandez, Maria Marcela; Denehy, Gerald E; Guzman-Armstrong, Sandra; Chalmers, Jane M; Qian, Fang

    2008-01-01

    This in-vitro study evaluated the inhibition of demineralization in enamel sections produced by MI paste, fluoride and a combination of both, compared to artificial saliva and NaF 5000 ppm in a caries progression pH-cycling model. Twenty-one teeth were demineralized to create subsurface enamel lesions (approximately 200 microns in depth). The teeth were sectioned and characterized using polarized-light-microscopy (PLM). A single section from each lesion was assigned to a treatment group: Artificial saliva, NaF 5000 ppm (Prevident, Colgate), MI paste (Recaldent, GC America Inc), NaF 1100 ppm (Crest, Procter & Gamble) and NaF 1100 ppm plus MI paste. The sections were covered with varnish except for an exposed window on the external surface of the lesion and placed in a six-day pH-cycling model with two daily treatment applications of two minutes each. The sections were characterized by PLM, and the lesion areas were measured using a digital image analysis system. Based on a paired-sample t-test, significant differences (p < .05) in percentage of change in lesion size were found between the high fluoride group and all the other groups. No significant difference was found between the artificial saliva and MI paste group, neither was there any significant difference between the NaF 1100 ppm, the combined application group or the MI paste group alone. In conclusion, the higher concentration of NaF (5000 ppm) reduced lesion progression to the greatest extent. The MI paste group did not show any effect on the inhibition of lesion progression. Further studies on the preventive effect and longer treatment applications are recommended.

  4. EDX-Element Analysis of the In Vitro Effect of Fluoride Oral Hygiene Tablets on Artificial Caries Lesion Formation and Remineralization in Human Enamel.

    PubMed

    Eggerath, J; Kremniczky, T; Gaengler, P; Arnold, W H

    2011-01-01

    Aim of this in-vitro-study was to assess the remineralization potential of a tooth cleaning tablet with different fluoride content quantitatively using EDX analysis.Twenty three caries free impacted third molars were examined; enamel surfaces were wax coated leaving two 3x4mm windows for exposure to demineralization/remineralization cycles. The teeth were randomly assigned to 4 groups of 5 control and 6 experimental teeth each. Demineralization by standardized HEC-gel, pH 4.7 at 37°C for 72h, was alternated by rinsing in remineralization solution, pH 7.0 at 37°C for 72h, total challenge time 432h. The negative control group N was treated during remineralization cycles with saline; positive control group P was treated with remineralization solution; experimental group D1 was exposed to remineralization solution containing Denttabs(®)-tablets with 1450 ppm F; experimental group D2 was exposed to remineralization solution and Denttabs(®)-tablets with 4350 ppm F. Each tooth was cut into serial sections and analyzed by scanning electron microscopy with EDX element analysis for assessment of the different zones of the lesions in 3 representative sections. Statistical analysis was based on the AVOVA test for repeated measurements and post hoc Bonferroni adjustment. The results showed a significantly higher Ca and P content in the body of the lesion in both fluoride treated groups compared to the controls. It can be concluded that higher concentrations of NaF may be more effective in remineralization of early advanced caries lesions.

  5. Natural enamel caries in polarized light microscopy: differences in histopathological features derived from a qualitative versus a quantitative approach to interpret enamel birefringence.

    PubMed

    De Medeiros, R C G; Soares, J D; De Sousa, F B

    2012-05-01

    Lesion area measurement of enamel caries using polarized light microscopy (PLM) is currently performed in a large number of studies, but measurements are based mainly on a mislead qualitative interpretation of enamel birefringence in a single immersion medium. Here, five natural enamel caries lesions are analysed by microradiography and in PLM, and the differences in their histopathological features derived from a qualitative versus a quantitative interpretation of enamel birefringence are described. Enamel birefringence in different immersion media (air, water and quinoline) is interpreted by both qualitative and quantitative approaches, the former leading to an underestimation of the depth of enamel caries mainly when the criterion of validating sound enamel as a negatively birefringent area in immersion in water is used (a current common practice in dental research). Procedures to avoid the shortcomings of a qualitative interpretation of enamel birefringence are presented and discussed. © 2012 The Authors Journal of Microscopy © 2012 Royal Microscopical Society.

  6. Comparison of CPP-ACP, Tri-Calcium Phosphate and Hydroxyapatite on Remineralization of Artificial Caries Like Lesions on Primary Enamel -An in vitro Study.

    PubMed

    Bajaj, Meghna; Poornima, P; Praveen, S; Nagaveni, N B; Roopa, K B; Neena, I E; Bharath, K P

    To compare CPP-ACP, Tri-calcium phosphate and Hydroxyapatite on remineralization of artificial caries like lesions on primary enamel. Ten extracted Primary molars coated with nail varnish, leaving a window of 2×4 mm on buccal and lingual surface were immersed in demineralizing solution for 96 hours and sectioned longitudinally to obtain 40 sections (4 sections per tooth) and were randomly divided into 4 groups (A to D) n=10; Group A: negative control, Group B: CPP-ACP, Group C: Tri-calcium phosphate, Group D: Hydroxyapatite. Sections were subjected to pH cycling for 10 days and were evaluated by polarized light microscope before and after treatment. Intra group comparison of demineralization and remineralization was done by paired t-test. One way ANOVA was used for multiple group comparisons followed by post HOC TUKEY'S Test for group wise comparisons. Remineralization was found more with Group D followed by Group B, C and A. Hydroxyapatite showed better remineralization when compared to CPP-ACP and Tri-calcium phosphate.

  7. Remineralization of caries lesions extending into dentin.

    PubMed

    ten Cate, J M

    2001-05-01

    Remineralization is one aspect of the overall process of tooth decay. However, it is primarily studied in shallow lesions. The aim of this study was to explore whether caries lesions in enamel and extending into the dentin can be remineralized. A single-section model was developed for the longitudinal and non-destructive monitoring of changes in enamel and dentin. Lesions at least 200 microm into dentin were formed in undersaturated acetate buffers. Next, the lesions were divided into groups (three treatment and one control) and remineralized. The treatments were: weekly immersion in 1,000 ppm fluoride, single treatment with methanehydroxybisphosphonate, and a constant level of 1 ppm fluoride. De- and remineralization was assessed by transverse microradiography. Remineralization was observed in enamel, but also in dentin, indicating that, deep into dentin, the pores become supersaturated to apatite formation. Treatments affected remineralization only in the outer part of enamel. Both findings are explained by a relatively fast diffusion of mineral ions, with precipitation being rate-limiting. The results suggest that dentin remineralization, underneath enamel, can be achieved and could possibly be used in clinical treatment strategies.

  8. Genetic influences on dental enamel that impact caries differ between the primary and permanent dentitions

    PubMed Central

    Bayram, Merve; Deeley, Kathleen; Reis, Maria Fernanda; Trombetta, Vanessa M.; Ruff, Timothy D.; Sencak, Regina C.; Hummel, Michael; Dizak, Piper M.; Washam, Kelly; Romanos, Helena F.; Lips, Helena F.; Alves, Gutemberg; Costa, Marcelo C.; Granjeiro, José M.; Antunes, Leonardo S.; Küchler, Erika C.; Seymen, Figen; Vieira, Alexandre R.

    2015-01-01

    Clinically, primary and permanent teeth are distinct anatomically and the presentation of caries lesions differs between the two dentitions. However, the possibility exists that genetic contributions to tooth formation of the two dentitions are different. The purpose of this study was to test the hypothesis that genetic associations with an artificial caries model will not be the same between primary and permanent dentitions. Enamel samples from primary and permanent teeth were tested for microhardness at baseline, after carious lesion creation, and after fluoride application to verify association with genetic variants of selected genes. Associations were found between genetic variants of ameloblastin, amelogenin, enamelin, tuftelin, tuftelin interactive protein 11, and matrix metalloproteinase 20 and enamel from permanent teeth but not with enamel from primary teeth. In conclusion, our data continue to support that genetic variation may impact enamel development and consequently individual caries susceptibility. These effects may be distinct between primary and permanent dentitions. PMID:26283008

  9. Genetic influences on dental enamel that impact caries differ between the primary and permanent dentitions.

    PubMed

    Bayram, Merve; Deeley, Kathleen; Reis, Maria F; Trombetta, Vanessa M; Ruff, Timothy D; Sencak, Regina C; Hummel, Michael; Dizak, Piper M; Washam, Kelly; Romanos, Helena F; Lips, Andrea; Alves, Gutemberg; Costa, Marcelo C; Granjeiro, José M; Antunes, Leonardo S; Küchler, Erika C; Seymen, Figen; Vieira, Alexandre R

    2015-08-18

    Clinically, primary and permanent teeth are distinct anatomically and the presentation of caries lesions differs between the two dentitions. Hence, the possibility exists that genetic contributions to tooth formation of the two dentitions are different. The purpose of this study was to test the hypothesis that genetic associations with an artificial caries model will not be the same between primary and permanent dentitions. Enamel samples from primary and permanent teeth were tested for microhardness at baseline, after carious lesion creation, and after fluoride application to verify association with genetic variants of selected genes. Associations were found between genetic variants of ameloblastin, amelogenin, enamelin, tuftelin, tuftelin interactive protein 11, and matrix metallopeptidase 20 and enamel from permanent teeth but not with enamel from primary teeth. In conclusion, our data continue to support that genetic variation may impact enamel development and consequently individual caries susceptibility. These effects may be distinct between primary and permanent dentitions. © 2015 Eur J Oral Sci.

  10. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from The National Dental PBRN

    PubMed Central

    Fellows, Jeffrey L; Gordan, Valeria V.; Gilbert, Gregg H.; Rindal, D. Brad; Qvist, Vibeke; Litaker, Mark S.; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J.; Johnson, Neil

    2014-01-01

    Purpose Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. We used actual clinical data to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods We combined data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists. Analysis of variance and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results Network dentists from 5 regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (p<0.05) by patient age and race/ethnicity, dentist use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (p<0.05) by dentist race/ethnicity, network region, and practice type. CLINICAL SIGNIFICANCE Identifying patient, dentist, and practice characteristics associated with enamel caries restorations can guide strategies to improve provider adherence to evidence-based clinical recommendations. PMID:25000667

  11. Impact of enamel defects on early caries development in preschool children.

    PubMed

    Carvalho, J C; Silva, E F; Gomes, R R; Fonseca, J A C; Mestrinho, H D

    2011-01-01

    Quantitative defects of the enamel are considered risk factors for caries development at the cavitated level. Since caries risk assessment and control should be implemented as early as possible in order to prevent operative treatment, it seemed interesting to investigate the relationship between enamel defects and caries development in the stages of progression that precede cavitation. The impact of enamel defects and selected child-mother indicators on early caries development was investigated in a cohort of Brazilian preschool children. The null hypothesis that developmental defects of the enamel and dental caries are independent and that an association between them occurs by chance was tested. The sample (n = 1,718) was made up of 2- to 5-year-olds. Developmental defects of enamel and caries on buccal surfaces were identified in 48 and 26% of the children, respectively. Bivariate analyses at the surface level showed neither an association between demarcated/diffuse opacity and caries experience (p ≥ 0.64, GLM), nor between the presence of hypoplastic surfaces and non-cavitated lesions (p = 0.29, GLM). The multivariate analyses indicated that in the mouths of individual children, hypoplastic surfaces were more likely to present filled surfaces and non-cavitated/cavitated lesions than non-hypoplastic surfaces (within-child p = 0.03, GEE). However, children having teeth with hypoplastic surfaces were not at higher caries risk than those children who did not present hypoplastic surfaces (between-child p = 0.23, GEE). The null hypothesis could not be accepted for quantitative defects such as hypoplasia, since they had a significant impact on the within-child prevalence of filled surfaces and non-cavitated/cavitated lesions.

  12. Imaging caries lesions and lesion progression with polarization-sensitive optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Xie, John; Shafi, Sahar; Featherstone, John D. B.; Breunig, Thomas; Le, Charles Q.

    2002-06-01

    New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence and for resolving the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the resolution of interproximal and occlusal caries, early root caries, and secondary caries around composite fillings. Longitudinal measurements of lesion progression established a strong correlation (p<0.001) between the reflected light from the lesion area and the square root of time indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

  13. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN.

    PubMed

    Fellows, Jeffrey L; Gordan, Valeria V; Gilbert, Gregg H; Rindal, D Brad; Qvist, Vibeke; Litaker, Mark S; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J; Johnson, Neil

    2014-04-01

    Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Network dentists from five regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (P < 0.05) by patient age and race/ethnicity, dentists' use of caries risk assessment, network region, and practice type. Enamel proximal restorations varied significantly (P < 0.05) by dentist race/ethnicity, network region, and practice type.

  14. Transillumination of interproximal caries lesions with 830-nm light

    NASA Astrophysics Data System (ADS)

    Jones, Graham C.; Jones, Robert S.; Fried, Daniel

    2004-05-01

    New imaging technology is needed for the early detection of dental caries (decay) in the interproximal contact sites between teeth. Previous measurements have demonstrated that dental enamel is highly transparent in the near-IR near 1310-nm making that wavelength range ideal for the transillumination of interproximal lesions. However, imaging at 1310-nm involves the use of expensive InGaAs technology. The purpose of this study was to compare the performance of a low cost near-IR sensitive imaging system employing a CCD camera with enhanced near-IR sensitivity operating at 830-nm with the 1310-nm InGaAs system. Images of simulated caries lesions were acquired through tooth sections of varying thickness and whole teeth in order to demonstrate the utility of a near-IR dental transillumination system for the imaging of early dental caries (decay). Simulated lesions, representing the optical scattering of natural dental caries, were placed in plano-parallel dental enamel sections and whole anterior teeth. The contrast ratio between the simulated lesions and surrounding sound enamel was calculated from analysis of the respective spatial intensity profiles in the acquired projection images. This study shows that near-IR transillumination at 830-nm offers significantly improved image contrast over the visible range, but less image contrast than at 1310-nm.

  15. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    PubMed Central

    Simón-Soro, Aurea; Guillen-Navarro, Miriam; Mira, Alex

    2014-01-01

    Background Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design Non-cavitated enamel caries lesions (n=15) and dentin caries lesions samples (n=12) were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci detected confirms that they

  16. Sugar Alcohols, Caries Incidence, and Remineralization of Caries Lesions: A Literature Review

    PubMed Central

    Mäkinen, Kauko K.

    2010-01-01

    Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early. Habitual use of xylitol, a sugar alcohol of the pentitol type, can be associated with significant reduction in caries incidence and with tooth remineralization. Other dietary polyols that can remarkably lower the incidence of caries include erythritol which is a tetritol-type alditol. Based on known molecular parameters of simple dietary alditols, it is conceivable to predict that their efficacy in caries prevention will follow the homologous series, that is, that the number of OH-groups present in the alditol molecule will determine the efficacy as follows: erythritol ≥ xylitol > sorbitol. The possible difference between erythritol and xylitol must be confirmed in future clinical trials. PMID:20339492

  17. Pulsed Nd:YAG laser selective ablation of surface enamel caries: II. Histology and clinical trials

    NASA Astrophysics Data System (ADS)

    Harris, David M.; Goodis, Harold E.; White, Joel M.; Arcoria, Charles J.; Simon, James; Burkart, John; Yessik, Michael J.; Myers, Terry D.

    2000-03-01

    High intensity infrared light from the pulsed Nd:YAG dental laser is absorbed by pigmented carious enamel and not absorbed by normal enamel. Therefore, this system is capable of selective removal of surface enamel caries. Safety and efficacy of the clinical procedure was evaluated in two sets of clinical trials at three dental schools. Carious lesions were randomized to drill or laser treatment. Pulp vitality, surface condition, preparations and restorations were evaluated by blinded evaluators. In Study 1 surface caries were removed from 104 third molars scheduled for extraction. One week post-treatment teeth were extracted and the pulp was examined histologically. In Study 2 90 patients with 422 lesions on 376 teeth were randomized to laser or drill and followed for six months. There were no adverse events and both clinical and histological evaluations of pulp vitality showed no abnormalities. Caries were removed in all conditions. A significantly greater number of preparations in the drill groups vs. laser groups entered dentin (drill equals 11, laser equals 1, p less than 0.001). This indicates that the more conservative laser treatment removed the caries but not the sound enamel below the lesion.

  18. In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience.

    PubMed

    Vieira, Alexandre R; Bayram, Merve; Seymen, Figen; Sencak, Regina C; Lippert, Frank; Modesto, Adriana

    2017-01-01

    We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel.

  19. In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience

    PubMed Central

    Vieira, Alexandre R.; Bayram, Merve; Seymen, Figen; Sencak, Regina C.; Lippert, Frank; Modesto, Adriana

    2017-01-01

    We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel. PMID:28275354

  20. Dental health assessed after interproximal enamel reduction: caries risk in posterior teeth.

    PubMed

    Zachrisson, Björn U; Minster, Line; Ogaard, Bjørn; Birkhed, Dowen

    2011-01-01

    We investigated whether careful interdental enamel reduction (using extrafine diamond disks with air cooling, followed by contouring with triangular diamond burs and polishing) leads to increased caries risk in premolars and first molars. Our subjects were 43 consecutive patients from 19 to 71 years of age who had received mesiodistal enamel reduction of anterior and posterior teeth 4 to 6 years previously. Dental caries were assessed on standardized bite-wing radiographs according to a 5-grade scale and with a fine-tip explorer catch. The incidence of interproximal caries was compared between reproximated and unground contralateral surfaces in the same patient. Patients were asked about their toothbrushing habits, use of dental floss and toothpicks, and regular fluoride supplementation after the orthodontic appliances were removed. The overall clinical impression generally showed healthy dentitions with excellent occlusion. Only 7 (2.5%) new caries lesions (all grade 1) were found among 278 reproximated mesial or distal surfaces, in 3 patients. Among 84 contralateral unground reference tooth surfaces, 2 lesions (2.4%) were seen. On nonpaired premolars and molars that had not been ground, 23 surfaces had to be referred for caries treatment (grade 3 or occlusal caries). Eleven of these occurred in 1 patient. None of the 43 patients reported increased sensitivity to temperature variations. Interdental enamel reduction with this protocol did not result in increased caries risk in posterior teeth. We found no evidence that proper mesiodistal enamel reduction within recognized limits and in appropriate situations will cause harm to the teeth and supporting structures. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  1. Imaging simulated secondary caries lesions with cross polarization OCT

    NASA Astrophysics Data System (ADS)

    Stahl, Jonathan; Kang, Hobin; Fried, Daniel

    2010-02-01

    The clinical diagnosis of secondary caries has been found to account for the replacement of the majority of intra-coronal restorations. Current methods to diagnose the presence of these lesions at early stages are considered insufficient due to their low sensitivity. Polarization-sensitive optical coherence tomography (PS-OCT) imaging studies have confirmed its effectiveness for imaging carious subsurface lesions in enamel and dentin. The objective of this study was to determine if PS-OCT can be used to nondestructively image demineralization through resin restorations on extracted teeth with both simulated and natural lesions. Simulated secondary caries lesions were created by exposing cavity preparations made in extracted human teeth to a demineralizing solution for 48 hours and subsequently restoring with resin. Negative control restorations were also prepared on each tooth. Optical changes in demineralized versus control preparations beneath restorations were measured as a function of depth using PS-OCT. PS-OCT images indicated that a significant increase in reflectivity and depth occurred in the simulated lesions compared with the control preparations. This study suggests that PS-OCT is well-suited to nondestructively detect early caries lesions in enamel beneath composite restorations.

  2. Novel amelogenin-releasing hydrogel for remineralization of enamel artificial caries

    PubMed Central

    Fan, Yuwei; Wen, Zezhang T; Liao, Sumei; Lallier, Thomas; Hagan, Joseph L; Twomley, Jefferson T; Zhang, Jian-Feng; Sun, Zhi; Xu, Xiaoming

    2013-01-01

    Recently, the use of recombinant full-length amelogenin protein in combination with fluoride has shown promising results in the formation of densely packed enamel-like structures. In this study, amelogenin (rP172)-releasing hydrogels containing calcium, phosphate, and fluoride were investigated for remineralization efficacy using in vitro early enamel caries models. The hydrogels were applied to artificial caries lesions on extracted human third molars, and the remineralization efficacy was tested in different models: static gel remineralization in the presence of artificial saliva, pH cyclic treatment at pH 5.4 acetic buffer and pH 7.3 gel remineralization, and treatment with multispecies oral biofilms grown in a continuous flowing constant-depth film fermenter. The surface microhardness of remineralized enamel increased significantly when amelogenin was released from hydrogel. No cytotoxicity was observed when periodontal ligament cells were cultured with the mineralized hydrogels. PMID:23338820

  3. Dentifrice fluoride and abrasivity interplay on artificial caries lesions.

    PubMed

    Nassar, Hani M; Lippert, Frank; Eckert, George J; Hara, Anderson T

    2014-01-01

    Incipient caries lesions on smooth surfaces may be subjected to toothbrushing, potentially leading to remineralization and/or abrasive wear. The interplay of dentifrice abrasivity and fluoride on this process is largely unknown and was investigated on three artificially created lesions with different mineral content/distribution. 120 bovine enamel specimens were randomly allocated to 12 groups (n = 10), resulting from the association of (1) lesion type [methylcellulose acid gel (MeC); carboxymethylcellulose solution (CMC); hydroxyethylcellulose gel (HEC)], (2) slurry abrasive level [low (REA 4/ RDA 69); high (REA 7/RDA 208)], and (3) fluoride concentration [0/275 ppm (14.5 mM) F as NaF]. After lesion creation, specimens were brushed in an automated brushing machine with the test slurries (50 strokes 2×/day). Specimens were kept in artificial saliva in between brushings and overnight. Enamel surface loss (SL) was determined by optical profilometry after lesion creation, 1, 3 and 5 days. Two enamel sections (from baseline and post-brushing areas) were obtained and analyzed microradiographically. Data were analyzed by analysis of variance and Tukey's tests (α = 5%). Brushing with high-abrasive slurry caused more SL than brushing with low-abrasive slurry. For MeC and CMC lesions, fluoride had a protective effect on SL from day 3 on. Furthermore, for MeC and CMC, there was a significant mineral gain in the remaining lesions except when brushed with high-abrasive slurries and 0 ppm F. For HEC, a significant mineral gain took place when low-abrasive slurry was used with fluoride. The tested lesions responded differently to the toothbrushing procedures. Both slurry fluoride content and abrasivity directly impacted SL and mineral gain of enamel caries lesions.

  4. Optical Assessment of Caries Lesion Structure and Activity

    NASA Astrophysics Data System (ADS)

    Lee, Robert Chulsung

    New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

  5. Quantitative evaluation of the enamel caries which were treated with casein phosphopeptide-amorphous calcium fluoride phosphate.

    PubMed

    Yazicioglu, O; Yaman, B C; Güler, A; Koray, F

    2017-06-01

    The aim of this in vivo study was to quantitatively evaluate the remineralization of the enamel caries on smooth and occlusal surfaces using DIAGNOdent, after daily application of casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP). Thirty volunteers, aged 18-30 years, with white spot lesions on the smooth and occlusal surfaces of the teeth were included in the study. These white spot lesions were visually examined and the degree of demineralization was quantitatively evaluated using DIAGNOdent. Volunteers with lesions scored as enamel caries on smooth surfaces (n = 109) and on occlusal surfaces (n = 176) were randomly divided into control and study groups. Both groups were instructed regarding oral hygiene and were asked to brush their teeth with the same tooth paste and tooth brush. In the study group, CPP-ACFP was applied daily for 4 min on the existing enamel caries lesions. After 4 weeks, the mineralization changes in enamel caries on the smooth and occlusal surfaces were assessed by DIAGNOdent. Recorded data were statistically analyzed by Wilcoxon signed-rank test and Mann-Whitney U-test. Comparison of DIAGNOdent values evaluated before and after the application of CPP-ACFP showed that the remineralization of enamel caries lesions on smooth and occlusal surfaces occurred in the study group (both, P < 0.001). The control group showed no quantitative changes at the end of 4 weeks (P > 0.05). At the end of the study period, the DIAGNOdent values differed significantly between the control and study groups (P < 0.001). Daily local application of CPP-ACFP for 4 min for 4 weeks results in significant remineralization of the initial caries lesions. CPP-ACFP can be used in the treatment of white spot lesions.

  6. Contact versus non-contact ablation of the artificial enamel caries by Er:YAG and CTH:YAG laser radiation

    NASA Astrophysics Data System (ADS)

    Dostálová, Tat'jana; Jelínková, Helena; Å ulc, Jan; Němec, Michal; Bučková, Michaela; Kašparová, Magdalena; Miyagi, Mitsunobu

    The aim of study is to compare the ablation effect of contact and non-contact interaction of Er:YAG and CTH:YAG laser radiation with artificial enamel caries lesion. The artificial caries was prepared in intact teeth to simulate demineralized surface and the laser radiation was applied. Contact and non-contact ablation was compared. Two laser systems Er:YAG 2.94 μm and CTH:YAG 2.1 μm were used. The enamel artificial caries were gently removed by laser radiation and flow Sonic fill composite resin was inserted. Scanning electron microscope was use to evaluate the enamel surface.

  7. Predicting infiltration of the surface layer of natural enamel caries.

    PubMed

    Meira, Kássia Regina Simões; de Mattos Brito, Camila Santos; de Sousa, Frederico Barbosa

    2015-06-01

    To test the hypothesis that the water volume more easily available for diffusion (αd) is the best predictor among all major components of the proportion of pore volume infiltrated by a liquid in the surface layer of dry natural enamel caries (NEC). Two aqueous solutions of mercuric and potassium iodide (Thoulet's solutions) with different refractive indexes (1.4 and 1.47) and penetration coefficients (3212 cm/s and 2297 cm/s) were tested at histological points (n = 63) of ground sections of NEC lesions. Component volumes were measured with microradiography and interpretation of birefringence. Real-time 2D mapping of capillary flow was performed with orientation-independent polarizing microscopy. αd was a good predictor for both liquids (T1.40: R(2) = 0.413; T1.47: R(2) = 0.505), but was similar to the water and air volumes for Thoulet's 1.47, and to the mineral and organic volumes for Thoulet's 1.40. From real-time 2D mapping, infiltration in ground sections occurred in two propagation directions, perpendicularly to the prism paths (at the centre of the lesion bodies) and axially to the prism paths (at all parts of the lesions), with two penetration rates, the faster related to prisms sheaths and the slower related to intraprismatic pores, affecting penetration length and air displacement. αd was a good predictor for both liquids, but was similar to the water and air volumes for T1.47 and to the mineral and organic volumes for T1.40. Both flow mechanics and component volumes are required to interpret infiltration of liquids into NEC. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. The prevalence of caries and enamel defects in 229 Malaysian children 16 years after water fluoridation (a pilot study).

    PubMed

    Majid, Z A; Hussein, N N; Bagramian, R A

    1996-07-01

    Two hundred and twenty-nine children aged 12-15 years who were continuous residents of Penang island, in the north of Peninsular Malaysia were examined for caries and enamel defects. Caries prevalence was 82.2% with a DMFT score of 3.4 and DMFS score of 4.9; there were very few missing teeth and very little untreated caries in the population examined. Majority of DF (decayed/filled) lesions were pits and fissures with approximal and smooth surfaces relatively caries free. The prevalence of enamel defects was 76.4% with 19.1% of all teeth examined being affected. More posterior than anterior teeth were affected by enamel defects just as there were more maxillary than mandibular teeth affected by enamel defects. Diffuse patchy opacities were the most common defect diagnosed and this was found in 60.2% of the population examined. A bilateral distribution of diffuse patchy opacities was seen in 41.5% of the population examined. Tooth surfaces with enamel defects were no more susceptible to caries than defect-free surfaces.

  9. Relative fluoride response of caries lesions created in fluorotic and sound teeth studied under remineralizing conditions.

    PubMed

    Alhawij, Hala; Lippert, Frank; Martinez-Mier, Esperanza Angeles

    2015-01-01

    The present in vitro pH cycling study investigated potential differences between caries lesions created in fluorosed and sound enamel with regards to their responsiveness to fluoride under remineralizing conditions. 360 human first molars (sound and fluorosed) were divided into four groups based on their Thylstrup-Fejerskov score (TF0-3). Each group was further divided into two treatment groups (n=45): deionized water or 383 ppm fluoride. Artificial enamel caries lesions were created and pH cycled for 20 d using an established net remineralization model. Quantitative light-induced fluorescence was used throughout the study to investigate lesion severity and changes thereof. Data were analyzed using two-way ANOVA. There were no differences in lesion severity between all groups after lesion creation (plesion=0.1934). The TF score vs. treatment interaction was significant at all other time points (p10 d=0.0280; p20 d≤0.0001; psecdemin=0.0411). Relative differences in responsiveness to fluoride vs. deionized water increased with increasing TF scores. In comparison to lesions created in sound enamel, lesions created in enamel with moderate fluorosis (TF 2/3) were more prone to remineralization in the presence than in the absence of fluoride. Furthermore, lesions created in enamel with moderate fluorosis exhibited more remineralization in the presence of fluoride than lesions created in sound teeth, whereas the opposite was true for deionized water. Bearing in mind the limitations of laboratory research, the extent of enamel fluorosis severity may directly impact subsequent lesion re- and progression as well as the lesion's responsiveness to fluoride. Caries lesions in fluorotic teeth are more vulnerable to progression but respond more strongly to fluoride than those in non-impacted teeth. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Quantitative evaluation of simulated human enamel caries kinetics using photothermal radiometry and modulated luminescence

    NASA Astrophysics Data System (ADS)

    Hellen, Adam; Mandelis, Andreas; Finer, Yoav; Amaechi, Bennett T.

    2011-03-01

    Photothermal radiometry and modulated luminescence (PTR-LUM) is a non-destructive methodology applied toward the detection, monitoring and quantification of dental caries. The purpose of this study was to evaluate the efficacy of PTRLUM to detect incipient caries lesions and quantify opto-thermophysical properties as a function of treatment time. Extracted human molars (n=15) were exposed to an acid demineralization gel (pH 4.5) for 10 or 40 days in order to simulate incipient caries lesions. PTR-LUM frequency scans (1 Hz - 1 kHz) were performed prior to and during demineralization. Transverse Micro-Radiography (TMR) analysis followed at treatment conclusion. A coupled diffusephoton- density-wave and thermal-wave theoretical model was applied to PTR experimental amplitude and phase data across the frequency range of 4 Hz - 354 Hz, to quantitatively evaluate changes in thermal and optical properties of sound and demineralized enamel. Excellent fits with small residuals were observed experimental and theoretical data illustrating the robustness of the computational algorithm. Increased scattering coefficients and poorer thermophysical properties were characteristic of demineralized lesion bodies. Enhanced optical scattering coefficients of demineralized lesions resulted in poorer luminescence yield due to scattering of both incident and converted luminescent photons. Differences in the rate of lesion progression for the 10-day and 40-day samples points to a continuum of surface and diffusion controlled mechanism of lesion formation. PTR-LUM sensitivity to changes in tooth mineralization coupled with opto-thermophysical property extraction illustrates the technique's potential for non-destructive quantification of enamel caries.

  11. Histochemical changes of occlusal surface enamel of permanent teeth, where dental caries is questionable vs sound enamel surfaces.

    PubMed

    Michalaki, M; Oulis, C J; Pandis, N; Eliades, G

    2016-12-01

    This in vitro study was to classify questionable for caries occlusal surfaces (QCOS) of permanent teeth according to ICDAS codes 1, 2, and 3 and to compare them in terms of enamel mineral composition with the areas of sound tissue of the same tooth. Partially impacted human molars (60) extracted for therapeutic reasons with QCOS were used in the study, photographed via a polarised light microscope and classified according to the ICDAS II (into codes 1, 2, or 3). The crowns were embedded in clear self-cured acrylic resin and longitudinally sectioned at the levels of the characterised lesions and studied by SEM/EDX, to assess enamel mineral composition of the QCOS. Univariate and multivariate random effect regressions were used for Ca (wt%), P (wt%), and Ca/P (wt%). The EDX analysis indicated changes in the Ca and P contents that were more prominent in ICDAS-II code 3 lesions compared to codes 1 and 2 lesions. In these lesions, Ca (wt%) and P (wt%) concentrations were significantly decreased (p = 0.01) in comparison with sound areas. Ca and P (wt%) contents were significantly lower (p = 0.02 and p = 0.01 respectively) for code 3 areas in comparison with codes 1 and 2 areas. Significantly higher (p = 0.01) Ca (wt%) and P (wt%) contents were found on sound areas compared to the lesion areas. The enamel of occlusal surfaces of permanent teeth with ICDAS 1, 2, and 3 lesions was found to have different Ca/P compositions, necessitating further investigation on whether these altered surfaces might behave differently on etching preparation before fissure sealant placement, compared to sound surfaces.

  12. Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature.

    PubMed

    Lynch, Richard J M

    2011-08-01

    Zinc is an essential trace element. In the mouth, it is present naturally in plaque, saliva and enamel. Zinc is formulated into oral health products to control plaque, reduce malodour and inhibit calculus formation. It has good oral substantivity, and elevated concentrations can persist for many hours in plaque and saliva following delivery from mouthrinses and toothpastes. Although low concentrations of zinc can both reduce enamel demineralisation and modify remineralisation, during caries clinical trials, the addition of zinc to fluoride toothpastes has not affected their ability to reduce caries. Mechanistic studies may help explain this apparent contradiction. Zinc is readily desorbed from hydroxyapatite by calcium, which is plentiful in plaque and saliva. Where crystal-growth sites remain occupied by zinc despite this, they may simply be 'over-grown' by remineralisation initiated at unoccupied sites. Further, under certain conditions, low concentrations of zinc can enhance remineralisation of enamel lesions, by retarding lesion arrestment. Although this may help to explain the apparent lack of an overall zinc effect on caries, it seems unlikely that any negative effects would be countered exactly by positive effects. Further mechanistic studies, complementing well-designed in vitro and in situ caries studies, should lead to further understanding of the zinc-enamel interactions relevant to demineralisation and remineralisation.

  13. Effect of resin infiltration on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions.

    PubMed

    Arslan, Soley; Zorba, Yahya Orcun; Atalay, Mustafa Altay; Özcan, Suat; Demirbuga, Sezer; Pala, Kansad; Percin, Duygu; Ozer, Fusun

    2015-01-01

    The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.

  14. Approximal secondary caries lesion progression, a 20-week in situ study.

    PubMed

    Thomas, R Z; Ruben, J L; ten Bosch, J J; Fidler, V; Huysmans, M C D N J M

    2007-01-01

    There is no consensus about the definition and progression of outer and wall lesions in secondary caries. In this study we investigated whether lesion progression is influenced by an adjacent composite restoration and whether wall lesions develop at the composite-tooth interface. In order to study the appearance and progression of approximal primary caries lesions and lesions next to composite restorations, 16 samples were placed in a full denture of each of 8 subjects. Each denture housed 4 restored and 4 unrestored enamel samples and similarly 8 dentin samples. All samples were distributed over 2 sample holders, in each of which 4 approximal spaces were simulated. Every 4 weeks the sample holders were microradiographed using transversal wavelength independent microradiography and lesion depth was measured. At the end of the study, after 20 weeks, the lesion depth of the outer lesions was 0-350 microm for enamel and 0-750 microm for dentin. The estimated difference in progression between secondary and primary lesions (1.1 microm/4 weeks, 95% CI: -9.2 to 11.4 microm) was not statistically significant (p = 0.83). Secondary outer lesions appeared and progressed as primary caries lesions. No clear wall lesions were found next to composite, but they were observed next to acrylic resin.

  15. Research on optical properties of dental enamel for early caries diagnostics using a He-Ne laser

    NASA Astrophysics Data System (ADS)

    Tang, Jing; Liu, Li; Li, Song-zhan

    2008-12-01

    A new and non-invasive method adapted for optical diagnosis of early caries is proposed by researching on the interaction mechanism of laser with dental tissue and relations of remitted light with optical properties of the tissue. This method is based on simultaneous analyses of the following parameters: probing radiation, backscattering and auto-fluorescence. Investigation was performed on 104 dental samples in vitro by using He-Ne laser (λ=632.8nm, 2.0+/-0.1mW) as the probing. Spectrums of all samples were obtained. Characteristic spectrums of dental caries in various stages (intact, initial, moderate and deep) were given. Using the back-reflected light to normalize the intensity of back-scattering and fluorescence, a quantitative diagnosis standard for different stages of caries is proposed. In order to verify the test, comparison research was conducted among artificial caries, morphological damaged enamel, dental calculus and intact tooth. Results show that variations in backscattering characteristic changes in bio-tissue morphological and the quantity of auto-fluorescence is correlated with concentration of anaerobic microflora in hearth of caries lesion. This method poses a high potential of diagnosing various stages of dental caries, and is more reliability to detect early caries, surface damage of health enamel and dental calculus.

  16. In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions.

    PubMed

    de Carvalho, Fabíola Galbiatti; Vieira, Basílio Rodrigues; Santos, Rogério Lacerda Dos; Carlo, Hugo Lemes; Lopes, Pablo Queiroz; de Lima, Bruno Alessandro Silva Guedes

    2014-01-01

    The purpose of this study was to analyze the protective effect of remineralizing agents on enamel caries lesions using surface Knoop microhardness testing (KHN) and atomic force microscopy (AFM). Forty-eight human enamel blocks were assigned to four groups (N=12): (1) control (without agent); (2) fluoride varnish (Duraphat); (3) nano-HAP paste (Desensibilize Nano P); and (4) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste Plus). Incipient caries-like lesions were artificially developed. Cariogenic challenge (pH-cycling) was performed for seven days. The pastes were applied before each immersion in demineralization solution, and the varnish was applied only once. KHN values were obtained at baseline, after incipient enamel lesion, and after challenge. The percentage of surface hardness recovery (%SMHR) was performed, and the surface morphology was evaluated by atomic force microscopy (AFM). ANOVA, Tukey's, and student paired t tests were applied at P<.05. After the cariogenic challenge, the nano-HAP group showed significantly higher KHN and %SMHR values than varnish. The CPP-ACP group showed no increase in KHN. The nano-HAP group showed, via AFM, a protective layer formation with globular deposits on the surface. SMHR and AFM morphology revealed that nano-hydroxyapatite paste showed a protective effect against in vitro enamel caries development.

  17. Predictive research methods of enamel and dentine for initial caries detection

    PubMed Central

    2013-01-01

    Currently, various research methods of enamel and dentine for precautionary diagnostics of initial caries forms are developed; however, the vast majority of these do not provide objective criteria of caries diagnostics or are very difficult to perform. Therefore, the search of diagnostics and enamel research methods, which will allow predicting caries emergence and to carry out personalised prevention of this pathology, is necessary. In this review, modern diagnostic methods that allow understanding the main aspects of caries process, assess the risk of its development, and also suggest the possibility of emergency prevention of caries progression in the nearest future are presented. PMID:23800183

  18. The efficiency of child formula dentifrices containing different calcium and phosphate compounds on artificial enamel caries

    PubMed Central

    Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Khumsub, Ploychompoo

    2016-01-01

    Objectives: Fluoride toothpaste has been extensively used to prevent dental caries. However, the risk of fluorosis is concerning, especially in young children. Calcium phosphate has been an effective remineralizing agent and is present in commercial dental products, with no risk of fluorosis to users. This in vitro study aimed to compare the effects of different calcium phosphate compounds and fluoride-containing dentifrices on artificial caries in primary teeth. Materials and Methods: Fifty sound primary incisors were coated with nail varnish, leaving two 1 mm2 windows on the labial surface before immersion in demineralizing solution for 96 hours to produce artificial enamel lesions. Subsequently, one window from each tooth was coated with nail varnish, and all 50 teeth were divided into five groups (n = 10); group A – deionized water; group B – casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) paste (Tooth Mousse); group C – 500 ppm F (Colgate Spiderman®); group D – nonfluoridated toothpaste with triple calcium phosphate (Pureen®); and group E – tricalcium phosphate (TCP). Polarized light microscopy and Image-Pro® Plus software were used to evaluate lesions. Results: After a 7-day pH-cycle, mean lesion depths in groups A, B, C, D, and E had increased by 57.52 ± 10.66%, 33.28 ± 10.16%, 17.04 ± 4.76%, 32.51 ± 8.99%, and 21.76 ± 8.15%, respectively. All data were processed by the Statistical Package for the Social Sciences (version 16.0) software package. Comparison of percentage changes using one-way analysis of variance and Fisher's least squares difference tests at a 95% level of confidence demonstrated that group A was significantly different from the other groups (P < 0.001). Lesions in groups B and D had a significant lesion progression when compared with groups C and E. Conclusions: All toothpastes in this study had the potential to delay the demineralization progression of artificial enamel caries in primary teeth. The

  19. The efficiency of child formula dentifrices containing different calcium and phosphate compounds on artificial enamel caries.

    PubMed

    Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Khumsub, Ploychompoo

    2016-01-01

    Fluoride toothpaste has been extensively used to prevent dental caries. However, the risk of fluorosis is concerning, especially in young children. Calcium phosphate has been an effective remineralizing agent and is present in commercial dental products, with no risk of fluorosis to users. This in vitro study aimed to compare the effects of different calcium phosphate compounds and fluoride-containing dentifrices on artificial caries in primary teeth. Fifty sound primary incisors were coated with nail varnish, leaving two 1 mm(2) windows on the labial surface before immersion in demineralizing solution for 96 hours to produce artificial enamel lesions. Subsequently, one window from each tooth was coated with nail varnish, and all 50 teeth were divided into five groups (n = 10); group A - deionized water; group B - casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (Tooth Mousse); group C - 500 ppm F (Colgate Spiderman(®)); group D - nonfluoridated toothpaste with triple calcium phosphate (Pureen(®)); and group E - tricalcium phosphate (TCP). Polarized light microscopy and Image-Pro(®) Plus software were used to evaluate lesions. After a 7-day pH-cycle, mean lesion depths in groups A, B, C, D, and E had increased by 57.52 ± 10.66%, 33.28 ± 10.16%, 17.04 ± 4.76%, 32.51 ± 8.99%, and 21.76 ± 8.15%, respectively. All data were processed by the Statistical Package for the Social Sciences (version 16.0) software package. Comparison of percentage changes using one-way analysis of variance and Fisher's least squares difference tests at a 95% level of confidence demonstrated that group A was significantly different from the other groups (P < 0.001). Lesions in groups B and D had a significant lesion progression when compared with groups C and E. All toothpastes in this study had the potential to delay the demineralization progression of artificial enamel caries in primary teeth. The fluoride 500 ppm and TCP toothpastes were equal in the deceleration of

  20. Numerical modelling of tooth enamel subsurface lesion formation induced by dental plaque.

    PubMed

    Ilie, O; van Turnhout, A G; van Loosdrecht, M C M; Picioreanu, C

    2014-01-01

    Using a one-dimensional mathematical model that couples tooth demineralisation and remineralisation with metabolic processes occurring in the dental plaque, two mechanisms for subsurface lesion formation were evaluated. It was found that a subsurface lesion can develop only as the result of alternating periods of demineralisation (acid attack during sugar consumption) and remineralisation (resting period) in tooth enamel with uniform mineral composition. It was also shown that a minimum plaque thickness that can induce an enamel lesion exists. The subsurface lesion formation can also be explained by assuming the existence of a fluoride-containing layer at the tooth surface that decreases enamel solubility. A nearly constant thickness of the surface layer was obtained with both proposed mechanisms. Sensitivity analysis showed that surface layer formation is strongly dependent on the length of remineralisation and demineralisation cycles. The restoration period is very important and the numerical simulations support the observation that often consumption of sugars is a key factor in caries formation. The calculated profiles of mineral content in enamel are similar to those observed experimentally. Most probably, both studied mechanisms interact in vivo in the process of caries development, but the simplest explanation for subsurface lesion formation remains the alternation between demineralisation and remineralisation cycles without any pre-imposed gradients.

  1. Isolated development of inner (wall) caries like lesions in a bacterial-based in vitro model.

    PubMed

    Diercke, K; Lussi, A; Kersten, T; Seemann, R

    2009-12-01

    The study conducted in a bacterial-based in vitro caries model aimed to determine whether typical inner secondary caries lesions can be detected at cavity walls of restorations with selected gap widths when the development of outer lesions is inhibited. Sixty bovine tooth specimens were randomly assigned to the following groups: test group 50 (TG50; gap, 50 microm), test group 100 (TG100; gap, 100 microm), test group 250 (TG250; gap, 250 microm) and a control group (CG; gap, 250 microm). The outer tooth surface of the test group specimens was covered with an acid-resistant varnish to inhibit the development of an outer caries lesion. After incubation in the caries model, the area of demineralization at the cavity wall was determined by confocal laser scanning microscopy. All test group specimens demonstrated only wall lesions. The CG specimens developed outer and wall lesions. The TG250 specimens showed significantly less wall lesion area compared to the CG (p < 0.05). In the test groups, a statistically significant increase (p < 0.05) in lesion area could be detected in enamel between TG50 and TG250 and in dentine between TG50 and TG100. In conclusion, the inner wall lesions of secondary caries can develop without the presence of outer lesions and therefore can be regarded as an entity on their own. The extent of independently developed wall lesions increased with gap width in the present setting.

  2. Infiltration of natural caries lesions in relation to their activity status and acid pretreatment in vitro.

    PubMed

    Neuhaus, K W; Schlafer, S; Lussi, A; Nyvad, B

    2013-01-01

    This study aimed at testing how active and inactive enamel caries lesions differ by their degree of resin infiltration, and whether the choice of acid pretreatment plays a crucial role. Four examiners assessed 104 human molars and premolars with noncavitated enamel lesions and classified them as 'active' or 'inactive' using the Nyvad criteria. Forty-five teeth were included in this study after independent unanimous lesion activity assessment. Lesions were cut perpendicularly into 2 halves. Each half lesion was pretreated with either 15% hydrochloric acid or 35% phosphoric acid. The lesions were infiltrated after staining with rhodamine isothiocyanate. Thin sections of 100 µm were prepared and the specimens were bleached with 30% hydrogen peroxide. The specimens were then counterstained with sodium fluorescein, subjected to confocal laser scanning microscopy and analyzed quantitatively. Outcome parameters were maximum and average infiltration depths as well as relative penetration depths and areas. In active lesions no significant difference of percentage maximum penetration depth and percentage average penetration depth between lesions pretreated with hydrochloric or phosphoric acid could be observed. In inactive lesions, however, phosphoric acid pretreatment resulted in significantly lower penetration compared to hydrochloric acid pretreatment. Surface conditioning with hydrochloric acid led to similar infiltration results in active and inactive lesions. Moreover, inactive lesions showed greater variability in all assessed infiltration parameters than did active lesions. In conclusion, caries lesion activity and acid pretreatment both influenced the infiltration. The use of phosphoric acid to increase permeability of the surface layer of active lesions should be further explored.

  3. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro.

    PubMed

    Huang, S B; Gao, S S; Yu, H Y

    2009-06-01

    The purpose of the research was to determine the effect of nano-hydroxyapatite concentrations on initial enamel lesions under dynamic pH-cycling conditions. Initial enamel lesions were prepared in bovine enamel with an acidic buffer. NaF (positive control), deionized water (negative control) and four different concentrations of nano-hydroxyapatite (1%, 5%, 10% and 15% wt%) were selected as the treatment agents. Surface microhardness (SMH) measurements were performed before/after demineralization and after 3, 6, 9 and 12 days of application, and the percentage surface microhardness recovery (%SMHR) was calculated. The specimens were then examined by a scanning electron microscope. The %SMHR in nano-hydroxyapatite groups was significantly greater than that of negative control. When the concentration of nano-HA was under 10%, SMH and %SMHR increased with increasing nano-hydroxyapatite concentrations. There were no significant differences between the 10% and 15% groups at different time periods in the pH-cycling. The SEM analysis showed that nano-hydroxyapatite particles were regularly deposited on the cellular structure of the demineralized enamel surface, which appeared to form new surface layers. It was concluded that nano-hydroxyapatite had the potential to remineralize initial enamel lesions. A concentration of 10% nano-hydroxyapatite may be optimal for remineralization of early enamel caries.

  4. Cerium chloride reduces enamel lesion initiation and progression in vitro.

    PubMed

    Wegehaupt, F J; Buchalla, W; Sener, B; Attin, T; Schmidlin, P R

    2014-01-01

    Determination of the potential of cerium chloride to reduce artificial carious mineral loss and lesion depth progression. A total of 160 enamel samples were prepared from 40 bovine lower central incisors. Crowns were sectioned into four pieces, embedded in acrylic resin, ground flat and allocated to eight groups (S1-S4 and D1-D4; n = 20). Specimens of groups D1-D4 were stored (for 7 days) in a demineralizing buffer solution to induce caries-like lesions. Afterwards, samples were treated for 30 s with one of the following solutions: placebo (S1 and D1), amine fluoride (S2 and D2), cerium chloride (S3 and D3) and a combination of fluoride and cerium chloride (S4 and D4). After another 7 (D1-D4) or 14 (S1-S4) days in demineralizing buffer solution, integrated mineral loss and lesion depth were determined by transversal microradiography and compared by Scheffé's post hoc tests. In groups S1-S4, the highest values for integrated mineral loss and lesion depth were observed for group S1 (placebo), the lowest values for group S4. The results in groups S2-S4 were not significantly different. In groups D1-D4, the highest values for integrated mineral loss and lesion depth were observed for group D1 (placebo), the lowest values in groups D3 and D4. In group D2, integrated mineral loss and lesion depth were significantly lower as compared to D1, but significantly higher compared to groups D3 and D4. Cerium chloride and its combination with fluoride are able to significantly reduce carious mineral loss and the progression of lesion depth.

  5. Effect of a new carbon dioxide laser and fluoride on occlusal caries progression in dental enamel

    NASA Astrophysics Data System (ADS)

    Nobre dos Santos, Marines; Fried, Daniel; Rapozo-Hilo, Marcia L.; Featherstone, John D. B.

    2002-06-01

    The purpose of this study was to investigate the effect of a new TEA carbon dioxide (CO2) laser (.9.6 micrometers , 5-8 microsecond(s) pulse duration) combined with fluoride (F), on the inhibition of caries-like progression in occlusal surfaces in sound and demineralized enamel. Of 120 occlusal tooth surfaces (10 per group), 90 were partially demineralized in a 50% HAP/0.1 M Lactic acid/carbopol solution (pH 5.0). Samples were treated with/without the laser (2.0 j/cm2 or 3.0 J/cm2) and/or F (as APF). Caries-like progression was tested by 5 days of pH cycling. Results were assessed by cross-sectional quantitative microradiography. The percent inhibition of caries progression with laser and/or F ranged from 87-170%. This new TEA CO2 laser produced significant protective effect against lesion progression, and in combination with fluoride treatment lesion reversal occurred.

  6. Remineralization of artificial dentinal caries lesions by biomimetically modified Mineral Trioxide Aggregate

    PubMed Central

    Qi, Yi-pin; Li, Nan; Niu, Li-na; Primus, Carolyn M.; Ling, Jun-Qi; Pashley, David H.; Tay, Franklin R.

    2011-01-01

    Fluoride-releasing restorative materials are available for remineralization of enamel and root caries. However, dentin remineralization is more difficult than enamel remineralization due to the paucity of apatite seed crystallites along the lesion surface for heterogeneous crystal growth. Extracellular matrix proteins play critical roles in controlling apatite nucleation/growth in collagenous tissues. This study examined the remineralization efficacy of mineral trioxide aggregate (MTA) in phosphate-containing simulated body fluid (SBF) by incorporating polyacrylic acid and sodium tripolyphosphate as biomimetic analogs of matrix proteins for remineralizing caries-like dentin. Artificial caries-like dentin lesions incubated in SBF were remineralized over a 6-week period using MTA or MTA containing biomimetic analogs in the absence or presence of dentin adhesive application. Lesion depths and integrated mineral loss were monitored with micro-computed tomography. Ultrastructure of baseline and remineralized lesions were examined by transmission electron microscopy. Dentin remineralization was best achieved using MTA containing biomimetic analogs regardless of whether an adhesive was applied; dentinal tubules within the remineralized dentin were occluded by apatite. It is concluded that the MTA version employed in the study may be doped with biomimetic analogs for remineralization of unbonded and bonded artificial caries-like lesions in the presence of SBF. PMID:22085925

  7. Quantifying the remineralization of artificial caries lesions using PS-OCT

    NASA Astrophysics Data System (ADS)

    Jones, Robert S.; Fried, Daniel

    2006-02-01

    New optical imaging methods are needed to determine whether caries lesions (tooth decay) are active and progressing or have become remineralized and arrested and are no longer progressing. The objective of this study was to use Polarization Sensitive Optical Coherence Tomography (PS-OCT) to image the fluoride enhanced remineralization of artificial enamel lesions. Artificial lesions were created by an acetate buffer on smooth enamel surfaces and were exposed for 20 days to a 2 ppm fluoride containing remineralization solution. PS-OCT images revealed the presence of a low scattering surface zone after the artificial lesions were remineralized. These samples displayed intact nondepolarizing surface zones when analyzed with Polarized Light Microscopy (PLM). No statistical difference in lesion depth before and after remineralization was found with both PS-OCT and PLM. The remineralized lesions showed a significant decrease in the overall integrated reflectivity compared with the demineralized lesions. Digital Microradiography confirmed the increase in mineral volume of the remineralized surface zone. This study determined that PS-OCT can image the restoration of the surface zone enamel after fluoride-enhanced remineralization of artificial in vitro dental caries.

  8. PIXE analysis of caries related trace elements in tooth enamel

    NASA Astrophysics Data System (ADS)

    Annegarn, H. J.; Jodaikin, A.; Cleaton-Jones, P. E.; Sellschop, J. P. F.; Madiba, C. C. P.; Bibby, D.

    1981-03-01

    PIXE analysis has been applied to a set of twenty human teeth to determine trace element concentration in enamel from areas susceptible to dental caries (mesial and distal contact points) and in areas less susceptible to the disease (buccal surfaces), with the aim of determining the possible roles of trace elements in the curious process. The samples were caries-free anterior incisors extracted for periodontal reasons from subjects 10-30 years of age. Prior to extraction of the sample teeth, a detailed dental history and examination was carried out in each individual. PIXE analysis, using a 3 MeV proton beam of 1 mm diameter, allowed the determination of Ca, Mn, Fe, Cu, Zn, Sr and Pb above detection limits. As demonstrated in this work, the enhanced sensitivity of PIXE analysis over electron microprobe analysis, and the capability of localised surface analysis compared with the pooled samples required for neutron activation analysis, makes it a powerful and useful technique in dental analysis.

  9. Association between developmental defects of enamel and dental caries in schoolchildren.

    PubMed

    Vargas-Ferreira, F; Zeng, J; Thomson, W M; Peres, M A; Demarco, F F

    2014-05-01

    Despite improvement, dental caries is still the main public oral health problem worldwide and the major cause of pain, tooth loss and chewing difficulties in children and adolescents; and it impacts negatively on oral health-related quality of life. A cross-sectional study of a multistage representative sample of 8-12-year-old Brazilian school children was carried out in order to investigate the association between enamel defects and dental caries. Children's mothers completed a questionnaire about socio-demographic and behavioural characteristics at home. Firth's bias reduced logistic regression models were undertaken to assess the association between the main exposure (enamel defects) and caries experience. The prevalence of any enamel defect was 64.0%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 35.0%, 29.5% and 3.7%, respectively. The prevalence of dental caries was 32.4%, with mean DMFT of 0.6 (SD, 1.2). Dental caries experience was more common among children who had enamel hypoplasia in their posterior teeth (OR=2.79; 95% CI: 1.05, 6.51) than among those with none. In anterior teeth, there was no association. Enamel hypoplasia appears to be an important risk factor for dental caries. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Effect of 10% carbamide peroxide bleaching on sound and artificial enamel carious lesions.

    PubMed

    Pinto, Cristiane Franco; Paes Leme, Adriana Franco; Cavalli, Vanessa; Giannini, Marcelo

    2009-01-01

    This study evaluated the effect of 10% carbamide peroxide (CP) bleaching on Knoop surface microhardness (KHN) and morphology of sound enamel and enamel with early artificial caries lesions (CL) after pH-cycling model (pHcm). Human dental enamel blocks were randomly divided into 6 groups (n=10): 1 - sound enamel bleached (S) with CP (Rembrandt/Den-Mat); 2 - S and submitted to pHcm; 3 - CL bleached with CP; 4 - CL stored in artificial saliva and submitted to pHcm; 5 - CL treated with placebo gel and submitted to pHcm; 6 - CL bleached with CP and submitted to pHcm. Enamel blocks with known initial KHN values were demineralized (groups 3 to 6) and submitted to 12 day pHcm (groups 2, 4, 5 and 6). After demineralization and treatments, KHN was determined and the specimens were examined using scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. The results showed that among CL groups (3 to 6) only the group 3 presented remineralization after treatments. S groups (1 and 2) showed higher KHN and presented less formation of porosities on enamel surface than CL groups after treatments. In conclusion, bleaching procedures on enamel with CL did not exacerbate the demineralization, but should be indicated with caution.

  11. Association between developmental defects of enamel and dental caries: A systematic review and meta-analysis.

    PubMed

    Vargas-Ferreira, F; Salas, M M S; Nascimento, G G; Tarquinio, S B C; Faggion, C M; Peres, M A; Thomson, W M; Demarco, F F

    2015-06-01

    Dental caries is the main problem oral health and it is not well established in the literature if the enamel defects are a risk factor for its development. Studies have reported a potential association between developmental defects enamel (DDE) and dental caries occurrence. We investigated the association between DDE and caries in permanent dentition of children and teenagers. A systematic review was carried out using four databases (Pubmed, Web of Science, Embase, and Science Direct), which were searched from their earliest records until December 31, 2014. Population-based studies assessing differences in dental caries experience according to the presence of enamel defects (and their types) were included. PRISMA guidelines for reporting systematic reviews were followed. Meta-analysis was performed to assess the pooled effect, and meta-regression was carried out to identify heterogeneity sources. From the 2558 initially identified papers, nine studies fulfilled all inclusion criteria after checking the titles, abstracts, references, and complete reading. Seven of them were included in the meta-analysis with random model. A positive association between enamel defects and dental caries was identified; meta-analysis showed that individuals with DDE had higher pooled odds of having dental caries experience [OR 2.21 (95% CI 1.3; 3.54)]. Meta-regression analysis demonstrated that adjustment for sociodemographic factors, countries' socioeconomic status, and bias (quality of studies) explained the high heterogeneity observed. A higher chance of dental caries should be expected among individuals with enamel defects. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Prevalence of enamel defects and association with dental caries in preschool children.

    PubMed

    Massignan, C; Ximenes, M; da Silva Pereira, C; Dias, L; Bolan, M; Cardoso, M

    2016-12-01

    This was to evaluate the prevalence of the developmental defects of enamel (DDE) in primary teeth and its association with dental caries. A cross-sectional study with a randomised representative sample was carried out with 1101 children aged 2-5 years enrolled in public preschools (50% prevalence of DDE in primary teeth, a standard error of 3%, and a confidence level of 95%). Three calibrated dentists (K > 0.62) performed clinical examination. Data collected were: sex, age, DDE (Modified DDE Index) and dental caries (WHO). Descriptive analysis, Chi-square test and multinomial logistic regression were applied for data analysis. Among children, 565 (51.3%) were boys; mean age was 3.7 (±0.9 years). The prevalence of enamel defect was 39.1%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 25.3, 19.1 and 6.1%, respectively. The prevalence of dental caries was 31.0%, with mean def-t 1.14 (±2.44). Primary teeth with enamel hypoplasia had three times the odds of having dental caries than those with absence of enamel defects (OR = 3.10; 95% CI: 1.91, 5.01). The presence of enamel defects was moderate and associated with dental caries.

  13. Investigation on the remineralization effect of arginine toothpaste for early enamel caries: nanotribological and nanomechanical properties

    NASA Astrophysics Data System (ADS)

    Yu, Ping; Arola, Dwayne D.; Min, Jie; Yu, Dandan; Xu, Zhou; Li, Zhi; Gao, Shanshan

    2016-11-01

    Remineralization is confirmed as a feasible method to restore early enamel caries. While there is evidence that the 8% arginine toothpaste has a good remineralization effect by increasing surface microhardness, the repair effect on wear-resistance and nanomechanical properties still remains unclear. Therefore, this research was conducted to reveal the nanotribological and nanomechanical properties changes of early caries enamel after remineralized with arginine toothpaste. Early enamel caries were created in bovine enamel blocks, and divided into three groups according to the treatment solutions: distilled and deionized water (DDW group), arginine toothpaste slurry (arginine group) and fluoride toothpaste slurry (fluoride group). All of the samples were subjected to pH cycling for 12 d. The nanotribological and nanomechanical properties were evaluated via the nanoscratch and nanoindentation tests. The wear depth and scratch morphology were observed respectively by scanning probe microscopic (SPM) and scanning electron microscopy (SEM). Finally, x-ray photoelectron spectroscopy (XPS) was used for element analysis of remineralized surfaces. Results showed that the wear depth of early caries enamel decreased after remineralization treatment and both the nanohardness and elastic modulus increased. Compared with the fluoride group, the arginine group exhibited higher nanohardness and elastic modulus with higher levels of calcium, fluoride, nitrogen and phosphorus; this group also underwent less wear and related damage. Overall, the synergistic effect of arginine and fluoride in arginine toothpaste achieves better nanotribological and nanomechanical properties than the single fluoride toothpaste, which could have significant impact on fight against early enamel caries.

  14. Possibilities and potential roles of the functional peptides based on enamel matrix proteins in promoting the remineralization of initial enamel caries.

    PubMed

    Ieong, Cheng Cheng; Zhou, Xue Dong; Li, Ji Yao; Li, Wei; Zhang, Ling Lin

    2011-03-01

    Dental caries is the most common oral diseases, and it gives a serious threat to oral and general health. Fluoride, a classic anti-caries agent, has a profound effect on caries prevention and treatment. However, fluorosis and fluoride-resistant strains limit the further application of fluoride treatment. Therefore, it is still of significant benefit to seek alternatives, bringing more effective anti-caries agents. The potential role of enamel matrix proteins(EMPs) in promoting the regeneration of periodontal tissue and inducing bone have been proved. EMPs have been successfully applied in the field of periodontal disease and dental implants in recent years. Previous researches revealed that enamel matrix proteins had an important role in the synthesis of hydroxyapatite in vitro. Some experiments about the degeneration or removal of EMP suggest that enamel matrix proteins are related to the occurrence and development of caries. Based on evidences illustrated by these experiments, this paper hypothesizes that functional peptides based on the function and structure of EMPs could promote remineralization of enamel caries, which could perform as a suitable treatment to enamel caries. The hypothesis may lead a new direction in the study on the prevention and treatment of enamel caries, and further study of the anti-caries mechanisms of EMP will enable researchers to find out the most effective anti-caries peptides, which could be developed into a bionics anti-cariogenic agent. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Effect of three different pastes on remineralization of initial enamel lesion: an in vitro study.

    PubMed

    Vyavhare, S; Sharma, D S; Kulkarni, V K

    2015-01-01

    Dental caries in enamel is unique as enamel is both acellular and avascular. Fluoride is one of the most effective remineralizing agents in caries prevention. The purpose of the study was to assess whether nano-hydroxyapatite and CPP-ACP can be used as an alternative to fluoride for remineralization of early carious lesions. Initial artificial carious lesions were prepared in enamel with demineralization solution. The treatment materials used as remineralizing agents were Nano-hydroxyapatite (10%), CPP - ACP (10%), NaF (1000 ppm) and Deionized water (negative control). Surface microhardness (SMH) measurements were performed before/after demineralization and after 3, 6, 9 and 12 days of pH cycling and the percentage surface microhardness recovery (%SMHR) was calculated. The specimens were then examined by scanning electron microscope. Percentage surface microhardness recovery of nano-hydroxyapatite and fluoride was significantly greater than CPP - ACP and negative control. There was no significant difference of %SMHR between n-HA and fluoride at different time periods in the pH cycling. SEM analysis revealed n-HA particles were deposited on the demineralized enamel surface which formed a new surface layer. When observed under SEM CPP - ACP failed to show any significant surface remineralization while surface globular crystal depositions with multiple discrete porosities were evident with fluoride. It was concluded that nano-hydroxyapatite and fluoride had the potential to remineralize initial enamel lesions. CPP - ACP can be used as an effective adjunct to fluoride therapy but cannot be used as an alternative to fluoride.

  16. Elevated fluoride products enhance remineralization of advanced enamel lesions.

    PubMed

    ten Cate, J M; Buijs, M J; Miller, C Chaussain; Exterkate, R A M

    2008-10-01

    Caries prevention might benefit from the use of toothpastes containing over 1500 ppm F. With few clinical studies available, the aim of this pH-cycling study was to investigate the dose response between 0 and 5000 ppm F of de- and remineralization of advanced (> 150 microm) enamel lesions. Treatments included sodium and amine fluoride, and a fluoride-free control. Mineral uptake and loss were assessed from solution calcium changes and microradiographs. Treatments with 5000 ppm F both significantly enhanced remineralization and inhibited demineralization when compared with treatments with 1500 ppm F. Slight differences in favor of amine fluoride over sodium fluoride were observed. The ratio of de- over remineralization rates decreased from 13.8 to 2.1 in the range 0 to 5000 ppm F. As much as 71 (6)% of the remineralized mineral was calculated to be resistant to dissolution during subsequent demineralization periods. With 5000-ppm-F treatments, more demineralizing episodes per day (10 vs. 2 for placebo) would still be repaired by remineralization.

  17. Automated detection of remineralization in simulated enamel lesions with PS-OCT

    NASA Astrophysics Data System (ADS)

    Lee, Robert C.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Previous in vitro and in vivo studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface structure and measure the thickness of the highly mineralized transparent surface zone of caries lesions. There are structural differences between active lesions and arrested lesions, and the surface layer thickness may correlate with activity of the lesion. The purpose of this study was to develop a method that can be used to automatically detect and measure the thickness of the transparent surface layer in PS-OCT images. Automated methods of analysis were used to measure the thickness of the transparent layer and the depth of the bovine enamel lesions produced using simulated caries models that emulate demineralization in the mouth. The transparent layer thickness measured with PS-OCT correlated well with polarization light microscopy (PLM) measurements of all regions (r2=0.9213). This study demonstrates that PS-OCT can automatically detect and measure thickness of the transparent layer formed due to remineralization in simulated caries lesions.

  18. [Enamel resistance to acid dissolution and its correlation with dental caries].

    PubMed

    Sánchez-Pérez, T L; Sáenz-Martínez, L P; Gómez-López, M E; Pérez-Quiroz, J

    1995-01-01

    Enamel resistance to acid dissolution is a factor which has an influence upon dental caries susceptibility. The objectives of this study were to determine enamel resistance to acid dissolution by applying the RM technique, and to correlate data obtained to the prevalence of dental caries. Two hundred and seventy one children between seven and nine years of age were chosen by non probabilistic sampling in two city districts, (six public schools in Mexico City). These children's central permanent incisives had already erupted. The DMF-T and dmf-t indexes were recorded, and the RM enamel resistance test was performed on them. A total of 56.4% of the subjects in the sample had very resistant enamel and 27.3%, less resistant enamel. A proportion of 57.9% was free of dental caries on the permanent dentition and 10% in the temporary dentition. The average obtained for the DMF-T index was 0.93 +/- 1.34 and that for dmf-t was 4.7 +/- 3.1. Data suggest that enamel resistance distribution is not homogeneous and this increases proportionally in relation to the eruption third (p < 0.05.) Spearman's correlation coefficient was found to be negative and statistically significant at p < 0.05. The RM technique showed the presence of individuals with different enamel resistance to acid dissolution.

  19. Nucleation and growth of hydroxyapatite nanocrystals for nondestructive repair of early caries lesions

    NASA Astrophysics Data System (ADS)

    Onuma, Kazuo; Yamagishi, Kazue; Oyane, Ayako

    2005-08-01

    Characterization of synthetic enamel formed by newly developed dental paste for repairing early caries lesions was performed using scanning and transmission electron microscopies and atomic force microscopy, with the chemical composition analysis using X-ray photoelectron spectroscopy. It was shown that the hydroxyapatite nanocrystals seamlessly grew in the interface between the paste and tooth enamel, and arranged their (0 0 0 1) face parallel to the tooth surface same as enamel apatite. The rapid growth of high crystalline large hydroxyapatite crystals by applying the paste is attributed to the dissociation of calcium phosphate clusters, Ca 9(PO 4) 6, which is the main growth unit of hydroxyapatite when it grows under physiological conditions, to ionic species in the concentrated and low pH phosphate solution.

  20. Monitoring of enamel lesion remineralization by optical coherence tomography: an alternative approach towards signal analysis

    NASA Astrophysics Data System (ADS)

    Sadr, Alireza; Mandurah, Mona; Nakashima, Syozi; Shimada, Yasushi; Kitasako, Yuichi; Tagami, Junji; Sumi, Yasunori

    Early detection, monitoring and remineralization repair of enamel lesions are top research priorities in the modern dentistry focusing on minimal intervention concept for caries management. We investigate the use of swept-source optical coherence tomography system (SS-OCT) without polarization-sensing at 1319 nm wavelength developed for clinical dentistry (Dental OCT System Prototype 2, Panasonic Healthcare Co., Ltd., Japan) in quantitative assessment of artificial enamel lesions and their remineralization. Bovine enamel blocks were subjected to demineralization to create subsurface lesions approximately 130 μm in depth over 2 weeks, and subjected to remineralization in solution containing bioavailable calcium and 1ppm fluoride at pH 6.5 for 2 weeks. Cross-sectional images of sound, demineralized and remineralized specimens were captured under hydrated conditions by the OCT. Finally, the specimens were cut into sections for nanoindentation to measure hardness through the lesion under 2mN load. Reflectivity had increased with demineralization. OCT images of lesions showed a boundary closely suggesting the lesion depth that gradually progressed with demineralization time. After remineralization, the boundary depth gradually decreased and nanoindentation showed over 60% average hardness recovery rate. A significant negative correlation was found between the slope power-law regression as a measure of attenuation and overall nanohardness for a range of data covering sound, demineralized and remineralized areas. In conclusion, OCT could provide clear images of early enamel lesion extent and signal attenuation could indicate its severity and recovery. Clinical data of natural lesions obtained using Dental OCT and analyzed by this approach will also be presented. Study supported by GCOE IRCMSTBD and NCGG.

  1. Monitoring remineralization of enamel subsurface lesions by optical coherence tomography.

    PubMed

    Mandurah, Mona M; Sadr, Alireza; Shimada, Yasushi; Kitasako, Yuichi; Nakashima, Syozi; Bakhsh, Turki A; Tagami, Junji; Sumi, Yasunori

    2013-04-01

    Optical coherence tomography (OCT) is a potential clinical tool for enamel lesion monitoring. Swept-source OCT findings were compared with cross-sectional nanohardness findings of enamel. Subsurface bovine enamel lesions in three groups were subjected to (1) deionized water (control), (2) phosphoryl oligosaccharide of calcium (POs-Ca) or (3) POs-Ca with 1 ppm fluoride for 14 days. B-scans images were obtained at 1310-nm center wavelength on sound, demineralized and remineralized areas after 4, 7, and 14 days. The specimens were processed for cross-sectional nanoindentation. Reflectivity from enamel that had increased with demineralization decreased with remineralization. An OCT attenuation coefficient parameter (μt), derived based on the Beer-Lambert law as a function of backscatter signal slope, showed a strong linear regression with integrated nanohardness of all regions (p<0.001, r=-0.97). Sound enamel showed the smallest, while demineralized enamel showed the highest μt. In group three, μt was significantly lower at four days than baseline, but remained constant afterwards. In group two, the changes were rather gradual. There was no significant difference between groups two and three at 14 days in nanohardness or μt POs-Ca with fluoride-enhanced nanohardness of the superficial zone. OCT signal attenuation demonstrated a capability for monitoring changes of enamel lesions during remineralization.

  2. In vitro performance of different methods in detecting occlusal caries lesions.

    PubMed

    Gomez, J; Zakian, C; Salsone, S; Pinto, S C S; Taylor, A; Pretty, I A; Ellwood, R

    2013-02-01

    Early caries detection is essential for the implementation of preventive, therapeutic and intervention strategies within general dental practice. The aim of this study was to compare the in vitro performance of the International Caries Detection and Assessment System (ICDAS), digital photographs scored with ICDAS (ICDAS photographs), fibre-optic transillumination (FOTI), optical coherence tomography (OCT), SoproLife(®) camera and two implementations of quantitative light-induced fluorescence a commercial (QLF-Inspektor Research systems) and a custom (QLF-Custom) system, to detect early and intermediate occlusal lesions. One hundred and twelve permanent extracted teeth were selected and assessed with each detection method. Histological validation was used as a gold standard. The detection methods were compared by means of sensitivity, specificity, areas under receiver operating characteristic (AUROC) curves for enamel and dentine levels and with the Spearman's rank correlation coefficient against histology. For any enamel or dentine caries detection, the AUROC curves ranged from 0.86 (OCT) to 0.98 (ICDAS and ICDAS photographs, SoproLife(®) camera) and at the dentine level from 0.83 (OCT) to 0.96 for FOTI. The correlations with histology ranged between 0.65 (OCT) and 0.88 (ICDAS and FOTI). Under in vitro conditions, the assessed detection methods showed excellent intra-examiner reproducibility. All the methods were strongly correlated with histology (p<0.01) except OCT which showed a moderate correlation (0.65). Even though all methods present similar performance in detecting occlusal caries lesions, visual inspection seems to be sufficient to be used in clinical practice for detection and assessment of lesion depth. Other methods may be useful in monitoring caries lesion behaviour. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Detecting and Treating Occlusal Caries Lesions

    PubMed Central

    Stolpe, M.; Meyer-Lueckel, H.; Paris, S.

    2015-01-01

    The health gains and costs resulting from using different caries detection strategies might not only depend on the accuracy of the used method but also the treatment emanating from its use in different populations. We compared combinations of visual-tactile, radiographic, or laser-fluorescence–based detection methods with 1 of 3 treatments (non-, micro-, and invasive treatment) initiated at different cutoffs (treating all or only dentinal lesions) in populations with low or high caries prevalence. A Markov model was constructed to follow an occlusal surface in a permanent molar in an initially 12-y-old male German patient over his lifetime. Prevalence data and transition probabilities were extracted from the literature, while validity parameters of different methods were synthesized or obtained from systematic reviews. Microsimulations were performed to analyze the model, assuming a German health care setting and a mixed public-private payer perspective. Radiographic and fluorescence-based methods led to more overtreatments, especially in populations with low prevalence. For the latter, combining visual-tactile or radiographic detection with microinvasive treatment retained teeth longest (mean 66 y) at lowest costs (329 and 332 Euro, respectively), while combining radiographic or fluorescence-based detections with invasive treatment was the least cost-effective (<60 y, >700 Euro). In populations with high prevalence, combining radiographic detection with microinvasive treatment was most cost-effective (63 y, 528 Euro), while sensitive detection methods combined with invasive treatments were again the least cost-effective (<59 y, >690 Euro). The suitability of detection methods differed significantly between populations, and the cost-effectiveness was greatly influenced by the treatment initiated after lesion detection. The accuracy of a detection method relative to a “gold standard” did not automatically convey into better health or reduced costs. Detection

  4. A novel classification system for assessment of approximal caries lesion progression in bitewing radiographs.

    PubMed

    Senneby, Anna; Elfvin, Margareta; Stebring-Franzon, Christina; Rohlin, Madeleine

    2016-01-01

    To design and pilot a novel classification system for the assessment of caries lesion progression in bitewing radiography and to report rater agreement of the system. A classification system with drawings and text was designed to assess caries lesion progression. Guidelines for Reporting Reliability and Agreement Studies were used to study and report rater agreement. Pairs of posterior bitewing radiographs (baseline and 1-year follow-up) with different status concerning caries lesion progression were selected from files from public dental health clinics. 10 raters, 5 general dental practitioners and 5 specialists in oral and maxillofacial radiology were asked to assess the radiographs with the aid of the classification system. Seven raters repeated their assessments. Rater agreement was expressed as percentage of agreement and kappa. Kappa for the interrater agreement of 10 raters assessing progression was 0.61, indicating substantial agreement. Agreement was moderate for progression in the outer half of the dentine (kappa 0.55) and within enamel (kappa 0.44). Pairwise interrater agreement varied (range 69-92%; kappa 0.42-0.84). For about half of the pairs of raters, kappa was substantial (≥0.61). Intrarater agreement assessing progression was substantial (kappa 0.66-0.82). We demonstrated the applicability of the proposed classification system on caries lesion progression with respect to rater agreement. This system can provide a common framework for clinical decision-making on caries interventional methods and patient visiting intervals. Scientifically, this system allows for a comparative analysis of different methods of prevention and treatment of caries as well as of different caries risk assessment methods.

  5. A novel classification system for assessment of approximal caries lesion progression in bitewing radiographs

    PubMed Central

    Elfvin, Margareta; Stebring-Franzon, Christina; Rohlin, Madeleine

    2016-01-01

    Objectives: To design and pilot a novel classification system for the assessment of caries lesion progression in bitewing radiography and to report rater agreement of the system. Methods: A classification system with drawings and text was designed to assess caries lesion progression. Guidelines for Reporting Reliability and Agreement Studies were used to study and report rater agreement. Pairs of posterior bitewing radiographs (baseline and 1-year follow-up) with different status concerning caries lesion progression were selected from files from public dental health clinics. 10 raters, 5 general dental practitioners and 5 specialists in oral and maxillofacial radiology were asked to assess the radiographs with the aid of the classification system. Seven raters repeated their assessments. Rater agreement was expressed as percentage of agreement and kappa. Results: Kappa for the interrater agreement of 10 raters assessing progression was 0.61, indicating substantial agreement. Agreement was moderate for progression in the outer half of the dentine (kappa 0.55) and within enamel (kappa 0.44). Pairwise interrater agreement varied (range 69–92%; kappa 0.42–0.84). For about half of the pairs of raters, kappa was substantial (≥0.61). Intrarater agreement assessing progression was substantial (kappa 0.66–0.82). Conclusions: We demonstrated the applicability of the proposed classification system on caries lesion progression with respect to rater agreement. This system can provide a common framework for clinical decision-making on caries interventional methods and patient visiting intervals. Scientifically, this system allows for a comparative analysis of different methods of prevention and treatment of caries as well as of different caries risk assessment methods. PMID:27043978

  6. Effects of enamel matrix derivative on remineralisation of initial enamel carious lesions in vitro.

    PubMed

    Xiang, Chenyang; Ran, Jinmei; Yang, Qingqing; Li, Wei; Zhou, Xuedong; Zhang, Linglin

    2013-04-01

    The purpose of this study was to investigate the effect of enamel matrix derivative on remineralisation of initial enamel carious lesions in vitro. Initial enamel carious lesions were created in bovine enamel blocks in vitro. The lesions were subjected to a pH-cycling regime of 24days. Each daily cycle included 4×3-min applications with one of four treatments: 1g/L NaF aqueous solution (positive control), 6% propylene glycol alginate (PGA) or distilled and deionised water (DDW) (both negative controls), and a gel of enamel matrix derivative and PGA (EMDgel). Samples were subjected to surface microhardness (SMH) testing, polarised light microscopy (PLM) and transverse microradiography (TMR) to measure SMH, mineral loss, lesion depth and mineral content of the surface layer and lesion body before and after pH-cycling. NaF samples showed the highest SMH recovery of all the groups (P<0.05). EMDgel samples showed significantly higher SMH recovery than did PGA ones (P<0.05). NaF samples showed significantly less mineral loss and shallower lesions than all other groups (P<0.05). The DDW and EMDgel samples showed significantly less mineral loss and shallower lesions than PGA samples. Mineral deposition predominated much more at the surface layer in the EMDgel group than in the PGA group (P<0.05). EMD, the active ingredient of EMDgel, may play an essential role in promoting remineralisation of initial enamel carious lesions. However, EMDgel as a whole did not cause detectable remineralisation of such lesions in vitro. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. A Study of the Potential to Detect Caries Lesions at the White-Spot Stage Using V(Z) Technique

    NASA Astrophysics Data System (ADS)

    Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

    Current wide-spread methods of non-destructive methods of caries diagnostics, such as X-ray techniques, do not provide the possibility to efficiently detect enamel caries lesions at the beginning ("white-spot") stage, when the tooth tissue is only slightly altered and no loss of the tissue occurs. Therefore, it is of paramount importance to develop new, more sensitive methods of caries diagnostics. In this paper, certain aspects of the ultrasonic approach to the problem are discussed - in particular, detection of the enamel's surface caries at the white-spot stage with a focused ultrasonic sensor positioned in front of the caries lesion (without cross-sectioning the tooth). Theoretical model using V(z) approach for layered media was applied to perform computer simulations resulting in V(z) curves for the different parameters of carious tissue and the degree of degradation. The curves were analyzed and it was shown that, comparing to a short-pulse/echo technique, V(z) approach provides much better distinction between sound and carious enamel and even makes possible to evaluate the degree of demineralization.

  8. Effect of fluoridated milk on enamel and root dentin demineralization evaluated by a biofilm caries model.

    PubMed

    Giacaman, R A; Muñoz, M J; Ccahuana-Vasquez, R A; Muñoz-Sandoval, C; Cury, J A

    2012-01-01

    Although some studies suggest an anticaries effect of fluoridated bovine milk (F-milk) on enamel, evidence is still considered weak. Even more uncertain, the effect of F-milk on root caries remains largely unknown. This study evaluated the effect of F-milk on enamel and on root dentin demineralization using a validated Streptococcus mutans biofilm model, simulating a high cariogenic challenge. S. mutans (UA159) biofilms were formed on bovine enamel and root dentin saliva-coated slabs after measuring initial surface microhardness (SH). Biofilms were exposed to 10% sucrose 8×/day and treated 2×/day with either: (1) 0.9% NaCl (negative control), (2) bovine milk, (3) F-milk (5.0 ppm F as NaF) or (4) NaF 0.05% (anticaries-positive control). Medium pH was monitored twice/day, as a biofilm acidogenicity indicator. After 5 days for enamel and 4 days for dentin, biofilms were recovered to analyze: biomass, soluble proteins, viable microorganisms, and extra- and intracellular polysaccharides. Enamel and dentin demineralization were estimated by percentage of SH loss. Results were compared by ANOVA and Tukey's test. Neither acidogenicity nor biofilm composition differed among treatment groups in biofilms formed on enamel or dentin (p > 0.05). F-milk, however, significantly reduced enamel and dentin demineralization when compared with the negative control (p < 0.05). Also, F-milk was as efficient as 0.05% NaF to reduce enamel (p > 0.05), but not dentin demineralization (p < 0.05). These findings suggest that milk containing 5.0 ppm of fluoride is effective to control enamel caries and that it may be effective on root dentin caries prevention. Copyright © 2012 S. Karger AG, Basel.

  9. Histologic and SEM evaluation of caries removal and restoration in enamel and dentin using a pulsed fiber optic delivered Nd:YAG laser

    NASA Astrophysics Data System (ADS)

    White, Joel M.; Goodis, Harold E.; Kudler, Joel J.; Eakle, W. S.; Neev, Joseph

    1994-09-01

    The pulsed Nd:YAG laser has been proposed as an alternative to the dental handpiece for caries removal in enamel and dentin. The purpose of this study was to systematically evaluate, in vitro, the process of caries removal and restoration in enamel and dentin. The effectiveness of this device was investigated utilizing scanning electron microscopy to determine the behavior of dentin after laser treatment of artificially created carious lesions in dentin. Histologic sections of extracted teeth after laser treatment and restoration demonstrated successful caries removal and restoration using the pulsed fiber optic delivered Nd:YAG laser as compared to both high and low speed rotary instrumentation. The adjacent enamel and dentin were unaffected by the laser irradiation although slight carbonization was seen on the dentin surface. Thermocouples placed in the pulp chamber during caries removal confirmed previous studies that showed laser parameters up to 1 W and 10 Hz being the same as conventional caries removal in the amount of heat generated which reaches the pulp. The addition of air/water coolant decreased pulpal temperature.

  10. A Microbeam Small-Angle X-ray Scattering Study on Enamel Crystallites in Subsurface Lesion

    NASA Astrophysics Data System (ADS)

    Yagi, N.; Ohta, N.; Matsuo, T.; Tanaka, T.; Terada, Y.; Kamasaka, H.; Kometani, T.

    2010-10-01

    The early caries lesion in bovine tooth enamel was studied by two different X-ray diffraction systems at the SPring-8 third generation synchrotron radiation facility. Both allowed us simultaneous measurement of the small and large angle regions. The beam size was 6μm at BL40XU and 50μm at BL45XU. The small-angle scattering from voids in the hydroxyapatite crystallites and the wide-angle diffraction from the hydroxyapatite crystals were observed simultaneously. At BL40XU an X-ray image intensifier was used for the small-angle and a CMOS flatpanel detector for the large-angle region. At BL45XU, a large-area CCD detector was used to cover both regions. A linear microbeam scan at BL40XU showed a detailed distribution of voids and crystals and made it possible to examine the structural details in the lesion. The two-dimensional scan at BL45XU showed distribution of voids and crystals in a wider region in the enamel. The simultaneous small- and wide-angle measurement with a microbeam is a powerful tool to elucidate the mechanisms of demineralization and remineralization in the early caries lesion.

  11. Clinical monitoring of early caries lesions using cross polarization optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Staninec, Michal; Darling, Cynthia L.; Chan, Kenneth H.; Pelzner, Roger B.

    New methods are needed for the nondestructive measurement of tooth demineralization and remineralization and to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role, since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm. It is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results from two clinical studies underway to measure the effect of fluoride intervention on early lesions. CP-OCT was used to monitor early lesions on enamel and root surfaces before and after intervention with fluoride varnish. The lesion depth and internal structure were resolved for all the lesions examined and some lesions had well defined surface zones of lower reflectivity that may be indicative of arrested lesions. Changes were also noted in the structure of some of the lesions after fluoride intervention.

  12. The association between enamel fluorosis and dental caries in U.S. schoolchildren.

    PubMed

    Iida, Hiroko; Kumar, Jayanth V

    2009-07-01

    The authors assessed the association between enamel fluorosis and dental caries to determine if there is any beneficial effect of enamel fluorosis in U.S. schoolchildren. The authors used data from a National Institute of Dental Research survey of the oral health of U.S. children conducted in 1986 and 1987 to determine the prevalence of caries and mean decayed, missing or filled surfaces on permanent maxillary right first molars in children 7 to 17 years of age who had a history of a single residence. (To date, this is the only national oral health data set in the United States with detailed information on fluoride exposures.) They examined the association between enamel fluorosis and caries using logistic regression analysis, controlling for potential confounders in communities with water at or above optimal fluoridation levels and in communities with nonfluoridated or suboptimally fluoridated water. Permanent maxillary right first molars with fluorosis consistently had lower levels of caries experience than did normal molars. Adjusted odds ratios for caries prevalence in molars with fluorosis were 0.71 (95 percent confidence interval [CI], 0.56-0.89) in communities with nonfluoridated or suboptimally fluoridated water and 0.89 (95 percent CI, 0.74-1.06) in communities with water at or above optimal fluoridation levels. This study's findings suggest that molars with fluorosis are more resistant to caries than are molars without fluorosis. The results highlight the need for those considering policies regarding reduction in fluoride exposure to take into consideration the caries-preventive benefits associated with milder forms of enamel fluorosis.

  13. INTRAPUPAL TEMPERATURE VARIATION DURING ER,CR:YSGG ENAMEL IRRADIATION ON CARIES PREVENTION

    PubMed Central

    de Freitas, Patrícia Moreira; Soares-Geraldo, Débora; Biella-Silva, Ana Cristina; Silva, Amanda Verna; da Silveira, Bruno Lopes; Eduardo, Carlos de Paula

    2008-01-01

    Studies have shown the cariostatic effect of Er,Cr:YSGG (2.78 μm) laser irradiation on human enamel and have suggested its use on caries prevention. However there are still no reports on the intrapulpal temperature increase during enamel irradiation using parameters for caries prevention. The aim of this in vitro study was to evaluate the temperature variation in the pulp chamber during human enamel irradiation with Er,Cr:YSGG laser at different energy densities. Fifteen enamel blocks obtained from third molars (3 x 3 x 3 mm) were randomly assigned to 3 groups (n=5): G1 – Er,Cr:YSGG laser 0.25 W, 20 Hz, 2.84 J/cm2, G2 – Er,Cr:YSGG laser 0.50 W, 20 Hz, 5.68 J/cm2, G3 – Er,Cr:YSGG laser 0.75 W, 20 Hz, 8.52 J/cm2. During enamel irradiation, two thermocouples were fixed in the inner surface of the specimens and a thermal conducting paste was used. One-way ANOVA did not show statistically significant difference among the experimental groups (α=0.05). There was intrapulpal temperature variation ≤0.1°C for all irradiation parameters. In conclusion, under the tested conditions, the use of Er,Cr:YSGG laser with parameters set for caries prevention lead to an acceptable temperature increase in the pulp chamber. PMID:19089198

  14. Retention of dental sealants placed on sound teeth and incipient caries lesions as part of a service-learning programme in rural areas in Mexico.

    PubMed

    Soto-Rojas, Armando E; Escoffié-Ramírez, Mauricio; Pérez-Ferrera, Gloriana; Guido, Joseph A; Mantilla-Rodriguez, Andres A; Martinez-Mier, Esperanza A

    2012-11-01

    Dental sealants are an effective treatment for the prevention and management of caries. To determine the retention of sealants placed in a rural setting in Mexico as part of an international service-learning (ISL) programme and to determine associations between dental sealant's retention and caries diagnosis at the time of sealant placement. Children aged 6-15 were examined for dental caries, received sealants by dental students as part of an ISL programme, and were re-examined 4, 2, or 1 years after placement to assess sealant survival. Sealants were placed on permanent sound surfaces and enamel caries lesions [International Caries Assessment and Detection System (ICDAS) criteria]. Sealant survival was explored using Cochran-Mantel-Haenszel tests and multivariate prediction models. 219 (46%) of 478 (mean age = 10.53 SD = 5.11) children who had received sealants returned for a recall examination (mean age = 10.89 SD = 3.11). After 1-4 years, 96.4% to 60.6% of the sealants placed on sound teeth had survived, and for sealants placed on surfaces with enamel caries lesions (ICDAS 1-3), 94.2% to 55.6% had survived. Differences were not statistically significant. Sealants had survival rates comparable to those previously reported in the literature. Sealants placed on sound and enamel caries lesions had similar survival rates. © 2012 The Authors. International Journal of Paediatric Dentistry © 2012 BSPD, IAPD and Blackwell Publishing Ltd.

  15. Dental enamel defects, caries experience and oral health-related quality of life: a cohort study.

    PubMed

    Arrow, P

    2017-06-01

    The impact of enamel defects of the first permanent molars on caries experience and child oral health-related quality of life was evaluated in a cohort study. Children who participated in a study of enamel defects of the first permanent molars 8 years earlier were invited for a follow-up assessment. Consenting children completed the Child Perception Questionnaire and the faces Modified Child Dental Anxiety Scale, and were examined by two calibrated examiners. ANOVA, Kruskal-Wallis, negative binomial and logistic regression were used for data analyses. One hundred and eleven children returned a completed questionnaire and 91 were clinically examined. Negative binomial regression found that oral health impacts were associated with gender (boys, risk ratio (RR) = 0.73, P = 0.03) and decayed, missing or filled permanent teeth (DMFT) (RR = 1.1, P = 0.04). The mean DMFT of children were sound (0.9, standard deviation (SD) = 1.4), diffuse defects (0.8, SD = 1.7), demarcated defects (1.5, SD = 1.4) and pit defects (1.3, SD = 2.3) (Kruskal-Wallis, P = 0.05). Logistic regression of first permanent molar caries found higher odds of caries experience with baseline primary tooth caries experience (odds ratio (OR) = 1.5, P = 0.01), the number of teeth affected by enamel defects (OR = 1.9, P = 0.05) and lower odds with the presence of diffuse enamel defects (OR = 0.1, P = 0.04). The presence of diffuse enamel defects was associated with lower odds of caries experience. © 2016 Australian Dental Association.

  16. In vivo remineralising effect of GC tooth mousse on early dental enamel lesions: SEM analysis.

    PubMed

    Ferrazzano, Gianmaria F; Amato, Ivana; Cantile, Tiziana; Sangianantoni, Giancarla; Ingenito, Aniello

    2011-08-01

    Casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP) exhibit anticariogenic potential in laboratory, animal and human experiments. The remineralising potential of synthetic CPPs on early enamel caries was investigated. In vivo study. University of Naples 'Federico II', School of Dentistry, Department of Paediatric Dentistry, 2010, Italy. 40 volunteers (age range 10-16 years) were recruited and divided in two groups of 20 (Group A and B). In Group A subjects two demineralised enamel specimens were placed on the buccal surfaces of the first molars and subjects were instructed to apply a commercial product containing CPPs (GC Tooth Mousse) only on the right-sided specimen and a placebo mousse on the left, for 1 month. In Group B subjects two enamel specimens were similarly placed into the mouth and used as controls. SEM analysis revealed a diffuse and homogeneous mineral coating, reducing the surface alterations only in the demineralised specimens treated with synthetic CPPs into the mouth. Results demonstrate that CPPs are able to promote remineralisation of early enamel lesions. © 2011 FDI World Dental Federation.

  17. Assessment of the remineralization in simulated enamel lesions via dehydration with near-IR reflectance imaging

    NASA Astrophysics Data System (ADS)

    Lee, Robert C.; Darling, Cynthia L.; Fried, Daniel

    2015-02-01

    Previous studies have demonstrated that near-IR imaging can be used to nondestructively monitor the severity of enamel lesions. Arrested lesions typically have a highly mineralized surface layer that reduces permeability and limits diffusion into the lesion. The purpose of this study was to investigate whether the rate of water loss correlates with the degree of remineralization using near-IR reflectance imaging. Artificial bovine (n=15) enamel lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for different periods. The samples were dehydrated using an air spray for 30 seconds and surfaces were imaged using an InGaAs camera at 1300-1700 nm wavelengths. Near-IR reflectance intensity differences before and after dehydration decreased with longer periods of remineralization. This study demonstrated that near-IR reflectance imaging was suitable for the detection of remineralization in simulated caries lesions and near-IR wavelengths longer than 1400 nm are well suited for the assessment of remineralization.

  18. Assessment of remineralization in simulated enamel lesions via dehydration with near-IR reflectance imaging.

    PubMed

    Lee, Robert C; Darling, Cynthia L; Fried, Daniel

    2015-02-24

    Previous studies have demonstrated that near-IR imaging can be used to nondestructively monitor the severity of enamel lesions. Arrested lesions typically have a highly mineralized surface layer that reduces permeability and limits diffusion into the lesion. The purpose of this study was to investigate whether the rate of water loss correlates with the degree of remineralization using near-IR reflectance imaging. Artificial bovine (n=15) enamel lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for different periods. The samples were dehydrated using an air spray for 30 seconds and surfaces were imaged using an InGaAs camera at 1300-1700 nm wavelengths. Near-IR reflectance intensity differences before and after dehydration decreased with longer periods of remineralization. This study demonstrated that near-IR reflectance imaging was suitable for the detection of remineralization in simulated caries lesions and near-IR wavelengths longer than 1400 nm are well suited for the assessment of remineralization.

  19. The primary and mixed dentition, post-eruptive enamel maturation and dental caries: a review.

    PubMed

    Lynch, Richard J M

    2013-12-01

    The mouth is in flux from the time the primary teeth begin to erupt, in the first year of life, through to the end of the 'mixed dentition' (i.e. the concurrent eruption of the permanent teeth and exfoliation of the primary teeth), at around 12 years of age. Primary teeth facilitate the development of the facial muscles and speech. They act as 'guides' for erupting permanent teeth. If lost prematurely, subsequent misalignment of permanent teeth can make them difficult to clean and possibly more caries-prone. During the mixed dentition phase, teeth are at relatively high risk of caries. Erupting teeth are difficult to clean and cleaning may be avoided because of tender gums and behavioural factors in children. Permanent enamel (and possibly primary enamel) undergoes post-eruptive maturation, accumulating fluoride, becoming harder, less porous and less caries-prone. Overall, primary teeth are more vulnerable to caries than permanent teeth. Widespread use of fluoride toothpaste has effected marked reductions in caries. Some evidence exists that fluoride delivered from toothpastes may be somewhat more effective in reducing caries in primary than in permanent teeth. However, caries remains a public health concern globally. New fluoride toothpaste formulations, optimised using in vivo fluoride delivery and efficacy studies, may improve the caries resistance of mineral deposited during post-eruptive maturation. Behaviour should not be ignored; new formulations will be more effective if used according to professionally endorsed recommendations based on sound science. Establishing good oral hygiene behaviour early in life can lead to lasting anti-caries benefits. © 2013 FDI World Dental Federation.

  20. In situ fluoride response of caries lesions with different mineral distributions at baseline.

    PubMed

    Lippert, F; Lynch, R J M; Eckert, G J; Kelly, S A; Hara, A T; Zero, D T

    2011-01-01

    The present in situ study investigated the fluoride response of caries lesions with similar mineral loss but two distinct mineral distributions (low- and high-'R', calculated as the ratio of mineral loss to lesion depth). Sixteen subjects wore eight gauze-covered enamel specimens with preformed lesions placed buccally on their mandibular partial dentures for periods up to 4 weeks. The participants brushed twice daily for 1 min with an 1,100 ppm F (as NaF) dentifrice. After 3 and 4 weeks, specimens were retrieved and analyzed microradiographically (TMR) and by quantitative light fluorescence (QLF). TMR results revealed that low- and high-R lesions showed opposite behaviors - low-R lesions further demineralized, whereas high-R lesions exhibited some remineralization. In comparison, lesion depth increased in low-R, but remained unchanged in high-R lesions; R decreased in both, but more in high-R lesions; mineral density at the lesion surface remained unchanged in low-R, but increased in high-R lesions. Differences in mineral loss between lesion types increased further between 3 and 4 weeks. QLF did not mirror TMR results as low-R lesions were found to remineralize, whereas high-R lesions remained unchanged. It is likely that low-R lesions differ from high-R lesions chemically and microstructurally; therefore rendering low-R lesion more susceptible to further dissolution. During lesion formation, low-R in contrast to high-R lesions may not lose all of the solubility-determining impurities such as magnesium and carbonate, which can reprecipitate again in different mineral phases within the lesion. In conclusion, mineral distribution at baseline directly impacts in situ lesion response to fluoride. 2011 S. Karger AG, Basel.

  1. Effects of XeCl excimer lasers and fluoride application on artificial caries-like lesions

    NASA Astrophysics Data System (ADS)

    Wilder-Smith, Petra B. B.; Phan, T.; Liaw, Lih-Huei L.; Berns, Michael W.

    1994-09-01

    In this study the affects of a pulsed excimer laser emitting at 308 nm (XeCl) on enamel susceptibility to artificial caries-like lesions were investigated. Additional effects of fluoride (F) application were also studied and SEC examinations performed. Sixty-four extracted human molar teeth were coated with acid resistant varnish leaving four windows, then sectioned, leaving one window on each tooth quarter. The windows were treated in one of the following ways: untreated (control), or lased, or exposed to 4 min. APF (1.23% F) before lasing, or exposed to 4 min. APF (1.23% F) after lasing. After lasing, microhardness profiles were obtained and SEM was performed. Caries resistance was generally increased at moderate fluences. F application combined with lasing enhanced caries resistance at some parameters. SEM showed effects ranging from minimal to localized effects to extended glazing. Pulsed excimer laser irradiation, especially combined with topical F application can inhibit development of artificial caries-like lesions.

  2. The effect of whitening agents on caries susceptibility of human enamel.

    PubMed

    Al-Qunaian, Talal A

    2005-01-01

    This in vitro study evaluated whether the treatment of human enamel with whitening agents containing different concentrations of carbamide or hydrogen peroxide changes the susceptibility of enamel to caries. Twenty-four sound human incisors were selected for this study. For each tooth, the crown was sectioned into two halves in the cervical-incisal direction. One half of the sectioned tooth was treated and the other half was used as a control specimen. Each half was randomly divided into three treatment groups (eight two-halves/group). The whitening agents were 10% carbamide peroxide, 20% carbamide peroxide with fluoride and 35% hydrogen peroxide. Following pretreatment, the specimens were demineralized for four days in an in vitro microbial caries model and then analyzed using a confocal laser scanning microscope (CLSM). Results showed that there were no significant differences between the treated and controlled specimens for teeth treated with 10% carbamide peroxide or 35% hydrogen peroxide. However, specimens treated with 20% carbamide peroxide with FP (0.11% fluoride and potassium nitrate) were less susceptible to caries than their controls at p < or = 0.05. In conclusion, application of bleaching agents does not increase the caries susceptibility of human enamel.

  3. Effect of three different remineralizing agents on enamel caries formation--an in vitro study.

    PubMed

    Sathe, N; Chakradhar Raju, R V S; Chandrasekhar, V

    2014-01-01

    Caries process is not a static one, but is dynamic with interspersed periods of demineralization and remineralization of enamel, intimately related and occurs episodically based upon the presence of cariogenic bacteria in dental plaque and the availability of refined carbohydrates for fermentation to organic acids. Early enamel caries could be reversed with avoidance of frank cavitation. The main objective of this study is to check wether enamel demineralization can be prevented by using the remineralizing agents. Forty freshly extracted human central incisors were selected and stored in saline at normal temperature. A window of 3 X 3mm enamel was created and all the specimens were then randomly divided into 4 groups of 10 each. Group I--teeth received no treatment, Group II--teeth treated with Acidulated Phosphate Flouride gel, Group III--teeth treated with Tooth Mousse Plus, Group IV--teeth treated with Remin+. Samples in all the groups were kept in artificial saliva for 24 hours and subjected to modified Ten Cate's solution at an acidic pH of 3.5 for 10 days. The samples were sectioned and subjected to SEM evaluation. Scanning Electron Microscope(SEM) images showed decrease in pore volume of the enamel in all the treatment groups compared to the control group indicating increase in resistance to demineralization in acidic pH. The three groups of remineralizing agents, Acidulated Phosphate Fluoride gel, Tooth Mousse Plus and Remin + showed significant increase in fluoride content and negligible increase in calcium content indicating there is remineraliztion.

  4. Effects of enamel matrix genes on dental caries are moderated by fluoride exposures.

    PubMed

    Shaffer, John R; Carlson, Jenna C; Stanley, Brooklyn O C; Feingold, Eleanor; Cooper, Margaret; Vanyukov, Michael M; Maher, Brion S; Slayton, Rebecca L; Willing, Marcia C; Reis, Steven E; McNeil, Daniel W; Crout, Richard J; Weyant, Robert J; Levy, Steven M; Vieira, Alexandre R; Marazita, Mary L

    2015-02-01

    Dental caries (tooth decay) is the most common chronic disease, worldwide, affecting most children and adults. Though dental caries is highly heritable, few caries-related genes have been discovered. We investigated whether 18 genetic variants in the group of non-amelogenin enamel matrix genes (AMBN, ENAM, TUFT1, and TFIP11) were associated with dental caries experience in 13 age- and race-stratified samples from six parent studies (N = 3,600). Linear regression was used to model genetic associations and test gene-by-fluoride interaction effects for two sources of fluoride: daily tooth brushing and home water fluoride concentration. Meta-analysis was used to combine results across five child and eight adult samples. We observed the statistically significant association of rs2337359 upstream of TUFT1 with dental caries experience via meta-analysis across adult samples (p < 0.002) and the suggestive association for multiple variants in TFIP11 across child samples (p < 0.05). Moreover, we discovered two genetic variants (rs2337359 upstream of TUFT1 and missense rs7439186 in AMBN) involved in gene-by-fluoride interactions. For each interaction, participants with the risk allele/genotype exhibited greater dental caries experience only if they were not exposed to the source of fluoride. Altogether, these results confirm that variation in enamel matrix genes contributes to individual differences in dental caries liability, and demonstrate that the effects of these genes may be moderated by protective fluoride exposures. In short, genes may exert greater influence on dental caries in unprotected environments, or equivalently, the protective effects of fluoride may obviate the effects of genetic risk alleles.

  5. Effects of enamel matrix genes on dental caries are moderated by fluoride exposures

    PubMed Central

    Shaffer, John R.; Carlson, Jenna C.; Stanley, Brooklyn O. C.; Feingold, Eleanor; Cooper, Margaret; Vanyukov, Michael M.; Maher, Brion S.; Slayton, Rebecca L.; Willing, Marcia C.; Reis, Steven E.; McNeil, Daniel W.; Crout, Richard J.; Weyant, Robert J.; Levy, Steven M.; Vieira, Alexandre R.; Marazita, Mary L.

    2014-01-01

    Dental caries (tooth decay) is the most common chronic disease, worldwide, affecting most children and adults. Though dental caries is highly heritable, few caries-related genes have been discovered. We investigated whether 18 genetic variants in the group of nonamelogenin enamel matrix genes (AMBN, ENAM, TUFT1, and TFIP11) were associated with dental caries experience in 13 age- and race-stratified samples from six parent studies (N=3,600). Linear regression was used to model genetic associations and test gene-byfluoride interaction effects for two sources of fluoride: daily tooth brushing and home water fluoride concentration. Meta-analysis was used to combine results across five child and eight adult samples. We observed the statistically significant association of rs2337359 upstream of TUFT1 with dental caries experience via meta-analysis across adult samples (p<0.002) and the suggestive association for multiple variants in TFIP11 across child samples (p<0.05). Moreover, we discovered two genetic variants (rs2337359 upstream of TUFT1 and missense rs7439186 in AMBN) involved in gene-by-fluoride interactions. For each interaction, participants with the risk allele/genotype exhibited greater dental caries experience only if they were not exposed to the source of fluoride. Altogether, these results confirm that variation in enamel matrix genes contributes to individual differences in dental caries liability, and demonstrate that the effects of these genes may be moderated by protective fluoride exposures. In short, genes may exert greater influence on dental caries in unprotected environments, or equivalently, the protective effects of fluoride may obviate the effects of genetic risk alleles. PMID:25373699

  6. Influence of CO2 (10.6 μm) and Nd:YAG laser irradiation on the prevention of enamel caries around orthodontic brackets.

    PubMed

    Seino, Priscila Yumi; Freitas, Patrícia Moreira; Marques, Márcia Martins; de Souza Almeida, Fernanda Campos; Botta, Sérgio Brossi; Moreira, Maria Stella Nunes Araújo

    2015-02-01

    One possible undesirable consequence of orthodontic therapy is the development of incipient caries lesions of enamel around brackets. The aim of this study was to compare the effects of CO2 (λ = 10.6 μm) and Nd:YAG (λ = 1,064 nm) lasers associated or not with topical fluoride application on the prevention of caries lesions around brackets. Brackets were bonded to the enamel of 65 premolars. The experimental groups (n = 13) were: G1--application of 1.23% acidulated fluoride phosphate gel (AFP, control); G2--Nd:YAG laser irradiation (0.6 W, 84.9 J/cm(2), 10 Hz, 110 μs, contact mode); G3--Nd:YAG laser irradiation associated with AFP; G4--CO2 laser irradiation (0.5 W, 28.6 J/cm(2), 50 Hz, 5 μs, and 10 mm focal distance); and G5--CO2 laser irradiation associated with AFP. Quantitative light-induced fluorescence was used to assess enamel demineralization. The data were statistically compared (α = 5%). The highest demineralization occurred in the Nd:YAG laser group (G2, 26.15% ± 1.94). The demineralization of all other groups was similar to that of the control group. In conclusion, CO2 laser alone was able to control enamel demineralization around brackets at the same level as that obtained with topical fluoride application.

  7. Prevalence and Association of Developmental Defects of Enamel with, Dental- Caries and Nutritional Status in Pre-School Children, Lucknow

    PubMed Central

    Saha, Sabyasachi; Jagannath, G.V.; Singh, Sanjay

    2015-01-01

    Background Developmental Defects of Enamel in the primary dentition may be associated and predictors of dental caries and nutritional status. The aim of the present study was to assess the Prevalence of Developmental Defects of Enamel and its Association with, Dental-Caries and Nutritional Status in Pre-School Children of Lucknow, India. Materials and Methods Multistage Sampling was done. A total of 302 pre-school (Rural and Urban) children were examined. Type III examination was conducted with WHO Probe. Developmental Enamel Defects (DED) and Dental Caries were assessed using WHO (1997) Proforma. Results The prevalence of DED of any type was 39.9% with that of demarcated opacities being the highest, followed by hypoplasia. The most frequently affected teeth were maxillary anterior teeth, while the least affected teeth were mandibular incisors. The mean dmft was 3.5. A positive association between DED and caries was observed. Association between Dental Caries & BMI was non-significant whereas Pearson correlation showed a negative correlation between the two. Conclusion The prevalence of enamel defects and caries was high, as the enamel defects were strongly associated with caries. PMID:26557622

  8. Casein phosphopeptide-amorphous calcium phosphate remineralization of primary teeth early enamel lesions.

    PubMed

    Zhou, Chunhua; Zhang, Dongliang; Bai, Yuxing; Li, Song

    2014-01-01

    Early childhood caries (ECC) is a serious problem that progresses rapidly and often goes untreated. Current traumatic treatments may be replaced by safe and effective remineralization at very early stages. The aim of this in vitro study was to evaluate the remineralization effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on enamel lesions by assessing ultrastructure, nanomechanical properties, and compound and elemental analysis. Enamel specimens from 6-year-old children were divided into groups: (1) native enamel; (2) water as negative control; (3) 500ppm NaF as positive control; and (4-7) CPP-ACP paste for 4, 8, 12, and 24h, as test groups. Ultrastructure and roughness were observed by atomic force microscopy (AFM); nanohardness and elastic modulus were measured by nanoindentation; compound and crystal size of enamel surface patterns were investigated by X-ray diffractometer (XRD). An electron microprobe (EPMA) was used for element analysis. Data were analyzed using one-way ANOVA. The CPP-ACP paste repaired the microstructure of enamel, including prism and interprism, through significantly increased hydroxyapatite crystal size (12.06±0.21nm) and Ca/P molar ratios (1.637±0.096) as compared with NaF (8.56±0.13nm crystal size and 1.397±0.086 Ca/P, p<0.01). Both CPP-ACP and NaF decrease roughness, and increase the nanohardness and elastic modulus, with no significant differences between the materials. The CPP-ACP paste is more suitable for children than NaF, due to advantages for remineralization. The AFM, nanoindentation, EPMA, and XRD are very helpful methods for further understanding of microscale and nanoscale remineralization mechanisms. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Silver diamine fluoride and glass ionomer differentially remineralize early caries lesions, in situ.

    PubMed

    Nantanee, Ratichanok; Santiwong, Busayarat; Trairatvorakul, Chutima; Hamba, Hidenori; Tagami, Junji

    2016-07-01

    The aim of the present study was to evaluate the percent mean mineral density (MD) change of early caries lesions after the application of silver diamine fluoride (SDF) or glass ionomer cement (GIC). This double-blind, crossover study involved two experimental phases of 28 days each. Thirty-two pairs of enamel slabs were created from the proximal surfaces of 16 premolars. Each pair of artificial carious slabs was randomly divided into the control or test group (38 % SDF or GIC). The slabs were attached to orthodontic brackets and bonded to the maxillary first permanent molars of 16 subjects for 28 days. After a 7-day washout period between phases, the subjects received the other material for the second phase. The mean MD of the lesions was measured by microcomputed tomography. SDF yielded a percent mean MD increase at a depth of 0-84 μm, although increase in the GIC group was observed at a depth of 24-108 μm. The percent mean MD changes of the SDF and GIC groups were similar (p = 0.100) and significantly higher than in control (p < 0.001, p = 0.003, respectively). The two materials increased the percent mean MD change of early proximal caries lesions to a similar extent, but with different spatial patterns. Due to deeper level of GIC remineralization, the refractive index of the GIC applied enamel might be closer to sound enamel. Hence, GIC is recommended for remineralization of anterior teeth. SDF staining makes it unsuitable for use in anterior teeth; thus, it is reserved for use in posterior teeth.

  10. In vitro evaluation of the efficacy of laser fluorescence (DIAGNOdent) to detect demineralization and remineralization of smooth enamel lesions

    PubMed Central

    Bahrololoomi, Zahra; Musavi, Seyed Ahmad; Kabudan, Mona

    2013-01-01

    Objective: Early detection of smooth surface lesions is important for appropriate management and monitoring of dental caries. The purpose of this in vitro study was to evaluate the efficacy of laser fluorescence to detect demineralization and remineralization of smooth enamel surfaces. Materials and Methods: In this in vitro study, 132 enamel blocks of semi-impacted human third molars were obtained; artificial caries lesions were induced and they were submitted to the pH-cycling process to create remineralization. Superficial microhardness (SMH) and laser fluorescence (LF) analysis were performed at baseline, after demineralization, and remineralization processes. The data were analyzed by Statistical Package for Social Sciences (SPSS)-16 using analysis of variance (ANOVA), Paired samples t-test, and Pearson's correlation test. Results: There was a significant difference between SMH values at baseline, after demineralization and after remineralization. Also, a statistically significant difference was observed between LF values in these three stages. The LF values increased after demineralization and then decreased after remineralization, and the SMH values decreased after demineralization and increased after remineralization. There was an inverse relationship between SMH and LF only at baseline and after demineralization, but not after remineralization. Conclusion: The results showed that LF is an appropriate method for detection of demineralization in an in vitro condition in smooth enamel lesions, but it was not so efficient in the detection of remineralization. PMID:23956542

  11. Remineralization potential of nano-hydroxyapatite on initial enamel lesions: an in vitro study.

    PubMed

    Huang, S; Gao, S; Cheng, L; Yu, H

    2011-01-01

    The application of nano-hydroxyapatite (HA) in the repair of early caries lesion has received considerable attention. Neither the effects of the size of HA nor the effects of the effective pH range of nano-HA on remineralization have been investigated comprehensively, and the protective mechanism is still open for debate. To address these factors, the remineralization effect of nano-HA on demineralized bovine enamel is investigated under pH cycling conditions through surface and cross-sectional microhardness (CSMH) tests and polarized light microscopy (PLM). The percentage of surface microhardness recovery and integrated mineral loss obtained from CSMH tests demonstrated that nano-HA provides better remineralization than micro-HA. However, detailed investigation using CSMH tests and PLM indicated that nano-HA helped mineral deposition predominantly in the outer layer of the lesion and only had a limited capacity to reduce lesion depth. Nevertheless, the remineralization effect of nano-HA increased significantly when the pH was less than 7.0. Clearly, nano-HA has potential as an effective repair material and anticaries agent. Our findings also suggest that both the particle- and ion-mediated remineralization pathways in nano-HA may contribute to the repair of demineralized enamel.

  12. Management of Post-orthodontic White Spot Lesions and Subsequent Enamel Discoloration with Two Microabrasion Techniques

    PubMed Central

    Jahanbin, Arezoo; Ameri, Hamideh; Shahabi, Mostafa; Ghazi, Ala

    2015-01-01

    Statement of the Problem Demineralization of enamel adjacent to orthodontic appliances frequently occurs, commonly due to insufficient oral hygiene. Purpose The aim of this study was to compare two microabrasion techniques on improving the white spot lesions as well as subsequent enamel discoloration. Materials and Method Sixty extracted premolar teeth without caries and hypoplasia were selected for this study. White spot lesions were artificially induced on the buccal surface of each tooth. Teeth were randomly assigned to three treatment groups, each treated with pumice powder as the control, microabrasion with 18% HCl, and microabrasion with 37% H3PO4. Subsequently, the three groups were daily immersed for five minutes in a tea-coffee solution for a period of one week. Colorimetric evaluation was done before and after formation of white spot lesions, after microabrasion, and after immersion in the colored solution; then the color differences (∆E) were calculated. Statistical analysis was performed by multiple measurement analysis and the Tukey’s test. Results This study showed that ∆E between the stages of white spot formation and microabrasion for H3PO4 was more than other groups and for the pumice powder group it was less than the others. Furthermore, there was a significant difference between ∆E of the three study groups (p= 0.017). Additionally, ∆E after placing the teeth in the colored solution and microabrasion was the highest for the HCl group and the lowest for the pumice powder group. There was also a significant difference between the three groups (p= 0.000). Conclusion Pumice powder alone had similar effects as 18% HCl on removing the white spot lesions. Nevertheless, 18% HCl makes the enamel susceptible for subsequent color staining more than the other microabrasion methods. PMID:26106636

  13. Management of Post-orthodontic White Spot Lesions and Subsequent Enamel Discoloration with Two Microabrasion Techniques.

    PubMed

    Jahanbin, Arezoo; Ameri, Hamideh; Shahabi, Mostafa; Ghazi, Ala

    2015-03-01

    Demineralization of enamel adjacent to orthodontic appliances frequently occurs, commonly due to insufficient oral hygiene. The aim of this study was to compare two microabrasion techniques on improving the white spot lesions as well as subsequent enamel discoloration. Sixty extracted premolar teeth without caries and hypoplasia were selected for this study. White spot lesions were artificially induced on the buccal surface of each tooth. Teeth were randomly assigned to three treatment groups, each treated with pumice powder as the control, microabrasion with 18% HCl, and microabrasion with 37% H3PO4. Subsequently, the three groups were daily immersed for five minutes in a tea-coffee solution for a period of one week. Colorimetric evaluation was done before and after formation of white spot lesions, after microabrasion, and after immersion in the colored solution; then the color differences (∆E) were calculated. Statistical analysis was performed by multiple measurement analysis and the Tukey's test. This study showed that ∆E between the stages of white spot formation and microabrasion for H3PO4 was more than other groups and for the pumice powder group it was less than the others. Furthermore, there was a significant difference between ∆E of the three study groups (p= 0.017). Additionally, ∆E after placing the teeth in the colored solution and microabrasion was the highest for the HCl group and the lowest for the pumice powder group. There was also a significant difference between the three groups (p= 0.000). Pumice powder alone had similar effects as 18% HCl on removing the white spot lesions. Nevertheless, 18% HCl makes the enamel susceptible for subsequent color staining more than the other microabrasion methods.

  14. Effect of ammonium hexafluorosilicate application for arresting caries treatment on demineralized primary tooth enamel.

    PubMed

    Hosoya, Yumiko; Tadokoro, Katsumi; Otani, Hideji; Hidaka, Kiyoshi; Inoue, Takashi; Miyazaki, Masashi; Tay, Franklin R

    2013-01-01

    Ammonium hexafluorosilicate (AHF) has been applied to arrest caries without discoloration. The purpose of this study was to observe structural and elemental changes of demineralized and AHF applied primary tooth enamel. Enamel from the labial surface of 20 primary canines was divided into an unground side and ground side at the center of the tooth, and demineralized with 35% phosphoric acid for 6 min. The teeth were divided into 4 groups according to a 3-min application of AHF and 1 week of soaking in artificial saliva, as follows: group A (neither AHF nor saliva), group B (only saliva), group C (only AHF), and group D (AHF and saliva), and then subdivided according to whether the enamel was ground or unground. Specimens were analyzed with scanning electron microscopy (SEM) and energy dispersive X-ray spectrometry (EDS). The data were statistically analyzed using ANOVA and Fisher's PLSD test at α = 0.05. In groups A and B, prism structures were seen, however, in groups C and D, enamel surfaces were covered with spherical particles. Ca/P ratio was significantly higher in groups C and D than in groups A and B. There was no significant difference between ground and unground enamel in the content of any element. The values for F, Na, Mg and Si persents and Ca/P ratio were significantly higher for the enamel surface than for points 10-30 µm beneath the surface. Results of this study suggest the possibility that AHF treatment arrests caries, although further study will be required to confirm this result.

  15. Terahertz pulsed imaging study to assess remineralization of artificial caries lesions

    NASA Astrophysics Data System (ADS)

    Churchley, David; Lynch, Richard J. M.; Lippert, Frank; O'Bryan Eder, Jennifer Susan; Alton, Jesse; Gonzalez-Cabezas, Carlos

    2011-02-01

    We compare terahertz-pulsed imaging (TPI) with transverse microradiography (TMR) and microindentation to measure remineralization of artificial caries lesions. Lesions are formed in bovine enamel using a solution of 0.1 M lactic acid/0.2% Carbopol C907 and 50% saturated with hydroxyapatite adjusted to pH 5.0. The 20-day experimental protocol consists of four 1 min treatment periods with dentifrices containing 10, 675, 1385, and 2700 ppm fluoride, a 4-h/day acid challenge, and, for the remaining time, specimens are stored in a 50:50 pooled human/artificial saliva mixture. Each specimen is imaged at the focal point of the terahertz beam (data-point spacing = 50 μm). The time-domain data are used to calculate the refractive index volume percent profile throughout the lesion, and the differences in the integrated areas between the baseline and post-treatment profiles are used to calculate ΔΔZ(THz). In addition, the change from baseline in both the lesion depth and the intensity of the reflected pulse from the air/enamel interface is determined. Statistically significant Pearson correlation coefficients are observed between TPI and TMR/microindentation (P < 0.05). We demonstrate that TPI has potential as a research tool for hard tissue imaging.

  16. Crystal Initiation Structures in Developing Enamel: Possible Implications for Caries Dissolution of Enamel Crystals

    PubMed Central

    Robinson, Colin; Connell, Simon D.

    2017-01-01

    Investigations of developing enamel crystals using Atomic and Chemical Force Microscopy (AFM, CFM) have revealed a subunit structure. Subunits were seen in height images as collinear swellings about 30 nM in diameter on crystal surfaces. In friction mode they were visible as positive regions. These were similar in size (30–50 nM) to collinear spherical structures, presumably mineral matrix complexes, seen in developing enamel using a freeze fracturing/freeze etching procedure. More detailed AFM studies on mature enamel suggested that the 30–50 nM structures were composed of smaller units, ~10–15 nM in diameter. These were clustered in hexagonal or perhaps a spiral arrangement. It was suggested that these could be the imprints of initiation sites for mineral precipitation. The investigation aimed at examining original freeze etched images at high resolution to see if the smaller subunits observed using AFM in mature enamel were also present in developing enamel i.e., before loss of the organic matrix. The method used was freeze etching. Briefly samples of developing rat enamel were rapidly frozen, fractured under vacuum, and ice sublimed from the fractured surface. The fractured surface was shadowed with platinum or gold and the metal replica subjected to high resolution TEM. For AFM studies high-resolution tapping mode imaging of human mature enamel sections was performed in air under ambient conditions at a point midway between the cusp and the cervical margin. Both AFM and freeze etch studies showed structures 30–50 nM in diameter. AFM indicated that these may be clusters of somewhat smaller structures ~10–15 nM maybe hexagonally or spirally arranged. High resolution freeze etching images of very early enamel showed ~30–50 nM spherical structures in a disordered arrangement. No smaller units at 10–15 nM were clearly seen. However, when linear arrangements of 30–50 nM units were visible the picture was more complex but also smaller units including

  17. Characterizing and identifying incipient carious lesions in dental enamel using micro-Raman spectroscopy.

    PubMed

    Mohanty, B; Dadlani, D; Mahoney, D; Mann, A B

    2013-01-01

    Early detection of dental caries is vital if improved patient outcomes are to be achieved by reversal of the demineralization process. Current techniques used by dentists for identifying carious lesions are effective in identifying more advanced lesions, but do not have sufficient sensitivity and specificity to detect them at the earliest stages. This study focused on characterizing the growth of incipient carious lesions in vitro using micro-Raman spectroscopy. The incipient carious lesions were grown on the buccal faces of human molars by controlled exposure to lactic acid. Lesions were cross-sectioned to expose the subsurface body of the lesion and then examined using micro-Raman spectroscopy. The intensity of the phosphate peaks in the Raman spectra was found to differ significantly between healthy enamel and the demineralized region of the lesions. The sensitivity of the phosphate peaks to the degree of demineralization was observed by taking a series of spectra over the cross section of the lesions. This revealed that the body of the lesion is highly demineralized, but in a narrow surface region (up to 10 µm) there is little demineralization. All the phosphate peaks were found to be sensitive to the degree of demineralization; however, changes in the intensity of the pronounced phosphate peak at 961 cm(-1) offer the most promise for identifying lesions. The results indicate that micro-Raman spectroscopy has both the sensitivity and selectivity to identify incipient carious lesions, but the presence of a surface layer with a relatively high mineral content could complicate the analysis.

  18. Dental Caries and Enamel Defects in Very Low Birth Weight Adolescents

    PubMed Central

    Nelson, S.; Albert, J.M.; Lombardi, G.; Wishnek, S.; Asaad, G.; Kirchner, H.L.; Singer, L.T.

    2011-01-01

    Objectives The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. Methods The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. Results The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents. Conclusion LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth. PMID:20975268

  19. Dental caries and enamel defects in very low birth weight adolescents.

    PubMed

    Nelson, S; Albert, J M; Lombardi, G; Wishnek, S; Asaad, G; Kirchner, H L; Singer, L T

    2010-01-01

    The purpose of this study was to examine developmental enamel defects and dental caries in very low birth weight adolescents with high risk (HR-VLBW) and low risk (LR-VLBW) compared to full-term (term) adolescents. The sample consisted of 224 subjects (80 HR-VLBW, 59 LR-VLBW, 85 term adolescents) recruited from an ongoing longitudinal study. Sociodemographic and medical information was available from birth. Dental examination of the adolescent at the 14-year visit included: enamel defects (opacity and hypoplasia); decayed, missing, filled teeth of incisors and molars (DMFT-IM) and of overall permanent teeth (DMFT); Simplified Oral Hygiene Index for debris/calculus on teeth, and sealant presence. A caregiver questionnaire completed simultaneously assessed dental behavior, access, insurance status and prevention factors. Hierarchical analysis utilized the zero-inflated negative binomial model and zero-inflated Poisson model. The zero-inflated negative binomial model controlling for sociodemographic variables indicated that the LR-VLBW group had an estimated 75% increase (p < 0.05) in number of demarcated opacities in the incisors and first molar teeth compared to the term group. Hierarchical modeling indicated that demarcated opacities were a significant predictor of DMFT-IM after control for relevant covariates. The term adolescents had significantly increased DMFT-IM and DMFT scores compared to the LR-VLBW adolescents. LR-VLBW was a significant risk factor for increased enamel defects in the permanent incisors and first molars. Term children had increased caries compared to the LR-VLBW group. The effect of birth group and enamel defects on caries has to be investigated longitudinally from birth. Copyright © 2010 S. Karger AG, Basel.

  20. Radiopaque Tagging Masks Caries Lesions following Incomplete Excavation in vitro.

    PubMed

    Schwendicke, F; Meyer-Lueckel, H; Schulz, M; Dörfer, C E; Paris, S

    2014-06-01

    One-step incomplete excavation seals caries-affected dentin under a restoration and appears to be advantageous in the treatment of deep lesions. However, it is impossible to discriminate radiographically between intentionally left, arrested lesions and overlooked or active lesions. This diagnostic uncertainty decreases the acceptance of minimally invasive excavation and might lead to unnecessary re-treatment of incompletely excavated teeth. Radiopaque tagging of sealed lesions might mask arrested lesions and assist in discrimination from progressing lesions. Therefore, we microradiographically screened 4 substances (SnCl2, AgNO3, CsF, CsCH3COO) for their effect on artificial lesions. Since water-dissolved tin chloride (SnCl2×Aq) was found to stably mask artificial lesions, we then investigated its radiographic effects on progressing lesions. Natural lesions were incompletely excavated and radiopaque tagging performed. Grey-value differences (△GV) between sound and carious dentin were determined and radiographs assessed by 20 dentists. While radiographic effects of SnCl2×Aq were stable for non-progressing lesions, they significantly decreased during a second demineralization (p < .001, t test). For natural lesions, tagging with SnCl2×Aq significantly reduced △GV (p < .001, Wilcoxon). Tagged lesions were detected significantly less often than untagged lesions (p < .001). SnCl2×Aq was suitable to mask caries-affected dentin and discriminate between arrested and progressing lesions in vitro. Radiopaque tagging could resolve diagnostic uncertainties associated with incomplete excavation.

  1. Gum containing calcium fluoride reinforces enamel subsurface lesions in situ.

    PubMed

    Kitasako, Y; Sadr, A; Hamba, H; Ikeda, M; Tagami, J

    2012-04-01

    The aim of this study was to assess the effect of chewing gum containing phosphoryl oligosaccharides of calcium (POs-Ca) and a low concentration of fluoride (F) on the hardness of enamel subsurface lesions, utilizing a double-blind, randomized, and controlled in situ model. Fifteen individuals wore removable lingual appliances with 3 bovine-enamel insets containing subsurface demineralized lesions. Three times a day for 14 days, they chewed one of the 3 chewing gums (placebo, POs-Ca, POs-Ca+F). After the treatment period, cross-sectional mineral content, nanoindentation hardness, and fluoride ion mapping by time-of-flight secondary ion mass spectrometry (TOF-SIMS) were evaluated. Although there were no statistical differences in overall mineral content and hardness recovery rates between POs-Ca and POs-Ca+F subsurface lesions (p > 0.05), nanoindentation at 1-μm distance increments from the surface showed statistical differences in hardness recovery rate between POs-Ca and POs-Ca+F in the superficial 20-μm region (p < 0.05). Fluoride mapping revealed distribution of the ion up to 20 μm from the surface in the POs-Ca+F group. Nanoindentation and TOF-SIMS results highlighted the benefits of bioavailability of fluoride ion on reinforcement of the superficial zone of subsurface lesions in situ (NCT01377493).

  2. Micro-hardness and mineral loss of enamel lesions after infiltration with various resins: influence of infiltrant composition and application frequency in vitro.

    PubMed

    Paris, S; Schwendicke, F; Seddig, S; Müller, W-D; Dörfer, C; Meyer-Lueckel, H

    2013-06-01

    The aim of this in vitro study was to evaluate the influence of infiltrant composition and application frequency on micro-hardness and lesion progression after resin infiltration of artificial enamel lesions. In each of 100 bovine enamel samples, three artificial caries lesions were created (pH=4.95, 50 days). After etching two of the lesions (37% phosphoric acid) specimens were randomly allocated to five infiltrants (four experimental infiltrants with different monomer and solvent compositions and penetration coefficients, and one commercial infiltrant [Icon, DMG]). Lesions were then infiltrated and light-cured, and infiltration repeated afterwards for one of the lesions. Infiltrated samples were cut into halves, with one half being demineralised for further 50 days. Micro-hardness (VHN) and integrated mineral loss (ΔZ) were evaluated at baseline and after second demineralisation. Repeated measures ANOVA and paired t-tests were used to analyse influence of material composition and application frequency on micro-hardness and lesion progression (integrated mineral loss difference ΔΔZ). Resin infiltration significantly increased micro-hardness and reduced lesion progression compared to untreated artificial lesions (p<0.05, t-test). Neither micro-hardness nor lesion progression were significantly influenced by material composition (p>0.05, ANOVA). In contrast, twice application resulted in significantly increased micro-hardness and demineralisation resistance of infiltrated lesions (p<0.05, ANOVA). Resin infiltration significantly improves micro-hardness and demineralisation resistance of enamel lesions; these effects are significantly enhanced if resins are applied twice. Experimental resins did not outperform the commercial infiltrant. This in vitro study demonstrated that resin infiltration significantly increases both micro-hardness and demineralisation resistance of enamel caries lesions. Twice application of the infiltrant seems to increase these effects. In

  3. Light diffuse reflectance for detection and differentiation of teeth caries lesions

    NASA Astrophysics Data System (ADS)

    Borisova, E.; Uzunov, Tz.; Valkanov, S.; Avramov, L.

    2007-05-01

    One of the goals of the contemporary dentistry is differentiation between carious stages that must be fast, non-invasive procedure, which will allow to the dentists to make reliable judgments. One suitable candidate for such method is reflectance spectroscopy. The objectives of current study are to determine the feasibility of applying the light reflectance spectroscopy technique for detection of different carious stages; therefore reflectance spectra of teeth illuminated at 450- 900 nm light were recorded. There are obtained reflectance signals from the healthy enamel, dentine and different lesion stages of the investigated teeth. These spectra are compared to that, obtained by non-carious tooth lesions - fluorosa and odontolithiasis, resembling on initial carious stages. There is observed a significant decrease of the intensity of the reflected light in blue region in the case of caries. Reflectance signals, obtained from non-carious lesions also have significantly different character and could be used for differentiation between them and initial carious stages. An algorithm for differentiation between carious stages is proposed with diagnostic accuracy achieved up to 86,1% between precarious stage and sound tooth and 100% for determination of deep cavitation. Some comments about role of teeth enamel structure and anisotropy factor of dental layers on the results obtained are also made.

  4. High contrast optical imaging methods for image guided laser ablation of dental caries lesions

    NASA Astrophysics Data System (ADS)

    LaMantia, Nicole R.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500-1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths.

  5. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

    NASA Astrophysics Data System (ADS)

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

    2010-07-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

  6. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

    PubMed Central

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

    2010-01-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity. PMID:20799842

  7. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries.

    PubMed

    Heravi, Farzin; Ahrari, Farzaneh; Mahdavi, Mahdieh; Basafa, Soroush

    2014-04-01

    This study investigated the effectiveness of low power red and infrared lasers and that of Er:YAG laser, in association with CPP-ACPF cream, on remineralization of white spot lesions. Fifty intact premolars were immersed in a demineralization solution for 10 weeks to induce caries like lesions and then were divided into five groups. In group 1, the teeth were covered with a CPP-ACPF cream for 3 minutes and then irradiated with a low power red laser (660 nm, 200 mW) for 1 minute through the cream. In group 2, the treatment was the same as that in group 1, but an infrared laser (810 nm, 200 mW) was employed. The specimens in group 3 were irradiated with an Er:YAG laser (100 mJ, 10 Hz) combined with CPP-ACPF. In group 4, the CPP-ACPF cream was applied for 4 minutes and group 5 was submitted to neither laser nor CPP-ACPF. The micro Vickers hardness was compared at 20, 60 and 100 µ from the enamel surface among the groups. The highest microhardness was observed in the low power red and Er:YAG laser groups and the lowest one belonged to the CPP-ACPF alone and control groups. However, no significant difference was found in microhardness of the experimental groups at any of the evaluation depths (p>0.05). With the laser parameters used in this study, neither the combined application of Er:YAG laser with CPP-ACPF nor the combination of low power lasers with CPP-ACPF provided a significant increase in remineralization of enamel caries. Key words:Low level laser, Er:YAG, laser, enamel caries, CPP-ACP, microhardness, white spot lesion.

  8. The effects of 1% pyrophosphate and 0.02% sodium fluoride on artificial caries lesions in vivo.

    PubMed

    Mellberg, J R; Petrou, I D; Deutchman, M; Grote, N

    1988-12-01

    We evaluated the potential of a pyrophosphate-fluoride solution to affect the remineralizing-demineralizing equilibrium, i.e., caries-inhibiting/-promoting effects on enamel in vivo. Fifteen subjects carried dentin blocks and enamel thin sections with artificial caries lesions in removable partial dentures for periods of two weeks, during which time they rinsed twice daily in a double-blind, randomized cross-over design with solutions containing (a) 90 ppm F, (b) 90 ppm F and 1% pyrophosphate, or (c) no active agents (placebo). A severe cariogenic challenge provided to the lesions by plaque under a stainless steel mesh cover resulted in the placebo-treated lesions losing 70.2% +/- 72.1% mineral. The pyrophosphate rinse with fluoride held the mineral loss to only 28.1 +/- 52.8%, while the fluoride rinse without pyrophosphate held the loss to 24.2 +/- 50.1%. The differences between the fluoride and placebo results were significant (p less than 0.01), but the difference between the two fluoride groups was not. A large amount of fluoride was deposited in the dentin lesions. In the surface layer, the concentration was increased from 1000 ppm F to more than 2300 ppm F by both fluoride treatments. The concentration of fluoride in both groups of fluoride-treated lesions further increased to more than 3500 ppm F in the approximate center of the lesion before declining in deeper layers toward the level found in the placebo-treated group. The findings from both mineral change and fluoride uptake phases of this study show that in the presence of 90 ppm F, 1% pyrophosphate did not promote demineralization of artificial caries lesions.

  9. Effect of caries infiltrant application on shear bond strength of different adhesive systems to sound and demineralized enamel.

    PubMed

    Jia, Liuhe; Stawarczyk, Bogna; Schmidlin, Patrick R; Attin, Thomas; Wiegand, Annette

    2012-12-01

    To investigate the influence of caries infiltrant application on the shear bond strength of different adhesives on sound and demineralized enamel. Sound and artificially demineralized (14 days, acidic buffer, pH 5.0) bovine enamel specimens were treated with a caries infiltrant (Icon, DMG), three different commercial adhesives (unfilled etch and- rinse adhesive: Heliobond, Ivoclar Vivadent; filled etch-and-rinse adhesive: Optibond FL, Kerr; or self-etching adhesive: iBOND Self Etch, Heraeus Kulzer) or a combination of caries infiltrant and adhesive. The shear bond strength of a nanohybrid composite was analyzed after thermocycling (5000x, 5° to 55°C) at a crosshead speed of 1 mm/min. Failure mode was inspected under a stereomicroscope at 25X magnification. In both sound and demineralized enamel, the shear bond strength of the caries infiltrant was not significantly different from the etch-and-rinse adhesives, while the self-etching adhesive showed significantly lower values compared to all other groups. Pretreatment with the caries infiltrant significantly increased the bond strength of the self-etching adhesive in both substrates and of the filled etch-and-rinse adhesive in demineralized enamel. While shear bond strength was not significantly different between the two substrates, cohesive failures were more likely to occur in demineralized than sound specimens. The shear bond strength of the caries infiltrant was similar to the etch-and-rinse adhesives. The caries infiltrant did not impair bonding to sound or demineralized enamel, and even increased adhesion of the selfetching agent.

  10. Bacterial colonization, enamel defects and dental caries in 4-6-year-old mono- and dizygotic twins.

    PubMed

    Ooi, Gregory; Townsend, Grant; Seow, W Kim

    2014-03-01

    Knowledge of the genetic and environmental influences in caries aetiology has relevance for preventive dentistry. This classical twin study compared concordance of mutans streptococci (MS) and lactobacilli (LB) colonization, enamel defects, and caries in a cohort of 4-6-year-old mono- (MZ) and dizygotic (DZ) twin pairs. The twins were examined for prevalence and concordance of enamel opacities and hypoplasia, oral counts of MS and LB, and dental caries. Bacterial counts were assessed using a commercial microbiological kit. Thirty-four MZ and 50 DZ twins (mean gestational age 35.0 ± 2.4 weeks, and birthweight 2.4 ± 0.6 kg) were examined. There were no statistically significant differences between MZ and DZ twins in the prevalence of MS, LB, and enamel hypoplasia. Concordance rates for MS and LB presence and prevalence of enamel defects within MZ and DZ twin pairs were not significantly different. There were more children with caries in DZ compared with MZ twins (18% vs 3%, P = 0.0029), most likely due to increased daily frequency of sugar consumption and less toothbrushing. Concordance data from MZ and DZ twins did not demonstrate any statistically significant difference in susceptibility for enamel defects and colonization of MS and LB. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Intraoral versus extraoral bitewing radiography in detection of enamel proximal caries: an ex vivo study

    PubMed Central

    Farid, Mary Medhat; Mostafa, Mostafa Saad El-Din

    2016-01-01

    Objective: To compare the diagnostic accuracy of digital intraoral and extraoral bitewing (EO BW) radiography in the detection of enamel proximal caries regardless of their ability to separate contacts. Methods: Artificial caries with different degrees of decalcification was induced in 80 human sound premolars and molars using formic acid. Intraoral radiographs were taken with photostimulable phosphor plate (PSP) and complementary metal oxide semiconductor (CMOS), using the paralleling bitewing technique. Extraoral bitewing radiographs were obtained using Sirona digital panoramic X-ray unit (Sirona Siemens, Bensheim, Germany). In total, 160 proximal surfaces were assessed by 2 observers twice. Area under the receiver operating characteristic curve (Az) values for each image type, observer and reading were compared using z-tests, with a significance level of p ≤ 0.05. Sensitivity, specificity, positive-predictive value and negative-predictive value for each observer and reading were calculated. Results: Spearman's test showed a strong positive correlation between the duration of demineralization and histological grading of carious teeth surfaces. For the three radiographic techniques, intraobserver reliability was strong to excellent. Moreover, interobserver agreement was strong. The differences between all detection methods were not statistically significant (p > 0.05). Intraoral bitewing using CMOS sensor had the highest sensitivity while EO BW had the highest specificity in the detection of incipient proximal caries. Conclusions: Within the limits of the ex vivo design, the difference in diagnostic accuracy between the three radiographic techniques was not significant. EO BW could be used in the detection of enamel proximal caries with results comparable with intraoral bitewing with PSP plate and CMOS sensor. PMID:26892946

  12. Effectiveness of two mouth rinses solutions in arresting caries lesions: a short-term clinical trial.

    PubMed

    Duarte, Ana Rita; Peres, Marco Aurélio; Vieira, Ricardo Sousa; Ramos-Jorge, Maria Letícia; Modesto, Adriana

    2008-01-01

    To clinically evaluate the additional effect of adding 0.12% chlorhexidine digluconate (CHX) to a 0.05% sodium fluoride (NaF) mouth rinse in arresting active enamel caries lesions after 28 days. A short-term double-blind clinical trial that included a total of 170 children, aged 11 to 15 years, with active smooth surface caries lesions (average 6.52) was conducted. The participants were enrolled and randomly distributed into two equal groups. Under the supervision of the research team, the children rinsed with a 15 ml solution of either 0.05% NaF (G1) or 0.05% NaF + 0.12% CHX (G2) for 1 min/day for 28 days. A clinical examination was carried out at the beginning and at the end of the study with children who underwent supervised tooth brushing. A calibrated examiner, who was unaware of the treatment given to each subject, examined all smooth surfaces dried with compressed air, isolated and illuminated with a reflector. The surface was considered active (A) or arrested (I). The frequency of A or I surfaces was evaluated by calculating the difference between the number found at the beginning and at the end of the trial. No significant differences were detected between the two groups with respect to caries lesion surfaces at baseline (6.49 +/- 4.45 - G1, 6.55 +/- 4.23 - G2, respectively), nor were differences found when age and gender wer taken into consideration. Arrestment proportions were 84.4% (G1) and 85.3% (G2) (P = 0.71; not significant). Although both solutions showed high arrestment proportions, the addition of CHX did not improve the arrestment capacity of the NaF mouth rinse.

  13. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

    PubMed

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

    2014-01-01

    Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

  14. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

    PubMed Central

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A.; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A.

    2014-01-01

    Background and objectives Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Design Dental plaque from children (N=20; aged 3–6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10–20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Results Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1–6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Conclusions Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric

  15. Prevalence of candida albicans in dental plaque and caries lesion of early childhood caries (ECC) according to sampling site

    PubMed Central

    Ghasempour, Maryam; Sefidgar, Seyed Ali Asghar; Eyzadian, Haniyeh; Gharakhani, Samaneh

    2011-01-01

    Background: Candida albicans may have cariogenic potential but its role in caries etiology has not been established. The aim of this study was to determine candida albicans in supragingival dental plaque and infected dentine of cervical and proximal in early childhood caries (ECC). Methods: This cross-sectional study was carried out on 6o children aged 2-5 years, which were divided into 3 groups: children with at least one cervical caries; children with at least one proximal caries and caries-free. The infected dentine was collected from cervical and proximal caries lesions and plaque samples were collected from the three groups in order to compare the frequency of candida albicans in the collected sites. All samples were cultured in Sabouraud and CHROMagar medium and the cases that were positive for candida albicans were cultured in germ tube. Data were collected and analyzed. Results: The mean age of the children was 3.9 years. From 100 samples, candida albicans samples were isolated in 55%, mold fungi were found in 29% cases and there was no fungal growth in 16% of the samples. In plaque samples, candida albicans were found in 15% of caries-free samples, 20% of the proximal and 80% of the cervical caries. In samples extracted from the caries, candida albicans were found in 60% of the proximal and 100% of the cervical caries. Mothers with university educational level had children with more cervical decays, caries free and proximal caries, respectively. Conclusion: The results showed that prevalence of Candida albicans in dental plaque and caries lesions of children with early childhood caries were relatively high and the prevalence was higher in cervical caries group. PMID:24551436

  16. EFFICACY OF FLUORIDE MOUTHRINSE CONTAINING TRICALCIUM PHOSPHATE ON PRIMARY ENAMEL LESIONS: A POLARIZED LIGHT MICROSCOPIC STUDY.

    PubMed

    Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Phuekcharoen, Pimonchat

    2015-01-01

    The aim of this study was to evaluate the effect of fluoride mouthrinse containing tricalcium phosphate (TCP) on remineralization of primary teeth enamel lesions compared with fluoride mouthrinse alone to determine if the addition of TCP gives additional benefit. Thirty-six sound primary incisors were immersed in a demineralizing solution (pH 4.4) for 96 hours at 37°C to create demineralized lesions. After artificial caries formation, the specimens were randomly assigned to one of three groups (n = 12): Group A: deionized water; Group B: 0.05% sodium fluoride (NaF) plus 20 ppm tricalcium phosphate mouthrinse and Group C: 0.05% sodium fluoride (NaF) only mouthrinse. A pH-cycling process was carried out for 7 days at 37°C. During pH-cycing, all the specimens were immersed for 1 minute; 3 times a day, in the respective mouthrinse. The specimens were then evaluated by polarized light microscopy with the computerized Image Pro Plus program. Data were analyzed using paired-t, one-way ANOVA and Tukey's multiple comparison tests at a 95% level of confidence. The depth of the lesions were significantly different between pre- and post-treatment for all groups (p = 0.00). The lesion depth in the Group A (control) increased by 102% (±15), in Group B by 34% (±12) and Group C by 36% (±9). The lesion depths differed significantly between the control (Group A) and treatment groups (Group B,C) (p < 0.05). Group A had a significantly greater increase in lesion depth compared to the other groups. There was no significant difference in the percent change in lesion depths between Groups B and C. We concluded that the fluoride mouthrinse containing tricalcium phosphate provides no additional benefit over the mouthrinse containing fluoride alone.

  17. Light- and electronmicroscopic study of infiltration of resin into initial caries lesions--a new methodological approach.

    PubMed

    Arnold, W H; Gaengler, P

    2012-01-01

    It was the purpose of this pilot study to investigate resin infiltration into various types of initial subsurface caries lesions using a combined microscopic technique with polarized light microscopy and fluorescence microscopy and subsequent scanning microscopy with EDX-element analysis. Six extracted premolars with initial caries lesions were used. Five were infiltrated with resin after imbibition of the subsurface carious pore volume of enamel with sodium fluorescein solution. After light curing the unbound dye was removed by washing out in water. Serial sections were cut through the lesions and investigated with polarized light microscopy, fluorescence microscopy and simultaneously with both microscopic techniques. The same sections were then studied with scanning electron microscopy and EDX-element analysis to prove the infiltration of the resin into the lesions. The results showed, that the combination technique adds further morphologic information to infiltration behaviour of the resin. The individual volume of early acute lesions versus chronic lesions involving dentin, and the fluorescein bound by resin was well documented in serial sections. The EDX calcium and phosphorus signals correlate negatively with the lesion extension, and the carbon signal correlates positively, thus labelling the resin infiltration. It could be demonstrated that resin infiltration is dependent from the pore volume of the lesion. It can be concluded that the combined polarized light microscopy with fluorescence microscopy is an advantageous tool for studying infiltration of resin into hard tissues. © 2011 The Authors Journal of Microscopy © 2011 Royal Microscopical Society.

  18. Quantitative characterization and micro-CT mineral mapping of natural fissural enamel lesions.

    PubMed

    Shahmoradi, Mahdi; Swain, Michael V

    2016-03-01

    The aim of this study was to characterize the mineral distribution pattern of natural fissural enamel lesions and to quantify structural parameters and mineral density of these lesions in comparison to proximal white spot enamel lesions. Imaging was undertaken using a high-resolution desktop micro-computed tomography system. A calibration equation was used to transform the grey level values of images into true mineral density values. The value of lesion parameters including the mineral density and the thickness of the surface layer of the enamel lesion were extracted from mineral density profiles. The thickness of the surface layer showed variation among different lesions and it ranged from 0-90 μm in proximal lesions and 0-137 μm in fissural lesions. The average thickness of surface layer in fissural lesions was significantly higher than smooth surface proximal lesions. Sound fissural enamel showed lower mineral density compared to proximal enamel. Micro-CT and the suggested de-noising and visualization method provide an efficient high-resolution approach for non-destructive evaluation of fissural lesions. Using these methods, the current study revealed the exclusive pattern and structure of fissural enamel lesions which may provide a basis for future studies on prevention and remineralization of these lesions. The common demineralization pattern of fissural lesions, which indicates the extension of the lesion in two directions towards the pulp horns, may explain the early inflammation and symptoms of the pulp in fissural lesions even when the lesion base appears far from the pulp roof in normal radiographs. In addition, the presence of the surface layer, indicates that vigorous probing of the occlusal fissures may lead to breakage and cavitation of the enamel lesions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Comparison of the effect of resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on surface hardness and streptococcus mutans adhesion to artificial enamel lesions.

    PubMed

    Aziznezhad, Mahdiye; Alaghemand, Homayoon; Shahande, Zahra; Pasdar, Nilgoon; Bijani, Ali; Eslami, Abdolreza; Dastan, Zohre

    2017-03-01

    Dental caries is a major public health problem, and Streptococcus mutans is considered the main causal agent of dental caries. This study aimed to compare the effect of three re-mineralizing materials: resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on the surface hardness and adhesion of Streptococcus mutans as noninvasive treatments for initial enamel lesions. This experimental study was conducted from December 2015 through March 2016 in Babol, Iran. Artificial enamel lesions were created on 60 enamel surfaces, which were divided into two groups: Group A and Group B (30 subjects per group). Group A was divided into three subgroups (10 samples in each subgroup), including fluoride varnish group, nano-hydroxy apatite paste group (Nano P paste), and resin infiltrant group (Icon-resin). In Group A, the surface hardness of each sample was measured in three stages: First, on an intact enamel (baseline); second, after creating artificial enamel lesions; third, after application of re-mineralizing materials. In Group B, the samples were divided into five subgroups, including intact enamel, demineralized enamel, demineralized enamel treated with fluoride varnish, Nano P paste, and Icon-resin. In Group B, standard Streptococcus mutans bacteria adhesion (PTCC 1683) was examined and reported in terms of colony forming units (CFU/ml). Then, data were analyzed using ANOVA, Kruskal-Wallis, Mann-Whitney, and post hoc tests. In Group A, after treatment with re-mineralizing materials, the Icon-resin group had the highest surface hardness among the studied groups, then the Nano P paste group and fluoride varnish group, respectively (p = 0.035). In Group B, in terms of bacterial adhesion, fluoride varnish group had zero bacterial adhesion level, and then the Nano P paste group, Icon-resin group, intact enamel group, and the de-mineralized enamel group showed bacterial adhesion increasing in order (p < 0.001). According to the study among the examined materials

  20. Comparison of the effect of resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on surface hardness and streptococcus mutans adhesion to artificial enamel lesions

    PubMed Central

    Aziznezhad, Mahdiye; Alaghemand, Homayoon; Shahande, Zahra; Pasdar, Nilgoon; Bijani, Ali; Eslami, Abdolreza; Dastan, Zohre

    2017-01-01

    Introduction Dental caries is a major public health problem, and Streptococcus mutans is considered the main causal agent of dental caries. This study aimed to compare the effect of three re-mineralizing materials: resin infiltrant, fluoride varnish, and nano-hydroxy apatite paste on the surface hardness and adhesion of Streptococcus mutans as noninvasive treatments for initial enamel lesions. Methods This experimental study was conducted from December 2015 through March 2016 in Babol, Iran. Artificial enamel lesions were created on 60 enamel surfaces, which were divided into two groups: Group A and Group B (30 subjects per group). Group A was divided into three subgroups (10 samples in each subgroup), including fluoride varnish group, nano-hydroxy apatite paste group (Nano P paste), and resin infiltrant group (Icon-resin). In Group A, the surface hardness of each sample was measured in three stages: First, on an intact enamel (baseline); second, after creating artificial enamel lesions; third, after application of re-mineralizing materials. In Group B, the samples were divided into five subgroups, including intact enamel, demineralized enamel, demineralized enamel treated with fluoride varnish, Nano P paste, and Icon-resin. In Group B, standard Streptococcus mutans bacteria adhesion (PTCC 1683) was examined and reported in terms of colony forming units (CFU/ml). Then, data were analyzed using ANOVA, Kruskal-Wallis, Mann-Whitney, and post hoc tests. Results In Group A, after treatment with re-mineralizing materials, the Icon-resin group had the highest surface hardness among the studied groups, then the Nano P paste group and fluoride varnish group, respectively (p = 0.035). In Group B, in terms of bacterial adhesion, fluoride varnish group had zero bacterial adhesion level, and then the Nano P paste group, Icon-resin group, intact enamel group, and the de-mineralized enamel group showed bacterial adhesion increasing in order (p < 0.001). Conclusion According to

  1. [Effect of arginine dentifrice on remineralization of initial enamel carious lesions].

    PubMed

    Xu, Pengcheng; Deng, Meng; Zhou, Xue-dong; Li, Jiyao; Cheng, Lei; Xu, Xin

    2014-02-01

    To evaluate remineralization efficacy of an arginine containing dentifrice on initial enamel carious lesions in vitro. Human enamel blocks with early lesions were prepared and randomly divided into three treatment groups: negative control group (distilled and deionized water), positive control group (fluoride containing dentifrice and 0.14% sodium monofluorophosphate), and test dentifrice group (8.0% arginine and 0.14% sodium monofluorophosphate). The lesions were subjected to a pH-cycling regime for 10 days. Surface enamel microhardness of the enamel blocks from each group was measured before and after pH cycling, and the surface microhardness recovery was calculated. Then, specimens were analyzed for enamel fluoride uptake (EFU) through acid etching method, after which they were treated in demineralization solution for a 2 h period of acid challenge. The other specimens were sectioned and examined through polarized light microscopy. In the test dentifrice group, microhardness recovery and EFU were significantly higher than those in the negative control and positive groups. The test dentifrice group was significantly resistant to the acid challenge compared with the other groups. Conspicuous remineralization of enamel subsurface lesions was observed under polarized light microscopy among samples treated with test dentifrice, whereas the control groups showed no significant changes on enamel subsurface lesions. This study presents the potential superiority of Pro-Argin dentifrice over conventional fluoride dentifrice in promoting the remineralization of initial enamel lesions.

  2. Effects of enamel fluorosis and dental caries on quality of life.

    PubMed

    Onoriobe, U; Rozier, R G; Cantrell, J; King, R S

    2014-10-01

    The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health-related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students (n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ8-10 in grades 4-5; CPQ11-14 in grades 6-12). All students were examined for fluorosis (Dean's index) and caries experience (d2-3fs or D2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d2-3fs and D2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d2-3fs and D2-3MFS scores was positively associated with CPQ11-14 (B = 0.240, p < .001), ECOHIS (B = 0.252, p ≤ .001), and FIS (B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child's caries experience negatively affects OHRQoL, while fluorosis has little impact.

  3. Effects of Enamel Fluorosis and Dental Caries on Quality of Life

    PubMed Central

    Onoriobe, U.; Rozier, R.G.; Cantrell, J.; King, R.S.

    2014-01-01

    The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health–related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students (n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ8-10 in grades 4-5; CPQ11-14 in grades 6-12). All students were examined for fluorosis (Dean’s index) and caries experience (d2-3fs or D2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d2-3fs and D2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d2-3fs and D2-3MFS scores was positively associated with CPQ11-14 (B = 0.240, p < .001), ECOHIS (B = 0.252, p ≤ .001), and FIS (B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child’s caries experience negatively affects OHRQoL, while fluorosis has little impact. PMID:25154834

  4. Remineralization of human natural caries and artificial caries-like lesions with an experimental whisker-reinforced ART-composite

    PubMed Central

    Yang, Bin; Flaim, Glenn; Dickens, Sabine H.

    2011-01-01

    To compare the remineralization of human natural caries and artificial caries-like dentin lesions from a novel whisker-reinforced experimental composite resin to a resin-modified glass ionomer cement (RM-GIC) as control. Ten molars with moderate natural dentin caries were prepared (N). Artificial caries-like dentin lesions were prepared in occlusal dentin of ten caries-free molars and demineralized at pH=4.3 for 48 h (A). The cavities were restored with ART-composite or RM-GIC. All restored teeth were sliced into 120-μm sections. Transverse microradiography combined with digital image analysis was performed to analyze the change in mineral density at the same position of the specimens before, after 4 weeks and 8 weeks remineralization/demineralization treatment. The mean percent remineralization ± standard deviation after 4 weeks and 8 weeks are: N: ART-composite: 27±9, 46±14; RM-GIC: 18±6, 36±11; A: ART-composite: 48±9, 66±11; RM-GIC: 50±13, 62±11. For the remineralization of natural caries, there was a significant difference between ART-composite and RM-GIC (p<0.05). For both restoratives there were significant differences between remineralization of natural and artificial caries (p<0.001). ART-composite and RM-GIC remineralized natural and artificial caries differently most likely due to differences in microstructure and composition of caries dentin. PMID:21232637

  5. Conservative approach for a clinical resolution of enamel white spot lesions.

    PubMed

    Nahsan, Flavia Pardo Salata; da Silva, Luciana Mendonça; Baseggio, Wagner; Franco, Eduardo Batista; Francisconi, Paulo Afonso Silveira; Mondelli, Rafael Francisco Lia; Wang, Linda

    2011-05-01

    Enamel white spot lesions in anterior teeth that compromise esthetics are common. Microabrasion is indicated, since it affects enamel superficially. An acid-abrasive slurry with 37% phosphoric acid with pumice was used on the enamel for a controlled time period. Home bleaching with hydrogen peroxide was then used, further improving the final result. The method is safe, easy, and conservative and provides good esthetic results.

  6. In vivo scanning electron microscope assessment of enamel permeability in primary teeth with and without early childhood caries.

    PubMed

    Narrenthran, J S; Muthu, M S; Renugalakshmi, A

    2015-01-01

    Over the years, certain primary teeth have been shown to be highly sensitive to dental caries, while others have remained caries-free. It has been hypothesized that this may be attributed to differences in the permeability of the enamel surface. The aim of the study was to evaluate the hypothesized differences in the permeability of primary tooth enamel in children with and those without Severe Early Childhood Caries (S-ECC) using scanning electron microscopy. Sixteen children between 3 and 6 years of age were randomly selected and divided into two groups: Group 1, children without S-ECC (n = 8), and Group 2, children with S-ECC (n = 8). In each child, 4 teeth (the maxillary right and left central and lateral incisors) were subjected to evaluation. An impression was made with polyvinylsiloxane impression material, and scanning electron microscopy was used to inspect the negative replicas for droplets. The results indicated higher significance when individual regions (cervical, middle, and incisal thirds) in the two groups were evaluated and compared. Similarly, the overall results showed high statistical significance between S-ECC and non-S-ECC teeth. There could be a positive relationship between the permeability of tooth enamel and the development of caries, which needs further research.

  7. Micro-computed tomographic analysis of progression of artificial enamel lesions in primary and permanent teeth after resin infiltration.

    PubMed

    Ozgul, Betul Memis; Orhan, Kaan; Oz, Firdevs Tulga

    2015-09-01

    We investigated inhibition of lesion progression in artificial enamel lesions. Lesions were created on primary and permanent anterior teeth (n = 10 each) and were divided randomly into two groups with two windows: Group 1 (window A: resin infiltration; window B: negative control) and Group 2 (window A: resin infiltration + fluoride varnish; window B: fluoride varnish). After pH cycling, micro-computed tomography was used to analyze progression of lesion depth and changes in mineral density. Resin infiltration and resin infiltration + fluoride varnish significantly inhibited progression of lesion depth in primary teeth (P < 0.05). Inhibition of lesion depth progression in permanent teeth was significantly greater after treatment with resin infiltration + fluoride varnish than in the negative control (P < 0.05). Change in mineral density was smaller in the resin infiltration and resin infiltration + fluoride varnish groups; however, the difference was not significant for either group (P > 0.05). Resin infiltration is a promising method of inhibiting progression of caries lesions.

  8. PS-OCT of natural pigmented and nonpigmented interproximal caries lesions

    NASA Astrophysics Data System (ADS)

    Ngaotheppitak, Patara; Darling, Cynthia L.; Fried, Daniel

    2005-03-01

    Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image early dental caries. The purpose of this study was to compare the measured reflectivity of natural caries lesions with the mineral loss measured using digital microradiography. An all polarization-maintaining fiber based PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of natural white spot lesions and pigmented lesions on the smooth surfaces of extracted teeth. There was a strong positive correlation between the increase in the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system and the increase in the integrated mineral loss or lesion severity for both white-spot and pigmented lesions, P <0.001. Therefore, PS-OCT is well-suited to assess the severity of natural caries lesions and resolve the internal structure of early caries lesions for the potential assessment of the lesion activity.

  9. How different do visuo-tactile criteria assess caries lesions activity status on occlusal surfaces?

    PubMed

    Floriano, I; Bonini, G C; Matos, R; Novaes, T F; Ekstrand, K R; Mendes, F M; Braga, M M

    2015-04-01

    We tested the association between active caries lesions assessed by two different criteria and clinical features of these caries lesions. Three examiners examined forty-nine 3- to 12-year-old children: one examiner used the Nyvad criteria, another examiner used the International Caries Detection and Assessment System with an additional criteria--Lesion Activity Assessment (ICDAS + LAA), and a reference examiner classified lesions regarding plaque stagnation, colour, lustre, cavities, depth and texture. Logistic regressions were used to test associations. For analyses, we grouped sound sites and inactive lesions vs active caries lesions, but also considering only inactive vs active lesions. Active lesions scored by both criteria were similarly associated with different clinical parameters tested, except when the sound sites were excluded from the analysis. In these cases, active lesions according to ICDAS + LAA were associated only with cavitation and texture. Texture was associated with divergences between criteria when differentiating sound or inactive lesions from active ones. Fewer divergences in differentiating active from inactive lesions were observed when lesions present lustre. Most clinical signs associated with active caries lesions were similar, but texture and severity tend to have a greater importance when using ICDAS + LAA for distinguishing caries activity status. Attention should be given to differences due to texture and lustre when using different indices. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Frequency of intake and amount of fluoride in milk for remineralisation of artificial caries on enamel and dentine: Ex vivo/in situ study.

    PubMed

    Cassiano, Luiza; Pessan, Juliano; Comar, Livia; Levy, Flavia; Cardoso, Cristiane; Dionisio, Aline; Manarelli, Michele; Grizzo, Larissa; Magalhães, Ana Carolina; Buzalaf, Marília

    2017-01-01

    This study analysed the effect of frequency of intake and amount of fluoride in milk on the remineralisation of artificial enamel and dentine caries lesions ex vivo/in situ. Pre-demineralised bovine enamel and dentine slabs were randomly allocated into 5 groups and fixed in removable appliances used by subjects for 7days in each phase. Each treatment comprised milk containing 2.5ppm fluoride daily (T1), or every other day (T2), 5.0ppm F daily (T3), or every other day (T4) or no treatment (T5). Enamel alterations were quantified by surface hardness recovery (%SHR) and transversal microradiography (TMR), and in dentine by TMR only. Data were analysed by ANOVA and Tukey's test (p<0.05). For enamel, the highest %SHR was found for T1 and T3 compared to control, without significant differences between them. All groups showed positive values of ΔΔZ - T1 (247.3±198.5); T2 (110.9±303.2); T3 (226.0±299.2); T5 (5.0±288.0), except T4 (-274.5±407.3). For dentine, the only group that presented remineralisation was T2 (350.0±657.5). Fluoridated milk daily seems to have higher remineralising effect on enamel than its use every other day. Dentine, does not seem to benefit from daily use of fluoridated milk. Copyright © 2016. Published by Elsevier Ltd.

  11. Microstructure and mechanical changes induced by Q-Switched pulse laser on human enamel with aim of caries prevention

    NASA Astrophysics Data System (ADS)

    Apsari, R.; Pratomo, D. A.; Hikmawati, D.; Bidin, N.

    2016-03-01

    This study was conducted to determine the effect of Q-Switched Nd: YAG laser energy dose to human enamel caries. The specifications of Q-Switched Nd: YAG laser as followed: wavelength of 1064 nm and 6 ns pulse width. Caries enamel samples taken from human teeth molars of 17-35 ages and the type of media caries. Energy doses used in this study were 723.65 mJ/cm2, 767.72 mJ/cm2, and 1065.515 mJ/cm2; 5 Hz repetition rate, and 20 second exposure time. Samples characterized the surface morphology and the percentage of constituent elements, especially calcium/phosphorus (Ca/P) with FESEM-EDAX. The fraction volume and crystallinity percentage of hydroxyapatite (HA) with XRD and hardness value using Vickers Microhardness Test. The results indicated that exposure of Q-Switched Nd:YAG laser on enamel caries resulting cracks, holes, and melt due to plasma production effects in the surface. Plasma production effect also resulted in micro properties such as percentage of Ca/P was close to normal, the fraction volume and crystallinity percentage of HA went up but did not change the crystal structure (in terms of the lattice structure). The hardness value also rose as linear as exposure energy dose caused by phototermal effect. Based on the results, Q-Switched Nd:YAG laser can be used as contactless drill dental caries replacement candidate with the additional therapy effect such as localized caries in order to avoid the spread, the ratio of Ca/P approaching healthy teeth, the fraction volume and crystallinity percentage of HA rose and established stronger teeth with peak energy dose 1065.515 mJ/cm2.

  12. Materials chemistry: A synthetic enamel for rapid tooth repair

    NASA Astrophysics Data System (ADS)

    Yamagishi, Kazue; Onuma, Kazuo; Suzuki, Takashi; Okada, Fumio; Tagami, Junji; Otsuki, Masayuki; Senawangse, Pisol

    2005-02-01

    The conventional treatment of dental caries involves mechanical removal of the affected part and filling of the hole with a resin or metal alloy. But this method is not ideal for tiny early lesions because a disproportionate amount of healthy tooth must be removed to make the alloy or resin stick. Here we describe a dental paste of synthetic enamel that rapidly and seamlessly repairs early caries lesions by nanocrystalline growth, with minimal wastage of the natural enamel.

  13. Differences between reported and actual restored caries lesion depths: results from The Dental PBRN.

    PubMed

    Rindal, D B; Gordan, V V; Fellows, J L; Spurlock, N L; Bauer, M R; Litaker, M S; Gilbert, G H

    2014-07-01

    The objectives of this research were to: (1) quantify the discordance between the caries lesion depth at which dentists restored initial lesions during a clinical study ("actual depth") and the lesion depth that they reported during a hypothetical clinical scenario ("reported depth"); (2) test the hypothesis that certain practitioner, practice, patient, and caries lesion characteristics are significantly associated with this discordance. Practitioner-investigators who perform restorative dentistry in their practices completed an enrollment questionnaire and participated in 2 consecutive studies on caries diagnosis and treatment. The first study was a survey asking about caries treatment. The second study collected data on restorations placed in routine clinical practice due to caries in patients over 19 years of age on occlusal surfaces only or proximal surfaces only. We report results on 2,691 restorations placed by 205 dentists in 1,930 patients with complete data. Discordance between actual depth and reported depth occurred in only about 2% of the restorations done due to proximal caries, but about 49% of the restorations done due to occlusal caries. Practice type, restorative material used and the diagnostic methods used were significantly associated with discordance. Dentists frequently restored occlusal caries at a shallower depth as compared to their reported depth, but the discordance was very small for proximal lesions. Discordance for occlusal caries was more common when radiographs were not taken or if a resin restoration was placed.

  14. Differences Between Reported And Actual Restored Caries Lesion Depths: Results From The Dental PBRN

    PubMed Central

    Rindal, DB; Gordan, VV; Fellows, JL; Spurlock, NL; Bauer, MR; Litaker, MS; Gilbert, GH

    2012-01-01

    Objective The objectives of this research were to (1) quantify the discordance between the caries lesion depth at which dentists restored initial lesions during a clinical study (“actual depth”) and the lesion depth that they reported during a hypothetical clinical scenario (“reported depth”); (2) test the hypothesis that certain practitioner, practice, patient, and caries lesion characteristics are significantly associated with this discordance. Methods Practitioner-investigators who perform restorative dentistry in their practices completed an enrollment questionnaire and participated in two consecutive studies on caries diagnosis and treatment. The first study was a survey asking about caries treatment. The second study collected data on restorations placed in routine clinical practice due to caries in patients over 19 years of age on occlusal surfaces only or proximal surfaces only. We report results on 2691 restorations placed by 205 dentists in 1930 patients with complete data. Results Discordance between actual depth and reported depth occurred in only about 2% of the restorations done due to proximal caries, but about 49% of the restorations done due to occlusal caries. Practice type, restorative material used and the diagnostic methods used were significantly associated with discordance. Conclusion Dentists frequently restored occlusal caries at a shallower depth as compared to their reported depth, but the discordance was very small for proximal lesions. Discordance for occlusal caries was more common when radiographs were not taken or if a resin restoration was placed. PMID:22245444

  15. Support for the role of Candida spp. in extensive caries lesions of children.

    PubMed

    Signoretto, Caterina; Burlacchini, Gloria; Faccioni, Fiorenzo; Zanderigo, Massimiliano; Bozzola, Nicolò; Canepari, Pietro

    2009-01-01

    Candida spp. are frequently detected in the mouths of children with extensive caries lesions compared with caries-free subjects. In this study we evaluated the presence of Candida spp. in association with mutans streptococci and lactobacilli in the saliva of children with dental decay, before and after anti-caries treatment. Samples of saliva from 14 children with caries lesions and from 13 caries-free subjects were evaluated for the presence of mutans streptococci, lactobacilli and Candida spp. by culture. Eleven of 14 carious subjects hosted Candida spp. in their saliva as against only 2 out of 13 subjects without caries lesions. Carious subjects were treated by adopting a conventional protocol for caries disease (rinses with a mouthwash containing 0.2% chlorhexidine and fluorine). After treatment, the salivary bacterial counts decreased for mutans streptococci and in some cases for lactobacilli, but large numbers of Candida spp. remained in the saliva of several children. The latter were treated with the antifungal drug nystatin (oral rinses) and evaluation of the level of yeasts in the saliva showed disappearance of the microorganism in several cases. The results indicate that antiseptic treatment alone for dental decay is not sufficient for the eradication of microorganisms potentially responsible for caries lesions, in particular when yeasts are present. We hypothesize that the oral cavity of children could act as a reservoir of fungi, and eradication could be needed to prevent both exacerbation of caries lesions, and colonization by Candida spp. of other host sites.

  16. CO2 laser irradiation enhances CaF2 formation and inhibits lesion progression on demineralized dental enamel-in vitro study.

    PubMed

    Zancopé, Bruna R; Rodrigues, Lívia P; Parisotto, Thais M; Steiner-Oliveira, Carolina; Rodrigues, Lidiany K A; Nobre-dos-Santos, Marinês

    2016-04-01

    This study evaluated if Carbon dioxide (CO2) (λ 10.6 μm) laser irradiation combined with acidulated phosphate fluoride gel application (APF gel) enhances "CaF2" uptake by demineralized enamel specimens (DES) and inhibits enamel lesion progression. Thus, two studies were conducted and DES were subjected to APF gel combined or not with CO2 laser irradiation (11.3 or 20.0 J/cm(2), 0.4 or 0.7 W) performed before, during, or after APF gel application. In study 1, 165 DES were allocated to 11 groups. Fluoride as "CaF2 like material" formed on enamel was determined in 100 DES (n = 10/group), and the surface morphologies of 50 specimens were evaluated by scanning electron microscopy (SEM) before and after "CaF2" extraction. In study 2, 165 DES (11 groups, n = 15), subjected to the same treatments as in study 1, were further subjected to a pH-cycling model to simulate a high cariogenic challenge. The progression of demineralization in DES was evaluated by cross-sectional microhardness and polarized light microscopy analyses. Laser at 11.3 J/cm(2) applied during APF gel application increased "CaF2" uptake on enamel surface. Laser irradiation and APF gel alone arrested the lesion progression compared with the control (p < 0.05). Areas of melting, fusion, and cracks were observed. CO2 laser irradiation, combined with a single APF application enhanced "CaF2" uptake on enamel surface and a synergistic effect was found. However, regarding the inhibition of caries lesion progression, no synergistic effect could be demonstrated. In conclusion, the results have shown that irradiation with specific laser parameters significantly enhanced CaF2 uptake by demineralized enamel and inhibited lesion progression.

  17. Absorption and thermal study of dental enamel when irradiated with Nd:YAG laser with the aim of caries prevention

    NASA Astrophysics Data System (ADS)

    Boari, H. G. D.; Ana, P. A.; Eduardo, C. P.; Powell, G. L.; Zezell, D. M.

    2009-07-01

    It is widely recognized that Nd:YAG can increase enamel resistance to demineralization; however, the safe parameters and conditions that enable the application of Nd:YAG laser irradiation in vivo are still unknown. The aim of this study was to determine a dye as a photoabsorber for Nd:YAG laser and to verify in vitro a safe condition of Nd:YAG irradiation for caries prevention. Fifty-eight human teeth were selected. In a first morphological study, four dyes (waterproof India ink., iron oxide, caries indicator and coal paste) were tested before Nd:YAG laser irradiation, under two different irradiation conditions: 60 mJ/pulse and 10 Hz (84.9 J/cm2); 80 mJ/pulse and 10 Hz (113.1 J/cm2). In a second study, the enamel surface and pulp chamber temperatures were evaluated during laser irradiations. All dyes produced enamel surface melting, with the exception of the caries indicator, and coal paste was the only dye that could be completely removed. All irradiation conditions produced temperature increases of up to 615.08°C on the enamel surface. Nd:YAG laser irradiation at 60 mJ/pulse, 10 Hz and 84.9 J/cm2 promoted no harmful temperature increase in the pulp chamber (ANOVA, p < 0.05). Among all dyes tested, the coal paste was an efficient photoabsorber for Nd:YAG irradiation, considered feasible for clinical practice. Nd:YAG laser at 84.9 J/cm2 can be indicated as a safe parameter for use in caries prevention.

  18. Detecting Proximal Secondary Caries Lesions: A Cost-effectiveness Analysis.

    PubMed

    Schwendicke, F; Brouwer, F; Paris, S; Stolpe, M

    2016-02-01

    When choosing detection methods for secondary caries lesions, dentists need to weigh sensitivity, allowing early initiation of retreatments to avoid lesion progression, against specificity, aiming to reduce risks of false-positive diagnoses and invasive overtreatments. We assessed the cost-effectiveness of different detection methods for proximal secondary lesions using Monte Carlo microsimulations. A vital permanent molar with an occlusal-proximal restoration was simulated over the lifetime of an initially 20-y-old. Three methods were compared: biannual tactile detection, radiographic detection every 2 y, and biannual laser fluorescence detection. Methods were employed either on their own or in pairwise combinations at sensitive and specific thresholds estimated with systematically collected data. A mixed public-private payer perspective in the context of German health care was applied. Effectiveness was calculated as years of tooth retention. Net-benefit analyses were used to evaluate cost-effectiveness acceptability at different willingness-to-pay thresholds. Radiographic detection verified by tactile assessment (both at specific thresholds) was least costly (mean, 1,060 euros) but had limited effectiveness (mean retention time, 50 y). The most effective but also more costly combination was laser fluorescence detection verified by radiography, again at specific thresholds (1157 euros, 53 y, acceptable if willingness to pay >32 euro/y). In the majority of simulations, not combining detection methods or applying them at sensitive thresholds was less effective and more costly. Net benefits were not greatly altered by applying different discounting rates or using different baseline prevalence of secondary lesions. Current detection methods for secondary lesions should best be used in combination, not on their own, at specific thresholds to avoid false-positive diagnoses leading to costly and invasive overtreatment. The relevant characteristics, such as predictive

  19. Ability of laser fluorescence device associated with fluorescent dyes in detecting and quantifying early smooth surface caries lesions.

    PubMed

    Mendes, Fausto Medeiros; de Oliveira, Elisabeth; de Faria, Dalva Lúcia Araújo; Nicolau, José

    2006-01-01

    A laser fluorescence (LF) device is a portable tool, but it does not measure minor mineral changes. Our in vitro study aim is to propose the association of an LF with two fluorescent dyes and to evaluate the performance in detecting and quantifying early demineralization. Artificial caries lesions are created in 40 primary canine teeth using a demineralizing solution (pH=4.8) for 12, 24, 48, and 96 h. LF measurements are performed with DIAGNOdent after demineralization in these samples and in 20 sound primary teeth. Measurements with LF with 0.2-mM tetrakis(N-methylpyridyl)porphyrin (LF TMPyP) and with 4-mM protoporphyrin IX (LF PPIX) are made. The amount of calcium loss is determined by atomic emission spectrometry. A correlation between LF and LF with dyes and mineral loss and receiver operating characteristics analysis are performed, as well as comparisons of sensitivity, specificity, and accuracy values. Significant correlation is obtained with LF TMPyP and mineral loss of lesions demineralized for 24, 48, and 96 h. Better performance is achieved with LF TMPyP for all parameters than with LF alone. LF PPIX does not present good results. In conclusion, LF TMPyP provides good performance in detecting and quantifying very early enamel caries lesions.

  20. In vitro study on tooth enamel lesions related to whitening dentifrice.

    PubMed

    de Araújo, Danilo Barral; Silva, Luciana Rodrigues; Campos, Elisângela de Jesus; Correia de Araújo, Roberto Paulo

    2011-01-01

    The tooth whitening substances for extrinsic use that are available in Brazil contain hydrogen peroxide or carbamide peroxide. Several studies have attributed the appearance of lesions in the enamel morphology, including hypersensitivity, to these substances. Such lesions justify fluoride therapy and application of infrared lasers, among other procedures. However, there is no consensus among researchers regarding the relevance of the severity of lesions detected on the tooth surface. The present study was carried out with an aim of evaluating in vitro the effects of the hydrogen peroxide, carbamide peroxide and sodium bicarbonate contained in dentifrice formulations, on human tooth enamel. After darkening process in laboratory, human premolars were brushed using dentifrice containing the two whitening substances (Rembrandt - carbamide peroxide and Mentadent - hydrogen peroxide) and the abrasive product (Colgate - sodium bicarbonate). The degree of specimen staining before and after this procedure was determined using spectrophotometry. Scanning electron microscopy (SEM) was used to obtain images, which were analyzed to show the nature of the lesions that appeared on the enamel surface. The effectiveness of the whitening caused by hydrogen peroxide and carbamide peroxide and the abrasion caused by bicarbonate were confirmed, given that the treated test pieces returned to their original coloration. Based on SEM, evaluation of the enamel surfaces subjected to the test products showed that different types of morphologic lesions of varying severity appeared. Whitening dentifrice containing hydrogen peroxide and carbamide peroxide produced lesions on the enamel surface such that the greatest sequelae were associated with exposure to hydrogen peroxide.

  1. Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system

    NASA Astrophysics Data System (ADS)

    Chen, Yueli; Otis, Linda; Piao, Daqing; Zhu, Quing

    2005-04-01

    Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

  2. Systematic Review on Noninvasive Treatment of Root Caries Lesions

    PubMed Central

    Meyer-Lueckel, H.

    2015-01-01

    The present systematic review critically summarizes results of clinical studies investigating chemical agents to reduce initiation or inactivation of root caries lesions (RCLs). Outcomes were DMFRS/DFRS (decayed, missing, filled root surfaces), surface texture (hard/soft), and/or RCI (root caries index). Three electronic databases were screened for studies from 1947 to 2014. Cross-referencing was used to further identify articles. Article selection and data abstraction were done in duplicate. Languages were restricted to English and German. Mean differences (MD) were calculated for changes in DMFRS/DFRS. Risk ratios (RR) were calculated for changes in surface texture and RCI in a random effects model. Thirty-four articles with 1 or more agents were included; they reported 30 studies with 10,136 patients who were 20 to 101 y old; and they analyzed 28 chemical agents (alone or in combination). Eleven studies investigated dentifrices, 10 rinses, 8 varnishes, 3 solutions, 3 gels, and 2 ozone applications. Meta-analyses revealed that dentifrices containing 5,000 ppm F- (RR = 0.49; 95% confidence interval [95% CI] = 0.42, 0.57; high level of evidence) or 1.5% arginine plus 1,450 ppm F- (RR = 0.79; 95% CI = 0.64, 0.98; very low level) are more effective in inactivating RCLs than dentifrices containing 1,100 to 1,450 ppm F-. Self-applied AmF/SnF2-containing dentifrice and rinse decreased the initiation of RCLs when compared with NaF products (standardized MD = 0.15; 95% CI = −0.22, 0.52; low level). Patients rinsing with a mouth rinse containing 225 to 900 ppm F- revealed a significantly reduced DMFRS/DFRS (MD = −0.18; 95% CI = −0.35, −0.01; low level) when compared with a placebo rinse. Significantly reduced RCI was found for CHX (MD = −0.67; 95% CI = −1.01, −0.32; very low level) as well as SDF (MD = −0.33; 95% CI = −0.39, −0.28; very low level) when compared with placebo varnish. Regular use of dentifrices containing 5,000 ppm F- and quarterly

  3. Biological factors in dental caries enamel structure and the caries process in the dynamic process of demineralization and remineralization (part 2).

    PubMed

    Hicks, John; Garcia-Godoy, Franklin; Flaitz, Catherine

    2004-01-01

    Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The physicochemical properties of the mineral comprising the tooth surface and subsurface modulate the development, arrestment and remineralization of dental caries. Post-eruption maturation of enamel surfaces and exposed root surfaces is important in order for more susceptible mineral phases to be modified by incorporation of soluble fluoride from the plaque into dental hydroxyapatite. The chemical reactions that occur during acidic conditions when tooth mineral dissolves (critical pH) are determined by the supersaturation of calcium and phosphate within plaque and saliva, as well as if fluoride is present.

  4. Determinant Factors of Untreated Dental Caries and Lesion Activity in Preschool Children Using ICDAS.

    PubMed

    Pinto-Sarmento, Tássia Cristina de Almeida; Abreu, Mauro Henrique; Gomes, Monalisa Cesarino; Costa, Edja Maria Melo de Brito; Martins, Carolina Castro; Granville-Garcia, Ana Flávia; Paiva, Saul Martins

    2016-01-01

    The aim of the present study was to investigate determinant factors associated with the presence of dental caries and lesion activity in preschool children. A population-based, cross-sectional study was carried out with 843 children of aged three to five years enrolled at public and private preschools in the city of Campina Grande, Brazil. A questionnaire addressing socio-demographic data and oral health care was self-administered by parents/caregivers. Three dentists previously calibrated examined the children for the diagnosis of dental caries and lesion activity using the International Caries Detection and Assessment System (ICDAS). Nutritional status was evaluated based on the body mass index. Logistic regression analysis for complex samples was performed (α = 5%). The prevalence of dental caries was 66.3%. Among the children with caries, 88.0% had active lesions. Dental caries was more prevalent in girls (OR = 1.53, 95%CI: 1.05-2.23), in children from families with a monthly household income ≤US$312.50 (OR = 2.38, 95%CI: 1.65-3.43) and those whose mothers had up to eight years of schooling (OR = 1.55, 95%CI: 1.07-2.23). Lesion activity was significantly associated with mother's schooling ≤ 8 years (OR = 2.15, 95%CI: 1.15-4.00). The prevalence rates of dental caries and lesion activity were high and mainly associated with a lower socioeconomic status and mother's schooling.

  5. Physical, chemical, and histologic changes in dentin caries lesions of primary teeth induced by regular use of polyol chewing gums.

    PubMed

    Mäkinen, K K; Chiego, D J; Allen, P; Bennett, C; Isotupa, K P; Tiekso, J; Mäkinen, P L

    1998-06-01

    A previous clinical trial showed that long-term use of saliva-stimulating polyol (xylitol and sorbitol) chewing gums was associated with arrest of dental caries in young subjects. After a 20-22-month intervention (when the subjects were 8 years old), a total of 23 primary teeth with extensive dentin caries lesions whose surface in clinical examination was found to be totally rehardened (remineralized) could be removed because the teeth were near their physiologic exfoliation time. These teeth were subjected to histologic, microhardness, and electron microscopic tests. The majority of the specimens had been remineralized from the surface by a non-cellular-mediated process within the remaining collapsed, organic extracellular matrix associated with the remaining dentinal surface. Many of the underlying dentinal tubules were filled with a matrix that had been subsequently mineralized. Dental microanalyses showed that the topmost (outer) 20-microm-thick rehardened layer of the lesions exhibited the highest Ca:P ratio, which leveled off at a depth of approximately 150 microm. The rehardened surface layer (normally <0.1 mm in thickness) was significantly (P < 0.001) harder than sound dentin and nearly as hard as sound enamel. Although the main source of the mineral present in the rehardened layer was most likely of salivary origin, some extracellular remineralization was probably mediated by odontoblasts. The results complete the dinical diagnoses of the original trial and suggest that regular use of polyol chewing gums may induce changes in dentin caries lesions, which in histologic and physiochemical studies show typical characteristics of rehardening and mineralization.

  6. How mechanical stresses modulate enamel demineralization in non-carious cervical lesions?

    PubMed

    Leal, Noélia M S; Silva, Juscelino L; Benigno, Maria Ivone M; Bemerguy, Eliane A; Meira, Josete B C; Ballester, Rafael Y

    2017-02-01

    To introduce an experimental non-carious cervical lesion (NCCL) model for studying the influence of presence and type of stress (tension or compression) on acid effects involved in NCCL formation on the enamel near the cement-enamel junction (CEJ). 108 bovine incisors were cut into 18 × 3×3 mm(3) beams, with a notch in the cervical region to generate a standardized area of stress concentration. Half of the specimens were immersed in distilled water and the other half in acetic acid solution (pH 4.5) for 72h. Each group was divided into three subgroups. Two subgroups underwent 800gf static loading, with the specimen positioned in a bending jig with the buccocervical region under either tension or compression. The load was applied simultaneously to immersion (in water or in acid). The third subgroup was not subjected to loading. Transversal and longitudinal 0.05 mm plates of the specimens were analyzed under a light microscope (40, 100 and 200×) to measure the enamel demineralization depth and to assess the presence of cracks, fractures and gaps at the enamel-dentin junction. The demineralization depth data were submitted to ANOVA and Tukey's test at a 5% significance level. Enamel demineralization depth (μm) was higher under tension (158±19 in transversal sections and 229±32 in longitudinal sections) than under compression (transversal: 129±16 and longitudinal: 167±10) or unstressed condition (transversal: 138±21 and longitudinal: 187±21). Specimens immersed in acid and subjected to tensile stress presented enamel micro fractures and wider gaps in the dentin-enamel junction. Enamel demineralization was significantly higher in the presence of tensile stress, due to wider gaps between dentin and enamel, stress corrosion cracking and increased enamel permeability to acid. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. In situ remineralization of subsurface enamel lesion after the use of a fluoride chewing gum.

    PubMed

    Lamb, W J; Corpron, R E; More, F G; Beltran, E D; Strachan, D S; Kowalski, C J

    1993-01-01

    In situ remineralization of early enamel lesions by a fluoride chewing gum was studied. Human enamel specimens with subsurface lesions were mounted in removable lower appliances for 6 adults. Subjects used a F-free dentifrice 3x/day and chewed five sticks/day for the F gum group (0.1 mg F/stick) or five sticks of sugarless gum. No gum was chewed for controls. Surface microhardness was performed on: (1) sound enamel; (2) lesions; (3) after intraoral exposure, and (4) after acid-resistance testing (ART). Separate specimens were etched and measured for F uptake and image analyses on microradiographs were performed for all regimens. delta Z values were calculated and converted to percent of mineralization. Values for F gum were significantly higher (p > 0.05) than non-F gum and controls for ART, percent remineralization, and F uptake up to 70 microns depth.

  8. Activity assessment of root caries lesions with thermal and near-IR imaging methods.

    PubMed

    Lee, Robert C; Darling, Cynthia L; Staninec, Michal; Ragadio, Antonio; Fried, Daniel

    2017-03-01

    The purpose of this study was to evaluate thermal and near-infrared (NIR) reflectance imaging methods for the assessment of the activity of root caries lesions. In addition, changes in the lesion structure were monitored with polarization sensitive optical coherence tomography (PS-OCT). Artificial bovine and natural root caries lesions were imaged with PS-OCT, and their dehydration rate was measured with thermal and NIR cameras. The lesion activity of the natural root caries samples was also assessed by two clinicians by conventional means according to ICDAS II guidelines. The thickness of the highly mineralized transparent surface layer measured using PS-OCT increased and the area enclosed by the time-temperature curve, ΔQ, measured with thermal imaging decreased significantly with longer periods of remineralization in simulated dentin lesions, but the NIR reflectance intensity differences, ΔI, failed to show any significant relationship with the degree of remineralization. The PS-OCT algorithm for the automated assessment of remineralization successfully detected the highly mineralized surface layer on both natural and simulated lesions. Thermal imaging provided the most accurate diagnosis of root caries lesion activity. These results demonstrate that thermal imaging and PS-OCT may be ideally suited for the nondestructive root caries lesion activity during a clinical examination. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Susceptibility of bovine dental enamel with initial erosion lesion to new erosive challenges

    PubMed Central

    Tereza, Guida Paola Genovez; Boteon, Ana Paula; Ferrairo, Brunna Mota; Gonçalves, Priscilla Santana Pinto; da Silva, Thiago Cruvinel; Honório, Heitor Marques; Rios, Daniela

    2017-01-01

    This in vitro study evaluated the impact of initial erosion on the susceptibility of enamel to further erosive challenge. Thirty bovine enamel blocks were selected by surface hardness and randomized into two groups (n = 15): GC- group composed by enamel blocks without erosion lesion and GT- group composed by enamel blocks with initial erosion lesion. The baseline profile of each block was determined using the profilometer. The initial erosion was produced by immersing the blocks into HCl 0.01 M, pH 2.3 for 30 seconds, under stirring. The erosive cycling consisted of blocks immersion in hydrochloric acid (0.01 M, pH 2.3) for 2 minutes, followed by immersion in artificial saliva for 120 minutes. This procedure was repeated 4 times a day for 5 days, and the blocks were kept in artificial saliva overnight. After erosive cycling, final profile measurement was performed. Profilometry measured the enamel loss by the superposition of initial and final profiles. Data were analyzed by t-test (p<0.05). The result showed no statistically significant difference between groups (GS = 14.60±2.86 and GE = .14.69±2.21 μm). The presence of initial erosion on bovine dental enamel does not enhance its susceptibility to new erosive challenges. PMID:28817591

  10. Susceptibility of bovine dental enamel with initial erosion lesion to new erosive challenges.

    PubMed

    Oliveira, Gabriela Cristina de; Tereza, Guida Paola Genovez; Boteon, Ana Paula; Ferrairo, Brunna Mota; Gonçalves, Priscilla Santana Pinto; Silva, Thiago Cruvinel da; Honório, Heitor Marques; Rios, Daniela

    2017-01-01

    This in vitro study evaluated the impact of initial erosion on the susceptibility of enamel to further erosive challenge. Thirty bovine enamel blocks were selected by surface hardness and randomized into two groups (n = 15): GC- group composed by enamel blocks without erosion lesion and GT- group composed by enamel blocks with initial erosion lesion. The baseline profile of each block was determined using the profilometer. The initial erosion was produced by immersing the blocks into HCl 0.01 M, pH 2.3 for 30 seconds, under stirring. The erosive cycling consisted of blocks immersion in hydrochloric acid (0.01 M, pH 2.3) for 2 minutes, followed by immersion in artificial saliva for 120 minutes. This procedure was repeated 4 times a day for 5 days, and the blocks were kept in artificial saliva overnight. After erosive cycling, final profile measurement was performed. Profilometry measured the enamel loss by the superposition of initial and final profiles. Data were analyzed by t-test (p<0.05). The result showed no statistically significant difference between groups (GS = 14.60±2.86 and GE = .14.69±2.21 μm). The presence of initial erosion on bovine dental enamel does not enhance its susceptibility to new erosive challenges.

  11. Effectiveness of varnish with CPP-ACP in prevention of caries lesions around orthodontic brackets: an OCT evaluation.

    PubMed

    Pithon, Matheus M; Dos Santos, Mariana J; Andrade, Camilla S S; Leão Filho, Jorge César B; Braz, Ana Karla S; de Araujo, Renato E; Tanaka, Orlando M; Fidalgo, Tatiana K S; Dos Santos, Adrielle M; Maia, Lucianne C

    2015-04-01

    To evaluate the in vitro efficiency of applying varnish containing casein phosphopeptide (CPP) and amorphous calcium phosphate (ACP) in prevention of caries lesions around orthodontic brackets. For this purpose, brackets were bonded to the vestibular surface of bovine incisors, and eight groups were formed (n = 15) according to exposure of oral hygiene substances and enamel varnish: 1 (control) brushing only performed, 2 (control) brushing + use of mouth wash with fluoride, 3 Duraphat varnish application only (Colgate-Palmolive Ind. E Com. Ltda, São Paulo, SP, Brazil), 4 Duraphat + brushing, 5 Duraphat + brushing + mouth wash, 6 MI Varnish application (GC America, USA), 7 MI + brushing, and 8 MI + brushing + mouth wash. The experimental groups alternated between pH cycling and the procedures described and were kept in an oven at temperature of 37°C. Both brushing and immersion in solutions was performed in a time interval of 1 minute, followed by washing in deionized water three times a day for 28 days of experimentation. Afterwards, evaluation by optical coherence tomography (OCT) of the special type (Ganymede OCT/Thorlabs, Newton, USA) was performed. In each group, a scanning exam of the white spot lesion area (around the region where brackets were bonded) and depth measurement of caries lesions were performed. Groups 1 and 3 were shown to differ statistically from groups 5, 6, 7, and 8 (p = 0.000). MI Varnish was shown to be more effective in diminishing caries lesion depth, compared with Duraphat, irrespective of being associated with brushing and mouth wash, or not. The major limitation of this study is that it is a study in which demineralization was obtained with the use of chemical products, and did not occur due to the presence of Streptococcus mutans and its acid byproducts. Application CPP-ACP-containing varnish irrespective of being associated with brushing and mouthwash, or not, reduced depth of caries lesions around orthodontic brackets. © The

  12. Enamel demineralization with two forms of archwire ligation investigated using an in situ caries model--a pilot study.

    PubMed

    Gameiro, Gustavo Hauber; Nouer, Darcy Flávio; Cenci, Maximiliano Sérgio; Cury, Jaime Aparecido

    2009-10-01

    A modified in situ model to assess enamel demineralization around orthodontic devices was developed and a pilot study was conducted to evaluate two types of archwire ligation. Enamel blocks were placed in palatal removable appliances where orthodontic brackets were bonded. The brackets on one side of the appliance were ligated with elastomeric rings and those on the other side with stainless steel wires. Four volunteers (two males, two females), mean age 27 years, wore the appliances for 14 days during which time a 20 per cent sucrose solution was dripped eight times a day onto the enamel blocks. The biofilm formed around the brackets was collected for microbiological analyses and the mineral loss around the brackets was determined by cross-sectional microhardness measurement. The ligatures evaluated did not differ significantly from each other regarding biofilm weight, total bacteria, total streptococci, mutans streptococci, or lactobacilli counts (P > 0.05, Wilcoxon paired test). Enamel demineralization was also not different around the brackets for the different ligation methods (P > 0.05, split-split-plot analysis of variance). However, a statistical power analysis based on the data showed a trend to higher demineralization around brackets ligated with elastomeric rings. The developed modified in situ model may be suitable to assess the caries potential of clinical procedures used in orthodontic treatment.

  13. Resin penetration in artificial enamel carious lesions after using sodium hypochlorite as a deproteinization agent.

    PubMed

    Gómez, Ss; Bravo, P; Morales, R; Romero, A; Oyarzún, A

    2014-01-01

    To study the degree of penetration of an adhesive resin in artificial enamel carious lesions after using sodium hypochlorite as deproteinization agent. Twenty included human third-molars, extracted for surgical indication, were used. Artificial lesions were created in the buccal and lingual sides of each specimen through a cycle of demineralization-remineralization. Samples were then incubated in human saliva for 7 days at 37 ° C. After surface cleaning, lesions and the peripheral sound enamel were etched with 37% orthophosphoric acid for 20 seconds. One lesion of each specimen was treated with 5.25% sodium hypochlorite (NaOCl) for one minute. The other lesion of each specimen was used as a control. Experimental and control lesions were sealed with a fluid resin marked with Rhodamine B. Lesions were sectioned for microscopic observation by epifluorescence and polarized light. The images obtained were analyzed morphometrically. The micrometer measurements were made with ImageJ ® software. The level of significance was assessed at p<0.05. The average sealant depth penetration in the control group was 94.9 ± 28.6 μm versus 122.8 ± 25.3 μm in the experimental group. This represents Δ 20.1% significantly greater penetration when using sodium hypochlorite (p<0.001). The results demonstrated a significant penetration of the sealing resin when the conventional technique is complemented with the application of 5.25% sodium hypochlorite for one minute in artificial enamel carious lesions.

  14. Effect of CPP-ACP Paste on Enamel Carious Lesion of Primary Upper Anterior Teeth Assessed by Quantitative Light-Induced Fluorescence: A One-Year Clinical Trial.

    PubMed

    Sitthisettapong, Thanya; Doi, Takashi; Nishida, Yuhei; Kambara, Masaki; Phantumvanit, Prathip

    2015-01-01

    The purpose of this clinical trial was to evaluate the effect of 1 year of daily application of 10% w/v CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) paste in addition to regular toothbrushing with fluoridated toothpaste on the remineralization of enamel carious lesions in preschool children using quantitative light-induced fluorescence (QLF). A total of 103 Thai children (aged 2(1)/2-3(1)/2 years) with high caries risk who had at least 1 enamel carious lesion (ICDAS 1-3) on the labial surface of the upper anterior teeth were assigned to receive either CPP-ACP paste (n = 53) or placebo control (n = 50) following toothbrushing with fluoridated toothpaste after lunch at school. QLF measurement was performed at baseline, 6 months and 1 year. At 1 year, a significant reduction in fluorescence loss (ΔF), lesion area and lesion volume (ΔQ; p ≤ 0.001) of the lesions were found over time in both groups. However, no significant difference was observed between the groups (p = 0.79, 0.98 and 0.88, respectively). There was no statistically significant difference between the odds of ΔQ transition to a stage of regression or arrest compared with progression from baseline to 1 year between the two groups (OR = 1.03, 95% CI 0.31-3.39). The daily application of 10% w/v CPP-ACP paste on a school day for 1 year resulted in no improvement of enamel carious lesion remineralization in the primary upper anterior teeth as assessed by QLF. The lesion improvement was not superior to remineralization from regular toothbrushing with fluoridated toothpaste alone in these children. © 2015 S. Karger AG, Basel.

  15. HPO2-4 content in enamel and artificial carious lesions.

    PubMed

    Arends, J; Davidson, C L

    1975-07-04

    The HPO2-4 and CO2-3 content was determined in sound enamel and in material collected from artificially produced carious lesions. The method described shows that the HPO2-4 content can be determined from the 875 cm(-1) infrared absorption band if correction for the CO2-3 contribution are made. The I.R. spectra show that the HPO2-4 content in sound human or bovine enamel is about 5% by weight. In artificially produced carious lesions (pH=4.0), the HPO2-4 content is in the order of 15 wt%. Most likely, the HPO2-4 ions in sound and carious enamel have a different enviroment.

  16. Evaluation of laser fluorescence in monitoring non-cavitated caries lesion progression on smooth surfaces in vitro.

    PubMed

    Rodrigues, J A; Sarti, C S; Assunção, C M; Arthur, R A; Lussi, A; Diniz, M B

    2017-07-02

    The aim of this study was to evaluate the performance of a pen-type laser fluorescence (LF) device (LFpen: DIAGNOdent pen) to detect and monitor the progression of caries-like lesions on smooth surfaces. Fifty-two bovine enamel blocks were submitted to three different demineralisation cycles for caries-like lesion induction using Streptococcus mutans, Lactobacillus casei and Actinomyces naeslundii. At baseline and after each cycle, the enamel blocks were analysed under Knoop surface micro-hardness (SMH) and an LFpen. One enamel block after each cycle was randomly chosen for Raman spectroscopy analysis. Cross-sectional micro-hardness (CSMH) was performed at different depths (20, 40, 60, 80 and 100 μm) in 26 enamel blocks after the second cycle and 26 enamel blocks after the third cycle. Average values of SMH (± standard deviation (SD)) were 319.3 (± 21.5), 80.5 (± 31.9), 39.8 (± 12.7), and 29.77 (± 10.34) at baseline and after the first, second and third cycles, respectively. Statistical significant difference was found among all periods (p < 0.01). The LFpen values were 4.3 (± 1.5), 7.5 (± 9.4), 7.1 (± 7.1) and 5.10 (± 3.58) at baseline and after the first, second, and third cycles, respectively, among all periods (p < 0.05). The CSMH values after the second and third cycles at 20, 40, 60, 80 and 100 μm were 182.8 (± 69.8), 226.1 (± 79.6), 247.20 (± 69.36), 262.35 (± 66.36) and 268.45 (± 65.49), and for the third cycle were 193.7 (± 73.4), 239.5 (± 81.5), 262.64 (± 82.46), 287.10 (± 78.44) and 284.79 (± 72.63) (n = 24 and 23), respectively. No correlation was observed between the LFpen and SMH values (p > 0.05). One sample of each cycle was characterised through Raman spectroscopy analysis. It can be concluded that LF was effective in detecting the first demineralisation on enamel; however, the method did not show any effect in monitoring lesion progression after three cycles of in vitro demineralisation.

  17. Prevalence of dental caries and enamel defects in the primary dentition of Antiguan pre-school children aged 3-4 years including an assessment of their habits.

    PubMed

    Vignarajah, S; Williams, G A

    1992-12-01

    In 1989 a national survey was carried out on children aged 3 to 4 years attending nursery schools, to investigate the prevalence of caries experience, nursing bottle caries and enamel defects in the primary dentition, and these children's dentally related habits. In the first part of the study, examination of 482 Antiguan children showed that the dmft and dmfs values were 0.80 and 1.26 respectively, and that 77 per cent of the children were caries free; 4.6 per cent of children had nursing bottle caries; and enamel defects occurred in 24 per cent of children. No significant difference was found in oral health between urban and rural samples. In the second part, which was an interview survey, habits such as thumb sucking (13 per cent), not brushing their teeth (3 per cent), and swallowing fluoride toothpaste (13 per cent) were found among 369 children. In the third (a questionnaire) survey, a response rate of 63 per cent was obtained. Significantly more of the children with nursing bottle caries (78.6 per cent) had the habit of sleeping with a feeding bottle than occurred in caries free children (25.6 per cent), but there was no difference in the infant feeding pattern. The children with enamel defects were breast fed for a shorter period and had an earlier introduction to bottle feeding, compared with children without enamel defects. In the final part of the survey, an assessment of snack eating habits at school, a 58 per cent response rate was achieved. The majority of children often brought healthier snacks, together with daily sugar-rich drinks. Significantly more caries free children brought sugary snacks less frequently than children with caries experience.

  18. Polarization sensitive optical coherence tomography for quantifying the severity of natural caries lesions on occlusal surfaces

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Ngaotheppitak, Patara; Darling, Cynthia L.; Ho, Chi M.

    2007-02-01

    Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image early dental caries. The purpose of this study was to compare the measured integrated reflectivity of natural caries lesions with the mineral loss measured using digital microradiography in order to determine if PS-OCT can be used as a nondestructive in vivo method to measure the severity of dental decay in the important occlusal surfaces. A PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of natural caries lesions on the occlusal surfaces of extracted teeth. The integrated reflectivity from lesion areas was compared to the integrated mineral loss from the same lesion area measured using digital microradiography. There was a strong correlation between the integrated mineral loss of the caries lesion measured using high resolution digital microradiography and the integrated reflectivity in the perpendicular polarization axis of the PS-OCT system demonstrating the potential for this method to nondestructively monitor the severity of caries lesion in the occlusal pit and fissure where most new decay is found. Although we find these results encouraging, we desire a higher correlation between the integrated mineral loss and the integrated reflectivity and we believe a higher correlation is attainable with better matching of the PS-OCT scans and the histological thin sections.

  19. Enhancing the detection of hidden occlusal caries lesions with OCT using high index liquids

    NASA Astrophysics Data System (ADS)

    Kang, Hobin; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    In a previous study, we investigated the influence of several high refractive index fluids on the performance of polarization sensitive optical coherence tomography (PS-OCT). That study showed that these liquids can increase the effective imaging depth and lesion contrast. Other in vitro and in vivo studies have shown that OCT can be used to show whether occlusal lesions have penetrated to the dentinal-enamel junction (DEJ) and spread laterally under the enamel. The purpose of this study was to determine if high index fluids can enhance the ability of OCT to detect hidden occlusal lesions and show if these lesions have penetrated through the enamel into the underlying dentin. Ten extracted teeth with occlusal lesions were imaged using OCT after the application of water, glycerol, BABB (33% Benzyl Alcohol + 67% Benzyl Benzoate) and a Cargille Liquid (Cedar Grove, NJ) (hydrogenated terphenyl 1- bromo-naphthalene) with a refractive index of 1.61. The intensity of the reflectance from the underlying lesion area for each sample was compared with the reflectance of the sound tooth surface for each fluid. The use of high index fluids significantly (P< 0.0001) increased the reflectivity of subsurface occlusal lesions under the surrounding sound enamel.

  20. Comparison of cross-sectional hardness and transverse microradiography of artificial carious enamel lesions induced by different demineralising solutions and gels.

    PubMed

    Magalhães, A C; Moron, B M; Comar, L P; Wiegand, A; Buchalla, W; Buzalaf, M A R

    2009-01-01

    The aims of this study were: (1) to correlate surface (SH) and cross-sectional hardness (CSH) with microradiographic parameters of artificial enamel lesions; (2) to compare lesions prepared by different protocols. Fifty bovine enamel specimens were allocated by stratified randomisation according to their initial SH values to five groups and lesions produced by different methods: MC gel (methylcellulose gel/lactic acid, pH 4.6, 14 days); PA gel (polyacrylic acid/lactic acid/hydroxyapatite, pH 4.8, 16 h); MHDP (undersaturated lactate buffer/methyl diphosphonate, pH 5.0, 6 days); buffer (undersaturated acetate buffer/fluoride, pH 5.0, 16 h), and pH cycling (7 days). SH of the lesions (SH(1)) was measured. The specimens were longitudinally sectioned and transverse microradiography (TMR) and CSH measured at 10- to 220-microm depth from the surface. Overall, there was a medium correlation but non-linear and variable relationship between mineral content and radicalCSH. radicalSH(1) was weakly to moderately correlated with surface layer properties, weakly correlated with lesion depth but uncorrelated with integrated mineral loss. MHDP lesions showed the highest subsurface mineral loss, followed by pH cycling, buffer, PA gel and MC gel lesions. The conclusions were: (1) CSH, as an alternative to TMR, does not estimate mineral content very accurately, but gives information about mechanical properties of lesions; (2) SH should not be used to analyse lesions; (3) artificial caries lesions produced by the protocols differ, especially considering the method of analysis.

  1. Effect of Lesion Baseline Severity and Mineral Distribution on Remineralization and Progression of Human and Bovine Dentin Caries Lesions.

    PubMed

    Lippert, Frank; Churchley, David; Lynch, Richard J

    2015-01-01

    The aims of this laboratory study were to compare the effects of lesion baseline severity, mineral distribution and substrate on remineralization and progression of caries lesions created in root dentin. Lesions were formed in dentin specimens prepared from human and bovine dentin using three protocols, each utilizing three demineralization periods to create lesions of different mineral distributions (subsurface, moderate softening, extreme softening) and severity within each lesion type. Lesions were then either remineralized or demineralized further and analyzed using transverse microradiography. At lesion baseline, no differences were found between human and bovine dentin for integrated mineral loss (x0394;Z). Differences in mineral distribution between lesion types were apparent. Human dentin lesions were more prone to secondary demineralization (x0394;x0394;Z) than bovine dentin lesions, although there were no differences in x0394;L. Likewise, smaller lesions were more susceptible to secondary demineralization than larger ones. Subsurface lesions were more acid-resistant than moderately and extremely softened lesions. After remineralization, differences between human and bovine dentin lesions were not apparent for x0394;x0394;Z although bovine dentin lesions showed greater reduction in lesion depth L. For lesion types, responsiveness to remineralization (x0394;x0394;Z) was in the order extremely softened>moderately softened>subsurface. More demineralized lesions exhibited greater remineralization than shallower ones. In summary, some differences exist between human and bovine dentin and their relative responsiveness to de- and remineralization. These differences, however, were overshadowed by the effects of lesion baseline mineral distribution and severity. Thus, bovine dentin appears to be a suitable substitute for human dentin in mechanistic root caries studies.

  2. Update on Nonsurgical, Ultraconservative Approaches to Treat Effectively Non-Cavitated Caries Lesions in Permanent Teeth

    PubMed Central

    Borges, Boniek Castillo Dutra; de Souza Borges, Juliane; de Araujo, Larissa Sgarbosa Napoleao; Machado, Claudia Tavares; dos Santos, Alex Jose Souza; de Assunçao Pinheiro, Isauremi Vieira

    2011-01-01

    Dental caries on tooth surfaces is still a problem in many industrialized countries. For many years, dentistry was influenced by a mechanical approach characterized by the use of high-speed rotary cutting instruments, and dentists predominantly used surgical methods to address caries. This included radical removal of diseased portions of the tooth, along with material-driven geometric extensions to areas that were assumed to be caries-resistant. This concept of extension for prevention was introduced by G. V. Black and influenced dentists for more than 120 years. Recently, a new paradigm of operative conservatism, sometimes referred to as “minimally invasive dentistry,” has gained popularity. This paradigm is designed to promote maximum preservation of healthy dental structures over a lifetime. The aim of this review is to discuss the efficacy of current nonsurgical treatments for non-cavitated caries lesions in permanent teeth. Based on results obtained from clinical trials, this review evaluates treatments such as consumption of CPP-ACP added gums, resin infiltration and fissure sealing. Although in a few cases an invasive approach is needed to arrest caries progression, the non-surgical approach generally provides potential benefits that include conserving structure by delaying intervention or minimizing the operative procedure. All current non-invasive methods are effective in treating non-cavitated caries lesions. The adoption of non-invasive approaches in the management of these lesions can preserve dental tissues, thus increasing tooth longevity. PMID:21494394

  3. Determinant Factors of Untreated Dental Caries and Lesion Activity in Preschool Children Using ICDAS

    PubMed Central

    Pinto-Sarmento, Tássia Cristina de Almeida; Abreu, Mauro Henrique; Gomes, Monalisa Cesarino; Costa, Edja Maria Melo de Brito; Martins, Carolina Castro; Granville-Garcia, Ana Flávia; Paiva, Saul Martins

    2016-01-01

    The aim of the present study was to investigate determinant factors associated with the presence of dental caries and lesion activity in preschool children. A population-based, cross-sectional study was carried out with 843 children of aged three to five years enrolled at public and private preschools in the city of Campina Grande, Brazil. A questionnaire addressing socio-demographic data and oral health care was self-administered by parents/caregivers. Three dentists previously calibrated examined the children for the diagnosis of dental caries and lesion activity using the International Caries Detection and Assessment System (ICDAS). Nutritional status was evaluated based on the body mass index. Logistic regression analysis for complex samples was performed (α = 5%). The prevalence of dental caries was 66.3%. Among the children with caries, 88.0% had active lesions. Dental caries was more prevalent in girls (OR = 1.53, 95%CI: 1.05–2.23), in children from families with a monthly household income ≤US$312.50 (OR = 2.38, 95%CI: 1.65–3.43) and those whose mothers had up to eight years of schooling (OR = 1.55, 95%CI: 1.07–2.23). Lesion activity was significantly associated with mother’s schooling ≤ 8 years (OR = 2.15, 95%CI: 1.15–4.00). The prevalence rates of dental caries and lesion activity were high and mainly associated with a lower socioeconomic status and mother’s schooling. PMID:26900846

  4. Near-infrared imaging of enamel hypomineralization due to developmental defects

    NASA Astrophysics Data System (ADS)

    Lee, Robert C.; Jang, Andrew; Fried, Daniel

    2017-02-01

    The increasing prevalence of mild hypomineralization due to developmental defects on tooth surfaces poses a challenge for caries detection and caries risk assessment and reliable methods need to be developed to discriminate such lesions from active caries lesions that need intervention. Previous studies have demonstrated that areas of hypomineralization are typically covered with a relatively thick surface layer of highly mineralized and transparent enamel similar to arrested lesions. Seventy-six extracted human teeth with mild to moderate degrees of suspicious fluorosis were imaged using near-infrared reflectance and transillumination. Enamel hypomineralization was clearly visible in both modalities. However, it was difficult to distinguish hypomineralization due to developmental defects from caries lesions with contrast measurements alone. The location of the lesion on tooth coronal surface (i.e. generalized vs. localized) seems to be the most important indicator for the presence of enamel hypomineralization due to developmental defects.

  5. Evaluation of the strain identity between isolates from caries lesions and root canals in early childhood caries cases.

    PubMed

    Nováková, Dana; Svec, Pavel; Kukletová, Martina; Záčková, Lenka; Sedláček, Ivo

    2013-11-01

    Early childhood caries (ECC) has become a serious medical problem worldwide in the last decade. Bacterial microflora of the dental plaque and oral cavity is considered an important factor in the formation and progression of dental caries. The aim of this study was strain typing and comparison of bacterial isolates retrieved from caries lesions and root canal contents of the same teeth. In total, 18 pairs of presumptive streptococci and lactobacilli retrieved from dental caries and root canals isolated from ECC-affected children, were selected on the basis of biotyping results and rep-PCR fingerprinting with (GTG)5 primer. Strain typing was further done using the RiboPrinter microbial characterization system (DuPont Qualicon). The automated ribotyping determined 14 pairs of the strains (77.8 %) to be identical. The results obtained confirmed that identical bacterial strains colonized both the decayed dental surface and the necrotic content of the dental pulp cavity during the cariogenesis. Our finding supports the assumption that bacteria could penetrate through the damaged dental surface to the inner parts of the teeth.

  6. Occlusal caries detection using polarized Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Ionita, I.; Bulou, A.

    2008-02-01

    The tooth enamel, because of its hydroxyapatite composition, must present a Raman spectrum with strong polarization anisotropy. Carious lesions of the enamel will produce an alteration of local symmetry and will increase much more scattering of light. This will reduce the anisotropy of the Raman spectra. Because of the difference between high sensitivity to polarization of the 959 cm -1 Raman peak in sound enamel and low sensitivity in carried enamel, Raman polarized spectroscopy could be a useful method to early detect teeth caries.

  7. CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study.

    PubMed

    Llena, C; Leyda, A M; Forner, L

    2015-09-01

    To evaluate the effects of novel casein phosphopeptide (CPP) formulations CPP-amorphous calcium phosphate (CCP- ACP) and CPP-amorphous calcium fluoride phosphate (CPP-ACFP) versus fluoride varnish on the remineralisation of enamel white spot lesions (WSLs) over a 12-week follow-up period. Double-blind prospective study. Eligibility criteria were patients between 6 and 14 years old and have WSLs on their permanent teeth. We evaluated 786 WSLs. Participants were divided randomly into three groups. Groups A and B were instructed to daily topical application of GC Tooth Mouse (CPP-ACP) or Mi Paste Plus (CPP-ACFP), Group C received a monthly professional application of Duraphat fluoride varnish. WSLs were categorised according to the International Caries Detection and Assessment System (ICDAS II; grades 0-3) and assessed by laser fluorescence (DIAGNOdent) at baseline and at 4, 8 and 12 weeks. Changes in mineralisation before and after treatment were analysed using two-way analysis of variance, with post hoc Bonferroni's non-parametric tests for multiple comparisons. DIAGNOdent values were significantly reduced in Group B at 4 weeks, and in Groups A and C at 8 weeks. Mean values in Group B were lower than in Groups A and C at 4 weeks, and lower than Group C at 8 weeks. CPP-ACFP appeared to have a specific effect on smooth-surface caries, but no significant effect on caries in pits and fissures. At 4 weeks, CPP-ACFP is superior to fluoride varnish at remineralising smooth-surface WSLs. CPP-ACP is not superior to fluoride varnish by any of the measures studied.

  8. In vitro ability of a laser fluorescence device in quantifying approximal caries lesions in primary molars.

    PubMed

    Celiberti, P; Leamari, V M; Imparato, J C P; Braga, M M; Mendes, F M

    2010-08-01

    This in vitro study aimed at evaluating the ability of Laser Fluorescence device (LFpen) in quantifying approximal caries lesions in primary molars. Two examiners assessed 123 approximal surfaces of primary molars using the DIAGNOdent pen (LFpen). Surfaces were determined to be either sound with white-spot lesions or have small cavitations. After sectioning, lesion depth was determined through polarized light microscopy. The intra-/inter-examiner agreement was calculated using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Furthermore, Spearman correlation coefficients (Rs) were calculated between LFpen readings and lesion depth. Correlation between LFpen values and lesion depth was low for both examiners (Rs=0.36 and 0.51), especially when cavitated lesions were excluded from the analysis (Rs=0.22 and 0.40). For all surfaces, ICC revealed intra- and inter-examiner reproducibility values of 0.75 and 0.63, respectively, but when only non-cavitated surfaces were analyzed, these values decreased (0.41 and 0.33, respectively). LFpen readings present low correlation with approximal caries lesion depth and low reproducibility, especially in white-spot lesions. Therefore, the device could not be a suitable method for monitoring non-cavitated approximal caries lesion in primary molars. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. Undermining of enamel as a mechanism of abfraction lesion formation: a finite element study.

    PubMed

    Rees, J S; Hammadeh, M

    2004-08-01

    Many workers have suggested that abfraction lesion formation is caused by the physical overloading of enamel. However, an alternative mechanism, involving undermining of the cervical enamel along the amelodentinal junction (ADJ), may be a more realistic explanation. The aim of this study was to examine what effect undermining of the buccal cervical enamel would have on the stress distribution in upper teeth. Two-dimensional plain strain finite element meshes of an upper incisor, canine and first premolar and the supporting periodontal ligament and alveolar bone were developed. Each tooth was loaded with an oblique 100 N load, and the nodal maximum principal stresses (MPS) along a buccal horizontal sampling plane 1.1 mm above the amelo-cemental junction was measured. A discontinuity between the cervical enamel and dentine elements was then introduced (0.1 mm wide) using gap elements. The vertical extent of this defect varied from 0.1 to 0.5 mm. The value of the MPS varied from 1.8 to 209 Mpa, and the lowest values were found for the intact teeth (range 0.6-30.3 MPa). The discontinuity caused a dramatic increase in the numerical values of the MPS, and in many instances these exceeded the known failure stress for enamel.

  10. Optical quantification of caries-like lesions in vitro by use of a fluorescent dye

    SciTech Connect

    Van de Rijke, J.W.; Ten Bosch, J.J. )

    1990-05-01

    An experimental method was developed for measurement of the fluorescence intensity of a dye that was introduced into caries-like lesions in vitro. A distinct pattern of change of fluorescence intensity with time appeared, displaying a plateau value and a peak value for each measurement. Both plateau and peak values showed a linear correlation with calcium loss, as measured with longitudinal microradiography. The correlation coefficients were r = 0.87 for plateau values and r = 0.89 for peak values. The difference in scattering by dry and wet caries lesions was also measured with the same equipment, which showed a linear correlation with calcium loss of r = -0.53.

  11. Molecular and structural evaluation of dentin caries-like lesions produced by different artificial models.

    PubMed

    Pacheco, Larissa Ferreira; Banzi, Éfani Caroline de Freitas; Rodrigues, Eliana; Soares, Luís Eduardo Silva; Pascon, Fernanda Miori; Correr-Sobrinho, Lourenço; Puppin-Rontani, Regina Maria

    2013-01-01

    This study evaluated structural and molecular issues of dentin caries-like lesions produced by different artificial models (ACL) compared with natural caries lesions (NCL). One hundred twenty-four sound occlusal dentin blocks and 47 carious blocks were obtained and surface hardness was analyzed (SH1). They were assigned to groups according to ACL: GB: Biological; GC: Chemical; GIS: In situ; GNC: natural caries (control). Blocks from groups 1, 2 and 3 were submitted to caries lesion induction. NCL and ACL blocks were submitted to surface hardness (SH 2), FT-Raman and µEDXRF analysis. All blocks were longitudinally sectioned and one of the halves was submitted to cross-sectional hardness (CSH) and the other to SEM analysis. SH1 and SH2 data were submitted to t test (unpaired and paired, respectively), CSH and SEM data to two-way and one-way ANOVA respectively, and Tukey and t tests, respectively (p<0.05). Data from FT-Raman/µEDXRF were submitted to one-way ANOVA and Dunnett multiple-comparisons test (a=0.05). GB and GNC showed lowest SH2 values that were significantly different from GC and GIS. Regarding CSH, GB and GNC showed no significant difference between them. SEM showed similar caries lesion depth for GB and GNC, being significantly higher than for GC and GIS. µEDXRF showed similar values of calcium and phosphate for GB and GNC; GNC values were significantly different from GIS. No significant difference was found among the groups concerning phosphate, carbonate and CH bonds values. For collagen type I, GC values were significantly different compared to other groups. It may be concluded that caries-like lesions produced by GB were the closest model to NCL.

  12. Enamel Formation Genes Influence Enamel Microhardness Before and After Cariogenic Challenge

    PubMed Central

    Shimizu, Takehiko; Ho, Bao; Deeley, Kathleen; Briseño-Ruiz, Jessica; Faraco, Italo M.; Schupack, Brett I.; Brancher, João A.; Pecharki, Giovana D.; Küchler, Erika C.; Tannure, Patricia N.; Lips, Andrea; Vieira, Thays C. S.; Patir, Asli; Yildirim, Mine; Poletta, Fernando A.; Mereb, Juan C.; Resick, Judith M.; Brandon, Carla A.; Orioli, Iêda M.; Castilla, Eduardo E.; Marazita, Mary L.; Seymen, Figen; Costa, Marcelo C.; Granjeiro, José M.; Trevilatto, Paula C.; Vieira, Alexandre R.

    2012-01-01

    There is evidence for a genetic component in caries susceptibility, and studies in humans have suggested that variation in enamel formation genes may contribute to caries. For the present study, we used DNA samples collected from 1,831 individuals from various population data sets. Single nucleotide polymorphism markers were genotyped in selected genes (ameloblastin, amelogenin, enamelin, tuftelin, and tuftelin interacting protein 11) that influence enamel formation. Allele and genotype frequencies were compared between groups with distinct caries experience. Associations with caries experience can be detected but they are not necessarily replicated in all population groups and the most expressive results was for a marker in AMELX (p = 0.0007). To help interpret these results, we evaluated if enamel microhardness changes under simulated cariogenic challenges are associated with genetic variations in these same genes. After creating an artificial caries lesion, associations could be seen between genetic variation in TUFT1 (p = 0.006) and TUIP11 (p = 0.0006) with enamel microhardness. Our results suggest that the influence of genetic variation of enamel formation genes may influence the dynamic interactions between the enamel surface and the oral cavity. PMID:23028741

  13. Saliva substitutes in combination with highly concentrated fluorides and brushing: in vitro effects on enamel subsurface lesions.

    PubMed

    Tschoppe, P; Siegel, A; Meyer-Lueckel, H

    2010-01-01

    Hyposalivation is often associated with high caries activity, in particular in patients undergoing irradiation in the head/neck area. Besides the use of saliva substitutes to relieve the oral symptoms, daily application of fluoride gels or toothpaste (5,000 μg F⁻/g) is recommended for caries prevention. The aim of this study was to evaluate potentially remineralising effects of these fluoride agents in combination with saliva substitutes on enamel subsurface lesions. Demineralised bovine specimens were either stored in mineral water [control; saturation with respect to octacalcium phosphate (S(OCP)): 0.8], a demineralising saliva substitute (Glandosane; S(OCP): 0.3) or in a modified (with respect to S(OCP)) saliva substitute [Saliva natura (SN); S(OCP): 1.9] for 5 weeks (37°C). The following treatments were applied twice daily (11-13/group): no treatment (0), ProSchmelz fluoride gel (PS; 10 min application), Duraphat toothpaste (DP; 10 s; brushing with toothpaste/storage solution slurry), combination of DP+PS. Mineral parameters before/after storage were evaluated from microradiographs. Storage in Glandosane led to significant demineralisation (p < 0.05; paired t test), whereas additional use of fluoride agents neutralised the demineralising effect (p > 0.05). Storage in water alone resulted in no changes in mineral parameters (p > 0.05), whereas in combination with fluorides remineralisation could be shown (p < 0.05). For SN alone, remineralisation was observed (p < 0.05), but no additional beneficial effects of fluorides were detected. Under the conditions chosen, the fluoride agents reduce the demineralising effects of Glandosane and promote the remineralisation of specimens stored in water. Remineralising effects of SN could not be enhanced by the fluorides.

  14. Enamel and dentine demineralization by a combination of starch and sucrose in a biofilm - caries model.

    PubMed

    Botelho, Juliana Nunes; Villegas-Salinas, Mario; Troncoso-Gajardo, Pía; Giacaman, Rodrigo Andrés; Cury, Jaime Aparecido

    2016-05-20

    Sucrose is the most cariogenic dietary carbohydrate and starch is considered non-cariogenic for enamel and moderately cariogenic for dentine. However, the cariogenicity of the combination of starch and sucrose remains unclear. The aim of this study was to evaluate the effect of this combination on Streptococcus mutans biofilm composition and enamel and dentine demineralization. Biofilms of S. mutans UA159 were grown on saliva-coated enamel and dentine slabs in culture medium containing 10% saliva. They were exposed (8 times/day) to one of the following treatments: 0.9% NaCl (negative control), 1% starch, 10% sucrose, or 1% starch and 10% sucrose (starch + sucrose). To simulate the effect of human salivary amylase on the starch metabolization, the biofilms were pretreated with saliva before each treatment and saliva was also added to the culture medium. Acidogenicity of the biofilm was estimated by evaluating (2 times/day) the culture medium pH. After 4 (dentine) or 5 (enamel) days of growth, biofilms (n = 9) were individually collected, and the biomass, viable microorganism count, and polysaccharide content were quantified. Dentine and enamel demineralization was assessed by determining the percentage of surface hardness loss. Biofilms exposed to starch + sucrose were more acidogenic and caused higher demineralization (p < 0.0001) on either enamel or dentine than those exposed to each carbohydrate alone. The findings suggest that starch increases the cariogenic potential of sucrose.

  15. Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride.

    PubMed

    Cochrane, N J; Saranathan, S; Cai, F; Cross, K J; Reynolds, E C

    2008-01-01

    Casein phosphopeptide stabilised amorphous calcium phosphate (CPP-ACP) and amorphous calcium fluoride phosphate (CPP-ACFP) solutions have been shown to remineralise enamel subsurface lesions. The aim of this study was to determine the effect of ion composition of CPP-ACP and CPP-ACFP solutions on enamel subsurface lesion remineralisation in vitro. CPP-bound and free calcium, phosphate and fluoride ion concentrations in the solutions were determined after ultrafiltration. The ion activities of the free ion species present were calculated using an iterative computational program. The mineral deposited in the subsurface lesions was analysed using transverse microradiography and electron microprobe. CPP was found to stabilise high concentrations of calcium, phosphate and fluoride ions at all pH values (7.0-4.5). Remineralisation of the subsurface lesions was observed at all pH values tested with a maximum at pH 5.5. The CPP-ACFP solutions produced greater remineralisation than the CPP-ACP solutions at pH 5.5 and below. The mineral formed in the subsurface lesions was consistent with hydroxyapatite and fluorapatite for remineralisation with CPP-ACP and CPP-ACFP, respectively. The activity gradient of the neutral ion pair CaHPO(4)(0) into the lesion was significantly correlated with remineralisation and together with HF(0) were identified as important species for diffusion.

  16. Approximal caries increment in relation to baseline approximal caries prevalence among adolescents in Sweden with and without a school-based fluoride varnish programme.

    PubMed

    Sköld, U M

    2016-12-01

    Approximal surfaces are a focal point for caries prevention among adolescents in Sweden and the aims of this study were therefore to evaluate approximal caries incidence and caries progression among adolescents with and without a three-year school-based fluoride varnish programme in relation to approximal caries prevalence at baseline. In all, 758 (89%) 13-year-olds completed the three-year randomised controlled trial. They all used fluoride toothpaste at home and had regular dental check-ups at the public dental clinics. The mean approximal caries incidence for the adolescents who were caries free on these surfaces at baseline was 0.13 (SD 0.54) in the fluoride varnish group and 0.79 (1.93) in the control group. The corresponding values for those who had caries at baseline in these groups were 1.29 (2.21) and 2.62 (3.22) respectively. The latter two groups also had 0.34 (1.00) and 0.70 (1.13) approximal enamel lesions that progressed. All differences were statistically significant (p⟨0.001). Among those individuals who had approximal caries at baseline, double the number of early approximal enamel lesions in the control group progressed compared with the fluoride varnish group. The school-based fluoride varnish programme inhibited new approximal lesions to a great extent and effectively kept approximal enamel lesions within the enamel among 13-16-year-olds. It is therefore recommended that such a programme is warranted when the approximal surfaces are still caries free in order to keep these surfaces free from caries and keep upcoming approximal enamel lesions within the enamel.

  17. Rehardening of caries-like lesions in root surfaces by saliva substitutes.

    PubMed

    Turssi, Cecilia P; Lima, Renata Q V; Faraoni-Romano, Juliana J; Serra, Mônica C

    2006-12-01

    This study sought to evaluate whether root dentine caries-like lesions could be remineralised by saliva substitutes. Root dentine slabs (3 x 3 x 2 mm) were cut from bovine incisors, ground flat, polished and pre-tested for Knoop microhardness (KHN) at five locations spaced 500 microm apart and 500 microm from the left edge of each sectioned piece. After 60 out of the 100 slabs had been selected based upon their KHN values, specimens were coated with wax except for their outer surface. Specimens were then cycled through a highly cariogenic challenge model to induce caries-like lesions, whose formation was confirmed by KHN measurements located 500 microm from the right edge of the specimen. According to a randomised complete block design, the experimental units (n = 15) were exposed to 1.5 ml of saliva substitutes, based on either mucin (MC) or carboxymethylcellulose (CM), to natural human saliva (HS) or to 100% relative humidity (RH) over 20 days. Remineralisation was verified by KHN measurements located 1000 microm apart from the right edge of the specimen. Analysis of variance indicated a significant (p < 0.0001) difference among the KHN values attained by the carious root dentine after exposure to the remineralising agents. Tukey's test ascertained that remineralisation was greatest with MC, intermediate with CM and least with HS, but rehardening did not reach the pre-caries lesion formation values. Saliva substitutes may provide partial remineralisation to preformed caries-like lesions in root dentine.

  18. Restorative Treatment Thresholds for Occlusal Primary Caries by Dentists in “The Dental Practice-Based Research Network”

    PubMed Central

    Gordan, Valeria V; Bader, James D; Garvan, Cynthia W; Richman, Joshua S; Qvist, Vibeke; Fellows, Jeffrey L; Rindal, D. Brad; Gilbert, Gregg H

    2010-01-01

    Objectives (1) Quantify at which carious lesion depths dentists intervene surgically for cases of varying caries penetration and caries risk; (2) Identify characteristics that are associated with surgical intervention. Methods Dentists in a practice-based research network who reported doing at least some restorative dentistry were surveyed. Dentists were asked to indicate whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration, and a written description of a patient at a specific level of caries risk. Using logistic regression, we analyzed associations of surgical treatment with dentist and practice characteristics, and patient caries risk levels. Results 519 DPBRN practitioner-investigators responded, of whom 63% indicated that they would surgically restore lesions located on inner enamel surfaces, and 90% of lesions located in outer dentin surfaces in a low caries risk individual. Regarding individuals at high caries risk, 77% reported that they would surgically restore inner enamel lesions and 94% reported restoring lesions located on the outer dentin surface. Dentists who did not assess caries risk were more likely to intervene on dentin lesions (p=.004). Practitioner-investigators who were in private practice were significantly more likely to intervene surgically on enamel lesions, compared to dentists from large group practices (p<.001). Conclusion Most dentists chose to provide some treatment to lesions that were within the enamel surface. Decisions to intervene surgically in the caries process differ by caries lesion depth, patient caries risk, assessment of caries risk, type of practice model, and percent of patients who self-pay. PMID:20123876

  19. In vivo remineralization of artificial enamel carious lesions using a mineral-enriched mouthrinse and a fluoride dentifrice: a polarized light microscopic comparative evaluation.

    PubMed

    Bansal, K; Gauba, K; Tewari, A; Chawla, H S; Sahni, A

    2010-01-01

    Remineralization process is accelerated by the presence of fluoride ions in the oral environment, but this mechanism of caries reversal will be further enhanced if the concentration of calcium, phosphate and fluoride ions is supersaturated with respect to that of oral fluids. This in vivo study was carried out to evaluate and compare the remineralizing efficacy of a urea-based mineral-enriched mouthrinse and a fluoridated dentifrice using an in vivo intraoral appliance model and polarized light microscopic evaluation technique. The specimens were prepared from sound teeth and artificial caries was produced using an artificial caries medium in vitro and enamel specimens were inserted in removable orthodontic appliances that were to be worn by 14 children of 10-15 years of age. They were divided into three groups - nonfluoridated dentifrice, fluoridated dentifrice and mineral-enriched mouthrinse groups. After the 6-month experimental period, during which the enamel specimens inserted in the intraoral appliance were subjected to one of the agents (either fluoride, nonfluoride dentifrice or mouthrinse) in vivo, the specimens were retrieved from the patients and were evaluated using the polarized light microscopic technique. On analysis, mineral gain occurred in all groups, viz. nonfluoride dentifrice group, fluoride dentifrice and mineral-enriched mouthrinse group. However, it was found to be complete in the mouthrinse group, i.e. both at the surface and at the subsurface (67%), while in the fluoridated dentifrice group, 43% of the samples showed mineral gain in both zones. In the nonfluoridated dentifrice group also, remineralization occurred but was limited either to the surface or the subsurface zone. Urea-based mineral-enriched mouthrinse was shown to be more efficacious in the process of remineralization of artificial carious lesions.

  20. Actinomyces spp. gene expression in root caries lesions

    PubMed Central

    Dame-Teixeira, Naile; Parolo, Clarissa Cavalcanti Fatturi; Maltz, Marisa; Tugnait, Aradhna; Devine, Deirdre; Do, Thuy

    2016-01-01

    Background The studies of the distribution of Actinomyces spp. on carious and non-carious root surfaces have not been able to confirm the association of these bacteria with root caries, although they were extensively implicated as a prime suspect in root caries. Objective The aim of this study was to observe the gene expression of Actinomyces spp. in the microbiota of root surfaces with and without caries. Design The oral biofilms from exposed sound root surface (SRS; n=10) and active root caries (RC; n=30) samples were collected. The total bacterial RNA was extracted, and the mRNA was isolated. Samples with low RNA concentration were pooled, yielding a final sample size of SRS=10 and RC=9. Complementary DNA (cDNA) libraries were prepared and sequenced on an Illumina® HiSeq 2500 system. Sequence reads were mapped to eight Actinomyces genomes. Count data were normalized using DESeq2 to analyse differential gene expression applying the Benjamini-Hochberg correction (false discovery rate [FDR]<0.001). Results Actinomyces spp. had similar numbers of reads (Mann-Whitney U-test; p>0.05), except for Actinomyces OT178 (p=0.001) and Actinomyces gerencseriae (p=0.004), which had higher read counts in the SRS. Genes that code for stress proteins (clp, dnaK, and groEL), enzymes of glycolysis pathways (including enolase and phosphoenolpyruvate carboxykinase), adhesion (Type-2 fimbrial and collagen-binding protein), and cell growth (EF-Tu) were highly – but not differentially (p>0.001) – expressed in both groups. Genes with the most significant upregulation in RC were those coding for hypothetical proteins and uracil DNA glycosylase (p=2.61E-17). The gene with the most significant upregulation in SRS was a peptide ABC transporter substrate-binding protein (log2FC=−6.00, FDR=2.37E-05). Conclusion There were similar levels of Actinomyces gene expression in both sound and carious root biofilms. These bacteria can be commensal in root surface sites but may be cariogenic

  1. Prevalence and extent of dental caries, dental fluorosis, and developmental enamel defects in Lithuanian teenage populations with different fluoride exposures.

    PubMed

    Machiulskiene, Vita; Baelum, Vibeke; Fejerskov, Ole; Nyvad, Bente

    2009-04-01

    The aim of this study was to describe the pattern of dental caries, dental fluorosis, and developmental defects of non-fluoride origin in Lithuanian children born and raised in regions with 1.1 ppm (1.1 mg/l F) and 0.3 ppm (0.3 mg/l F) water fluoride levels, respectively. All permanent surfaces/teeth of 300 teenagers were examined for dental caries, dental fluorosis, and non-fluoride developmental defects. The caries prevalence of the study population was 100%. The mean number of decayed surfaces (DS) differed only slightly and statistically insignificantly between the '1.1 ppm fluoride' and '0.3 ppm fluoride' groups (19.6 and 18.1, respectively). However, a greater number of inactive lesions and fewer fillings were found in the '1.1 ppm fluoride' group than in the '0.3 ppm fluoride' group (mean difference 1.18 and -2.80, respectively). The prevalence of dental fluorosis was 45% and 21%, respectively; the prevalence of non-fluoride opacities was 8% and 19%, respectively; and the prevalence of hypoplasia was 12% and 16%, respectively, in the '1.1 ppm fluoride' and '0.3 ppm fluoride' groups. Higher caries levels were noted in children with no fluorosis compared to those with fluorosis recorded (mean DS difference, 3.43). The results lend support to the hypothesis that the presence of fluoride in the oral environment promotes lesion arrest rather than inhibiting the initiation of new lesions.

  2. A 20-year study of dentists' and dental hygienists' assessment of dental caries lesions in bite-wing radiographs.

    PubMed

    Gabre, Pia; Birring, Eva; Gahnberg, Lars

    2006-01-01

    Epidemiological data reveal that the prevalence of dental caries in western countries has decreased in recent decades. The aim of this study was to investigate how dentists and dental hygienists assess dental caries lesions in bite-wing radiographs between 1983 and 2003. All dentists and dental hygienists in Public Dental Health in Uppsala County were offered to take part in the study. The participants assessed manifest and initial caries lesions in eight bite-wing radiographs from three patients individually. An X-ray viewer and binoculars were used. The assessments were repeated in the same radiographs every five years, a total of five times, between 1983 and 2003. In the different test occasions 80-103 dentists and 11-48 dental hygienists participated. The registration of dental caries changed between 1983 and 2003. The number of manifest lesions registered by dentists decreased between 1983 and 1988, but were stable after 1988. Dental hygienists showed no changes in the registration of manifest lesions during the study. Initial lesions registered by dentists and dental hygienists increased between 1988 and 1998. Assessments of initial caries lesions displayed a wider range than manifest lesions. Increasing age and more years in the profession resulted in fewer registered initial caries lesions. Dental hygienists had a tendency to register less caries than dentists. In conclusion, the result of the study indicate that inclusion of initial caries lesions in epidemiological reports should lead to a reduction in reliability. The changes in assessments of manifest caries lesions that took place in the 19805s should be considered when epidemiological data are evaluated.

  3. Enamel lesion parameter correlations between polychromatic micro-CT and TMR.

    PubMed

    Hamba, H; Nikaido, T; Sadr, A; Nakashima, S; Tagami, J

    2012-06-01

    Transverse microradiography (TMR) is considered as the gold standard technique for the evaluation of enamel lesions. Micro-computed tomography (µCT) has the advantage of non-destructive measurements, but the beam-hardening effect with polychromatic x-rays is a major drawback. To date, no study has validated µCT against TMR. The objective of this study was to validate µCT measurements of enamel lesions under various x-ray conditions and software beam-hardening correction (BHC) against TMR. Human molars with natural white-spot lesions were scanned for 5 min by µCT at 100 kV in different conditions: 50 µA (0.5-mm Al filter), 165 µA (0.5-mm Al/0.3-mm Cu), and 200 µA (0.5-mm Al/0.4-mm Cu), with or without BHC. Grayscale values were converted into mineral density values using phantoms. Thin sections at the same positions were then prepared for TMR. Lesion depth (LD; µm) and mineral loss (ΔZ; vol%µm) were compared between µCT and TMR by Pearson's correlations. µCT measurements correlated well with TMR under all conditions (p < 0.001, r > 0.86 for LD and ΔZ), except for 0.5-mm Al without BHC (p > 0.05). Even without BHC, combined Al/Cu filters successfully reduced the beam-hardening effect. µCT can be used as a non-destructive alternative to TMR with comparable parameters for the study of enamel lesions.

  4. Maternal identification of dental caries lesions in their children aged 1-3 years.

    PubMed

    Fernandes, I B; Sá-Pinto, A C; Silva Marques, L; Ramos-Jorge, J; Ramos-Jorge, M L

    2017-06-01

    To analyse the maternal identification of different stages of dental caries in children aged 1-3 years. A cross-sectional study was conducted with 274 children and their mothers. The mothers answered a questionnaire on the occurrence of dental caries in their children and completed questions addressing their demographic/socio-economic status. The oral examination of the children was performed using the International Caries Detection and Assessment System. Descriptive, Chi square test and Poisson regression statistical analyses were performed. The prevalence of initial and established/severe dental caries lesions by age were: 1 year (23.2 and 24.2%), 2 years (17.9 and 55.7%) and 3 years (23.3 and 60.3%) respectively. Significant associations between clinical examinations and the mothers' reports were observed among children aged 1 year old who had initial stage caries lesions (p = 0.006) and in children aged 1, 2 and 3 years old who had established/severe stage caries lesions (p < 0.001). After adjustment for confounding variables it was found that mothers were more able to identify dental caries both at initial (PR 4.01, 95% CI 1.35-11.94) and established/severe stages (PR 9.14, 95% CI 2.49-33.56) in children aged 1 year old. In children aged 2 and 3 years, this identification was more evident in the established/severe stage (2 years, PR 2.98, 95% CI 1.42-6.26; 3 years, PR 2.75, 95% CI 1.09-6.93). Mothers of children aged 1 year old identified dental caries at initial and established/severe stages. Mothers of children aged 2 and 3 years identified dental caries only at established/severe stages.

  5. Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

    PubMed

    Byrd, Tammi O

    2016-06-01

    An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. A microbiological study of primary root-caries lesions with different treatment needs.

    PubMed

    Beighton, D; Lynch, E; Heath, M R

    1993-03-01

    Samples of altered or carious dentin for microbiological culture were obtained from 301 primary root-caries lesions in 59 patients by means of a standardized sampling procedure. This involved the cleansing of each root surface of extraneous supragingival plaque by means of a hand-held toothbrush and distilled water and the collection of the sample with a sterile dental excavator passed through the entire vertical dimension of each lesion. The total number of colony-forming units (cfu) in each sample and the numbers of mutans streptococci (primarily Streptococcus mutans), lactobacilli, yeasts, and Gram-positive pleomorphic rods (GPPR) were determined. Individual bacterial counts were expressed as log10 (cfu per sample), as a percentage of the total number of bacteria per sample, and as a frequency of isolation from lesions with different clinical diagnostic criteria. Clinical measurements of each lesion were made for color, texture, position relative to the gingival margin, and treatment need. Lesions classified as soft yielded significantly more bacteria, mutans streptococci, lactobacilli, and GPPR than leathery lesions, which yielded more bacteria than hard lesions. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries; leathery and treat therapeutically; and hard no treatment. The total numbers of bacteria, mutans streptococci, lactobacilli, GPPR, and yeasts decreased significantly with decreasing treatment need. The frequency of isolation of mutans streptococci, lactobacilli, and yeasts was significantly greater from lesions requiring restoration and from lesions situated within 1 mm of the gingival margin. We suggest that the majority of root caries is initiated adjacent to the gingival margin.

  7. Dose-response effects of zinc and fluoride on caries lesion remineralization.

    PubMed

    Lippert, F

    2012-01-01

    The present mechanistic in vitro study aimed to investigate dose-response effects of zinc and fluoride on caries lesion remineralization and subsequent protection from demineralization. Artificial caries lesions were created using a methylcellulose acid gel system. Lesions were remineralized for 2 weeks using citrate-containing artificial saliva which was supplemented with zinc (0-153 μmol/l) and fluoride (1.1 or 52.6 μmol/l) in a 7 × 2 factorial design. Lesions were also remineralized in the absence of zinc and citrate, but in the presence of fluoride. After remineralization, all lesions were demineralized for 1 day under identical conditions. Changes in mineral distribution characteristics of caries lesions after remineralization and secondary demineralization were studied using transverse microradiography. At 1.1 μmol/l fluoride, zinc exhibited detrimental effects on remineralization in a dose-response manner and mainly by preventing remineralization near the lesion surface. At 52.6 μmol/l fluoride, zinc retarded remineralization only at the highest concentration tested. Zinc enhanced overall remineralization at 3.8-15.3 μmol/l. At 76.5 and less so at 153 μmol/l, zinc showed extensive remineralization of deeper parts within the lesions at the expense of remineralization near the surface. Citrate did not interfere with remineralization at 1.1 μmol/l fluoride, but enhanced remineralization at 52.6 μmol/l fluoride. Lesions exhibiting preferential remineralization in deeper parts showed higher mineral loss after secondary demineralization, suggesting the formation of more soluble mineral phases during remineralization. In summary, zinc and fluoride showed synergistic effects in enhancing lesion remineralization, however only at elevated fluoride concentrations.

  8. Remineralization of Demineralized Enamel via Calcium Phosphate Nanocomposite

    PubMed Central

    Weir, M.D.; Chow, L.C.; Xu, H.H.K.

    2012-01-01

    Secondary caries remains the main problem limiting the longevity of composite restorations. The objective of this study was to investigate the remineralization of demineralized human enamel in vitro via a nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP). NACP were synthesized by a spray-drying technique and incorporated into a dental resin. First, caries-like subsurface enamel lesions were created via an acidic solution. Then, NACP nanocomposite or a commercial fluoride-releasing control composite was placed on the demineralized enamel, along with control enamel without a composite. These specimens were then treated with a cyclic demineralization/remineralization regimen for 30 days. Quantitative microradiography showed typical enamel subsurface demineralization before cyclic demineralization/remineralization treatment, and significant remineralization in enamel under the NACP nanocomposite after the demineralization/remineralization treatment. The NACP nanocomposite had the highest enamel remineralization (mean ± SD; n = 6) of 21.8 ± 3.7%, significantly higher than the 5.7 ± 6.9% for fluoride-releasing composite (p < 0.05). The enamel group without composite had further demineralization of −26.1 ± 16.2%. In conclusion, a novel NACP nanocomposite was effective in remineralizing enamel lesions in vitro. Its enamel remineralization was 4-fold that of a fluoride-releasing composite control. Combined with the good mechanical and acid-neutralization properties reported earlier, the new NACP nanocomposite is promising for remineralization of demineralized tooth structures. PMID:22933607

  9. Imaging natural occlusal caries lesions with optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Douglas, Shane M.; Fried, Daniel; Darling, Cynthia L.

    2010-02-01

    Several studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively measure the severity of demineralization in the important occlusal surfaces. The purpose of this study was to assess the potential of PS-OCT and OCT methods for the measurement of the depth of natural occlusal carious lesions. Teeth were screened for potential occlusal lesions using near infrared imaging (NIR). A PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of the area of interest on the occlusal surface. The teeth were serial sectioned to 200 μm thickness and examined with polarized light microscopy (PLM) and Transverse Microradiography (TMR) for comparison. The lesion depth measured nondestructively with PS-OCT was compared to the lesion depth measured with PLM and TMR to assess the performance of these methods and determine if polarization sensitivity is required. The lesion depth measured using OCT correlated well with the lesion depths measured with TMR and PLM. Although polarization sensitivity provided better contrast it was not necessary to have polarization sensitivity to identify deep occlusal lesions.

  10. Effect of casein phosphopeptide-amorphous calcium phosphate (cpp-acp) on caries-like lesions in terms of time and nano-hardness: An in vitro study.

    PubMed

    Mettu, Shanthan; Srinivas, Namineni; Reddy Sampath, C H; Srinivas, Nallanchakrava

    2015-01-01

    Time bound increase in the nanohardness of the enamel after remineralization with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in a regular interval of 1 h has not been explored in the literature to a greater extent. To determine and compare the maximum hardness of the remineralized caries-like lesions, in terms of nanohardness and the rate of achieving maximum hardness at 1-h interval, after treatment with artificial saliva and CPP-ACP, over 12 h. Fifty longitudinal sections of extracted sound permanent maxillary central, lateral incisors were immersed in demineralizing solution for 4 days. The samples were then randomly divided into three groups, consisting of 12 sections each for soaking them in three different media-isotonic saline, artificial saliva, and CPP-ACP for 12 h. The nanohardness was measured on the labial surface, at baseline, after erosion, and after remineralization at 1-h interval. The data was analyzed with paired t-test, one-way analysis of variance (ANOVA) and post-hoc analysis. CPP-ACP increased the enamel hardness significantly (P < 0.001), at an increased rate, than artificial saliva. This study has provided an insight into the frequency of use of CPP-ACP, once per day, as the nanohardness of enamel samples increased within 1 h of application and remained within the normal limits after 12 h.

  11. Effect of acid-etching on remineralization of enamel white spot lesions.

    PubMed

    Al-Khateeb, S; Exterkate, R; Angmar-Månsson, B; ten Cate, J M; ten Cate, B

    2000-02-01

    This in vitro study aimed at investigating whether full remineralization would occur in white spot lesions when the surface porosity was increased by acid-etching. The effect of fluoride was also investigated. Enamel blocks with in vitro produced white spot lesions were used. Group A was exposed to a remineralizing solution only. In group B, the lesions were etched with 35% phosphoric acid for 30 s, then treated as in group A. Group C was treated as group A + daily treatment with a fluoride toothpaste slurry (1,000 ppm) for 5 min. Group D was treated as group B + the daily fluoride treatment of group C. The remineralization was measured weekly with Quantitative Light-induced Fluorescence during the experimental period. After 10 weeks of remineralization, mineral profiles were assessed with transverse microradiography. The enamel fluorescence was partly regained. There were significant differences in the lesion depth, mineral content at the surface layer, and integrated mineral loss between the groups. Addition of fluoride accelerated the remineralization only in the beginning; in later stages the process leveled out and even reached a plateau in all the groups. It was concluded that full remineralization was not achieved by etching, by the addition of fluoride, nor by the combination of both treatments in this in vitro study.

  12. Enamel-Caries Prevention Using Two Applications of Fluoride-Laser Sequence.

    PubMed

    Noureldin, Amal; Quintanilla, Ines; Kontogiorgos, Elias; Jones, Daniel

    2016-03-01

    Studies demonstrated a significant synergism between fluoride and laser in reduction of enamel solubility. However, minimal research has focused on testing the sequence of their application and no other research investigated the preventive effect of repeated applications of a combined treatment. This study investigated the effect of two applications of fluoride-laser sequence on the resistance of sound enamel to cariogenic challenge compared to one-time application. Sixty enamel slabs were cut from 10 human incisors, ground flat, polished and coated with nail varnish except a 2 x 2 mm window. Specimens were randomly assigned into five groups of 12 specimens; (CON-) negative-control received no treatment, (CON+) positive-control received pH challenge, (FV) treated with M fluoride varnish, (F-L1) one-application fluoride-varnish followed by CO2 laser-treatment (short-pulsed 10.6 µm, 2.4J/ cm2, 10HZ, 10sec), and (F-L2) two-applications of fluoride varnish-laser treatment. Specimens were left in distilled water for one day between applications. Except CON-, all groups were submitted to pH cycling for 9-days (8 demin/ remin + 1 day remineralisation bath) at 37°C. Enamel demineralization was quantitatively evaluated by measurement of Knoop surface-microhardness (SM H) (50-grams/10 seconds). Data were analyzed using one-way ANOVA (p ≤ 0.05) followed by Duncan's Multiple Range Test. Within the limitations of this study, it was found that one or two applications of fluoride-laser sequence significantly improved resistance of the sound enamel surface to acid attack compared to FV-treated group. Although the two applications of fluoride-laser sequence (F-L1 and F-L2) showed higher SMH values, significant resistance to demineralization was only obtained with repeated applications.

  13. Effects of ozone and sodium hypochlorite on caries-like lesions in dentin.

    PubMed

    Zaura, E; Buijs, M J; ten Cate, J M

    2007-01-01

    The hypothesis that ozone promotes remineralization of dentinal lesions was tested in vitro. Artificial caries-like lesions in dentin were treated with ozone gas, with another potent oxidizer (sodium hypochlorite, NaOCl, 10%) or with water. The specimens were then remineralized and subsequently demineralized again. Mineral content was assessed by transverse microradiography. NaOCl-treated samples showed damaged surface and, after being remineralized, demineralized significantly more than water- or ozone-treated groups. No difference was found between ozone and water groups. The exposure to ozone had thus no effect on remineralization and subsequent demineralization of remineralized dentinal lesions.

  14. Microbiological or chemical models of enamel secondary caries compared by polarized-light microscopy and energy dispersive X-ray spectroscopy.

    PubMed

    Paradella, Thaís Cachuté; de Sousa, Fernando Augusto Cervantes Garcia; Koga-Ito, Cristiane Yumi; Jorge, Antonio Olavo Cardoso

    2009-08-01

    Different secondary caries models may present different results. The purpose of this study was to compare different in vitro secondary caries models, evaluating the obtained results by polarized-light microscopy (PLM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS). Standardized human enamel specimens (n = 12) restored with different materials (Z250 conventional composite resin-CRZ, Freedom polyacid-modified composite resin-CRF, Vitremer resin-modified glass-ionomer-GIV, and Fuji IX conventional glass-ionomer cement-GIF) were submitted to microbiological (MM) or chemical caries models (CM). The control group was not submitted to any caries model. For MM, specimens were immersed firstly in sucrose broth inoculated with Streptococcus mutans ATCC 35688, incubated at 37 degrees C/5% CO(2) for 14 days and then in remineralizing solution for 14 days. For CM, specimens were submitted to chemical pH-cycling. Specimens were ground, submitted to PLM and then were dehydrated, gold-sputtered and submitted to SEM and EDS. Results were statistically analyzed by Kruskall-Wallis and Student-Newman-Keuls tests (alpha = 0.05). No differences between in vitro caries models were found. Morphological differences in enamel demineralization were found between composite resin and polyacid-modified composite resin (CRZ and CRF) and between the resin-modified glass-ionomer and the glass-ionomer cement (GIF and GIV). GIF showed higher calcium concentration and less demineralization, differing from the other materials. In conclusion, the glass-ionomer cement showed less caries formation under both in vitro caries models evaluated.

  15. Dental Calculus Arrest of Dental Caries

    PubMed Central

    Keyes, Paul H.; Rams, Thomas E.

    2016-01-01

    Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

  16. Detecting Secondary Caries Lesions: A Systematic Review and Meta-analysis.

    PubMed

    Brouwer, F; Askar, H; Paris, S; Schwendicke, F

    2016-02-01

    Secondary caries lesions are the main late complication of dental restorations, limiting their life span and generating costs by repeated reinterventions. Accurate detection of secondary lesions is crucial for estimating the true burden of the disease and allocating appropriate treatments. We aimed to assess the accuracy of detection methods for secondary caries lesions. Clinical or in vitro studies were included that investigated the accuracy of 5 detection methods--visual, tactile, radiography, laser fluorescence, quantitative light-induced fluorescence--of natural or artificially induced secondary lesions, as verified against an established reference test. Sensitivity, specificity, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated and publication bias assessed. From 1,179 screened studies, 23 were included. Most studies were performed in vitro, on permanent posterior teeth, and had high risk of bias or applicability concerns. Lesions were on proximal (14 studies) or other surfaces and adjacent to amalgam (16 studies) or tooth-colored materials. Visual (n = 11), radiographic (n = 13), and laser fluorescence detection (n = 8) had similar sensitivities (0.50 to 0.59) and specificities (0.78 to 0.83), with visual and laser fluorescence assessment being more accurate on nonproximal surfaces and adjacent to composites, respectively. Tactile assessment (n = 7) had low accuracy. Light-induced fluorescence (n = 3) was sensitive on nonproximal surfaces but had low specificities. Most analyses seemed to suffer from publication bias. Despite being a significant clinical and dental public health problem, detection of secondary caries lesions has been assessed by only a few studies with limited validity and applicability. Visual, radiographic and laser-fluorescence detection might be useful to detect secondary lesions. The validity of tactile assessment and quantitative light-induced fluorescence remains unclear at present.

  17. Minimal intervention dentistry: part 4. Detection and diagnosis of initial caries lesions.

    PubMed

    Guerrieri, A; Gaucher, C; Bonte, E; Lasfargues, J J

    2012-12-01

    The detection of carious lesions is focused on the identification of early mineral changes to allow the demineralisation process to be managed by non-invasive interventions. The methods recommended for clinical diagnosis of initial carious lesions are discussed and illustrated. These include the early detection of lesions, evaluation of the extent of the lesion and its state of activity and the establishment of appropriate monitoring. The place of modern tools, including those based on fluorescence, is discussed. These can help inform patients. They are also potentially useful in regular control visits to monitor the progression or regression of early lesions. A rigorous and systematic approach to caries diagnosis is essential to establish a care plan for the disease and to identify preventive measures based on more precise diagnosis and to reduce reliance on restorative measures.

  18. In situ remineralization of white-spot enamel lesions by 500 and 1,100 ppm F dentifrices.

    PubMed

    Mensinkai, Poornima K; Ccahuana-Vasquez, Renzo A; Chedjieu, Irene; Amaechi, Bennett T; Mackey, Allen C; Walker, Trenton J; Blanken, Douglas D; Karlinsey, Robert L

    2012-08-01

    The aim of this study was to evaluate the remineralization potential of three silica-containing NaF dentifrice systems in an intraoral model. Subjects (N = 30) in this randomized, three-phase, 28-day, crossover study served as their own control. Each participant wore a customized orthodontic appliance attached to a mandibular molar and contained one tooth block with caries-like lesion. For each phase, participants engaged in twice-daily brushing for 2 min with one of the following dentifrices: 500 ppm F, 500 ppm F plus functionalized β-tricalcium phosphate (fTCP), and a clinically proven 1,100 ppm F. After each phase, appliances were removed, and specimens were analyzed using surface microhardness (SMH), transverse microradiography (TMR), and cross-sectional microhardness (CSMH). Statistically significant (p < 0.05) remineralization of white-spot lesions relative to baseline occurred for each dentifrice as determined with SMH and TMR. No significant differences (p > 0.05) in SMH were found among the three groups, but trending revealed the 500 ppm F plus fTCP produced 26% and 27% greater SMH recovery relative to 500 and 1,100 ppm F, respectively. Similarly, no significant differences (p > 0.05) in TMR were found among the groups. However, the 500 ppm F plus fTCP dentifrice produced 10% and 38% greater mineral recovery relative to 500 and 1,100 ppm F, respectively, while reducing the lesion depth 30% and 52%, respectively. Significant differences (p < 0.05) in CSMH existed among the three dentifice groups at different enamel depths, but statistical differences (p < 0.05) in relative lesion size were only found between 500 ppm F plus fTCP and 500 ppm F. The combination of fTCP and fluoride in a single-compartment, water-based dentifrice can cooperate with fluoride to produce significant remineralization. These results suggest that the combination of 500 ppm F with fTCP may provide comparable anticaries benefits relative to a 1,100 ppm F dentifrice.

  19. Assessment of natural enamel lesions with optical coherence tomography in comparison with microfocus x-ray computed tomography

    PubMed Central

    Espigares, Jorge; Sadr, Alireza; Hamba, Hidenori; Shimada, Yasushi; Otsuki, Masayuki; Tagami, Junji; Sumi, Yasunori

    2015-01-01

    Abstract. A technology to characterize early enamel lesions is needed in dentistry. Optical coherence tomography (OCT) is a noninvasive method that provides high-resolution cross-sectional images. The aim of this study is to compare OCT with microfocus x-ray computed tomography (μCT) for assessment of natural enamel lesions in vitro. Ten human teeth with visible white spot-like changes on the enamel smooth surface and no cavitation (ICDAS code 2) were subjected to imaging by μCT (SMX-100CT, Shimadzu) and 1300-nm swept-source OCT (Dental SS-OCT, Panasonic Health Care). In μCT, the lesions appeared as radiolucent dark areas, while in SS-OCT, they appeared as areas of increased signal intensity beneath the surface. An SS-OCT attenuation coefficient based on Beer–Lambert law could discriminate lesions from sound enamel. Lesion depth ranged from 175 to 606  μm in SS-OCT. A correlation between μCT and SS-OCT was found regarding lesion depth (R=0.81, p<0.001) and also surface layer thickness (R=0.76, p<0.005). The images obtained clinically in real time using the dental SS-OCT system are suitable for the assessment of natural subsurface lesions and their surface layer, providing comparable images to a laboratory high-resolution μCT without the use of x-ray. PMID:26158079

  20. Assessment of natural enamel lesions with optical coherence tomography in comparison with microfocus x-ray computed tomography.

    PubMed

    Espigares, Jorge; Sadr, Alireza; Hamba, Hidenori; Shimada, Yasushi; Otsuki, Masayuki; Tagami, Junji; Sumi, Yasunori

    2015-01-01

    A technology to characterize early enamel lesions is needed in dentistry. Optical coherence tomography (OCT) is a noninvasive method that provides high-resolution cross-sectional images. The aim of this study is to compare OCT with microfocus x-ray computed tomography ([Formula: see text]) for assessment of natural enamel lesions in vitro. Ten human teeth with visible white spot-like changes on the enamel smooth surface and no cavitation (ICDAS code 2) were subjected to imaging by μCT (SMX-100CT, Shimadzu) and 1300-nm swept-source OCT (Dental SS-OCT, Panasonic Health Care). In [Formula: see text], the lesions appeared as radiolucent dark areas, while in SS-OCT, they appeared as areas of increased signal intensity beneath the surface. An SS-OCT attenuation coefficient based on Beer-Lambert law could discriminate lesions from sound enamel. Lesion depth ranged from 175 to [Formula: see text] in SS-OCT. A correlation between [Formula: see text] and SS-OCT was found regarding lesion depth ([Formula: see text], [Formula: see text]) and also surface layer thickness ([Formula: see text], [Formula: see text]). The images obtained clinically in real time using the dental SS-OCT system are suitable for the assessment of natural subsurface lesions and their surface layer, providing comparable images to a laboratory high-resolution [Formula: see text] without the use of x-ray.

  1. The diagnostic accuracy of a laser fluorescence device and digital radiography in detecting approximal caries lesions in posterior permanent teeth: an in vivo study.

    PubMed

    Menem, R; Barngkgei, I; Beiruti, N; Al Haffar, I; Joury, Easter

    2017-04-01

    The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18-37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P < 0.001). The optimal cut-off values for detecting approximal caries lesions in posterior permanent teeth were >16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen's diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth.

  2. Influence of salivary macromolecules and fluoride on enamel lesion remineralization in vitro.

    PubMed

    Fujikawa, H; Matsuyama, K; Uchiyama, A; Nakashima, S; Ujiie, T

    2008-01-01

    The aim of this study was to investigate the influence of salivary macromolecules on enamel lesion remineralization in the presence or absence of fluoride. Paraffin-stimulated whole saliva was centrifuged, and the supernatant was dialyzed in 1,000 molecular-weight cutoff dialysis tubes, first against a phosphate buffer and then against a mineral solution containing Ca and phosphate. Artificial subsurface lesions of human enamel, created in pH 4.5 acetate buffer, were remineralized for 28 days in 4 remineralizing solutions: group C--mineral solution as a control; group S--mineral solution + dialyzed saliva; group F--mineral solution + 1 ppm F; group SF--mineral solution + dialyzed saliva + 1 ppm F. Changes in relative mineral concentration in the lesions were assessed by transverse microradiography. The results showed statistically significant mineral gains in the lesion body in groups C (DeltaZ = 3,254 +/- 1,562% x microm) and SF (DeltaZ = 2,973 +/- 1,349% x microm), but not in groups S (DeltaZ = 5,192 +/- 1,863% x microm) and F (DeltaZ = 4,310 +/- 1,138% x microm) compared with the baseline group (DeltaZ = 5,414 +/- 461% x microm). It was also found that the mineral density at the surface layer in group F (75.0 +/- 15.7%) was greater than that in the baseline group (30.1 +/- 12.3%) with statistical significance, but not in group SF (39.9 +/- 16.5%). It was concluded that the macromolecules inhibited lesion remineralization fundamentally but that these molecules, in the presence of fluoride, seemed to play an important role in the continuation of remineralization by reducing mineral gains at the surface layer.

  3. Developmental Enamel Defects of the Permanent First Molars and Incisors and Their Association with Dental Caries in the Region of Wielkopolska, Western Poland.

    PubMed

    Opydo-Szymaczek, Justyna; Gerreth, Karolina

    2015-01-01

    To assess the prevalence of developmental defects of the enamel (DDE) in permanent first molars and incisors and their association with dental caries in two age groups of children living in Wielkopolska, Poland. The sample consisted of 225 children ages 6-8 years and 245 children ages 12-14 years (mean age ± SD = 9.9 ± 2.6). Dental defects were described using the modified DDE index. Caries experience was recorded using the DMFT index (number of decayed, missing and filled teeth) for all permanent teeth and for first permanent molars and incisors (DMFT-IM). Overall, 25.7% of the subjects had at least one permanent first molar or incisor affected by DDE. Diffuse opacity was the most common type of DDE, while hypoplasia was the least prevalent. The mean number of teeth with caries (DT) and the mean number of molars and incisors with caries (DT-IM) were higher in subjects with enamel hypoplasia and/or demarcated opacity than in subjects without DDE or with diffuse opacities (p < 0.05). Caries prevalence was higher in children with hypoplasia and/or demarcated opacity than in subjects without DDE. The differences were statistically significant only for the younger group (p < 0.05). The overall tooth prevalence of DDE in molars and incisors is comparable to that observed in low-fluoride communities. However, a preponderance of diffuse defects suggests the need for further investigation into the aetiology of DDE among Polish children. The results confirm that demarcated opacities and hypoplasia should be considered important caries risk factors.

  4. Remineralization of initial enamel carious lesions using fluoridated milk in vitro.

    PubMed

    Ongtenco, Kristine L; Anthonappa, Robert P; Itthagarun, Anut; King, Nigel M; Lalloo, Ratilal; Nair, Raj G

    2014-11-01

    Milk is a universal dietary component and it is now recognized as an effective medium for the delivery of fluoride (F). This study sought (i) to evaluate fluoridated milk (2.5 ppm, 5 ppm, 10 ppm) for remineralizing carious lesions and (ii) to determine the optimum frequency for treating carious lesions with fluoridated milk. Artificial carious lesions, 90-180 μm deep, were created on extracted third molar teeth that were sectioned to produce specimens of 100-120 μm thickness. Specimens were randomly divided into 13 groups (n = 20) for treatment with deionized water, plain milk or fluoridated milk (2.5 ppm, 5 ppm, 10 ppm); once daily, twice daily or on alternate days as part of a 20-day pH cycling model. Lesion depth (LD) and mineral content were evaluated before and after pH cycling. Paired t-test, ANOVA and Student-Newman-Keuls tests were employed to make comparisons within and between the different groups. Fluoridated milk significantly reduced LD and increased the mineral content of the lesions compared to plain milk and deionized water (p < 0.05). The greatest reduction in LD was with 2.5 ppm F milk used twice daily (p < 0.05). Milk with 2.5 ppm F used twice daily demonstrated the greatest remineralization of artificial enamel carious lesions in vitro.

  5. Dental Caries Progression Among U.S. Marine Corps Personnel Following Operational Deployment

    DTIC Science & Technology

    2012-06-01

    enamel junction (DEJ), 70% showed measurable radiographic progression within one year, and 92% showed progression within three years. In contrast...In addition, Lenora and colleagues42 have shown that acid is only an initiator of enamel erosion and stimulator of an uncontrolled inflammatory...Introduction: Dental caries remains a major problem in the US military. Incipient lesions progress slowly, taking 3-4 years to progress from the enamel

  6. Casein phosphopeptide-amorphous calcium phosphate and glass ionomer show distinct effects in the remineralization of proximal artificial caries lesion in situ.

    PubMed

    Thepyou, Rathapong; Chanmitkul, Wanvipa; Thanatvarakorn, Ornnicha; Hamba, Hidenori; Chob-Isara, Wanwalai; Trairatvorakul, Chutima; Tagami, Junji

    2013-01-01

    This study aimed to compare the ability of casein-phosphopeptide amorphous-calcium-phosphate (CPP-ACP) and glass-ionomer (GI) in remineralizing proximal artificial caries lesions (ACLs). Molar enamel-slabs were divided into: original-lesion control, intra-oral controls, and experimental (CPP-ACP or GI) groups. Specimens received ACLs and were bonded on subject maxillary first molars. After 4-weeks, mineral density (MD) was analyzed by μCT. Compared to control, CPP-ACP increased MD at 0-38/68-84 microns and the GI group had an increase at 0-68 microns, with a greater increase in MD compared to the CPP-ACP group from 0-53 microns. The mean percent remineralization (%R) showed differences between the GI, CPP-ACP groups and their paired controls. GI tended to increase remineralization more than CPP-ACP. In conclusion, CPP-ACP and GI demonstrated distinct remineralizing ability. GI induced greater remineralization in the superficial lesion, while CPP-ACP remineralized the lesion body. Their effects on percent remineralization and reducing lesion depth of proximal ACLs were similar.

  7. Children's discomfort may vary among different treatments for initial approximal caries lesions: preliminary findings of a randomized controlled clinical trial.

    PubMed

    Mattos-Silveira, Juliana; Floriano, Isabela; Ferreira, Fernanda R; Viganó, Maria Eduarda F; Mendes, Fausto M; Braga, Mariana M

    2015-07-01

    Longer and more complex dental procedures could negatively affect patient's acceptability of minimal invasive techniques. Therefore, this short communication aims to show the preliminary findings regarding children's discomfort reported after some minimal invasive treatments in treating initial caries lesions on approximal surfaces: flossing instruction, silver diamine fluoride (SDF) application and caries resin infiltration. Children allocated in the infiltration group showed higher levels of discomfort than those in the SDF and control groups. These findings suggest that the simplest interventions for approximal initial caries lesions cause less discomfort for children and should be applied where possible. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Near-IR and PS-OCT imaging of developmental defects in dental enamel

    NASA Astrophysics Data System (ADS)

    Hirasuna, Krista; Fried, Daniel; Darling, Cynthia L.

    2007-02-01

    Polarization sensitive optical coherence tomography (PS-OCT) and near-IR (NIR) imaging are promising new technologies under development for monitoring early carious lesions. Fluorosis is a growing problem in the U.S., and the more prevalent mild fluorosis can be visually mistaken for early enamel demineralization. Some initial NIR images suggest that enamel defects and dental caries manifest different optical behavior in the NIR. Unfortunately, there is little quantitative information available regarding the differences in optical properties of sound enamel, enamel developmental defects, and demineralized enamel due to caries. This study tested the hypothesis that hypomineralized enamel due to fluorosis can be differentiated from demineralized enamel due to caries using NIR and PS-OCT imaging because of different optical behavior in the NIR. Thirty extracted human teeth with various degrees of suspected fluorosis and/or caries were imaged using PS-OCT and NIR transillumination. An InGaAs camera and a near-IR diode laser were used to measure the optical attenuation through transverse tooth sections (~200 μm). Developmental defects were clearly visible in the polarization-resolved OCT images, demonstrating that PS-OCT can be used to nondestructively measure the depth and possible severity of the defects. Enamel defects on whole teeth that could be imaged with high contrast with visible light were transparent in the near-IR while demineralized areas due to caries were opaque. In contrast, dental caries could be clearly distinguished from sound enamel. This study suggests that PS-OCT and NIR methods may potentially be used as tools to assess the severity and extent of enamel defects and for the differentiation of mild fluorosis defects from early carious lesions.

  9. Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a systematic review.

    PubMed

    Gao, Sherry Shiqian; Zhang, Shinan; Mei, May Lei; Lo, Edward Chin-Man; Chu, Chun-Hung

    2016-02-01

    As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was approved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to arrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in remineralising and arresting caries in children. A systematic search of publications from 1948 to 2014 was conducted using four databases: PubMed, Cochrane Library, ISI Web of Science and Embase. The key words used were (fluoride) AND (remineralisation OR remineralization OR arresting) AND (children caries OR early childhood caries). The title and abstract of initially identified publications were screened. Clinical trials about home-use fluorides, laboratory studies, case reports, reviews, non-English articles and irrelevant studies were excluded. The full texts of the remaining papers were retrieved. Manual screening was conducted on the bibliographies of the remaining papers to identify relevant articles. A total of 2177 papers were found, and 17 randomised clinical trials were included in this review. Ten studies investigated the remineralising effect on early enamel caries using silicon tetrafluoride, fluoride gel, silver diamine fluoride or sodium fluoride. Seven studies reported an arresting effect on dentine caries using silver diamine fluoride or nano-silver fluoride. Meta-analysis was performed on four papers using 5 % sodium fluoride varnish to remineralise early enamel caries, and the overall percentage of remineralised enamel caries was 63.6 % (95 % CI: 36.0 % - 91.2 %; p < 0.001). Meta-analysis was also performed on five papers using 38 % silver diamine fluoride to arrest dentine caries and the overall proportion of arrested dentine caries was 65.9 % (95 % CI: 41.2 % - 90.7 %; p < 0.001). Professionally applied 5 % sodium fluoride varnish can remineralise early enamel caries and 38 % silver diamine fluoride is

  10. Effects of different antibacterial agents on enamel in a biofilm caries model.

    PubMed

    Savas, Selcuk; Kucukyılmaz, Ebru; Celik, Esra U; Ates, Mustafa

    2015-01-01

    Using a mature biofilm model, the aim of this study was to evaluate the effectiveness of different antibacterial agents in comparison with silver diamine fluoride (SDF). Forty-eight saliva-coated enamel slabs were inoculated with Streptococcus mutans monospecies biofilm. The biofilms were then exposed to 10% sucrose in tryptone yeast-extract culture medium, 8 times per day for 7 days. After the biofilm growth period, the enamel slabs were treated with one of the following substances: 1) distilled water; 2) SDF; 3) acidulated phosphate fluoride (APF); 4) ammonium hexafluorosilicate (AHF); 5) ammonium hexafluorosilicate + cetylpyridinium chloride (AHF+CPC); or 6) 0.2% chlorhexidine (CHX). After these treatment procedures, the samples were incubated at 37ºC for 2 days, and the numbers of viable microorganisms in the biofilms were counted. The number of viable bacteria was significantly reduced by all of the antibacterial agents (P < 0.05). However, SDF showed the highest antibacterial activity (P < 0.05), and the effectiveness of the other agents was lower (P < 0.05). SDF has a highly effective antibacterial action against cariogenic Streptococcus mutans biofilm; none of the other fluoride agents used in this study, or 0.2 CHX agent, showed an antibacterial effect comparable to that of SDF.

  11. In vitro inhibition of bovine enamel demineralization by enamel matrix derivative.

    PubMed

    Ran, Jin Mei; Ieong, Cheng Cheng; Xiang, Chen Yang; Lv, Xue Ping; Xue, Jing; Zhou, Xue Dong; Li, Wei; Zhang, Ling Lin

    2014-01-01

    This study aimed to determine whether enamel matrix derivative (Emdogain) affects the demineralization of bovine enamel in vitro and to assess the agent's anti-caries potential. Bovine enamel blocks were prepared and randomly divided into three groups (n = 15 per group), which were treated with distilled water (negative control), NaF (positive control), or Emdogain. All three groups were pH-cycled 12 times over 6 days. The percentage of surface enamel microhardness reduction (%SMHR), calcium demineralization rate (CDR), surface roughness, lesion depth and mineral loss after demineralization were examined. Surface morphology of specimens was studied by scanning electron microscopy. The Emdogain and positive control groups showed similar surface roughness, lesion depths and mineral loss, which were significantly lower than those in the negative control group. In addition, the enamel surfaces of both the Emdogain and NaF groups showed much narrower intercrystalline spaces than the surfaces of the negative control group, which exhibited extensive microfractures along the crystal edges. %SMHR differed significantly among all three groups, with the smallest value in the Emdogain group and the greatest in the negative control group. These results indicate that enamel matrix derivative (Emdogain) can significantly inhibit demineralization of bovine enamel in vitro, suggesting that it has potential as an anti-caries agent.

  12. Casein phosphopeptide-amorphous calcium phosphate incorporated into sugar confections inhibits the progression of enamel subsurface lesions in situ.

    PubMed

    Walker, G D; Cai, F; Shen, P; Adams, G G; Reynolds, C; Reynolds, E C

    2010-01-01

    Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been demonstrated to exhibit anticariogenic activity in randomized, controlled clinical trials of sugar-free gum and a tooth cream. Two randomized, double-blind, crossover studies were conducted to investigate the potential of CPP-ACP added to hard candy confections to slow the progression of enamel subsurface lesions in an in situ model. The confections studied were: (1) control sugar (65% sucrose + 33% glucose syrup); (2) control sugar-free; (3) sugar + 0.5% (w/w) CPP-ACP; (4) sugar + 1.0% (w/w) CPP-ACP; (5) sugar-free + 0.5% (w/w) CPP-ACP. Participants (10 and 14 in study 1 and 2) wore a removable palatal appliance containing enamel half-slabs with subsurface lesions, except for meals and oral hygiene procedures, and consumed 1 confection 6 times a day for 10 days. The enamel half-slabs were inset to allow the development of plaque on the enamel surface. Participants rested for 1 week before crossing over to another confection. The appliances were stored in a humid container at 37 degrees C when not in the mouth. After each treatment period, the enamel half-slabs were removed, paired with their demineralized control half-slabs, embedded, sectioned and then analysed using transverse microradiography. In both studies consumption of the control sugar confection resulted in significant demineralization (progression) of the enamel subsurface lesions. However, consumption of the sugar confections containing CPP-ACP did not result in lesion progression, but in fact in significant remineralization (regression) of the lesions. Remineralization by consumption of the sugar + 1.0% CPP-ACP confection was significantly greater than that obtained with the sugar-free confection.

  13. A tissue-dependent hypothesis of dental caries.

    PubMed

    Simón-Soro, A; Belda-Ferre, P; Cabrera-Rubio, R; Alcaraz, L D; Mira, A

    2013-01-01

    Current understanding of dental caries considers this disease a demineralization of the tooth tissues due to the acid produced by sugar-fermenting microorganisms. Thus, caries is considered a diet- and pH-dependent process. We present here the first metagenomic analysis of the bacterial communities present at different stages of caries development, with the aim of determining whether the bacterial composition and biochemical profile are specific to the tissue affected. The data show that microbial composition at the initial, enamel-affecting stage of caries is significantly different from that found at subsequent stages, as well as from dental plaque of sound tooth surfaces. Although the relative proportion of Streptococcus mutans increased from 0.12% in dental plaque to 0.72% in enamel caries, Streptococcus mitis and Streptococcus sanguinis were the dominant streptococci in these lesions. The functional profile of caries-associated bacterial communities indicates that genes involved in acid stress tolerance and dietary sugar fermentation are overrepresented only at the initial stage (enamel caries), whereas other genes coding for osmotic stress tolerance as well as collagenases and other proteases enabling dentin degradation are significantly overrepresented in dentin cavities. The results support a scenario in which pH and diet are determinants of the disease during the degradation of enamel, but in dentin caries lesions not only acidogenic but also proteolytic bacteria are involved. We propose that caries disease is a process of varying etiology, in which acid-producing bacteria are the vehicle to penetrate enamel and allow dentin degrading microorganisms to expand the cavity. © 2013 S. Karger AG, Basel.

  14. Oral health-related knowledge, attitudes, behavior, and family characteristics among Finnish schoolchildren with and without active initial caries lesions.

    PubMed

    Poutanen, Raija; Lahti, Satu; Seppä, Liisa; Tolvanen, Mimmi; Hausen, Hannu

    2007-04-01

    The aim of this study was to determine whether the presence of active initial caries lesions among 11 to 12-year-old schoolchildren is associated with parental and child-related factors and whether there are gender differences in these associations. The data were gathered by questionnaires from children and their parents, who replied without knowing the other's answers. All the children were invited to participate in a screening for the presence or absence of active initial caries lesions. Factors associated with children's initial caries were studied with logistic regression analyses. The parents' self-assessed poor dental health, the parents' and the child's poor oral health-related behavior, and the child's response "I don't know" to the question concerning his/her parents' possible dental caries were associated with the presence of active initial caries lesions. The results of logistic regression analyses were different between girls and boys. Among the girls, many parent-related factors were associated with the presence of initial caries. Among the boys, most factors were related to the child; and of the parent-related factors, only parents' poor self-assessed dental health was associated with initial caries; the effect was modified by the father's occupational level. Parental factors affect boys' and girls' dental health differently. Among boys, the effect of the fathers was seen as the father's occupational level; among girls, parental knowledge and behavior were important. When school interventions to promote health are planned, the important role of the parents should be emphasized.

  15. Near-IR and CP-OCT imaging of suspected occlusal caries lesions.

    PubMed

    Simon, Jacob C; Kang, Hobin; Staninec, Michal; Jang, Andrew T; Chan, Kenneth H; Darling, Cynthia L; Lee, Robert C; Fried, Daniel

    2017-03-01

    Radiographic methods have poor sensitivity for occlusal lesions and by the time the lesions are radiolucent they have typically progressed deep into the dentin. New more sensitive imaging methods are needed to detect occlusal lesions. In this study, cross-polarization optical coherence tomography (CP-OCT) and near-IR imaging were used to image questionable occlusal lesions (QOC's) that were not visible on radiographs but had been scheduled for restoration on 30 test subjects. Near-IR reflectance and transillumination probes incorporating a high definition InGaAs camera and near-IR broadband light sources were used to acquire images of the lesions before restoration. The reflectance probe utilized cross-polarization and operated at wavelengths from 1,500 to 1,700 nm where there is an increase in water absorption for higher contrast. The transillumination probe was operated at 1,300 nm where the transparency of enamel is highest. Tomographic images (6 × 6 × 7 mm(3) ) of the lesions were acquired using a high-speed swept-source CP-OCT system operating at 1,300 nm before and after removal of the suspected lesion. Near-IR reflectance imaging at 1,500-1,700 nm yielded significantly higher contrast (P < 0.05) of the demineralization in the occlusal grooves compared with visible reflectance imaging. Stains in the occlusal grooves greatly reduced the lesion contrast in the visible range yielding negative values. Only half of the 26 lesions analyzed showed the characteristic surface demineralization and increased reflectivity below the dentinal-enamel junction (DEJ) in 3D OCT images indicative of penetration of the lesion into the dentin. This study demonstrates that near-IR imaging methods have great potential for improving the early diagnosis of occlusal lesions. Lasers Surg. Med. 49:215-224, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

    PubMed Central

    Arslan, Umut; Karaağaoğlu, Ergun; Özkan, Gökhan; Kanlı, Aydan

    2014-01-01

    Background: Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. Aims: To show that two information theory measures, information content (IC) and proportional reduction in diagnostic uncertainty (PRDU), can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. Study Design: Diagnostic accuracy study. Methods: Sixty freshly extracted permanent human molar and pre-molar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11), enamel caries (n=22) and dentin caries (n=27). Diagnostic performance of i) visual inspection, ii) radiography, iii) laser fluorescence (LF) and iv) micro-computed tomography (M-CT) caries detection methods was evaluated by calculating IC and PRDU. Results: Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05), (PRDU: 70.5%) and second evaluation (IC: 1.105; p<0.05), (PRDU: 73.8%) for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC:1.105; p<0.05), (PRDU:73.8%) and second evaluation (IC:1.061; p<0.05), (PRDU:70.8%). IC and PRDU were

  17. Influence of repeated APF applications on long-term remineralization of initial lesions in bovine enamel

    SciTech Connect

    Bodde, H.E.; Nelson, D.G.; Koops, P.G.; Arends, J.

    1985-01-01

    Initial lesions in bovine enamel were remineralized in vitro for periods lasting from one hour to two weeks; in some cases, remineralization was interrupted daily for a ten-minute APF application. After two weeks, surface coatings appeared on APF-treated specimens; SEM and TEM observations, including selected area and micro-electron diffraction, indicated both a layered structure within these coatings, and the predominance of calcium fluoride single crystals, ranging from 0.1 to 1.0 micrometer in size. Using double (/sup 45/Ca and /sup 32/P) labeled remineralizing solutions, the authors obtained depth profiles of deposited labeled calcium and phosphate; these indicated that repeated APF applications prevented inward penetration of calcium and phosphate and limited the deposition of these ions to an outer surface region corresponding to the surface coating. These phenomena are explained in terms of the composition and apparent reactivity of the coating.

  18. Comparison of the chemical composition of normal enamel from exfoliated primary teeth and teeth affected with early childhood caries: an in vitro study.

    PubMed

    Das, Bhaskar; Muthu, Murugan Satta; Farzan, Jamaluddin Mohammed

    2016-01-01

    The aim of this study was to compare the chemical composition of enamel from teeth with early childhood caries (unaffected fragments) and from healthy primary teeth. Forty exfoliated primary teeth (Group I) and 40 teeth affected with ECC (Group II) were collected. Unaffected enamel from the ECC group was sampled. Elemental analysis was carried out with energy-dispersive X-ray spectroscopy (EDS), following which the same tooth samples were subjected to amino acid analysis by high-performance liquid chromatography (HPLC). Statistically significant differences were observed in the percentage of phosphorus (P) and the Ca/P ratios between the two groups in the elemental analysis. Amino acid analysis revealed no significant difference in the amino acid profile and the quantity of amino acid or protein content between the two groups. This study showed significant differences in the P content and Ca/P ratio between the enamel from teeth with ECC and in that from healthy primary teeth. These findings indicate that differences in the composition of enamel could be a risk factor for ECC. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Comparison Between Biofilm Production, Phospholipase and Haemolytic Activity of Different Species of Candida Isolated from Dental Caries Lesions in Children

    PubMed Central

    Shenoy, Neetha

    2016-01-01

    Introduction C.albicans is the most commonly isolated fungal pathogen in the oral cavity, but isolation of non-albicans Candida is increasing in recent years. We wish to demonstrate the virulence factors of Candida spp. isolated from the dental caries lesion of the children as presence of virulence factors determines the pathogenic potential of any microorganism. Aim To compare biofilm production, phospholipase and haemolytic activity of C.albicans with that of non-albicans species of Candida isolated from dental caries lesions of children to evaluate the role of non- albicans species of Candida in formation of dental caries. Materials and Methods Oral swabs were collected from caries lesion of 100 school children of age 5-10 years with dental caries. Candida isolates were tested for biofilm production, phospholipase and haemolytic activity. Statistical analysis was done by Chi-Square test and Mann-Whitney U test wherever applicable using SPSS version 11.5. Results Out of the 100 children with dental caries 37 were positive for Candida by smear or culture and 31 by culture. C.albicans was the most prevalent isolate followed by C.krusei, C.tropicalis and C.albicans. Out of 21 C.albicans isolates, 10 (47.6%) showed phospholipase activity and 18 (85.71%) produced biofilm. Of the 10 non-albicans strains, 5 (50%) showed phospholipase activity and 6 (60%) produced biofilm. All isolates of Candida produced haemolysin (100%). Conclusion There was no statistically relevant difference between the virulence factor production by C.albicans and non-albicans species of Candida. In other words, our study shows that both C.albicans and non-albicans species of Candida isolated from caries lesions of the children, produce these virulence factors. So we can say that non-albicans species of Candida also are involved in caries formation. PMID:27190803

  20. Erosive effects of beverages in the presence or absence of caries simulation by acidogenic challenge on human primary enamel: an in vitro study.

    PubMed

    Tedesco, T K; Gomes, N G; Soares, F Z M; Rocha, R O

    2012-02-01

    To evaluate in vitro the erosive effects of beverages in the presence or absence of caries simulation (acidogenic challenge) on the microhardness of primary enamel. Forty human primary teeth were submitted to the erosive effects: 3 × 20-min-long daily immersion in fresh orange juice (orange group), strawberry yogurt drink (yog group), or cola soft drink (cola group) separately or in combination with acidogenic challenge (pH cycling for 10 days). Specimens were also submitted to acidogenic challenge alone, and in the negative control group specimens were not submitted to any treatment. Mineral loss was evaluated by cross-sectional microhardness determination. The data (Knoop hardness numbers, KHN) were subjected to 2-way analysis of variance and Tukey's post hoc test (α = 0.05%). All the test beverages significantly reduced the sample cross-sectional enamel hardness (KHN ± SD, 235.93 ± 18.15, 257.23 ± 21.79, and 253.23 ± 13.86 in the orange, yog, and cola groups, respectively) compared to samples in the negative control group (290.27 ± 3.92). In vitro acidogenic challenge exacerbated the mineral loss induced by all beverages (166.02 ± 4.28, 190.43 ± 17.55, and 198.39 ± 21.39 in the orange, yog, and cola groups combined to acidogenic challenge, respectively) compared to acidogenic challenge alone. All beverages exhibited erosive effects on primary enamel. Simulated caries challenge considerably exacerbated the enamel softening of primary teeth.

  1. Clinical evaluation of an enhanced white light and fluorescence device for early detection of caries lesions.

    PubMed

    Amaechi, B T; Chedjieu, I; Lozano-Pineda, Juanita

    2013-01-01

    Sensitivity of a device based on Fluorescence Imaging with Reflectance Enhancement (FIRE) in detecting a potential incipient lesion (PIL) was compared with visual examination to demonstrate non-inferiority to it. Visual examination (VE) and an investigational device (ID) were used to detect PIL (actual incipient caries [AIC] and hypomineralization). Seventeen subjects satisfied data analysis criteria. Two-hundred and seventy-seven AIC and 367 hypomineralizations reached VE consensus. Ground truth was generated from consensus VE results and image information from enhanced white light (eWL) and FIRE images. Data from VE and ID in Still Image (IDSM) and Video (IDVM) modes were evaluated against ground truth. Overall sensitivity of VE, IDSM, and IDVM evaluated against ground truth were 0.94, 0.884, and 0.848, respectively, for Actual Incipient Caries (AIC) detection, and 0.95, 0.916, and 0.883, respectively, for PIL detection. Sensitivity of ID in both modes was > 90% that of VE, thus demonstrating non-inferiority of IDSM and IDVM to VE. The investigated eWL and fluorescence device is clinically effective and at least as good as expert VE in detecting PIL. An enhanced white light device with FIRE technology can be used, in Video or Still Image Detection modes, as an aid to caries diagnosis.

  2. The prevalence of questionable occlusal caries lesions: findings from The Dental Practice-Based Research Network

    PubMed Central

    Makhija, Sonia K; Gilbert, Gregg H.; Funkhouser, Ellen; Bader, James D; Gordan, Valeria V.; Rindal, D. Brad; Bauer, Michael; Pihlstrom, Daniel J.; Qvist, Vibeke

    2012-01-01

    Objectives Questionable occlusal caries (QOC) can be defined as clinically-suspected caries with no cavitation or radiographic evidence of occlusal caries. To our knowledge, its prevalence has not been quantified; this was the objective of this study. Methods A total of 82 dentist and hygienist practitioner-investigators from “The Dental Practice-Based Research Network” (DPBRN) participated. When patients presented with at least one unrestored occlusal surface, their number of unrestored occlusal surfaces and QOC were quantified. Information also was recorded about patient characteristics on consented patients who had QOC. Data analysis adjusted for patient clustering within practices. Results Overall, 6,910 patients had at least one unrestored occlusal surface, with a total of 50,445 unrestored surfaces. Thirty-four percent of all patients and 11% of unrestored surfaces among all patients had QOC. Patient- and surface-level QOC prevalence varied significantly by region (p<0.001; p<0.03). The highest percent for patient-and surface-level prevalence was in Florida/Georgia (42%; 16%). Conclusions To our knowledge, this is the first study to quantify the prevalence of QOC in routine clinical practice. These results document a high prevalence overall, with wide variation in prevalence among DPBRN’s five main regions. Clinical Implications QOC lesions are common in routine practice and warrant further investigation regarding how best to manage them. PMID:23204090

  3. Effects of dentifrices on artificial caries like lesions: an in vitro pH cycling study.

    PubMed

    Rana, R; Itthagarun, A; King, N M

    2007-08-01

    To evaluate remineralising effects of three dentifrices, Vicco by Vicco Labs, India, Perioe Cavity Care by LG Care, Korea and Colgate Total by Colgate-Palmolive, Thailand on artificial caries like lesions. In vitro single-section and pH cycling model. Extracted third molars were painted with nail varnish, leaving 1 mm wide windows before placing demineralising solution for 96h to produce artificial carious lesions 150-200 miocrom deep. Teeth were then cut longitudinally into 100-150 microm thick sections and randomly assigned to three groups. Polarised light microscopy and microradiography were used to evaluate lesion depth, before and after the 10 day pH cycle. Sections in Group A were treated with Vicco by Vicco Labs, India (-ve control), Group B were treated with Perioe Cavity Care by LG Care, Korea and Group C were treated with Colgate Total by Colgate-Palmolive, Thailand. Mean lesion depths in Groups B and C reduced by 7% and 12% respectively, whereas lesion depth increased by 13% in Group A. Comparisons made among groups using ANOVA and Student-Newman-Keuls tests showed that three groups were significantly different from each other (p < 0.05). Perioe Cavity Care and Colgate Total remineralised initial carious lesions. However, the remineralising potential of Colgate Total was higher than that of Perioe Cavity Care.

  4. Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document.

    PubMed

    Kühnisch, J; Ekstrand, K R; Pretty, I; Twetman, S; van Loveren, C; Gizani, S; Spyridonos Loizidou, M

    2016-02-01

    The European Academy of Paediatric Dentistry (EAPD) encourages prevention and arrest of active dental caries. Therefore, the present guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management. A search of different databases was conducted using all terms related to the subject. Relevant papers were identified after a review of their titles, abstracts or full texts. Three workshops were held during the corresponding EAPD interim seminar in Brussels in 2015. Several statements were agreed upon and, furthermore, gaps in our knowledge were identified. Following the systematic reviews and outcomes of the seminars, it was concluded that visual and radiographic caries detection should be utilised as a basic diagnostic approach to locate, assess and monitor non-cavitated caries lesions in primary and permanent teeth. As another important evaluation step, a caries risk assessment should be performed at a child's first dental visit, and reassessments should be performed on a regular basis. It is widely accepted that non-cavitated caries lesions can be managed non-invasively in the majority of cases. The spectrum of measures includes a low cariogenicity tooth-friendly diet, daily and appropriate management of the biofilm, home and within the dental office/surgery usage of fluorides as well as sealing techniques. The detection and management of non-cavitated caries is an essential aspect of preventive dentistry. Therefore, the EAPD encourages oral health care providers and caregivers to implement preventive practices that can arrest early caries and improve individual and public dental health.

  5. Microbiome of Deep Dentinal Caries Lesions in Teeth with Symptomatic Irreversible Pulpitis

    PubMed Central

    Rôças, Isabela N.; Rachid, Caio T. C. C.; Lima, Kenio C.; Assunção, Isauremi V.; Gomes, Patrícia N.; Siqueira, José F.

    2016-01-01

    This study used a next-generation sequencing approach to identify the bacterial taxa occurring in the advanced front of caries biofilms associated with pulp exposure and irreversible pulpitis. Samples were taken from the deepest layer of dentinal caries lesions associated with pulp exposure in 10 teeth diagnosed with symptomatic irreversible pulpitis. DNA was extracted and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Bacterial taxa were mapped to 14 phyla and 101 genera composed by 706 different OTUs. Three phyla accounted for approximately 98% of the sequences: Firmicutes, Actinobacteria and Proteobacteria. These phyla were also the ones with most representatives at the species level. Firmicutes was the most abundant phylum in 9/10 samples. As for genera, Lactobacillus accounted for 42.3% of the sequences, followed by Olsenella (13.7%), Pseudoramibacter (10.7%) and Streptococcus (5.5%). Half of the samples were heavily dominated by Lactobacillus, while in the other half lactobacilli were in very low abundance and the most dominant genera were Pseudoramibacter, Olsenella, Streptococcus, and Stenotrophomonas. High bacterial diversity occurred in deep dentinal caries lesions associated with symptomatic irreversible pulpitis. The microbiome could be classified according to the relative abundance of Lactobacillus. Except for Lactobacillus species, most of the highly prevalent and abundant bacterial taxa identified in this study have been commonly detected in infected root canals. The detected taxa can be regarded as candidate pathogens for irreversible pulpitis and possibly the pioneers in pulp invasion to initiate endodontic infection. PMID:27135405

  6. Microbiome of Deep Dentinal Caries Lesions in Teeth with Symptomatic Irreversible Pulpitis.

    PubMed

    Rôças, Isabela N; Alves, Flávio R F; Rachid, Caio T C C; Lima, Kenio C; Assunção, Isauremi V; Gomes, Patrícia N; Siqueira, José F

    2016-01-01

    This study used a next-generation sequencing approach to identify the bacterial taxa occurring in the advanced front of caries biofilms associated with pulp exposure and irreversible pulpitis. Samples were taken from the deepest layer of dentinal caries lesions associated with pulp exposure in 10 teeth diagnosed with symptomatic irreversible pulpitis. DNA was extracted and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Bacterial taxa were mapped to 14 phyla and 101 genera composed by 706 different OTUs. Three phyla accounted for approximately 98% of the sequences: Firmicutes, Actinobacteria and Proteobacteria. These phyla were also the ones with most representatives at the species level. Firmicutes was the most abundant phylum in 9/10 samples. As for genera, Lactobacillus accounted for 42.3% of the sequences, followed by Olsenella (13.7%), Pseudoramibacter (10.7%) and Streptococcus (5.5%). Half of the samples were heavily dominated by Lactobacillus, while in the other half lactobacilli were in very low abundance and the most dominant genera were Pseudoramibacter, Olsenella, Streptococcus, and Stenotrophomonas. High bacterial diversity occurred in deep dentinal caries lesions associated with symptomatic irreversible pulpitis. The microbiome could be classified according to the relative abundance of Lactobacillus. Except for Lactobacillus species, most of the highly prevalent and abundant bacterial taxa identified in this study have been commonly detected in infected root canals. The detected taxa can be regarded as candidate pathogens for irreversible pulpitis and possibly the pioneers in pulp invasion to initiate endodontic infection.

  7. Pilot clinical study to assess caries lesion activity using quantitative light-induced fluorescence during dehydration

    NASA Astrophysics Data System (ADS)

    Ando, Masatoshi; Ferreira-Zandoná, Andrea G.; Eckert, George J.; Zero, Domenick T.; Stookey, George K.

    2017-03-01

    This study aimed to evaluate the ability of quantitative light-induced fluorescence (QLF) to assess caries lesion activity using visual examination (VE) as the gold standard. Twenty-four visible white spot lesions on buccal surfaces were examined from 23 children, ages 9 to 14 years. At baseline, the surface was hydrated with water, and thereafter, it was dehydrated with continuous compressed air during image acquisition. QLF images were acquired at 0 (baseline), 5, and 15 s. QLF variables [QLFV: fluorescence loss (ΔF), lesion size (S), ΔQ: ΔF×S] was recorded. Changes-in-QLFV per second (ΔQLFV) were determined: ΔQLFV=(QLFVN-QLF/N), where N indicates dehydration time. One experienced dentist conducted VE independently using a dental unit's light, compressed air, and explorer. QLFV and ΔQLFV of the active group (n=11) were compared with those of the inactive group (n=13) using two-sample t-tests. As the surface was dehydrated, S and ΔQ values of the active group increased, whereas QLFV of the inactive group showed only a small change. ΔQLFV of the active group were larger than those of the inactive group; however, the difference did not reach statistical significance (p>0.11). Within the limitations of this study, QLF data indicated increments for lesions designated as active and minimal change for lesions defined as inactive.

  8. Effect of monitor display on detection of approximal caries lesions in digital radiographs.

    PubMed

    Isidor, S; Faaborg-Andersen, M; Hintze, H; Kirkevang, L-L; Frydenberg, M; Haiter-Neto, F; Wenzel, A

    2009-12-01

    The aim was to compare the accuracy of five flat panel monitors for detection of approximal caries lesions. Five flat panel monitors, Mermaid Ventura (15 inch, colour flat panel, 1024 x 768, 32 bit, analogue), Olórin VistaLine (19 inch, colour, 1280 x 1024, 32 bit, digital), Samsung SyncMaster 203B (20 inch, colour, 1024 x 768, 32 bit, analogue), Totoku ME251i (21 inch, greyscale, 1400 x 1024, 32 bit, digital) and Eizo FlexScan MX190 (19 inch, colour, 1280 x 1024, 32 bit, digital), were assessed. 160 approximal surfaces of human teeth were examined with a storage phosphor plate system (Digora FMX, Soredex) and assessed by seven observers for the presence of caries lesions. Microscopy of the teeth served as validation for the presence/absence of a lesion. The sensitivities varied between observers (range 7-25%) but the variation between the monitors was not large. The Samsung monitor obtained a significantly higher sensitivity than the Mermaid and Olórin monitors (P<0.02) and a lower specificity than the Eizo and Totoku monitors (P<0.05). There were no significant differences between any other monitors. The percentage of correct scores was highest for the Eizo monitor and significantly higher than for the Mermaid and Olórin monitors (P<0.03). There was no clear relationship between the diagnostic accuracy and the resolution or price of the monitor. The Eizo monitor was associated with the overall highest percentage of correct scores. The standard analogue flat panel monitor, Samsung, had higher sensitivity and lower specificity than some of the other monitors, but did not differ in overall accuracy for detection of carious lesions.

  9. In Situ analysis of CO2 laser irradiation on controlling progression of erosive lesions on dental enamel.

    PubMed

    Lepri, Taísa Penazzo; Scatolin, Renata Siqueira; Colucci, Vivian; De Alexandria, Adílis Kalina; Maia, Lucianne Cople; Turssi, Cecília Pedroso; Corona, Silmara Aparecida Milori

    2014-08-01

    The present study aimed to evaluate in situ the effect of CO2 laser irradiation to control the progression of enamel erosive lesions. Fifty-six slabs of bovine incisors enamel (5 × 3 × 2.5 mm(3) ) were divided in four distinct areas: (1) sound (reference area), (2) initial erosion, (3) treatment (irradiated or nonirradiated with CO2 laser), (4) final erosion (after in situ phase). The initial erosive challenge was performed with 1% citric acid (pH = 2.3), for 5 min, 2×/day, for 2 days. The slabs were divided in two groups according to surface treatment: irradiated with CO2 laser (λ = 10.6 µm; 0.5 W) and nonirradiate. After a 2-day lead-in period, 14 volunteers wore an intraoral palatal appliance containing two slabs (irradiated and nonirradiated), in two intraoral phases of 5 days each. Following a cross-over design during the first intraoral phase, half of the volunteers immersed the appliance in 100 mL of citric acid for 5 min, 3×/day, while other half of the volunteers used deionized water (control). The volunteers were crossed over in the second phase. Enamel wear was determined by an optical 3D profilometer. Three-way ANOVA for repeated measures revealed that there was no significant interaction between erosive challenge and CO2 laser irradiation (P = 0.419). Erosive challenge significantly increased enamel wear (P = 0.001), regardless whether or not CO2 laser irradiation was performed. There was no difference in enamel wear between specimens CO2 -laser irradiated and non-irradiated (P = 0.513). Under intraoral conditions, CO2 laser irradiation did not control the progression of erosive lesions in enamel caused by citric acid.

  10. In vitro remineralization of human and bovine white-spot enamel lesions by NaF dentifrices: A pilot study

    PubMed Central

    Karlinsey, R. L.; Mackey, A. C.; Walker, T. J.; Frederick, K. E.; Blanken, D. D.; Flaig, S. M.; Walker, E. R.

    2011-01-01

    The aim of this feasibility study was to evaluate the in vitro remineralization effects of four dentifrice systems using microhardness and fluoride uptake analyses. In vitro testing for the potential remineralization of the white-spot lesions in bovine and human enamel was performed using a 10-day pH cycling model. The study involved the following NaF silica-based dentifrices: 1) placebo (0 ppm F), 2) 500 ppm F, 3) 1150 ppm F, and 4) 500 ppm F plus functionalized tricalcium phosphate (fTCP). Each day consisted of four two-minute treatments, one four-hour acid challenge (pH = 5.0), and immersion in artificial saliva (pH = 7.0) between these events. After cycling, specimens were analyzed for surface microhardness (SMH), enamel fluoride uptake (EFU), and cross-sectional microhardness (CSM). Statistical analyses revealed significant differences (ANOVA, LSD, p<0.05) among the four groups, with the placebo and 500 ppm F dentifrices providing significantly less remineralization relative to the 1150 ppm F and 500 ppm F plus fTCP dentifrices. Notably, while CSM measurements for both enamel types generated similar profiles for the four groups, SMH and EFU revealed human enamel was more sensitive to the 500 ppm F dentifrice groups compared to bovine enamel. This apparent sensitivity may be due to the inherent structural differences between the two substrates. PMID:21643437

  11. Structure of artificial enamel lesions after topical applications of high-concentration sodium fluoride solution in vitro.

    PubMed

    Wen, H B; Cui, F Z; Chen, X Q; Wang, Q; Li, H D

    1995-01-01

    A three-layer structure, including a columnar layer (CL), a buffer layer, and unaffected intact enamel, was successively formed from the outer to the inner part of artificial enamel lesions (AEL) by topical applications of a high-concentration acidic sodium fluoride solution (10,000 ppm, pH 5.6) in vitro. The AEL was produced in bovine enamel that was decalcified for 5 days in a lactic acid gel system. The morphological observations by using scanning electron microscopy showed that the CL was made of columnar deposits of small globules about 0.5 microns in diameter. It was observed for the first time that small globules filled the demineralized interprismatic regions in the buffer layer. The unaffected intact enamel was protected from further demineralization under the acidic condition. Structure and composition of the CL were investigated by using X-ray diffraction and X-ray photoelectron spectroscopy. In the CL the atomic ratio was Ca:P = 12.6 and Ca:F = 0.75, and the small globules were mainly a mixture of polycrystalline calcium fluoride and hydroxyapatite. For comparison, the sound enamel and the AEL attained by applications of 0 and 100 ppm acidic sodium fluoride solutions (pH 5.6) were also investigated. The formation mechanism of the three-layer structure and the related cariostatic effects are discussed.

  12. Inhibition of enamel erosion and promotion of lesion rehardening by fluoride: a white light interferometry and microindentation study.

    PubMed

    Fowler, C E; Gracia, L; Edwards, M I; Willson, R; Brown, A; Rees, G D

    2009-01-01

    The primary aim of the present in vitro studies was to investigate fluoride as an inhibitor of citric acid-mediated demineralization of human enamel and promoter of lesion repair using a combination of white light interferometry, scanning electron microscopy, and microindentation. Secondary aims included investigation of the importance of brushing on bulk tissue loss, and comparison of the relative efficacy of commercially available toothpastes on inhibiting enamel surface softening and rehardening of incipient erosive lesions. Resin-mounted polished enamel specimens were prepared from extracted human molars and pre-molars. Mean surface roughness (Sa) and bulk tissue loss following exposure to an erosive challenge, or an erosive challenge plus brushing were investigated using a MicroXAM ADE PhaseShift white light interferometer. Surface morphology was determined using a Zeiss Evo 50 scanning electron microscope (SEM). The utility of fluoride-based treatments to protect against subsequent acid demineralization and to promote remineralization of pre-formed incipient lesions was determined using microindentation-based enamel surface softening and enamel lesion rehardening models. Treating human enamel specimens with Sensodyne Pronamel conferred a clear protective benefit against a subsequent 300-second citric acid challenge as evidenced by the interferometry and SEM data. The increase in Sa and bulk tissue loss caused by an erosive challenge followed by brushing was markedly reduced by pre-treatment with sodium fluoride (NaF) in a concentration-dependent manner. Sensodyne Pronamel statistically outperformed Colgate Sensitive Enamel Protect both in the enamel surface softening model and lesion rehardening model, and conferred statistically superior enamel fluoride uptake. Treatment of erosive lesions with Sensodyne Pronamel resulted in statistically superior rehardening versus two Crest Pro-Health formulations containing stannous fluoride (SnF2) and sodium

  13. Near-infrared hyperspectral imaging of water evaporation dynamics for early detection of incipient caries.

    PubMed

    Usenik, Peter; Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

    2014-10-01

    Incipient caries is characterized as demineralization of the tooth enamel reflecting in increased porosity of enamel structure. As a result, the demineralized enamel may contain increased amount of water, and exhibit different water evaporation dynamics than the sound enamel. The objective of this paper is to assess the applicability of water evaporation dynamics of sound and demineralized enamel for detection and quantification of incipient caries using near-infrared hyperspectral imaging. The time lapse of water evaporation from enamel samples with artificial and natural caries lesions of different stages was imaged by a near-infrared hyperspectral imaging system. Partial least squares regression was used to predict the water content from the acquired spectra. The water evaporation dynamics was characterized by a first order logarithmic drying model. The calculated time constants of the logarithmic drying model were used as the discriminative feature. The conducted measurements showed that demineralized enamel contains more water and exhibits significantly faster water evaporation than the sound enamel. By appropriate modelling of the water evaporation process from the enamel surface, the contrast between the sound and demineralized enamel observed in the individual near infrared spectral images can be substantially enhanced. The presented results indicate that near-infrared based prediction of water content combined with an appropriate drying model presents a strong foundation for development of novel diagnostic tools for incipient caries detection. The results of the study enhance the understanding of the water evaporation process from the sound and demineralized enamel and have significant implications for the detection of incipient caries by near-infrared hyperspectral imaging. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Secondary caries adjacent to amalgam restorations lined with a fluoridated dentin desensitizer.

    PubMed

    García-Godoy, F; Flaitz, C M; Hicks, M J

    1998-12-01

    To determine the in vitro effect of a fluoridated dentin desensitizer solution (DentinBloc) on (1) secondary caries formation, and (2) the interfacial adaptation when used as a cavity liner before amalgam (Dis-persalloy) placement. 24 macroscopically caries-free molars were selected. Class V cavity preparations on mesial and distal surfaces were placed along the cemento-enamel junction, providing an enamel margin and a root surface margin. DentinBloc was applied prior to alloy restoration in the experimental group for 60 s (the excess was removed with cotton pellets), while a copal cavity varnish (Copalite) was used before alloy restoration in the control group. Polarized light evaluation was performed on longitudinal sections (24 caries risk sites for enamel and dentin margins in each group). Alloy-tooth interfaces were evaluated by SEM. Wall lesions were present in 100% of caries-risk sites for the control group, while 58% of enamel risk sites and 50% of root risk sites had wall lesions in the DentinBloc group. Surface lesion depth was reduced 13% at enamel margins and by 18% at root margins in the experimental group when compared to the control group. Relatively small interface gaps between the alloy and tooth surfaces were seen in both groups, but these were less for the root surface margins (2-5 microns) than for the enamel margins (5-15 microns).

  15. A longitudinal study of occlusal caries in Newark New Jersey school children: relationship between initial dental finding and the development of new lesions.

    PubMed

    Markowitz, Kenneth; Fairlie, Karen; Ferrandiz, Javier; Nasri-Heir, Cibele; Fine, Daniel H

    2012-11-01

    Dental caries is a significant public health problem especially amongst children from low-income backgrounds. This longitudinal study examined the development of new occlusal caries in 227 Newark, NJ children ages 10-18. The role of previous caries experience and the presence of occlusal white and dark lesions in predicting the development of new lesions were examined. At each visit, the patient's teeth were given a visual-tactile examination and the subject's decayed, missing and filled (DMFS) score was determined. Next, molars lacking probeable caries or restorations were examined using transillumination for occlusal white and dark spots. This examination was repeated periodically. A Cox proportional hazard was used to analyse data concerning the development of new occusal caries in molars. The longitudinal data indicates that patients who were caries free at visit-1 developed significantly fewer occlusal caries during the longitudinal study. The hazard ratio for subjects who had first-visit caries was 2.27 compared to caries free subjects. Intact molars with occlusal white or dark lesions had caries hazard ratios of 0.78 and 1.49 respectively, compared to molars lacking initial colour changes. Having a prior caries history places the subject at increased risk of developing future caries. Teeth with dark lesions but not white lesions are at significantly increased risk for developing decay. White lesions may represent remineralizing or slowly progressing lesions. The results of this study can help identify patients and tooth surfaces at risk for future occlusal decay. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. A longitudinal study of occlusal caries in Newark New Jersey school children: relationship between initial dental finding and the development of new lesions

    PubMed Central

    Markowitz, Kenneth; Fairlie, Karen; Ferrandiz, Javier; Nasri-Heir, Cibele

    2012-01-01

    Objective Dental caries is a significant public health problem especially amongst children from low-income backgrounds. This longitudinal study examined the development of new occlusal caries in 227 Newark, NJ children ages 10–18. The role of previous caries experience and the presence of occlusal white and dark lesions in predicting the development of new lesions were examined. Design At each visit, the patient’s teeth were given a visual-tactile examination and the subject’s decayed; missing and filled (DMFS) score was determined. Next, molars lacking probeable caries or restorations were examined using transillumination for occlusal white and dark spots. This examination was repeated periodically. A Cox proportional hazard was used to analyze data concerning the development of new occusal caries in molars. Results The longitudinal data indicates that patients who were caries free at visit-1 developed significantly fewer occlusal caries during the longitudinal study. The hazard ratio for subjects who had first-visit caries was 2.27 compared to caries free subjects. Intact molars with occlusal white or dark lesions had caries hazard ratios of 0.78 and 1.49 respectively, compared to molars lacking initial color changes. Conclusion Having a prior caries history places the subject at increased risk of developing future caries. Teeth with dark lesions but not white lesions are at significantly increased risk for developing decay. White lesions may represent remineralizing or slowly progressing lesions. The results of this study can help identify patients and tooth surfaces at risk for future occlusal decay. PMID:22841633

  17. Measurement of surface hardness of primary carious lesions in extracted human enamel -measurement of Knoop hardness using Cariotester.

    PubMed

    Shimizu, Akihiko; Yamamoto, Takatsugu; Nakashima, Syozi; Nikaido, Toru; Sugawara, Toyotaro; Momoi, Yasuko

    2015-01-01

    The clinical feasibility of a novel device called a Cariotester was investigated by measuring the Knoop hardness (KHN) of white spot lesions diagnosed as ICDAS code 1, 2 or 3. To obtain an equation for converting the Cariotester indentation depth into the KHN, a regression analysis was performed between the depth and measured KHN for human enamel. The Cariotester was then used to measure the indentation depth for white spots (ICDAS code 1, 2 or 3) in extracted teeth, and the KHN values were determined using the above equation. The KHN was 219.9±19.7, 162.4±24.0 and 31.7±17.5 for code 1, 2 and 3 lesions, respectively, which was 30, 49 and 90% lower than that for healthy enamel. Using the formula reported in the literature, the mineral density was calculated to be 87.7 vol.% for healthy enamel, and 75.1, 66.1 and 35.5 vol.% for code 1, 2 and 3 lesions, respectively.

  18. Diagnosis of dental caries using quantitative light-induced fluorescence

    NASA Astrophysics Data System (ADS)

    Amaechi, Bennett T.; Higham, Susan M.

    2001-10-01

    Current dental diagnostic methods can detect caries but cannot quantify the mineral status of the lesion. Quantitative Light-induced Fluorescence (QLF) measures the percentage fluorescence radiance change of demineralised enamel with respect to surround sound enamel, and related it directly to the amount of mineral lost during demineralisation. Demineralisation of teeth to produce caries-like lesions and the subsequent remineralisation of the lesions were monitored quantitatively and longitudinally with QLF. The influence of factors such as presence of plaque or saliva, lesion staining, lesion magnification, tooth thickness and developmental hypomineralisation, on the reproducibility of QLF imaging and analysis were investigated, Results showed that the integrated fluorescence change (hence the mineral loss) increased linearly with demineralisation time and decreased with increasing remineralisation time. Caries detection was limited by saliva or plaque, but enhanced by staining. QLF could not discriminate between developmental hypomineralisation and caries. Neither the variation in tooth thickness nor lesion magnification within the limit of a sharp image made a significant difference in QLF analysis. It was concluded that QLF could detect and quantitatively monitor the mineral changes in an incipient caries on a longitudinal basis, however detection may be limited by the presence of saliva or plaque or enhanced by staining.

  19. Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions

    PubMed Central

    de Assunção, Isauremi Vieira; da Costa, Giovanna de Fátima Alves; Borges, Boniek Castillo Dutra

    2014-01-01

    AIM: To systematically review the literature on the efficacy of noninvasive methods of arresting the progression of non-cavitated occlusal carious lesions in dentin. METHODS: The Medline/PubMed, LILACS, SciELO and Scopus databases were searched to identify relevant publications through to November 2013. Only clinical trials evaluating the ability of noninvasive methods to arrest the progression of occlusal non-cavitated carious lesions in dentin were included. Screening, data extraction and quality assessment were conducted independently and in duplicate. RESULTS: Of 167 citations identified, nine full text articles were screened and five were included in the analysis. All papers reported on occlusal fissure sealing using a self-curing glass ionomer (n = 1) or resin-based (n = 4) sealant. Only the use of resin-based sealant to obliterate occlusal fissures arrested the progression of non-cavitated occlusal carious lesions in dentin. CONCLUSION: Occlusal fissure sealing with a resin-based sealant may arrest the progression of non-cavitated occlusal dentinal caries. Further clinical trials with longer follow-up times should be performed to increase scientific evidence. PMID:24868513

  20. Detecting and treating occlusal caries lesions: a cost-effectiveness analysis.

    PubMed

    Schwendicke, F; Stolpe, M; Meyer-Lueckel, H; Paris, S

    2015-02-01

    The health gains and costs resulting from using different caries detection strategies might not only depend on the accuracy of the used method but also the treatment emanating from its use in different populations. We compared combinations of visual-tactile, radiographic, or laser-fluorescence-based detection methods with 1 of 3 treatments (non-, micro-, and invasive treatment) initiated at different cutoffs (treating all or only dentinal lesions) in populations with low or high caries prevalence. A Markov model was constructed to follow an occlusal surface in a permanent molar in an initially 12-y-old male German patient over his lifetime. Prevalence data and transition probabilities were extracted from the literature, while validity parameters of different methods were synthesized or obtained from systematic reviews. Microsimulations were performed to analyze the model, assuming a German health care setting and a mixed public-private payer perspective. Radiographic and fluorescence-based methods led to more overtreatments, especially in populations with low prevalence. For the latter, combining visual-tactile or radiographic detection with microinvasive treatment retained teeth longest (mean 66 y) at lowest costs (329 and 332 Euro, respectively), while combining radiographic or fluorescence-based detections with invasive treatment was the least cost-effective (<60 y, >700 Euro). In populations with high prevalence, combining radiographic detection with microinvasive treatment was most cost-effective (63 y, 528 Euro), while sensitive detection methods combined with invasive treatments were again the least cost-effective (<59 y, >690 Euro). The suitability of detection methods differed significantly between populations, and the cost-effectiveness was greatly influenced by the treatment initiated after lesion detection. The accuracy of a detection method relative to a "gold standard" did not automatically convey into better health or reduced costs. Detection methods

  1. Restorative treatment thresholds for interproximal primary caries based on radiographic images: findings from the Dental Practice-Based Research Network.

    PubMed

    Gordan, Valeria V; Garvan, Cynthia W; Heft, Marc W; Fellows, Jeffrey L; Qvist, Vibeke; Rindal, D Brad; Gilbert, Gregg H

    2009-01-01

    This study sought to quantify the depths of proximal caries lesions that lead dentists in regular clinical practice to intervene restoratively, based on hypothetical scenarios that present radiographic images and patient background information, and to identify characteristics associated with restorative intervention in lesions that have penetrated only the enamel surface. This study surveyed dentists from the Dental Practice-Based Research Network (DPBRN) who had reported doing at least some restorative dentistry (n = 901). Dentists were asked to indicate the depth at which they would restore a lesion, based on a series of radiographic images depicting interproximal caries at increasing lesion depths in a mandibular premolar; in addition, the dentists were questioned regarding two caries risk scenarios: one involving a patient with low caries risk and another involving a patient at higher risk. Logistic regression was used to analyze associations between the decision to intervene restoratively and specific dentist, practice, and patient characteristics. Of the 901 DPBRN practitioner-investigators, 500 (56%) completed the survey. For a high caries risk patient, 66% of respondents indicated that they would restore a proximal enamel lesion, while 24% would do so once the lesion had reached into the outer third of the dentin. For a low caries risk patient, 39% of respondents reported that they would restore an enamel lesion, and 54% would do so once the lesion had reached into the outer third of the dentin. In multivariate analyses that accounted for dentist and practice characteristics, dentists in large group practices were less likely to intervene surgically for enamel caries, regardless of patient's caries risk.

  2. Fluorescence-Based Methods for Detecting Caries Lesions: Systematic Review, Meta-Analysis and Sources of Heterogeneity

    PubMed Central

    Gimenez, Thais; Braga, Mariana Minatel; Raggio, Daniela Procida; Deery, Chris; Ricketts, David N.; Mendes, Fausto Medeiros

    2013-01-01

    Background Fluorescence-based methods have been proposed to aid caries lesion detection. Summarizing and analysing findings of studies about fluorescence-based methods could clarify their real benefits. Objective We aimed to perform a comprehensive systematic review and meta-analysis to evaluate the accuracy of fluorescence-based methods in detecting caries lesions. Data Source Two independent reviewers searched PubMed, Embase and Scopus through June 2012 to identify papers/articles published. Other sources were checked to identify non-published literature. Study Eligibility Criteria, Participants and Diagnostic Methods The eligibility criteria were studies that: (1) have assessed the accuracy of fluorescence-based methods of detecting caries lesions on occlusal, approximal or smooth surfaces, in both primary or permanent human teeth, in the laboratory or clinical setting; (2) have used a reference standard; and (3) have reported sufficient data relating to the sample size and the accuracy of methods. Study Appraisal and Synthesis Methods A diagnostic 2×2 table was extracted from included studies to calculate the pooled sensitivity, specificity and overall accuracy parameters (Diagnostic Odds Ratio and Summary Receiver-Operating curve). The analyses were performed separately for each method and different characteristics of the studies. The quality of the studies and heterogeneity were also evaluated. Results Seventy five studies met the inclusion criteria from the 434 articles initially identified. The search of the grey or non-published literature did not identify any further studies. In general, the analysis demonstrated that the fluorescence-based method tend to have similar accuracy for all types of teeth, dental surfaces or settings. There was a trend of better performance of fluorescence methods in detecting more advanced caries lesions. We also observed moderate to high heterogeneity and evidenced publication bias. Conclusions Fluorescence-based devices

  3. In situ remineralisation of eroded enamel lesions by NaF rinses.

    PubMed

    Mathews, Mary S; Amaechi, Bennett T; Ramalingam, Karthikeyan; Ccahuana-Vasquez, Renzo A; Chedjieu, Irene P; Mackey, Allen C; Karlinsey, Robert L

    2012-05-01

    The purpose of this pilot study was to evaluate the remineralisation of eroded enamel by NaF rinses in an intra-oral model. Serving as their own control, subjects (N=80) participated in a randomised, four-leg (20 subjects/leg), 28-day, parallel design study. In each leg, each participant wore a customised orthodontic bracket attached to a mandibular molar that contained one tooth block having an initial erosive lesion (0.3% citric acid, pH 3.75, 2 h). Within the 28-day period, participants engaged in twice-daily brushing for 1 min with a fluoride-free dentifrice followed by 1-min rinsing with one of the following aqueous rinses: fluoride-free (0 ppm F), 225 ppm F, 225 ppm F plus functionalised β-tricalcium phosphate (fTCP), and 450 ppm F. Following intra-oral exposure, appliances were removed and specimens were analysed using surface microhardness (SMH) and transverse microradiography (TMR). Statistically significant (p<0.05) remineralisation, as determined by SMH and TMR, of the eroded enamel relative to baseline occurred for each fluoride system. No significant differences in SMH were observed amongst the fluoride groups (p>0.05), however, 225 ppm plus fTCP produced 27% and 7% SMH indent length reduction relative to 225 ppm F and 450 ppm F, respectively. No significant differences in TMR were observed amongst the fluoride groups (p>0.05), however, 225 ppm F plus fTCP and 450 ppm F produced significant (p<0.05) mineral gains relative to the fluoride-free control, whilst 225 ppm F did not (p>0.05). Relative to the 225 ppm F group, the 450 ppm F and 225 ppm F plus fTCP groups produced 65% and 61% greater mineral change, respectively. These pilot results demonstrate this model is sensitive to fluoride and that addition of fTCP to an aqueous rinse containing 225 ppm F may provide significant remineralisation benefits. Therefore, the combination of relatively low levels of fluoride and fTCP might be an effective alternative to a high fluoride treatment for anti

  4. Selective enamel etching in cervical lesions for self-etch adhesives: A systematic review and meta-analysis.

    PubMed

    Szesz, Anna; Parreiras, Sibelli; Reis, Alessandra; Loguercio, Alessandro

    2016-10-01

    To identify if selective etching of enamel (SEE) margins improves the retention rates and marginal discoloration of cervical composite restorations in non-carious cervical lesions (NCCLs) of adult patients. MEDLINE, Scopus, Web of Science, LILACS, BBO Library, Cochrane Library and SIGLE were searched without restrictions, as well as IADR abstracts and gray literature via trial registries. Dissertations and theses were searched using the ProQuest Dissertations and Periódicos Capes Theses databases. We included randomized clinical trials that compared the clinical effectiveness of SEE using the self-etch adhesive for direct composite resin restorations in NCCLs in the permanent dentition. After removal of duplicates, 2689 articles were identified. Following screening of abstracts, 10 studies remained in the qualitative synthesis. Seven were considered to be at "low" risk of bias. The report of the studies varied from 1 to 5 years. Except for one-year follow-up, there was a significantly lower marginal discoloration and marginal adaptation during all follow-up periods. Significantly less loss of retention of restorations at the 3-year follow-up was observed with the selective enamel etching technique. Selective enamel prior to application of self-etch adhesive systems in NCCLs might improve clinical performance of resin-composite cervical restorations, although further long-term research is required to confirm this. Selective enamel etching prior to application of self-etch adhesive systems in NCCLs can produce composite restorations with higher longevity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Dental caries experience and enamel opacities in children residing in urban and rural areas of Antigua with different levels of natural fluoride in drinking water.

    PubMed

    Vignarajah, S

    1993-06-01

    In 1988/89, a national study was carried out to investigate the prevalence of caries experience among children aged 5 to 6, 12, and 15 to 19 years and also to measure the level of dental fluorosis among 12 to 14 year-old pupils attending schools in urban and rural areas in Antigua with various levels of natural fluoride in public water. In the first part of the study, all three age groups who were life-long residents of three areas with 0.1-0.2 ppmF (urban), 0.1-0.3 ppmF (rural) and 0.6-1.0 ppmF (rural) showed that the caries levels for each age group were not significantly different among the three fluoride communities or between urban and rural samples. In all three age groups, occlusal surfaces were more frequently affected by caries, and untreated dental caries was common. In part two of the survey, the Tooth Surface Index of Fluorosis (TSIF) was used to record fluorotic enamel defects among children aged 12 to 14 years who were life-long residents of 0.1-0.3 ppm fluoride and 0.6-1.0 ppm fluoride areas. In the low fluoride areas, mottling was absent in 97 per cent of facial surfaces of anterior maxillary teeth. In contrast, in the 0.6-1.0 ppm fluoride area, the value was 87 per cent. In both communities mottling was limited to a whitish colour. Analysis of the highest TSIF scores revealed that statistically significant differences were apparent in children with fluorosis between two communities.

  6. [The effect of different etching time on enamel lesions of deciduous teeth].

    PubMed

    Song, Li-yuan; Wang, Jun

    2010-04-01

    To study the effect of etching time on the demineralization of deciduous teeth enamel using confocal laser scanning microscope. Twenty-eight primary incisors were used in this experiment. Each incisor was created 4 rectangular windows in the labial surface. The 4 windows of each tooth were randomly divided into 4 treatment groups with different etching time of 30s(A), 60s(B), 90s(C) and 120s(D). All the treatment groups were applied with 32% phosphoric acid gel. After staining by 0.1 mmol/L rhodamine B, the examination of the demineralization regions were performed by a confocal laser scanning microscope (CLSM). The data was analyzed by test of normality and S-N-K analysis with SPSS 11.0 software package. As the etching time increased, the CLSM band was thickening,but the scales-liked structure was becoming unsharp.All the three parameters, area of the fluorescent lesion(FLA), average lesion fluorescence(AF) and total lesion fluorescence(TF) were increasing. The FLA value of A,B,C,D were (5.5 + or - 1.6) x 10(2) microm(2), (7.4 + or - 2.7) x 10(2) microm(2), (9.2 + or - 3.0) x 10(2)microm(2), (9.6 + or - 2.9) x 10(2) microm(2); The TF value of A,B,C,D were (3.5 + or - 1.3) x 10(4), (5.7 + or - 2.9) x 10(4), (8.3 + or - 3.6) x 10(4), (9.7 + or - 3.4) x 10(4); The AF value of A,B,C,D were 128.4 + or - 35.3,166.6 + or - 21.1, 200.8 + or - 19.4 and 219.1 + or - 12.8,respectively. The pairwise comparison of AF showed significant difference between the four groups, while there was no significant difference between group C(90s) and group D(120s) in both FLA and TF. The degree of demineralization increases with the etching time. Etching time has a large effect on the profile of demineralization.Supported by Research Fund of Science and Technology Commission of Shanghai Municipality(Grant No.074119644 and 08DZ2271100) and Shanghai Leading Academic Discipline Project (Grant No.S30206).

  7. Serial removal of caries lesions from tooth occlusal surfaces using near-IR image-guided IR laser ablation

    NASA Astrophysics Data System (ADS)

    Chan, Kenneth H.; Tom, Henry; Darling, Cynthia L.; Fried, Daniel

    2015-02-01

    Previous studies have established that caries lesions can be imaged with high contrast without the interference of stains at near-IR wavelengths greater than 1300-nm. It has been demonstrated that computer controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, we report our progress towards the development of algorithms for generating rasterized ablation maps from near-IR reflectance images for the removal of natural lesions from tooth occlusal surfaces. An InGaAs camera and a filtered tungsten-halogen lamp producing near-IR light in the range of 1500-1700-nm were used to collect crosspolarization reflectance images of tooth occlusal surfaces. A CO2 laser operating at a wavelength of 9.3- μm with a pulse duration of 10-15-μs was used for image-guided ablation.

  8. Serial removal of caries lesions from tooth occlusal surfaces using near-IR image-guided IR laser ablation.

    PubMed

    Chan, Kenneth H; Tom, Henry; Darling, Cynthia L; Fried, Daniel

    2015-02-24

    Previous studies have established that caries lesions can be imaged with high contrast without the interference of stains at near-IR wavelengths greater than 1300-nm. It has been demonstrated that computer controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, we report our progress towards the development of algorithms for generating rasterized ablation maps from near-IR reflectance images for the removal of natural lesions from tooth occlusal surfaces. An InGaAs camera and a filtered tungsten-halogen lamp producing near-IR light in the range of 1500-1700-nm were used to collect crosspolarization reflectance images of tooth occlusal surfaces. A CO2 laser operating at a wavelength of 9.3- μm with a pulse duration of 10-15-μs was used for image-guided ablation.

  9. The wolf in sheep’s clothing: Microtomographic aspects of clinically incipient radiation-related caries

    PubMed Central

    Morais-Faria, Karina; Neves-Silva, Rodrigo; Lopes, Marcio-Ajudarte; Ribeiro, Ana-Carolina-Prado; de Castro Jr, Gilberto; da Conceição-Vasconcelos, Karina-Gondim-Moutinho; Brandão, Thais-Bianca; Santos-Silva, Alan-Roger

    2016-01-01

    Background Radiation-related caries (RRC) can cause rapid progression, with a high potential for dental destruction affecting mainly cervical and incisal areas. Unlike the injuries that occur in the conventional caries, incipient RRC present in unusual surfaces have difficult diagnosis and classification stages of cavitation. Material and Methods Evaluate the radiographic patterns of demineralization of RRC by using micro-CT. Ten teeth with incipient RRC and 10 teeth with incipient conventional caries (control group) matched by anatomic teeth group and caries affected surfaces were evaluated by X-ray microtomography (micro-CT) Skyscan 1174V2 (50Kv, 1.3 megapixel, Kontich, Belgium). Teeth were placed in a standard position for micro-CT (coronal, transaxial and sagittal sections) during images acquisition. Lesions were classified according to the depth of invasion and relationship with enamel, dentin and pulp. Results RRC samples presented deeper lesions with higher involvement of enamel and dentin. Control group presented focal and superficial lesions with lower involvement of enamel and dentin. Conclusions Incipient RRC present aggressive microtomographic patterns of demineralization when compared to conventional caries, as indicated by deep lesions, regardless of its clinically incipient aspects. Key words:Head and neck cancer, radiotherapy, microtomography, radiation caries. PMID:26946198

  10. A comparative evaluation of remineralizing ability of bioactive glass and amorphous calcium phosphate casein phosphopeptide on early enamel lesion

    PubMed Central

    Palaniswamy, Udaya Kumar; Prashar, Neha; Kaushik, Mamta; Lakkam, Surender Ram; Arya, Shikha; Pebbeti, Swetha

    2016-01-01

    Background: This study was done to evaluate remineralizing potential of bioactive glasses (BAGs) and amorphous calcium phosphate-casein phosphopeptide (ACP-CPP) on early enamel lesion. Materials and Methods: Twenty freshly extracted mandibular premolars were sectioned sagittally. The buccal half was impregnated in acrylic resin blocks and treated with 37% phosphoric acid in liquid form, to demineralize enamel surface to simulate early enamel lesion. The samples were divided into two groups. The samples in Group I were treated with ACP-CPP (GC Tooth Mousse) and in Group II with BAG (Sensodyne Repair and Protect) and stored in saliva to prevent dehydration. The samples were tested for microhardness. The data obtained was analyzed using ANOVA post hoc multiple comparison and independent sample t- test and presented as a mean and standard deviation. Results: All the samples showed a decrease in the microhardness after demineralization. After application of remineralizing agents, Group II showed a highly significant increase in the microhardness (P < 0.05) after 10 days, while Group I showed a significant increase in microhardness after 15 days (P < 0.05). Conclusion: Both the remineralizing agents tested in this study can be considered effective in repair and prevention of demineralization. BAG showed better results initially, but eventually both have similar remineralizing potential. PMID:27605985

  11. Enamel loss associated with orthodontic adhesive removal on teeth with white spot lesions: an in vitro study.

    PubMed

    Tüfekçi, Eser; Merrill, Thomas E; Pintado, Maria R; Beyer, John P; Brantley, William A

    2004-06-01

    Teeth with white spot lesions (WSL) might be more prone to enamel loss during bracket debonding. This in vitro study compared enamel loss from teeth with (n = 14) and without (n = 14) WSL after polishing with low-speed finishing burs or disks (Sof-Lex, 3M ESPE, St Paul, Minn). Debonded surfaces were analyzed with a contact stylus profilometer, and digitized data were compared with baseline readings by using AnSur NT software (Regents, University of Minnesota, Minneapolis, Minn). Specimen surfaces were also examined with a scanning electron microscope. Two-way analysis of variance was performed to analyze the data. In teeth without WSL, the volume losses were 0.16 mm(3) for the bur group and 0.10 mm(3) for the disk group; the mean maximum depths were 47.7 microm for the bur group and 54.3 microm for the disk group. In teeth with WSL, the volume losses were 0.06 and 0.17 mm(3), and the mean maximum depths were 35.1 and 48.7 microm for the bur and disk groups, respectively. There were no significant differences in enamel loss between the 2 groups of teeth without WSL (P =.12). However, in teeth with WSL, the burs removed less enamel than the disks (P = 0.006). Scanning electron microscope examination showed that any damage on the enamel surface was usually located in the cervical third of the teeth. On most specimens, even though tooth surfaces appeared resin-free to the naked eye, there were remnants of it. The differences between groups were so small that they might be clinically insignificant.

  12. Reversal of primary root caries using a dentifrice with a high fluoride content.

    PubMed

    Lynch, E; Baysan, A

    2001-01-01

    Root caries is a widespread problem and can be quite serious in older populations. The restoration of root carious lesions is often difficult. Compared to enamel caries, there has been limited research into the pharmaceutical management of primary root caries lesions (PRCLs), and many of these studies have been carried out in vitro, with limited numbers of clinical trials. Fluoride is presently a cornerstone in dentifrice formulations for cost-effective and anticaries therapy. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse PRCLs, since more fluoride is required for the remineralization of roots than for enamel. This paper reviews the effects of dentifrices with high fluoride contents on the management of root caries.

  13. The influence of the caries definition on disease prevalence and distribution in 20-23 year old persons in Stockholm.

    PubMed

    Wikner, S

    1993-01-01

    The aim was to investigate to what extent an extension of the caries criterion into the dentin, may influence the need for therapeutical intervention. Using a computerized technic, the depth of all approximal lesions in posterior teeth in 151 persons, aged 20 and 23 years, were measured on magnified (x5) radiographs and expressed as per cent of the enamel width. The proportion diseased 20 year old persons was 88% if the criterion was any sign of caries but only 50% if the criterion was at least one lesion, reaching the dentin. When caries was defined as a lesion having a depth, corresponding the double enamel width the figure was 11% and the proportion surfaces in need of therapeutical treatment constituted 2% of the total caries volume. It is concluded that an extension of the filling criterion into the superficial layers of the dentin may reduce the need for filling therapy in 20 year old persons to a very low level.

  14. Eroded enamel lesion remineralization by saliva as a possible factor in the site-specificity of human dental erosion.

    PubMed

    Amaechi, B T; Higham, S M

    2001-08-01

    The composition and flow of saliva, which determine its functions, vary within intraoral sites and among individuals. Also, the susceptibility to tooth erosion reportedly varies among individuals and within the dental arches. A possible effect of saliva on early-eroded lesions may be a contributory factor. The aims here were firstly to determine the remineralization of eroded enamel lesions by saliva, and secondly to investigate any variation of this remineralization within the dental arches and among individuals. Early enamel erosion was produced on human premolars using orange juice. Control sections and two test slabs were cut from each tooth. The two slabs from the same lesion were bonded with composite resins to the palatal surface of upper right lateral incisor teeth and the lingual surface of the lower right lateral incisor teeth of volunteers, who then chewed a sugar-free gum four times daily. After 28-day intraoral exposure, mineral loss (DeltaZ) and lesion depth (ld) were quantified using microradiography and the data analysed by paired t-test (n=10, alpha=0.05). Mean DeltaZ was significantly lower in the group of slabs positioned palatally (P<0.001) and lingually (P<0.001) when compared with the control group, and in the lingually placed group when compared with the palatally positioned (P<0.01). A significantly lower ld was observed in the group of slabs positioned palatally (P<0.05) and lingually (P<0.001) when compared with the control group, and in the lingually positioned group when compared with the palatally placed (P<0.05). It was concluded that saliva can remineralize early enamel erosion, and that the degree of remineralization varies within intraoral sites and may be responsible for the differing susceptibility to erosion within the dental arches.

  15. An in vitro evaluation of selective demineralised enamel removal using bio-active glass air abrasion.

    PubMed

    Banerjee, Avijit; Pabari, Hiten; Paolinelis, George; Thompson, Ian D; Watson, Timothy F

    2011-12-01

    Unnecessary over-preparation of carious enamel often occurs clinically during operative caries management. The working hypothesis to be investigated in this study is the potential for bio-active glass air abrasion to remove selectively only demineralised enamel in artificial enamel lesions when compared to equivalent alumina air abrasion, so potentially minimising cavity over-preparation. Bisected artificial, paired smooth surface enamel lesions on ethics-approved, extracted sound human molars were created and subsequently air abraded with 27 μm alumina (n = 19) and bio-active glass (n = 19). The difference between pre-operative lesion boundary and post-operative cavity margin was calculated following optical confocal fluorescent assessment of the lesion boundary. Data indicated mean% over-preparation (sound enamel removal) of 176% with alumina and 15.2% for bio-active glass (p = 0.005). Bio-active glass abrasion removed completely the demineralised enamel from artificial lesions with clinically insignificant over-preparation of sound tissue, indicating technique selectivity towards grossly demineralised enamel. Alumina air abrasion resulted in substantial enamel removal in both sound and demineralised tissues indicating the operator selectivity required to use the techniques effectively in clinical practice.

  16. Brief communication: a pilot study: smooth surface early caries (caries incipiens) detection with KaVo DIAGNODent in historical material.

    PubMed

    Tomczyk, Jacek; Komarnitki, Iulian; Olczak-Kowalczyk, Dorota

    2013-03-01

    In many odontological studies concerning archeological material, there is no analysis of early caries lesions (caries incipiens) that manifest as a carious spot. At this stage of caries, the enamel is still hard, and thus, it is impossible to diagnose caries by visual methods. We assessed the usefulness of the DIAGNODent pen (DD laser) in analyzing noncavity lesions on the smooth surface sites of crowns from historical populations. Twenty-seven individuals were examined: 18 from Radom (Poland), and nine from Tell Masaikh and Terqa (Syria). A total of 562 teeth were characterized. The series represented different climatic zones, but were dated from the similar period, 18th to 19th century AD. We used four diagnostic techniques: visual, DD laser, radiographic, and histological as the gold standard. DD laser showed that the mean values of healthy enamel in both series did not exceed 15 units. The mean values of smooth and rough spots in the Syrian population were significantly higher than those from Poland. This study showed that all the noncarious spots from the Radom series did not exceed 30 units. In the Syrian samples, this limit was higher at 44 units. These results were confirmed by histology and radiography. The DD laser provided good results in detecting dentine carious lesions in historical material, but its efficiency in diagnosing early caries (caries incipiens) remains uncertain based on the presented series.

  17. Methods Dentists Use to Diagnose Primary Caries Lesions Prior to Restorative Treatment: Findings from The Dental PBRN

    PubMed Central

    Rindal, D. Brad; Gordan, Valeria V.; Litaker, Mark S.; Bader, James D.; Fellows, Jeffrey L.; Qvist, Vibeke; Wallace-Dawson, Martha C.; Anderson, Mary L.; Gilbert, Gregg H.

    2012-01-01

    Objective To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. Methods A total of 228 DPBRN dentists recorded information on 5,676 consecutive restorations inserted due to primary caries lesions on 3,751 patients. Practitioner-investigators placed a mean of 24.9 (SD=12.4) restorations. Lesions were categorized as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorized as clinical assessment, radiographs, and/or optical. Statistical analysis utilized generalized mixed-model ANOVA to account for the hierarchical structure of the data. Results By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p<0.0001). Conclusion These results — obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios — quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics. PMID:20884316

  18. Surface pre-conditioning with bioactive glass air-abrasion can enhance enamel white spot lesion remineralization.

    PubMed

    Milly, Hussam; Festy, Frederic; Andiappan, Manoharan; Watson, Timothy F; Thompson, Ian; Banerjee, Avijit

    2015-05-01

    To evaluate the effect of pre-conditioning enamel white spot lesion (WSL) surfaces using bioactive glass (BAG) air-abrasion prior to remineralization therapy. Ninety human enamel samples with artificial WSLs were assigned to three WSL surface pre-conditioning groups (n=30): (a) air-abrasion with BAG-polyacrylic acid (PAA-BAG) powder, (b) acid-etching using 37% phosphoric acid gel (positive control) and (c) unconditioned (negative control). Each group was further divided into three subgroups according to the following remineralization therapy (n=10): (I) BAG paste (36 wt.% BAG), (II) BAG slurry (100 wt.% BAG) and (III) de-ionized water (negative control). The average surface roughness and the lesion step height compared to intra-specimen sound enamel reference points were analyzed using non-contact profilometry. Optical changes within the lesion subsurface compared to baseline scans were assessed using optical coherence tomography (OCT). Knoop microhardness evaluated the WSLs' mechanical properties. Raman micro-spectroscopy measured the v-(CO3)(2-)/v1-(PO4)(3-) ratio. Structural changes in the lesion were observed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy-energy dispersive X-ray spectrometry (SEM-EDX). All comparisons were considered statistically significant if p<0.05. PAA-BAG air-abrasion removed 5.1 ± 0.6 μm from the lesion surface, increasing the WSL surface roughness. Pre-conditioning WSL surfaces with PAA-BAG air-abrasion reduced subsurface light scattering, increased the Knoop microhardness and the mineral content of the remineralized lesions (p<0.05). SEM-EDX revealed mineral depositions covering the lesion surface. BAG slurry resulted in a superior remineralization outcome, when compared to BAG paste. Pre-conditioning WSL surfaces with PAA-BAG air-abrasion modified the lesion surface physically and enhanced remineralization using BAG 45S5 therapy. Copyright © 2015 Academy of Dental Materials. Published by Elsevier

  19. Is the morphology and activity of the occlusal carious lesion related to the lesion progression stage?

    PubMed

    Neves, Aline Almeida; Vargas, Daniel Otero Amaral; Santos, Thais Maria Pires; Lopes, Ricardo Tadeu; Sousa, Frederico Barbosa

    2016-12-01

    To investigate the relationship between degree of dentin demineralization with both lesion activity and morphology of the occlusal carious cavity. Occlusal sites (n=138) were identified by visual examination (Nyvad's scores 0-6) in 67 extracted teeth which were scanned in a high energy micro-CT. After 3D reconstruction, each stack was resliced in the mesio-distal direction and tooth mineral density (MD) was measured along a path from enamel to the deepest part of dentin in the slice showing the most severe carious involvement. Each site was classified in "open" or "closed" (if cavitated) depending on the morphology of the surrounding enamel walls as measured using micro-CT and as active or inactive in enamel or dentin by a clinical scoring system. Lesions showing dentin cavitation presented higher demineralization degree compared to non-cavitated, or enamel cavitated lesions. Inactive lesions presented lower demineralization degree compared to active lesions, although with a low effect size. According to the morphological aspect of the carious cavity, open enamel lesions showed lower dentin demineralization degree than closed lesion environments. Active lesions showed higher dentin demineralization degree than inactive ones, while lesions showing closed cavitation resulted in higher dentin demineralization degree only for enamel lesions. Including those parameters in treatment decisions may help to improve prognosis and increase effectiveness of the caries diagnostic systems in the clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Effects of a macrolide antibiotic on enamel formation in rat incisors--primary lesion of ameloblast at the transition stage.

    PubMed

    Abe, Toshio; Miyajima, Hiroaki; Okada, Kosuke

    2003-09-01

    A novel macrolide antibiotic was administered orally to 5-week-old Jcl:Wistar rats at a dose of 5,000 mg/kg/day for 5 weeks, and then a half of animals were maintained without any treatment for 10 weeks. A white discolored lesion with horizontal stripes developed on the surface of the upper and lower incisors after dosing for 4 weeks, and these macroscopical incisal lesions disappeared with the eruption in 4 weeks after stop of administration. Histopathologically, increase in number of karyopycnosis of ameloblast at the transitional stage, vacuolar degeneration of ameloblast and cystic change in the maturation stage, and impaired iron pigment secretion at the pigmentation stage were observed. Microradiography, calcio-traumatic zones, which means hypocalcification, were observed on the superficial layer of enamel. These results suggest that the primary lesion induced by a novel macrolide antibiotic is the increased karyopycnosis of ameloblast at the transitional stage, and followed by later stage.

  1. Shedding New Light on Early Caries Detection

    PubMed Central

    Choo-Smith, Lin-P'ing; Dong, Cecilia C.S.; Cleghorn, Blaine; Hewko, Mark

    2009-01-01

    Dental caries continues to be a common chronic disease among various population groups. Patient care can be improved with detection at the earliest stage. However, current techniques do not have sufficient sensitivity and specificity. We discuss 2 new methods — optical coherence tomography (OCT) and polarized Raman spectroscopy (PRS) — that are potentially useful for early caries detection and monitoring. OCT produces morphologic depth images of near-surface tissue structures with a resolution that is an order of magnitude greater than ultrasound imaging. Based on measurement of back-scattered near infrared light, OCT shows that sound enamel causes high-intensity back-scattering at the tooth surface that decreases rapidly with depth. In contrast, incipient lesions cause higher light back-scattering at the tooth surface and subsurface scattering indicative of porosity caused by demineralization. The scatter region within the enamel correlates well with the classical triangular shape of subsurface lesions observed in histologic sections. OCT imaging not only allows identification of incipient lesions, but also provides information on surface integrity and lesion depth. PRS furnishes biochemical information about the tooth's composition, mineral content and crystallinity. The depolarization ratio derived from the dominant phosphate peak of hydroxyapatite in sound teeth is consistently lower than that from incipient caries. This difference is attributed to the change in enamel crystallite morphology or orientation that occurs with acid demineralization. Thus, PRS can be used to confirm suspect lesions determined by OCT and rule out false-positive signals from non-carious anomalies. The combination of OCT and PRS provides a new detection method with high sensitivity and specificity that will improve caries management and patient care. Future studies are aimed at developing intraoral probes to validate the findings in vivo. PMID:19126361

  2. Genetic Variation in MMP20 Contributes to Higher Caries Experience

    PubMed Central

    Tannure, Patricia Nivoloni; Kuchler, Erika Calvano; Lips, Andrea; de Castro Costa, Marcelo; Luiz, Ronir Raggio; Granjeiro, Jose Mauro; Vieira, Alexandre Rezende

    2012-01-01

    Summary Matrix metalloproteinases play an important role during the initial process of enamel development and therefore may play a role in caries. Objectives To evaluate the association between MMP20 and caries experience in Brazilian children. Methods Eligible unrelated children with or without caries were evaluated using a cohort design. Demographic data and oral health habits were obtained though a questionnaire. Caries data was collected by clinical examination. Genotyping of the selected polymorphism was carried out by real-time PCR from genomic DNA. Allele and genotype frequencies were compared between groups with distinct caries experience and oral health habits. Results Of 388 subjects, 161 were caries free children. There were no differences between caries levels and genotype distribution in the total cohort. When ethnic background was considered, differences in genotype distribution were observed in caries free children versus children with caries in Caucasians (p=0.03). Differences could also be seen when poor oral hygiene was used to stratify the analysis (p=0.02). Regression analysis, adjusted for genotype and ethnicity, confirmed that ingestion of sweets between meals increases the risk of presenting carious lesions (p=0.00001; OR=2.33; 95%CI 1.53–3.54). Conclusion Variation in MMP20 may be associated with caries experience mainly in Caucasian subjects with poor oral health habits. PMID:22330321

  3. Intraoral pH measurement of carious lesions with qPCR of cariogenic bacteria to differentiate caries activity.

    PubMed

    Kuribayashi, Megumi; Kitasako, Yuichi; Matin, Khairul; Sadr, Alireza; Shida, Kanako; Tagami, Junji

    2012-03-01

    A low pH environment is created by cariogenic bacteria. This study was aimed to measure pH of carious lesions intraorally using a micro-pH sensor, and assess predominant acid-producing cariogens by qPCR to differentiate caries activities. 103 dentine lesions classified as active or arrested caries based on the clinical and radiological examinations were collected from patients after intraoral measurement of the lesion surface pH using a micro-pH sensor. Quantitative detection of genomic DNA copies of target cariogenic bacteria (mutans streptococci and Lactobacillus spp.) in each lesion was performed using real-time PCR. Correlation between the pH ranges and the number of bacterial species was examined by Spearman test. 50 samples were diagnosed as active and 53 as arrested lesions. Statistically significant difference was observed on average surface pH value between active and arrested lesions (p<0.05). Prevalence of Lactobacillus spp. was higher in active lesions than in arrested lesions (76% vs. 58% of samples, respectively). When the carious lesions were categorised into four different pH ranges (up to 5.5, from 5.6 to 5.8, from 5.9 to 6.1 and 6.2 or above), increased prevalence of Lactobacillus spp. was observed with decrease of pH levels. A significant negative relationship was found between pH value and number of Lactobacillus spp. (r=-0.209, p<0.05) but no such correlation was found for mutans streptococci. Intraoral pH measurement might be clinically useful to determine acidity of the local environment of carious lesions as one aspect of the caries activity assessment. The population of certain bacteria may indicate activity of carious lesions. Intraoral pH measurement of the carious lesions using a micro-pH sensor may be a clinically feasible method for assessment of lesion acidity. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Retrospective Assessment of Caries Experience Among U.S. Naval Academy Midshipmen

    DTIC Science & Technology

    2012-06-01

    enamel .   Dental  Caries  Prevalence  and  Incidence   Epidemiological  studies  have  provided  an...radiographs  of  the  rate  of  progression  of  approximal  carious  lesions  through  human   dental   enamel .    Arch...Wu  T.    Surveillance  for   dental   caries,   dental  sealants,  tooth  retention,

  5. Dye-enhanced laser fluorescence detection of caries lesions around brackets.

    PubMed

    Alencar, Cássio José Fornazari; Braga, Mariana Minatel; de Oliveira, Elisabeth; Nicolau, José; Mendes, Fausto Medeiros

    2009-11-01

    The aim was to evaluate the performance of DIAGNOdent [laser fluorescence(LF) and LFpen] devices enhanced by fluorescent dye in detecting mineral loss around brackets and comparing the inhibitory effect of bonding material on artificial demineralization, and to verify whether LF methods show the same trends of mineral loss. Brackets were bonded to premolar halves with Fuji Ortho LC, Transbond XT, and Ortho Glass LC cements (n = 15). The teeth were soaked in demineralizing solution (pH = 4.8) for 16 days. Mineral loss was calculated by atomic emission spectrometry, and lesions were measured with LF devices with dye [tetrakis N-methylpyridyl porphyrin (TMPyP)]. Groups were compared with regard to LF readings and mineral loss, and performance of caries detection was calculated. Higher mineral loss and LF-TMPyP values occurred in the resin group. LFpen-TMPyP readings were significantly higher in the demineralized groups. Correlation was observed between mineral loss and LF measurements. LF methods are capable of identifying lower demineralization around brackets bonded with resin-modified glass ionomer cements.

  6. A Comparative Analysis of Caries Inhibitory Effect of Remineralizing Agents on Human Enamel Treated With Er:YAG Laser: An In-vitro Atomic Emission Spectrometry Analysis

    PubMed Central

    Nair, Aswin Saseendran; Kumar, R Krishna; Ahameed, Syed Shaheed; Punnathara, Sairaj; Peter, Joby

    2016-01-01

    Introduction The tug of war to maintain tooth integrity is dependent on a ratio between demineralization and remineralization. Hence, demineralization should be retarded and remineralization should be enhanced to maintain a natural equilibrium in the oral cavity. Aim To compare in-vitro acid resistance of human enamel when using Casein Phosphopeptides Amorphous Calcium Phosphate (CPP-ACP) [GC Tooth mousse] cream, Casein Phosphopeptide Amorphous Calcium Fluoride Phosphate (CPP-ACFP) [GC Tooth mousse plus] cream, Er:YAG laser alone, combination of CPP-ACP with Er:YAG laser, CPP-ACFP with Er:YAG laser. Materials and Methods An in-vitro study was done on 100 specimens which were prepared from 50 human premolars to investigate the caries inhibitory effect of remineralizing agents and laser on enamel using an atomic emission spectrometry analysis. The enamel specimens were randomly allocated into 6 groups: Untreated (control); CPP-ACP (GC Tooth mousse); CPP-ACFP (GC Tooth mousse plus); Er:YAG laser treatment alone; CPP-ACP with Er:YAG laser; CPP-ACFP with Er: YAG laser. Then specimens were immersed individually in 5ml of acetate buffer solution (0.1mol/L, pH 4.5) and incubated at 37°C for 24 hours, to determine the acid resistance by analyzing the calcium release using atomic emission spectrometry. An ANOVA model was constructed (p-value 0.05), followed by post-hoc Tukey’s test for multiple pair wise comparisons of mean values. Results There was a significant difference among the various groups with respect to amount of calcium released (p<0.001). The lowest mean score of calcium release was observed for CPP-ACFP with Er:YAG laser followed by CPP-ACFP but the differences between these groups were statistically not significant (p>0.05). Similarly the differences between CPP-ACP with Er:YAG laser and CPP-ACP also were not significant (p>0.05). The highest mean score of calcium release was for Er:YAG laser and no significant statistical difference was noticed in

  7. The caries balance: the basis for caries management by risk assessment.

    PubMed

    Featherstone, John D B

    2004-01-01

    Dental caries progression or reversal depends upon the balance between demineralization and remineralization. The 'Caries Balance' is determined by the relative weight of the sums of pathological factors and protective factors. Minimally invasive dentistry aims at the least possible removal of enamel or dentin, including reducing pathological factors and enhancing remineralization to avoid any removal of hard tissues. A structured caries risk assessment should be carried out based upon the concept of the caries balance. Following the risk assessment a treatment plan is devised which leads to the control of dental caries for the patient. The balance between pathological and preventive factors can be swung in the direction of caries intervention and prevention by the active role of the dentist and his/her auxiliary staff. Much is now understood about the mechanism of dental caries. We have known for a long time that demineralization of enamel, dentin or cementum is caused by organic acids that are generated by so-called acidogenic bacteria in the plaque when these bacteria feed upon fermentable carbohydrates (Silverstone, 1973; Featherstone, 2000; Loesche, 1986). The natural repair process is remineralization, which occurs when the pH rises again and calcium and phosphate from saliva together with fluoride enter the subsurface region of the lesion and form a new veneer on the existing crystal remnants in the lesion (Ten Cate and Featherstone, 1991). This veneer is less soluble than the original mineral and resists further acid attacks. The key to improved dental health for all is now for the dental profession to embrace this knowledge and put it into practice in the real world, to inhibit caries formation and progression, and to enhance the natural repair process.

  8. Minimal intervention dentistry II: part 3. Management of non-cavitated (initial) occlusal caries lesions--non-invasive approaches through remineralisation and therapeutic sealants.

    PubMed

    Holmgren, C; Gaucher, C; Decerle, N; Doméjean, S

    2014-03-01

    Epidemiological data on dental caries show that prevention and treatment needs have evolved significantly over the past two decades. In younger patients the distribution of caries lesions is mainly found on the occlusal surfaces. The treatment approaches utilised by dentists must evolve to integrate preventive and treatment solutions tailored to the care needs, which are straightforward to implement in the dental office and whose effectiveness is underpinned by scientific evidence. This article aims to describe the principles of non-invasive management of non-cavitated (initial) occlusal caries lesions, based on evidence from recent studies published in the international literature.

  9. Stress and strain distribution in demineralized enamel: A micro-CT based finite element study.

    PubMed

    Neves, Aline Almeida; Coutinho, Eduardo; Alves, Haimon Diniz Lopes; de Assis, Joaquim Teixeira

    2015-10-01

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

  10. Imaging laser irradiated enamel surfaces with polarization sensitive optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Hsu, Dennis J.; Darling, Cynthia L.; Fried, Daniel

    2008-02-01

    Several studies have shown that lasers can be used to modify the surface morphology and chemical composition of tooth enamel to render it less soluble. Other studies have shown that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to non-destructively measure the efficacy of fluoride in inhibiting the development of artificial caries lesions. The purpose of this study was to determine if PS-OCT can be used to measure inhibition of enamel demineralization after CO II laser irradiation. Polarized light microscopy and microradiography were used to measure lesion severity on histological thin sections for comparison. PS-OCT was able to measure a significant reduction in the integrated reflectivity due to inhibition by the laser even though the laser modification of the enamel surface caused a slight increase in reflectivity. This study shows that the PS-OCT is well-suited for in vivo measurements of caries inhibition after laser treatments.

  11. Near-infared hyperspectral imaging of teeth for dental caries detection

    NASA Astrophysics Data System (ADS)

    Zakian, Christian; Pretty, Iain; Ellwood, Roger

    2009-11-01

    Near-infrared (NIR) is preferred for caries detection compared to visible light imaging because it exhibits low absorption by stain and deeper penetration into teeth. Hyperspectral images from 1000 to 2500 nm have been obtained for a total of 12 extracted teeth (premolars and molars) with different degrees of natural lesion. Analysis of the reflectance spectra suggests that light scattering by porous enamel and absorption by water in dentin can be used to quantify the lesion severity and generate a NIR caries score. Teeth were ground for histological examination after the measurements. The NIR caries score obtained correlates significantly (Spearman's correlation of 0.89, p<0.01) with the corresponding histological score. Results yield a sensitivity of >99% and a specificity of 87.5% for enamel lesions and a sensitivity of 80% and a specificity >99% for dentine lesions. The nature of the technique offers significant advantages, including the ability to map the lesion distribution rather than obtaining single-point measurements, it is also noninvasive, noncontact, and stain insensitive. These results suggest that NIR spectral imaging is a potential clinical technique for quantitative caries diagnosis and can determine the presence of occlusal enamel and dentin lesions.

  12. Comparison of the incipient lesion enamel fluoride uptake from various prescription and OTC fluoride toothpastes and gels.

    PubMed

    Schemehorn, B R; DiMarino, J C; Movahed, N

    2014-01-01

    The objective of this in vitro study was to compare the fluoride uptake into incipient enamel lesions of a novel 970 ppm F- ion SnF2 over-the-counter (OTC) gel (Enamelon Preventive Treatment Gel) and a novel 1150 ppm F- ion OTC toothpaste (Enamelon), each delivering amorphous calcium phosphate (ACP), to the uptake from two different prescription strength, 5000 ppm F- ion dentifrices containing tri-calcium phosphate (TCP) and a prescription 900 ppm F- ion paste containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP). The test procedure followed method #40 in the US-FDA Anticaries Drug Products for OTC Human Use, Final Monograph testing procedures. Eight sets of twelve incisor enamel cores were mounted in Plexiglas rods and the exposed surfaces were polished. The indigenous fluoride levels of each specimen were determined prior to treatment. The treatments were performed using slurries of a negative control (water) and the following products applied to a set of sound enamel cores: 5000 ppm F- ion, sodium fluoride (NaF) prescription (Rx) dentifrice "A" containing TCP; 5000 ppm F- ion, NaF Rx dentifrice "B" containing TCP; 900 ppm F- ion, NaF Rx paste with CPP-ACP; 1150 ppm F- ion, NaF OTC toothpaste; 1150 ppm F- ion, stannous fluoride (SnF2) OTC toothpaste delivering ACP (Enamelon); 1100 ppm F- ion, SnF2 OTC toothpaste; and 970 ppm F- ion, SnF2 OTC gel delivering ACP (Enamelon Preventive Treatment Gel). The twelve specimens of each group were immersed into 25 ml of their assigned slurry with constant stirring (350 rpm) for 30 minutes. Following treatment, one layer of enamel was removed from each specimen and analyzed for fluoride and calcium. The pre-treatment fluoride (indigenous) level of each specimen was subtracted from the post-treatment value to determine the change in enamel fluoride due to the test treatment. The increase in the average fluoride uptake for treated enamel cores was: 10,263 ± 295 ppm for the 970 ppm F- ion, Enamelon Preventive

  13. Insights into the Virulence Traits of Streptococcus mutans in Dentine Carious Lesions of Children with Early Childhood Caries.

    PubMed

    Bezerra, Daniela S; Stipp, Rafael N; Neves, Beatriz G; Guedes, Sarah F F; Nascimento, Marcelle M; Rodrigues, Lidiany K A

    2016-01-01

    Streptococcus mutans is an oral bacterium considered to play a major role in the development of dental caries. This study aimed to investigate the prevalence of S. mutans in active and arrested dentine carious lesions of children with early childhood caries and to examine the expression profile of selected S. mutans genes associated with survival and virulence, within the same carious lesions. Dentine samples were collected from 29 active and 16 arrested carious lesions that were diagnosed in preschool children aged 2-5 years. Total RNA was extracted from the dentine samples, and reverse transcription quantitative real-time PCR analyses were performed for the quantification of S. mutans and for analyses of the expression of S. mutans genes associated with bacterial survival (atpD, nox, pdhA) and virulence (fabM and aguD). There was no statistically significant difference in the prevalence of S. mutans between active and arrested carious lesions. Expression of the tested genes was detected in both types of carious dentine. The pdhA (p = 0.04) and aguD (p = 0.05) genes were expressed at higher levels in arrested as compared to active lesions. Our findings revealed that S. mutans is part of the viable microbial community in active and arrested dentine carious lesions. The increase in expression of the pdhA and aguD genes in arrested lesions is likely due to the unfavourable environmental conditions for microbial growth, inherent to this type of lesions. © 2016 S. Karger AG, Basel.

  14. Air-rotor stripping and enamel demineralization in vitro.

    PubMed

    Twesme, D A; Firestone, A R; Heaven, T J; Feagin, F F; Jacobson, A

    1994-02-01

    This investigation sought to evaluate the effects of air-rotor stripping on the susceptibility of human enamel to demineralization using an in vitro caries model. Crowns of extracted premolar teeth were abraded (0.5 mm) on one proximal surface by air-rotor stripping. The teeth were placed in a demineralizing gel and removed at various intervals up to 336 hours. Lesion depth and mineral content on the abraded and intact surfaces was measured with contact microradiography and computerized image analysis (double window technique). For each time interval measured, lesion depth was greater (p < 0.05) on the abraded surfaces and mineral density was significantly less (p < 0.05). In a second experiment, the effect of fluoride supplements (dentifrice or topical gel) were examined on abraded and intact enamel surfaces that were exposed to the acid gel for 192 hours. The data showed that fluoride treatments significantly reduced lesion penetration on intact and abraded surfaces compared with a no fluoride group. Lesion depth on the abraded, fluoride treated surfaces was significantly greater (p < 0.05) than on the intact untreated surfaces. No significant differences (p < 0.05) were apparent between the fluoride treatment groups with respect to lesion depth and mineral density within the lesion. These results suggest that air-rotor stripping significantly increases the susceptibility of proximal enamel surfaces to demineralization. As a result, the clinician should use caution in the application of this technique until the long-term effects on caries susceptibility have been determined.

  15. In vitro Induction of residual caries lesions in dentin: comparative mineral loss and nano-hardness analysis.

    PubMed

    Schwendicke, Falk; Eggers, Kerrin; Meyer-Lueckel, Hendrik; Dörfer, Christof; Kovalev, Alexander; Gorb, Stanislav; Paris, Sebastian

    2015-01-01

    Artificially inducing dentinal lesions mimicking those remaining after selective excavation should allow to investigate the effects and limits of such selective excavation, for example regarding the mechanical properties of treated teeth or the remineralisation of sealed residual lesions. Such analyses might otherwise be limited by the variability of natural lesions or ethical and practical concerns. This study compared different demineralisation protocols for their suitability to induce lesions similar to natural residual caries. Twelve natural deep lesions were excavated until leathery dentin remained, and analysed for their mineral loss (ΔZ), lesion depth (LD), mineral loss ratio (R), the slope of the mineral gradient and their nano-hardness profile. Artificial lesions were induced using four different demineralisation protocols (acetic acid pH = 4.95; 0.1 M lactic acid gel pH = 5.0; 0.5 M ethylenediaminetetraacetic acid pH = 7.2; Streptococcus mutans biofilms) and their depths monitored over different demineralisation times. Lesions with depths most according to those of natural lesions were analysed using transversal microradiography. Lesions induced by acetic acid solution did not significantly differ with regards to LD, ΔZ, R and mineral profile. Seven dentin specimens were subsequently submitted to a moderately acidic (pH = 5.3) methylhydroxydiphosphonate-buffered acetate solution for 12 weeks. Natural and artificial residual lesions were similarly deep (mean ± SD: LD = 626 ± 212 and 563 ± 88 µm), demineralised (R = 19.5 ± 4.7 and 29.8 ± 4.1%), showed a flat and continuous mineral gradient (slope = 0.10 ± 0.05 and 0.13 ± 0.06 vol%/µm) and did not significantly differ regarding their nano-hardness profile. The described protocol induces lesions with mineral content and mechanical properties similar to natural residual lesions.

  16. Management of patients with active caries.

    PubMed

    Milgrom, Peter

    2014-07-01

    This paper reports on a mechanism to manage caries as a disease and to medically intervene in the disease process to halt progression. The goal of this paper is to provide this alternative to a surgical-only approach. The management of caries begins with assessing lesion activity and the potential for arrest. This requires a clinical and radiological assessment and evaluation of risk. Hopeless teeth are extracted and large cavities filled to reduce infection. Risk reduction strategies are employed so efforts to arrest lesions can be successful. Teeth with lesions in the enamel or outer third of the dentin should be sealed, not restored, as restorations can weaken teeth and can be traumatic to pulps.

  17. How do dental students determine patients' caries risk level using the Caries Management By Risk Assessment (CAMBRA) system?

    PubMed

    Doméjean, Sophie; Léger, Stéphanie; Rechmann, Peter; White, Joel M; Featherstone, John D B

    2015-03-01

    Research has demonstrated the validation of specific caries risk assessment (CRA) systems, but little is known about how dental practitioners assign a caries risk level to their patients. The aim of this study was to explore dental students' decision making in caries risk assignment when using the Caries Management By Risk Assessment (CAMBRA) system. Multiple correspondence analysis and chi-squared automated interaction detector analysis were performed on data collected retrospectively for a period of six years (2003-09) at the University of California, San Francisco predoctoral dental clinic. The study population consisted of 12,952 patients from six years of age through adult who received a baseline CRA during the period, were new to CAMBRA, and had not received any prior CAMBRA recommendations. The results showed variation in decision making and risk level assignment, illustrated by the range of percentages for the three scores (low, moderate, and high/extreme caries risk) when CRA was assigned for the first time. For those first-time CRAs, decision making was mainly based on four factors: cavities or caries lesions into dentin on radiograph, restorations during the last three years due to caries, visible heavy plaque, and interproximal lesions into enamel (by radiographs). This study's findings provide important data regarding one group of CAMBRA users and thus contribute to the development of knowledge about the implementation of caries risk assessment in contemporary dental practice.

  18. Hyperspectral laser-induced autofluorescence imaging of dental caries

    NASA Astrophysics Data System (ADS)

    Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

    2012-01-01

    Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentine and pulp. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Laser induced autofluorescence was shown to be a useful method for early detection of demineralization. The existing studies involved either a single point spectroscopic measurements or imaging at a single spectral band. In the case of spectroscopic measurements, very little or no spatial information is acquired and the measured autofluorescence signal strongly depends on the position and orientation of the probe. On the other hand, single-band spectral imaging can be substantially affected by local spectral artefacts. Such effects can significantly interfere with automated methods for detection of early caries lesions. In contrast, hyperspectral imaging effectively combines the spatial information of imaging methods with the spectral information of spectroscopic methods providing excellent basis for development of robust and reliable algorithms for automated classification and analysis of hard dental tissues. In this paper, we employ 405 nm laser excitation of natural caries lesions. The fluorescence signal is acquired by a state-of-the-art hyperspectral imaging system consisting of a high-resolution acousto-optic tunable filter (AOTF) and a highly sensitive Scientific CMOS camera in the spectral range from 550 nm to 800 nm. The results are compared to the contrast obtained by near-infrared hyperspectral imaging technique employed in the existing studies on early detection of dental caries.

  19. A randomized clinical trial of the anti-caries efficacy of 5,000 compared to 1,450 ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents.

    PubMed

    Ekstrand, K R; Poulsen, J E; Hede, B; Twetman, S; Qvist, V; Ellwood, R P

    2013-01-01

    Root caries is prevalent in elderly disabled nursing home residents in Denmark. This study aimed to compare the effectiveness of tooth brushing with 5,000 versus 1,450 ppm of fluoridated toothpaste (F-toothpaste) for controlling root caries in nursing home residents. The duration of the study was 8 months. Elderly disabled residents (n = 176) in 6 nursing homes in the Copenhagen area consented to take part in the study. They were randomly assigned to use one of the two toothpastes. Both groups had their teeth brushed twice a day by the nursing staff. A total of 125 residents completed the study. Baseline and follow-up clinical examinations were performed by one calibrated examiner. Texture, contour, location and colour of root caries lesions were used to evaluate lesion activity. No differences (p values >0.16) were noted in the baseline examination with regards to age, mouth dryness, wearing of partial or full dentures in one of the jaws, occurrence of plaque and active (2.61 vs. 2.67; SD, 1.7 vs.1.8) or arrested lesions (0.62 vs. 0.63; SD, 1.7 vs. 1.7) between the 5,000 and the 1,450 ppm fluoride groups, respectively. Mean numbers of active root caries lesions at the follow-up examination were 1.05 (2.76) versus 2.55 (1.91) and mean numbers of arrested caries lesions were 2.13 (1.68) versus 0.61 (1.76) in the 5,000 and the 1,450 ppm fluoride groups, respectively (p < 0.001). To conclude, 5,000 ppm F-toothpaste is significantly more effective for controlling root caries lesion progression and promoting remineralization compared to 1,450 ppm F-toothpaste. Copyright © 2013 S. Karger AG, Basel.

  20. Characterization of early dental caries by polarized Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Choo-Smith, Lin-P'ing; Ko, Alex C.-T.; Hewko, Mark D.; Dong, Cecilia C.; Cleghorn, Blaine M.; Sowa, Michael G.

    2006-02-01

    The early approximal caries lesion in enamel is observed clinically as a white spot and is difficult to detect and/or monitor with current methods available to dentists. New methods with high sensitivity and specificity are required to enable improved early dental caries diagnosis. Using unpolarized Raman spectroscopy to examine unsectioned teeth, peak intensity changes in the phosphate (PO 4 3-) vibrations (ν II, ν 3 and ν 4) were observed between spectra of sound and carious enamel. However, there is little change in the ν I vibration with this approach. In contrast, when tooth sections were examined by unpolarized Raman spectroscopy, marked changes in the ν I peak at 959 cm -1 were noted between healthy and carious enamel. These differences suggest that sampling orientation play a role in understanding the spectral changes. Using polarized Raman spectroscopy to examine unsectioned samples, cross polarized measurements from sound enamel exhibited significant reduction of the ν I peak compared with parallel polarized measurements. A similar reduction was observed with carious enamel, however, the reduction was not as prominent. By calculating the depolarization ratio of the area under the ν I peak, sound enamel can be clearly distinguished from demineralized regions. The spectral changes observed are attributed to changes in the structure and/or orientation of the apatite crystals as a result of the acid demineralization process.

  1. Comparative analysis of optical coherence tomography signal and microhardness for demineralization evaluation of human tooth enamel

    NASA Astrophysics Data System (ADS)

    de Cara, Ana Claudia Ballet; Zezell, Denise Maria; Ana, Patricia A.; Deana, Alessandro Melo; Amaral, Marcello Magri; Dias Vieira, Nilson, Jr.; de Freitas, Anderson Zanardi

    2012-06-01

    The diagnosis of dental caries at an early stage enables the implementation of conservative treatments based on dental preservation. Several diagnostic methods have been developed, like visual-tactile and radiographic are the most commons but are limited for this application. The Optical Coherence Tomography is a technique that provides information of optical properties of enamel, which may change due to the decay process. The objective of this study was to evaluate the ability of OCT to detect different stages of demineralization of tooth enamel during the development of artificial caries lesions, taking as a reference standard for comparison sectional microhardness testing. Different stages of caries lesions were simulated using the pH cycling model suggested Feathestone and modified by Argenta. The samples were exposed to 0 (control group), 5, 10, 15, 20 and 25 days at a daily regimen of three hours demineralization followed by remineralization during 20 hours. It was used an OCT system with at 930nm. Sectional images were generated in all lesion region. The results obtained from the OCT technique presented similar behavior to microhardness, except for the group 25 days, due to inability to perform indentations reading in areas of more intense demineralization. A linear relationship was observed between the OCT and microhardness techniques for detection of demineralization in enamel. This relationship will allow the use of OCT technique in quantitative assessment of mineral loss and for the evaluation of incipient caries lesions.

  2. Clinical monitoring of smooth surface enamel lesions using CP-OCT during nonsurgical intervention.

    PubMed

    Chan, Kenneth H; Tom, Henry; Lee, Robert C; Kang, Hobin; Simon, Jacob C; Staninec, Michal; Darling, Cynthia L; Pelzner, Roger B; Fried, Daniel

    2016-12-01

    Studies have shown that cross-polarization optical coherence tomography (CP-OCT) can be used to image the internal structure of carious lesions in vivo. The objective of this study was to show that CP-OCT can be used to monitor changes in the internal structure of early active carious lesions on smooth surfaces during non-surgical intervention with fluoride. Lesions on the smooth surfaces of teeth were imaged using CP-OCT on 17 test subjects. Lesion structural changes were monitored during fluoride varnish application at 6-week intervals for 30 weeks. The lesion depth (Ld ), integrated reflectivity (ΔR), and surface zone thickness (Sz ) were monitored. A distinct transparent surface zone that may be indicative of lesion arrestment was visible in CP-OCT images on 62/63 lesions before application of fluoride varnish. The lesion depth and internal structure were resolved for all the lesions. The overall change in the mean values for Ld , ΔR, and Sz for all the lesions was minimal and was not significant during the study (P > 0.05). Only 5/63 lesions manifested a significant increase in Sz during intervention. Even though it appears that most of the lesions manifested little change with fluoride varnish application in the 30 weeks of the study, CP-OCT was able to measure the depth and internal structure of all the lesions including the thickness of the important transparent surface zone located at the surface of the lesions, indicating that CP-OCT is ideally suited for monitoring lesion severity in vivo. Lasers Surg. Med. 48:915-923, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Enamel resistance to demineralization following Er:YAG laser etching for bonding orthodontic brackets

    PubMed Central

    Ahrari, Farzaneh; Poosti, Maryam; Motahari, Pourya

    2012-01-01

    Background: Several studies have shown that laser-etching of enamel for bonding orthodontic brackets could be an appropriate alternative for acid conditioning, since a potential advantage of laser could or might be caries prevention. This study compared enamel resistance to demineralization following etching with acid phosphoric or Er:YAG laser for bonding orthodontic brackets. Materials and Methods: Fifty sound human premolars were divided into two equal groups. In the first group, enamel was etched with 37% phosphoric acid for 15 seconds. In the second group, Er:YAG laser (wavelength, 2 940 nm; 300 mJ/pulse, 10 pulses per second, 10 seconds) was used for tooth conditioning. The teeth were subjected to 4-day PH-cycling process to induce caries-like lesions. The teeth were then sectioned and the surface area of the lesion was calculated in each microphotographs and expressed in pixel. The total surface of each specimen was 196 608 pixels. Results: Mean lesion areas were 7 171 and 7532 pixels for Laser-etched and Acid-etched groups, respectively. The two sample t-test showed that there was no significant difference in lesion area between the two groups (P = 0.914). Conclusion: Although Er:YAG laser seems promising for etching enamel before bonding orthodontic brackets, it does not reduce enamel demineralization when exposed to acid challenge. PMID:23162591

  4. Application of NIR Raman spectroscopy for detecting and characterizing early dental caries

    NASA Astrophysics Data System (ADS)

    Ko, A. C.; Choo-Smith, L.-P.; Zhu, R.; Hewko, M.; Dong, C.; Cleghorn, B.; Sowa, M. G.

    2006-02-01

    Early dental caries detection facilitates implementation of non-surgical methods for arresting caries progression and promoting tooth remineralization. We present a method based on Raman spectroscopy with near-IR laser excitation to provide biochemical contrast for detecting and characterizing incipient carious lesions found in extracted human teeth. Changes in Raman spectra are observed in PO 4 3- vibrations arising from hydroxyapatite of mineralized tooth tissue. Examination of various intensities of the PO 4 3- ν2, ν3, ν4 vibrations showed consistent increased intensities in spectra of carious lesions compared to sound enamel. The spectral changes are attributed to demineralization-induced alterations of enamel crystallite morphology and/or orientation. This hypothesis is supported by reduced Raman polarization anisotropy derived from polarized Raman spectra of carious lesions. Polarized Raman spectral imaging of carious lesions found on whole (i.e. un-sectioned) tooth samples will also be presented.

  5. OCT of early dental caries: a comparative study with histology and Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Hewko, Mark D.; Choo-Smith, Lin-P'ing; Ko, Alex C.; Leonardi, Lorenzo; Dong, Cecilia C.; Cleghorn, Blaine; Sowa, Michael G.

    2005-03-01

    Early dental caries result from destruction of the tooth's outer mineral matrix by acid-forming bacteria found in dental plaques. Early caries begin as surface disruptions where minerals are leached from the teeth resulting in regions of decreased mineral matrix integrity. Visually, these early carious regions appear as white spots due to the higher backscattering of incident light. With age these areas may become stained by organic compounds. Optical coherence tomography (OCT) examination of human teeth demonstrates a difference in penetration depth of the OCT signal into the carious region in comparison with sound enamel. However, while OCT demonstrates a structural difference in the enamel in the region of the caries, this technique provides little insight into the source of this difference. Raman spectroscopy provides biochemical measures derived from hydroxyapatite within the enamel as well as information on the crystallinity of the enamel matrix. The differences in the biochemical and morphological features of early caries and intact sound enamel are compared. Histological thin sections confirm the observations by OCT morphological imaging while Raman spectroscopy allows for biochemical identification of carious regions by a non-destructive method. Visual examination and conventional radiographic imaging of the intact tooth are used in clinical assessment prior to optical measurements. The combination of OCT, Raman spectroscopy and thin section histology aid in determining the changes that give rise to the visual white spot lesions.

  6. Remineralisation and arresting caries in children with topical fluorides.

    PubMed

    Gugnani, Neeraj; Gugnani, Shalini

    2017-06-23

    Data sourcesThe Cochrane Library, PubMed, Embase and the ISI Web of Science.Study selectionEnglish language clinical trials in children with outcome measures including the remineralisation or arresting effect of caries by professional fluoride treatment were considered.Data extraction and synthesisTwo reviewers screened the studies and assessed risk of bias. Random effects meta-analysis was conducted.ResultsSeventeen studies were included, ten focused on remineralisation, seven on arresting carious lesions. Meta-analysis of four studies using 5% fluoride varnish found a 63.6% (95% CI; 36.0% - 91.2%) remineralisation of early enamel caries. For five studies using 38% silver diamine fluoride solution meta-analysis found 65.9% (95% CI; 41.2% - 90.7%) of caries arrested.ConclusionsProfessionally applied 5% sodium fluoride varnish shows the capability to remineralise early enamel caries in children. Silver diamine fluoride solution at 38% is effective in arresting active dentine caries. Because the number of clinical trials that studied the arresting effect of dental caries is limited, more clinical trials should be performed.

  7. DENTAL CARIES

    PubMed Central

    Boucher, George O.

    1951-01-01

    The most generally accepted theory as to the cause of dental caries is that certain bacteria in the mouth, in the presence of fermentable sugars, cause the formation of acids which in turn decalcify teeth. Physicians may help reduce the incidence of caries by recommending elimination of refined sugars from the diet, or at least control of the amount consumed. Cleaning the teeth with a well designed tooth brush after each meal will to a certain extent mechanically remove the fermentable sugar and debris from the teeth. One step further in oral hygiene that may be beneficial is to use a dentifrice with 5 per cent dibasic ammonium phosphate and 3 per cent urea to reduce the formation of acid. Anything that will increase salivation will aid in buffering any acids that may be present. A 2 per cent solution of sodium fluoride applied to the thoroughly dried “intact” enamel surface may prevent caries. Sodium fluoride added to drinking water to a concentration of 1 part per million is utilized by the body in formation of an enamel that is particularly resistant to caries. PMID:14801729

  8. Reproducibility and diagnostic outcomes of two visual-tactile criteria used by dentists to assess caries lesion activity: a cross-over study.

    PubMed

    Tikhonova, S M; Feine, J S; Pustavoitava, N N; Allison, P J

    2014-01-01

    The aim of this study was to evaluate the reproducibility and differences in diagnostic outcomes by practicing dental clinicians previously inexperienced in using the Nyvad criteria and the ICDAS II criteria with the Lesion Activity Assessment system (ICDAS II + LAA). Four volunteer dentists were randomly allocated to one of two groups. Both groups of dentists examined the same voluntary sample (n = 140) of caries active young adults using Nyvad and ICDAS II + LAA criteria in different sequences. The first group used the Nyvad criteria during period 1, followed by ICDAS II + LAA during period 2; the second group did the examinations in the opposite sequence. Before the period 1 and 2 examinations, dentists from both groups were trained with the Nyvad or ICDAS II + LAA criteria, depending on the group to which they were assigned. Intra-examiner agreement for lesion severity was high for both diagnostic instruments (weighted kappa 0.62-0.80). For lesion activity the intra-examiner unweighted kappa values ranged from 0.31 to 0.61 for ICDAS II + LAA and from 0.36 to 0.51 for Nyvad. The mean number of active non-cavitated caries lesions was significantly higher for ICDAS II + LAA (6.14 ± 5.4) than for Nyvad (3.90 ± 3.9) (p < 0.001). Active cavitated/dentinal caries lesions were significantly higher for ICDAS II + LAA (4.14 ± 4.1) than for Nyvad (2.13 ± 3.1) (p < 0.001). Both the Nyvad and ICDAS II + LAA diagnostic criteria showed high reproducibility for lesion severity assessment. The mean number of active caries lesions among high caries risk subjects was significantly higher using the ICDAS II + LAA criteria, which may subsequently lead to more caries treatment. ISRCTN65592532.

  9. Dental caries patterns in preschool children.

    PubMed

    Johnsen, D C

    1984-01-01

    Management of dental caries as a disease requires the same level of skill and broad perspective as managing many other diseases. Dental caries has several variations, four of which were presented here. Long-term outlook for children with two of the caries patterns (those secondary to fissure defects or hypoplastic defects) is good if the teeth are restored. Management of children with nursing caries often involves dealing with well-intentioned but overindulgent parents. Prevention of nursing caries goes beyond simply informing the parents of potential dangers from excessive feeding with the bottle. Hypoplastic defects can resemble nursing caries; the differentiation is important in treating the child. The child with extensive proximal molar lesions may be the most difficult to manage on a long-term basis. A successful prevention program will mean a change in life style for the parent and child. The child with a cleft lip and/or palate has the disadvantages of enamel defects and a significant medical condition inviting overindulgence.

  10. Investigation of acid-etched CO2 laser ablated enamel surfaces using polarization sensitive optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Nahm, Byung J.; Kang, Hobin; Chan, Kenneth; Fried, Daniel

    2012-01-01

    A carbon dioxide laser operating at the highly absorbed wavelength of 9.3μm with a pulse duration of 10-15μs is ideally suited for caries removal and caries prevention. The enamel thermally modified by the laser has enhanced resistance to acid dissolution. This is an obvious advantage for caries prevention; however, it is often necessary to etch the enamel surface to increase adhesion to composite restorative materials and such surfaces may be more resistant to etching. The purpose of the study was to non-destructively measure the susceptibility of laser-ablated enamel surfaces to acid dissolution before and after acid-etching using Polarization Sensitive Optical Coherence Tomography (PS-OCT). PS-OCT was used to acquire images of bovine enamel surfaces after exposure to laser irradiation at ablative fluence, acid-etching, and a surface softened dissolution model. The integrated reflectivity from lesion and the lesion depth were measured using PS-OCT. Samples were also sectioned for examination by Polarized Light Microscopy (PLM). PS-OCT images showed that acid-etching greatly accelerated the formation of subsurface lesions on both laser-irradiated and non-irradiated surfaces (P<0.05). A 37.5% phosphoric acid etch removed the laser modified enamel layer after 5-10 seconds.

  11. Update on early childhood caries since the Surgeon General's Report.

    PubMed

    Tinanoff, Norman; Reisine, Susan

    2009-01-01

    The 2000 Surgeon General's Report on Oral Health included a limited discussion of the condition known as early childhood caries. Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, early childhood caries is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci, also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. On the basis of this knowledge of specific risk factors for an individual, different preventive strategies and different intensities of preventive therapies can be implemented. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with a fluoridated dentifrice, systemic fluoride supplement to children who live in a nonfluoridated area and who are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent.

  12. Caries risk assessment in schoolchildren - a form based on Cariogram® software

    PubMed Central

    CABRAL, Renata Nunes; HILGERT, Leandro Augusto; FABER, Jorge; LEAL, Soraya Coelho

    2014-01-01

    Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk. PMID:25466473

  13. Marginal integrity and secondary caries of selectively excavated teeth in vitro.

    PubMed

    Schwendicke, F; Kern, M; Blunck, U; Dörfer, C; Drenck, J; Paris, S

    2014-10-01

    Selective caries removal involves sealing of carious dentine beneath restorations, which might decrease their marginal integrity and increase the susceptibility for secondary caries and microleakage. The present study compared these marginal characteristics of restorations in selectively and completely excavated teeth. In 32 premolars, shallow and deep artificial lesions were created on pulpo-axial walls of mesial-distal-occlusal cavities, with mesial and distal margins located in enamel and dentine, respectively. Demineralised dentine was either removed or left before adhesively restoring the teeth (n=8), which were then submitted to thermo-mechanical cycling. The integrity of gingivo-cervical margins was assessed using scanning electron microscopy. In half of each margin, caries was induced adjacent to restorations using a continuous-culture biofilm model, and resulting lesions were evaluated using transversal microradiography. The other half of each margin was used to assess microleakage. Integrity or microleakage of margins located in enamel did not differ significantly between groups, and bacterial biofilms did not induce distinct caries lesions in enamel. Dentinal margins in teeth with deep compared with shallow lesions showed a significantly higher proportion of marginal imperfections, gaps and microleakage (p≤0.05, Mann-Whitney/χ(2)-test). In contrast, neither marginal integrity nor microleakage differed significantly between completely and selectively excavated teeth (p>0.05). Dentinal mineral loss adjacent to restorations did not differ significantly between groups (p>0.80). The marginal characteristics of restorations were affected by the depth of sealed or excavated lesions, but not by the performed caries excavation. This study did not find selective excavation detrimental for restoration integrity in vitro. Selective excavation of deep lesions was shown to reduce pulpal risks, whilst leaving caries beneath restorations is feared to compromise the

  14. Microbiomes of Site-Specific Dental Plaques from Children with Different Caries Status.

    PubMed

    Richards, Vincent P; Alvarez, Andres J; Luce, Amy R; Bedenbaugh, Molly; Mitchell, Mary Lyn; Burne, Robert A; Nascimento, Marcelle M

    2017-08-01

    The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression. Copyright © 2017 American Society for Microbiology.

  15. In-vivo quantification of natural incipient caries lesions using the quantitative light-induced fluoroscence method: a reproducibility study

    NASA Astrophysics Data System (ADS)

    Tranaeus, Sofia; Shi, Xie-Qi; Trollsas, Karin; Lindgren, Lars-Erik; Angmar-Mansson, Birgit

    2000-03-01

    A new method for detection and quantification of natural incipient caries lesions, the Quantitative Light-induced Fluorescence method (QLF), has recently been developed. The aim of this study was to test the repeatability and reproducibility of the analytical part of the method. In vivo captured images (CCD-video camera, Panasonic WV-KS 152, with an argon ion laser as light source) of 15 different incipient caries lesions on smooth surfaces were analyzed by three analysts. The images were analyzed three times in a randomized order, twice for the first reconstructed area (P1A1 and P1A2), and then once for a second one (P2A1). Three parameters were measured, lesion area (mm2), average change in fluorescence (%), and maximum change in fluorescence (%) in the lesion. Repeated measures ANOVA were used to calculate the intra-, and inter-examiner reliability. Intra-examiner reliability for all three analysts showed an intra-class correlation coefficient, R, between 0.93 and 0.99 (for the analyses with the first patch, P1A1 and P1A2, as well as between the first and the second patch, P1A1 and P2A1). Inter-examiner reliability showed an inter-class correlation coefficient, R, between 0.95 and 0.99 (for analyses P1A1, P1A2 and P2A1). It was concluded that the Quantitative Light- induced fluorescence method showed excellent repeatability and reproducibility concerning the analytical part of the method.

  16. ER-YAG laser pretreatment effect on in vitro secondary caries formation around composite restorations.

    PubMed

    Ceballos, L; Toledano, M; Osorio, R; García-Godoy, F; Flaitz, C; Hicks, J

    2001-02-01

    This in vitro study determined if Er-YAG laser used in instead of acid-etching influenced artificial secondary caries formation in enamel and root surfaces. Class V cavities were prepared in buccal and lingual surfaces of 10 extracted caries-free molars, with cervical margins in the root surface and occlusal margins in enamel. The specimens were randomly assigned to 2 groups: Group 1: Enamel and dentin etched with 35% phosphoric acid gel (Scotchbond 15s, rinse 10s; n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). Group 2: Enamel and dentin surfaces conditioned using a pulsed Er-YAG laser (KAVO) with 2.94 microm wavelength, 250 micros pulse duration, 300 mJ for enamel and 250 mJ for root surface pulse energy, 2 Hz repetition rate, and water cooling (n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). The cavity preparations were restored with a wet-bonding technique (Scotchbond 1 adhesive system) and a hybrid resin, light-cured composite (Z100, A3 shade), according to the manufacturer's instructions. Acid-resistant varnish was applied leaving the restoration and a 1 mm rim of adjacent surface enamel and root surface exposed. The specimens were thermocycled (5-50 degrees C, 500 cycles, dwell time 30s). Following artificial caries formation (2.2 mM calcium, 2.2 mM phosphate, 50 mM acetic acid, 5.0 mg/L fluoride, pH 4.25, 10 days), longitudinal sections (3/tooth, 30 occlusal and cervical caries risk sites per group) were taken for polarized light microscopic examination (water imbibition). Primary surface lesion depth and wall lesion frequency was determined and compared between groups (Student's t-test). Er-YAG laser irradiation resulted in a 56% reduction in primary enamel surface lesion depth (116 microm mean depth) when compared with the acid-etched group (263 microm mean depth), and a 39% decrease in root surface lesion depth (194 microm mean depth) compared with that (316

  17. Effect of fluoride toothpastes on enamel demineralization.

    PubMed

    Arnold, Wolfgang H; Dorow, Andreas; Langenhorst, Stephanie; Gintner, Zeno; Bánóczy, Jolan; Gaengler, Peter

    2006-06-15

    It was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization. A 3 x 3 mm window on the enamel surface of 90 human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 6 groups and the lower half of the window was covered with varnish serving as control. The teeth were immersed in a toothpaste slurry containing: placebo tooth paste (group 1); remineralization solution (group 2); Elmex Anticaries (group 3); Elmex Sensitive (group 4); Blend-a-med Complete (group 5) and Colgate GRF (group 6). Ten teeth of each group were used for the determination of the F- content in the superficial enamel layer and acid solubility of enamel expressed in soluble phosphorus. Of 6 teeth of each group serial sections were cut and investigated with polarization light microscopy (PLM) and quantitative energy dispersive X-ray analysis (EDX). The PLM results showed an increased remineralization of the lesion body in the Elmex Anticaries, Elmex Sensitive and Colgate GRF group but not in the Blend-a-med group. A statistically significant higher Ca content was found in the Elmex Anticaries group. The fluoride content in the superficial enamel layer was significantly increased in both Elmex groups and the Blend-a-med group. Phosphorus solubility was significantly decreased in both Elmex groups and the Blend-a-med group. It can be concluded that amine fluoride compounds in toothpastes result in a clearly marked remineralization of caries like enamel lesions followed by sodium fluoride and sodium monofluorophosphate formulations.

  18. Effect of fluoride toothpastes on enamel demineralization

    PubMed Central

    Arnold, Wolfgang H; Dorow, Andreas; Langenhorst, Stephanie; Gintner, Zeno; Bánóczy, Jolan; Gaengler, Peter

    2006-01-01

    Background It was the aim of this study to investigate the effect of four different toothpastes with differing fluoride compounds on enamel remineralization. Methods A 3 × 3 mm window on the enamel surface of 90 human premolars was demineralized in a hydroxyethylcellulose solution at pH 4.8. The teeth were divided into 6 groups and the lower half of the window was covered with varnish serving as control. The teeth were immersed in a toothpaste slurry containing: placebo tooth paste (group 1); remineralization solution (group 2); Elmex Anticaries (group 3); Elmex Sensitive (group 4); Blend-a-med Complete (group 5) and Colgate GRF (group 6). Ten teeth of each group were used for the determination of the F- content in the superficial enamel layer and acid solubility of enamel expressed in soluble phosphorus. Of 6 teeth of each group serial sections were cut and investigated with polarization light microscopy (PLM) and quantitative energy dispersive X-ray analysis (EDX). Results The PLM results showed an increased remineralization of the lesion body in the Elmex Anticaries, Elmex Sensitive and Colgate GRF group but not in the Blend-a-med group. A statistically significant higher Ca content was found in the Elmex Anticaries group. The fluoride content in the superficial enamel layer was significantly increased in both Elmex groups and the Blend-a-med group. Phosphorus solubility was significantly decreased in both Elmex groups and the Blend-a-med group. Conclusion It can be concluded that amine fluoride compounds in toothpastes result in a clearly marked remineralization of caries like enamel lesions followed by sodium fluoride and sodium monofluorophosphate formulations. PMID:16776820

  19. Need for new caries detection methods

    NASA Astrophysics Data System (ADS)

    Young, Douglas A.; Featherstone, John D. B.

    1999-05-01

    Dental caries (tooth decay) continues to be a major problems for adults as well as children, even though great advances have been made in preventive methods in the last 20 years. New methods for the management of caries will work best if lesions can be detected at an early stage and chemical rather than physical intervention can take place, thereby preserving the natural tooth structure and helping the saliva to heal, or remineralize, the areas of early decay. Clinical detection of caries in the US relies on visual examination, tactile with hand held explorer, and conventional radiographs, all of which are inadequate for the occlusal (biting) surfaces of the teeth where most of the decay now occurs. The dentist often has to explore by drilling with a dental bur to confirm early decay in these areas. New method that can determine the extent and degree of subsurface lesions in these surfaces non-destructively are essential for further advances in the clinical management of dental caries. Optical methods, which exploit the differences between sound and carious enamel and dentin, show great promise for the accurate detection of these lesions. Two or three- dimensional images, which include a measure of severity will be needed.

  20. Randomised Clinical Trial on Resin Infiltration and Fluoride Varnish vs Fluoride Varnish Treatment Only of Smooth-surface Early Caries Lesions in Deciduous Teeth.

    PubMed

    Turska-Szybka, Anna; Gozdowski, Dariusz; Mierzwińska-Nastalska, Elżbieta; Olczak-Kowalczyk, Dorota

    2016-01-01

    To clinically evaluate the effectiveness of resin infiltration in conjunction with fluoride varnish treatment vs fluoride varnish treatment alone on facial smooth-surface caries lesions in deciduous teeth. This randomised clinical trial was conducted in 419 children aged 18-71 months with at least two active smooth-surface caries lesions in deciduous teeth (ICDAS II score 2). Eighty-one participants met the inclusion criteria and were allocated to one of the two treatment groups: resin infiltration and fluoride varnish (RI+FV) (n = 41) and fluoride varnish only (FV) (n = 40). The prevalence of treated white spot lesions (WSL) was scored. Fluoride varnish was applied in both groups every 3 months for a year. The mean baseline age of children was 3.8 ± 1.3 years. The effectiveness of resin infiltration measured as the percentage of children who did not present any progression of the treated lesions amounted to 43.1%. After one year, 92.1% of the infiltrated lesions (RI+FV) and 70.6% of the FV lesions had not progressed (p < 0.001). Resin infiltration in conjunction with fluoride varnish treatment of early facial smooth-surface caries lesions in deciduous teeth is superior to fluoride varnish treatment alone for reducing lesion progression.

  1. Early diagnosis of incipient caries based on non-invasive lasers

    NASA Astrophysics Data System (ADS)

    Velescu, A.; Todea, C.; Vitez, B.

    2016-03-01

    AIM: The aim of this study is to detect incipient caries and enamel demineralization using laser fluorescence.This serves only as an auxilary aid to identify and to monitor the development of these lesions. MATERIALS AND METHODS: 6 patients were involved in this study, three females and three male. Each patient underwent a professional cleaning, visual examination of the oral cavity, and then direct inspection using DiagnoCam and DIAGNOdent. After data recording each patient was submitted to retro-alveolar X-ray on teeth that were detected with enamel lesions. All data was collected and analyzed statistically. RESULTS: Of 36 areas considered in clinically healthy, 24 carious surfaces were found using laser fluorescence, a totally non-invasive method for detecting incipient carious lesions compared with the radiographic examination. CONCLUSIONS: This method has good applicability for patients because it improves treatment plan by early detection of caries and involves less fear for anxious patients and children.

  2. DENTINE CARIES: ACID-TOLERANT MICROORGANISMS AND ASPECTS ON COLLAGEN DEGRADATION.

    PubMed

    Lager, Anders Hedenbjörk

    2014-01-01

    Dental caries is a common disease all over the world, despite the fact that it can be both effectively prevented and treated. It is driven by acids produced by oral microorganisms as a consequence of their metabolism of dietary carbohydrates. Given enough acid challenge, eventually the tooth enamel barrier will be broken down, and the carious lesion will extend into underlying hard tissue, forming a macroscopic cavity in the dentine. In comparison to biofilm on enamel, a dentine carious lesion provides a vastly different environment for the residing microorganisms. The environment influences the types and numbers of microorganisms that can colonize the dentine caries lesion. The overall aims for this thesis are to enumerate and further study microorganisms found in established dentine caries lesions and also to illuminate how host-derived proteolytic enzymes might contribute to this degradation, not only to better understand the caries process in dentine but also to find incitements for new methods to influence the natural progression of caries lesions. In Paper I, the numbers of remaining viable microorganisms after completed excavation using two excavation methods were investigated. Samples of carious dentine tissue were collected before and after excavation and cultivated on different agar media in different atmospheres. Analysis was performed by counting the number of colony-forming units (CFUs). Key findings: The number of remaining microorganisms after excavation was low for both methods, but some microorganisms always remained in the cavity floors even when the cavities were judged as caries free using normal clinical criteria. In Paper II, the acid tolerant microbiota in established dentine caries lesions was investigated. Samples were taken as in Paper I, but on three levels (superficial, center of lesion, floor of lesion after completed excavation). The samples were cultivated in anaerobic conditions on solid pH-selective agar media of different acidity

  3. [Comparison of reproducibility measurements for calibration of dental caries epidemiological surveys].

    PubMed

    Assaf, Andréa Videira; Zanin, Luciane; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2006-09-01

    This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.

  4. Oral diagnosis and treatment planning: part 2. Dental caries and assessment of risk.

    PubMed

    Yip, K; Smales, R

    2012-07-27

    Dental caries or tooth decay may be defined as a dynamic process causing progressive destruction of hard tooth substance (enamel, dentine and cementum) involving demineralisation of the inorganic portion of the tooth, and dissolution of the organic portion. The onset and progression of carious lesions involves multiple host, micro-organism and substrate factors interacting in a continuous flux. The diagnosis of initial lesions remains a challenge for practitioners and, despite numerous studies, the assessment of future caries risk is still based largely on a patient's past caries experience. If caries is allowed to progress then pulpitis will occur, which may result in subsequent pulpal necrosis and lead to a local periapical and perhaps a systemic infection.

  5. Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

    PubMed Central

    Karlsson, Lena

    2010-01-01

    A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. PMID:20454579

  6. Association between the number of early carious lesions and diet in children with a high prevalence of caries.

    PubMed

    Llena, C; Leyda, A; Forner, L; Garcet, S

    2015-03-01

    An investigation was conducted in a population of paediatric patients with a high risk of caries in order to assess the association between caries history (CH) and the number of early carious lesions (ECLs) and the frequency and timing of cariogenic food and beverage intake, sugar-containing medication, the frequency and efficacy of tooth brushing, and the use of topical fluorides. Study design: descriptive study. One hundred children aged 6-15 years with≥ ECL of a permanent tooth and not enrolled in any dental health educational or preventive programme were selected. For diagnosis it was used an explorer according to the ICDAS II criteria. The participants completed a closed-list questionnaire on the frequency and timing of cariogenic food intake. There was a nonsignificant tendency to present more ECLs and a greater CH among patients who consumed cariogenic foods and beverages. A significant relationship (p<0.05) was observed between cariogenic beverages and the number of ECL or CH. Using the number of ECLs as dependent variable, regular fluoridated rinses (p=0.003), frequent sugar-containing medication (p=0.007), and cariogenic beverage consumption (p=0.024) were identified as explanatory parameters in the linear regression model. The Student t-test was used to compare ECL and CH with dietetic factors, fluoridated rinses, sugar- containing medicines, and the frequency and efficacy of tooth brushing. Linear regression analysis correlated the number of ECLs to the mentioned explanatory variables. The frequent consumption of sugary beverages and medications, and failure to regularly use fluoridated rinses, were positively correlated to an increased number of ECLs in patients with a high prevalence of caries.

  7. Update on Early Childhood Caries since the Surgeon General's Report

    PubMed Central

    Tinanoff, Norman; Reisine, Susan

    2009-01-01

    The 2000 Surgeon General's Report on Oral Health (SGROH) included a limited discussion of the condition known as Early Childhood Caries (ECC). Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, ECC is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. Based on this knowledge of specific risk factors for an individual, different preventive strategies as well as different intensities of preventive therapies can be employed. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with fluoridated dentifrice, systemic fluoride supplement to children living in a non-fluoridated area that are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent. PMID:19945074

  8. In-vitro Thermal Maps to Characterize Human Dental Enamel and Dentin.

    PubMed

    Lancaster, Paula; Brettle, David; Carmichael, Fiona; Clerehugh, Val

    2017-01-01

    The crown of a human tooth has an outer layer of highly-mineralized tissue called enamel, beneath which is dentin, a less-mineralized tissue which forms the bulk of the tooth-crown and root. The composition and structure of enamel and dentin are different, resulting in different thermal properties. This gives an opportunity to characterize enamel and dentin from their thermal properties and to visually present the findings as a thermal map. The thermal properties of demineralized enamel and dentin may also be sufficiently different from sound tissue to be seen on a thermal map, underpinning future thermal assessment of caries. The primary aim of this novel study was to produce a thermal map of a sound, human tooth-slice to visually characterize enamel and dentin. The secondary aim was to map a human tooth-slice with demineralized enamel and dentin to consider future diagnostic potential of thermal maps for caries-detection. Two human slices of teeth, one sound and one demineralized from a natural carious lesion, were cooled on ice, then transferred to a hotplate at 30°C where the rewarming-sequence was captured by an infra-red thermal camera. Calculation of thermal diffusivity and thermal conductivity was undertaken, and two methods of data-processing used customized software to produce thermal maps from the thermal characteristic-time-to-relaxation and heat-exchange. The two types of thermal maps characterized enamel and dentin. In addition, sound and demineralized enamel and dentin were distinguishable within both maps. This supports thermal assessment of caries and requires further investigation on a whole tooth.

  9. In-vitro Thermal Maps to Characterize Human Dental Enamel and Dentin

    PubMed Central

    Lancaster, Paula; Brettle, David; Carmichael, Fiona; Clerehugh, Val

    2017-01-01

    The crown of a human tooth has an outer layer of highly-mineralized tissue called enamel, beneath which is dentin, a less-mineralized tissue which forms the bulk of the tooth-crown and root. The composition and structure of enamel and dentin are different, resulting in different thermal properties. This gives an opportunity to characterize enamel and dentin from their thermal properties and to visually present the findings as a thermal map. The thermal properties of demineralized enamel and dentin may also be sufficiently different from sound tissue to be seen on a thermal map, underpinning future thermal assessment of caries. The primary aim of this novel study was to produce a thermal map of a sound, human tooth-slice to visually characterize enamel and dentin. The secondary aim was to map a human tooth-slice with demineralized enamel and dentin to consider future diagnostic potential of thermal maps for caries-detection. Two human slices of teeth, one sound and one demineralized from a natural carious lesion, were cooled on ice, then transferred to a hotplate at 30°C where the rewarming-sequence was captured by an infra-red thermal camera. Calculation of thermal diffusivity and thermal conductivity was undertaken, and two methods of data-processing used customized software to produce thermal maps from the thermal characteristic-time-to-relaxation and heat-exchange. The two types of thermal maps characterized enamel and dentin. In addition, sound and demineralized enamel and dentin were distinguishable within both maps. This supports thermal assessment of caries and requires further investigation on a whole tooth. PMID:28747886

  10. The association between loading of restorations and secondary caries lesions is moderated by the restoration material elasticity.

    PubMed

    Askar, Haitham; Brouwer, Fredrik; Lehmensiek, Michel; Paris, Sebastian; Schwendicke, Falk

    2017-03-01

    Secondary caries limits the longevity of restorations and is thought to be associated with faulty restorations, e.g. dentin-restoration interfacial gaps. Recent evidence indicates that loading of restorations might aggravate the effects of gaps on interfacial mineral loss. It is unclear if this effect of loading is dose-dependent or not, and if restoration material properties like elasticity moderate the association between load and mineral loss. We hypothesized that mineral loss of secondary lesions increases with increasing load, and that this association is moderated by the elastic modulus of the placed restoration material. Dentin-restoration specimens with simulated interfacial gaps were submitted to cariogenic Lactobacillus-rhamnosus-biofilms for 10days, and concurrently loaded with different loads (0/42/84/126g per specimen, n=12/group). Two different composites (LEC: low elastic-modulus composite, HEC: high elastic-modulus composite) were employed. Transversal microradiography was used to evaluate the superficial and interfacial (wall) lesion mineral loss. Generalized linear modeling (GLM) was used to evaluate the association between loading, material and their interaction on mineral loss. Surface mineral loss was not significantly associated with loading, material, or their interaction (p-values ranged between p=0.062 and 0.526). For deep interfacial (wall) lesions, the applied load (p=0.023) but not the material (p=0.382) showed a significant effect. The interaction between both significantly affected mineral loss (p=0.01). Loads of ≥84g per specimens were associated with higher wall lesion mineral loss. Loads above a certain threshold significantly increased interfacial (wall) lesion mineral loss. This association was moderated by the elasticity of the placed restoration materials. The clinical relevance of our findings remains unclear, as future studies are needed to understand how exactly both load and material elasticity affect secondary lesion

  11. Microhardness and Roughness of Infiltrated White Spot Lesions Submitted to Different Challenges.

    PubMed

    Neres, É Y; Moda, M D; Chiba, E K; Briso, Alf; Pessan, J P; Fagundes, T C

    A white spot lesion is the first clinical sign of a caries lesion and represents mineral loss from the enamel subsurface. The purpose of this study was to evaluate the microhardness and surface roughness of white spot lesions after application of a resin infiltrant and subjection to different challenges. Caries-like lesions were induced in bovine enamel discs (n=50), and the specimens were randomly divided into five study groups (n=10): demineralized enamel (negative control, G1), infiltrated enamel (G2), infiltrated enamel submitted to brushing (G3), infiltrated enamel submitted to pH cycling (G4), and infiltrated enamel submitted to artificial aging (G5). Half of each enamel surface was used as its own positive control. Roughness data were analyzed using the Kruskal-Wallis test followed by the Dunn test. Results from microhardness were analyzed by two-way analysis of variance, followed by the Tukey test for multiple comparisons. The level of significance was set at 5%. Microhardness and roughness values obtained from the test side of the specimens were significantly lower compared with the sound enamel for all groups. Microhardness values obtained for G2, G3, and G5 were not significantly different. Values found for G1 were significantly lower compared with those for G2, G3, and G5. The lowest microhardness values were observed for G4, which was significantly different from the other groups. Surface roughness was not significantly different between G2 and G3. The resin infiltrant presented superiority over the unprotected white spot lesions, as they were more resistant to mechanical and aging challenges. However, resin infiltration was not able to reestablish the properties of sound enamel and was not resistant to a new cariogenic challenge.

  12. Aquaporin 5 Interacts with Fluoride and Possibly Protects against Caries

    PubMed Central

    Deeley, Kathleen; Poletta, Fernardo A.; Mereb, Juan C.; Leite, Aline L.; Barreta, Priscila A. T. M.; Silva, Thelma L.; Dizak, Piper; Ruff, Timothy; Patir, Asli; Koruyucu, Mine; Abbasoğlu, Zerrin; Casado, Priscila L.; Brown, Andrew; Zaky, Samer H.; Bayram, Merve; Küchler, Erika C.; Cooper, Margaret E.; Liu, Kai; Marazita, Mary L.; Tanboğa, İlknur; Granjeiro, José M.; Seymen, Figen; Castilla, Eduardo E.; Orioli, Iêda M.; Sfeir, Charles; Owyang, Hongjiao; Buzalaf, Marília A. R.; Vieira, Alexandre R.

    2015-01-01

    Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride. PMID:26630491

  13. Aquaporin 5 Interacts with Fluoride and Possibly Protects against Caries.

    PubMed

    Anjomshoaa, Ida; Briseño-Ruiz, Jessica; Deeley, Kathleen; Poletta, Fernardo A; Mereb, Juan C; Leite, Aline L; Barreta, Priscila A T M; Silva, Thelma L; Dizak, Piper; Ruff, Timothy; Patir, Asli; Koruyucu, Mine; Abbasoğlu, Zerrin; Casado, Priscila L; Brown, Andrew; Zaky, Samer H; Bayram, Merve; Küchler, Erika C; Cooper, Margaret E; Liu, Kai; Marazita, Mary L; Tanboğa, İlknur; Granjeiro, José M; Seymen, Figen; Castilla, Eduardo E; Orioli, Iêda M; Sfeir, Charles; Owyang, Hongjiao; Buzalaf, Marília A R; Vieira, Alexandre R

    2015-01-01

    Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.

  14. Effect of erythritol and xylitol on dental caries prevention in children.

    PubMed

    Honkala, Sisko; Runnel, Riina; Saag, Mare; Olak, Jana; Nõmmela, Rita; Russak, Silvia; Mäkinen, Pirkko-Liisa; Vahlberg, Tero; Falony, Gwen; Mäkinen, Kauko; Honkala, Eino

    2014-01-01

    The aim of this study was to test the efficacy of long-term, daily intake of erythritol and xylitol candy, compared with sorbitol candy, on the development of enamel and dentin caries lesions. The study was a double-blind randomized controlled prospective clinical trial. Altogether 485 primary school children, first- and second-graders at baseline, from southeastern Estonia participated in this 3-year intervention. Each child consumed four erythritol, xylitol or sorbitol (control) candies three times per school day. The daily intake of polyol was about 7.5 g. The International Caries Detection and Assessment System (ICDAS) was used in the clinical examinations by four calibrated examiners at baseline and at 12, 24 and 36 months. The annual examination analyses and the follow-up analyses confirmed that the number of dentin caries teeth and surfaces at 24 months follow-up and surfaces at 36 months follow-up was significantly lower in the mixed dentition in the erythritol group than in the xylitol or control group. Time of enamel/dentin caries lesions to develop and of dentin caries lesions to progress was significantly longer in the erythritol group compared to the sorbitol and xylitol groups. Also the increase in caries score was lower in the erythritol group than in the other groups. In the follow-up examinations, a lower number of dentin caries teeth and surfaces was found in the erythritol group than in the xylitol or control groups. Time to the development of caries lesions was longest in the erythritol group. ClinicalTrials.gov Identifier NCT01062633. © 2014 S. Karger AG, Basel.

  15. Effect of CPP-ACP paste on dental caries in primary teeth: a randomized trial.

    PubMed

    Sitthisettapong, T; Phantumvanit, P; Huebner, C; Derouen, T

    2012-09-01

    This clinical trial tested the effect of daily application of 10% w/v calcium phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste for 1 yr when added to regular toothbrushing with fluoridated toothpaste to prevent dental caries in pre-school children. High-caries-risk children aged 2½ to 3½ yrs in a suburban area of central Thailand were assigned to receive either CPP-ACP (n = 150) or a placebo control (n = 146) in addition to fluoridated toothpaste. The International Caries Detection and Assessment System (ICDAS) was recorded at baseline, 6 mos, and 1 yr. At 1 yr, a significant increase in mean numbers of enamel and dentin caries lesions, as well as dmfs, was found in both groups (p < 0.001). No significant difference was observed between groups on these 3 outcome measures (p = 0.23, 0.84, and 0.91, respectively). The odds of enamel caries lesion transitions to a state of regression or stability, compared with progression from baseline, was also not different between groups [OR = 1.00, 95% CI (0.86, 1.17)]. This trial found that daily application of 10% w/v CPP-ACP paste on school days for 1 yr, when added to regular toothbrushing with a fluoride toothpaste, had no significant added effect in preventing caries in the primary dentition of these pre-school children (ClinicalTrials.gov number CT01 604109).

  16. Effect of CPP-ACP Paste on Dental Caries in Primary Teeth

    PubMed Central

    Sitthisettapong, T.; Phantumvanit, P.; Huebner, C.; DeRouen, T.

    2012-01-01

    This clinical trial tested the effect of daily application of 10% w/v calcium phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste for 1 yr when added to regular toothbrushing with fluoridated toothpaste to prevent dental caries in pre-school children. High-caries-risk children aged 2½ to 3½ yrs in a suburban area of central Thailand were assigned to receive either CPP-ACP (n = 150) or a placebo control (n = 146) in addition to fluoridated toothpaste. The International Caries Detection and Assessment System (ICDAS) was recorded at baseline, 6 mos, and 1 yr. At 1 yr, a significant increase in mean numbers of enamel and dentin caries lesions, as well as dmfs, was found in both groups (p < 0.001). No significant difference was observed between groups on these 3 outcome measures (p = 0.23, 0.84, and 0.91, respectively). The odds of enamel caries lesion transitions to a state of regression or stability, compared with progression from baseline, was also not different between groups [OR = 1.00, 95% CI (0.86, 1.17)]. This trial found that daily application of 10% w/v CPP-ACP paste on school days for 1 yr, when added to regular toothbrushing with a fluoride toothpaste, had no significant added effect in preventing caries in the primary dentition of these pre-school children (ClinicalTrials.gov number CT01 604109). PMID:22805294

  17. Enamel bevelling and retention of composite restorations in non-carious cervical lesions.

    PubMed

    Ahmed, Khaled

    2016-09-01

    Data sourcesMedline, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), the Cochrane Library, abstracts of the annual conference of the International Association for Dental Research (IADR), System for Information on Grey literature in Europe (SIGLE), ProQuest Dissertations and Theses Fulltext database as well as the Periódicos Capes Theses, Current Controlled Trials, International Clinical trials registry platform, the ClinicalTrials.gov, Rebec and the EU Clinical Trials Register.Study selectionRandomised clinical trials (RCTs) that compared the retention rates of restorations in NCCLs placed with or without bevel with at least one year follow-up were considered.Data extraction and synthesisData were abstracted using standardised forms and study quality was assessed using the Cochrane risk of bias tool. Marginal discolouration scores were dichotomised into yes and no, and risk differences for retention rate and marginal discolouration were calculated for each study for analysis.ResultsFour studies were included. Two studies were considered to be at high risk of bias and not included in the meta-analysis. The overall risk difference was 0.0 (95%CI; 0.04 to 0.04) for the retention rate and 0.05 ((95%CI; 0.02 to 0.13) for the marginal discolouration, suggesting that enamel beveling does not influence retention rate or marginal discolouration.ConclusionsOne may conclude that there is no difference between bevelled and non-bevelled technique over the short-term follow-up of 12-18 months of clinical service, although this conclusion was based on only two low risk of bias RCTs. Additionally, there is not enough evidence to support this conclusion over longer-term follow-ups. There is a need for better standardisation and the reporting of RCTs investigating this technique variation after longer-term follow-up periods.

  18. Image-guided removal of occlusal caries lesions with a λ= 9.3-μm CO2 laser using near-IR transillumination

    NASA Astrophysics Data System (ADS)

    Chung, Leon C.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Fried, Daniel; Darling, Cynthia L.

    2015-02-01

    Previous studies have shown that near-IR transillumination is well suited for imaging deep occlusal lesions. The purpose of this study was to determine if near-IR images can be used to guide a CO2 laser for the selective removal of natural occlusal lesions on extracted teeth. Near-IR occlusal transillumination images of extracted human teeth with natural occlusal caries lesions were acquired using an InGaAs camera and near-IR light at wavelengths from 1290 to 1470-nm from a filtered tungsten halogen source. A CO2 laser operating at 9.3-μm with a pulse duration of 10-15-μs and a pulse repetition rate of 100-300-Hz was used for caries removal. Optical Coherence tomography was used to confirm lesion presence and serial scans were used to assess selective removal. Teeth were also sectioned for histological examination using polarized light microscopy. This study suggests that near-infrared transillumination is a promising method for the image guided laser ablation of occlusal caries lesions but the use of serial near-IR transillumination imaging for monitoring lesion removal was limited.

  19. Image-guided removal of occlusal caries lesions with a λ= 9.3-µm CO2 laser using near-IR transillumination.

    PubMed

    Chung, Leon C; Tom, Henry; Chan, Kenneth H; Simon, Jacob C; Fried, Daniel; Darling, Cynthia L

    2015-02-24

    Previous studies have shown that near-IR transillumination is well suited for imaging deep occlusal lesions. The purpose of this study was to determine if near-IR images can be used to guide a CO2 laser for the selective removal of natural occlusal lesions on extracted teeth. Near-IR occlusal transillumination images of extracted human teeth with natural occlusal caries lesions were acquired using an InGaAs camera and near-IR light at wavelengths from 1290 to 1470-nm from a filtered tungsten halogen source. A CO2 laser operating at 9.3-µm with a pulse duration of 10-15-µs and a pulse repetition rate of 100-300-Hz was used for caries removal. Optical Coherence tomography was used to confirm lesion presence and serial scans were used to assess selective removal. Teeth were also sectioned for histological examination using polarized light microscopy. This study suggests that near-infrared transillumination is a promising method for the image guided laser ablation of occlusal caries lesions but the use of serial near-IR transillumination imaging for monitoring lesion removal was limited.

  20. New method to detect caries via fluorescence

    NASA Astrophysics Data System (ADS)

    Eberhart, J.; Frentzen, M.; Thoms, M.

    2007-07-01

    Caries, a common and widespread infectious disease, has to be detected as early as possible. Based on the need for an easy and handy tool for preventing invasive treatment a new fluorescence camera system has been developed. Using this camera the so-called porphyrins, metabolic products of oral pathogenic bacteria can be visualized. Thereby fluorophores are excited at a wavelength of 405nm by the built-in GaN-LEDs. Healthy and diseased dental hard tissues fluoresce in the green and in the red spectral range, respectively, thus allowing differentiation by coulor. To prove the reliability of this fluorescence camera system, freshly extracted teeth were examined. Three different methods of analysis were verified and compared to give information about the lesions (sensitivity & selectivity): The extent of the fluorescence area, the integral of the red/green ratio of the lesion and the maximum red/green ratio in the area of interest. Histological sections of the teeth served as reference. In addition, the camera was compared to a tip probe sensor already available on the market. In total, our results show that regarding the three different algorithms of analysis, the maximum of the red/green ratio is a preferential method to evaluate carious lesions. Sound tissue, enamel caries and dentin caries can be clearly distinguished. The new fluorescence camera is a handy, efficient and fast device in order to detect lesions and seems to be superior to the tip probe sensor regarding the positioning. Further studies are required.

  1. Fluorine analysis of human enamel around fluoride-containing materials under different pH-cycling by μ-PIGE/PIXE system

    NASA Astrophysics Data System (ADS)

    Komatsu, H.; Yamamoto, H.; Matsuda, Y.; Kijimura, T.; Kinugawa, M.; Okuyama, K.; Nomachi, M.; Yasuda, K.; Satoh, T.; Oikawa, S.

    2011-10-01

    The caries preventive effect of fluoride-containing materials (FCMs) might depend on the caries risk of the individuals. Two pairs of demineralizing and remineralizing solutions of pH-cycling were prepared for simulating low and high caries risk. The purpose of this study was to determine fluorine (F) uptake into human enamel around FCMs under different pH-cycling using the in-air μ-PIGE/PIXE system. Fluoride-containing glass ionomer cement (Fuji IXGP FAST CAPSULE (FN)), and composite resin (BEAUTIFIL II with FLUORO BOND SHAKE ONE (BS)) were used in this study. The pH-cycling (pH 6.8-4.5) was carried out for 5 weeks. After pH-cycling, the caries progression was analyzed using transverse micro-radiography (TMR). The fluorine and calcium distributions in the carious lesion in each specimen were evaluated using the PIGE/PIXE system. From TMR analysis, there was a difference in caries risk between the two kinds of pH-cycling. Although the caries preventive effect of BS and FN was confirmed at low risk, the effect at high risk was confirmed for FN only. From the analysis of the fluorine uptake in the outer 200 μm of the lesion we concluded that there was no significant difference between the pH-cycling solutions. However, we found different fluorine concentrations in the enamel for the two FCMs. The decreased caries progression under high risk for FN indicated that an adequate amount of fluorine supplied from the material is required at higher caries risk. It was confirmed that the caries preventive effect of FCM depends on the caries risk. The fluorine analysis of teeth under various pH-cycling conditions gives information to evaluate the caries preventive effect of fluoride-containing materials according to the caries risk.

  2. Atomic force microscopy observation of the enamel roughness and depth profile after phosphoric acid etching.

    PubMed

    Loyola-Rodriguez, Juan Pablo; Zavala-Alonso, Veronica; Reyes-Vela, Enrique; Patiño-Marin, Nuria; Ruiz, Facundo; Anusavice, Kenneth J

    2010-01-01

    The aim was to compare the enamel surface roughness (ESR) and absolute depth profile (ADP) (mean peak-to-valley height) by atomic force microscopy (AFM) before and after using four different phosphoric acids. A total of 160 enamel samples from 40 upper premolars were prepared. The inclusion criterion was that the teeth have healthy enamel. Exclusion criteria included any of the following conditions: facial restorations, caries lesions, enamel hypoplasia and dental fluorosis. Evaluations of the ESR and ADP were carried out by AFM. The Mann-Whitney U-test was used to compare continuous variables and the Wilcoxon test was used to analyze the differences between before and after etching. There were statistically significant differences (P enamel; Etch-37 and Scotchbond Etching Gel showed higher profiles after etching (P enamel. However, consistently Etch-37 and Scotchbond Etching Gel showed the highest increase regarding the ESR and ADP after etching healthy enamel. AFM was a useful tool to study site-specific structural topography changes in enamel after phosphoric acid etching.

  3. Remineralization of bovine enamel subsurface lesions: effects of different calcium-phosphate saturations in buffered aqueous solutions.

    PubMed

    Tschoppe, Peter; Kielbassa, Andrej M

    2011-06-01

    To evaluate the remineralizing effects of aqueous phosphate-buffered solutions using various saturations with respect to octacalcium phosphate or brushite (OCP/DCPD) on bovine enamel subsurface lesions. Demineralized specimens (n=18 per group) were exposed to one of six phosphate-buffered solutions with theoretical OCP saturations of S0.83, S1.17, S1.43, S1.64, S1.83, or S1.99 (pH, 6.3; calcium concentration, 0.53 to 3.18 mM). One aqueous solution without calcium was used as a negative control (S0; pH, 6.3); one without calcium and phosphate was a reference (S; pH, 4.3). HEPES-buffered Buskes solution served as a reference (B2.46; pH, 7.0); a pH-adjusted one was a positive control (B1.21; pH, 6.3). Mineral losses (whole lesion and surface area/inner part of the lesion) before and after storage (2 and 5 weeks, 37 °C) were evaluated from microradiographs. The pH values of all solutions remained stable. Compared to baseline, S0.83 to S1.99 and B2.46 to B1.21 showed significantly increased mineral gains after both storage periods (P<.05, paired t test). S0 showed neutral effects (P=.190), whereas S demineralized the specimens (P<.001). Storage in S1.64, S1.83, and S1.99 revealed no differences compared to B2.46 (P>.997, ANOVA and Tukey), but a mineral gain of S1.64 to S1.99 was significantly increased compared to B1.21 (P<.012). Similar results could be observed for surface areas and inner lesion parts. The in vitro conditions chosen revealed that the used phosphate buffer system was suitable to maintain stable pH values. The higher saturated (OCP) solutions S1.64, S1.83, and S1.99 revealed mineral gains comparable to B2.46; thus, saturations of 1.64 (OCP) or 1 (DCPD) might be preferable for remineralization studies. © 2011 By Quintessence Publishing Co, Inc.

  4. Efficacy of amelogenin-chitosan hydrogel in biomimetic repair of human enamel in pH-cycling systems

    PubMed Central

    Ruan, Qichao; Liberman, David; Bapat, Rucha; Chandrababu, Karthik Balakrishna; Phark, Jin-Ho; Moradian-Oldak, Janet

    2016-01-01

    Amelogenin-chitosan (CS-AMEL) hydrogel has shown great potential for the prevention, restoration, and treatment of defective enamel. As a step prior to clinical trials, this study aimed to examine the efficacy of CS-AMEL hydrogel in biomimetic repair of human enamel with erosive or caries-like lesions in pH-cycling systems. Two models for enamel defects, erosion and early caries, were addressed in this study. Two pH-cycling systems were designed to simulate the daily cariogenic challenge as well as the nocturnal pH conditions in the oral cavity. After pH cycling and treatment with CS-AMEL hydrogel, a synthetic layer composed of oriented apatite crystals was formed on the eroded enamel surface. CS-AMEL repaired the artificial incipient caries by re-growing oriented crystals and reducing the depth of the lesions by up to 70% in the pH-cycling systems. The results clearly demonstrate that the CS-AMEL hydrogel is effective at the restoration of erosive and carious lesions under pH-cycling conditions. PMID:27331142

  5. Effect of fluoride, lesion baseline severity and mineral distribution on lesion progression.

    PubMed

    Lippert, F; Butler, A; Lynch, R J M; Hara, A T

    2012-01-01

    The present study investigated the effects of fluoride (F) concentration, lesion baseline severity (ΔZ(base)) and mineral distribution on lesion progression. Artificial caries lesions were created using three protocols [methylcellulose acid gel (MeC), hydroxyethylcellulose acid gel (HEC), carboxymethylcellulose acid solution (CMC)] and with low and high ΔZ(base) groups by varying demineralization times within protocols. Subsequently, lesions were immersed in a demineralizing solution for 24 h in the presence of 0, 1, 2 or 5 ppm F. Changes in mineral distribution characteristics of caries lesions were studied using transverse microradiography. At baseline, the protocols yielded lesions with three distinctly different mineral distributions. Secondary demineralization revealed differences in F response between and within lesion types. In general, lowΔZ lesions were more responsive to F than highΔZ lesions. LowΔZ MeC lesions showed the greatest range of response among all lesions, whereas highΔZ HEC lesions were almost unaffected by F. Laminations were observed in the presence of F in all but highΔZ HEC and CMC lesions. Changes in mineral distribution effected by F were most pronounced in MeC lesions, with remineralization/mineral redeposition in the original lesion body at the expense of sound enamel beyond the original lesion in a dose-response manner. Both ΔZ(base) and lesion mineral distribution directly impact the F response and the extent of secondary demineralization of caries lesions. Further studies - in situ and on natural white spot lesions - are required to better mimic in vivo caries under laboratory conditions. Copyright © 2012 S. Karger AG, Basel.

  6. Weaker dental enamel explains dental decay.

    PubMed

    Vieira, Alexandre R; Gibson, Carolyn W; Deeley, Kathleen; Xue, Hui; Li, Yong

    2015-01-01

    Dental caries continues to be the most prevalent bacteria-mediated non-contagious disease of humankind. Dental professionals assert the disease can be explained by poor oral hygiene and a diet rich in sugars but this does not account for caries free individuals exposed to the same risk factors. In order to test the hypothesis that amount of amelogenin during enamel development can influence caries susceptibility, we generated multiple strains of mice with varying levels of available amelogenin during dental development. Mechanical tests showed that dental enamel developed with less amelogenin is "weaker" while the dental enamel of animals over-expressing amelogenin appears to be more resistant to acid dissolution.

  7. High-resolution PS-OCT of enamel remineralization

    NASA Astrophysics Data System (ADS)

    Can, Anna M.; Darling, Cynthia L.; Fried, Daniel

    2008-02-01

    Previous studies have demonstrated that Polarization Sensitive Optical Coherence Tomography (PS-OCT) can be used to image the remineralization of early artificial caries lesions. However, the depth resolution of the imaging system employed in those previous studies was limited and the outer surface structure of the lesions were not resolved as clearly as desired. The purpose of this study was to repeat the earlier remineralization study using a broadband light-source of higher resolution to determine if there can be improved resolution of the remineralized surface zones of the lesions. An all polarization-maintaining fiber based PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of bovine enamel surfaces exposed to a demineralizing solution at pH-4.9 followed by a fluoride containing remineralizing solution at pH-7.0 containing 2-ppm fluoride. The structure of surface zones could be clearly resolved in the samples that remineralized using PS-OCT. PS-OCT measured a significant (p<0.05) reduction in the integrated reflectivity between the severity of the lesions that were exposed to the remineralization solution and those that were not. The lesion depth and mineral loss was also measured with polarized light microscopy and transverse microradiography after sectioning the enamel blocks. These results show that PS-OCT can be used to non-destructively monitor the remineralization potential of anti-caries agents.

  8. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy.

    PubMed

    Bjørndal, Lars; Reit, Claes; Bruun, Gitte; Markvart, Merete; Kjaeldgaard, Marianne; Näsman, Peggy; Thordrup, Marianne; Dige, Irene; Nyvad, Bente; Fransson, Helena; Lager, Anders; Ericson, Dan; Petersson, Kerstin; Olsson, Jadranka; Santimano, Eva M; Wennström, Anette; Winkel, Per; Gluud, Christian

    2010-06-01

    Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (-22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.

  9. Dental caries detection by optical spectroscopy: a polarized Raman approach with fibre-optic coupling

    NASA Astrophysics Data System (ADS)

    Ko, A. C.-T.; Choo-Smith, L.-P.; Werner, J.; Hewko, M.; Sowa, M. G.; Dong, C.; Cleghorn, B.

    2006-09-01

    Incipient dental caries lesions appear as white spots on the tooth surface; however, accurate detection of early approximal lesions is difficult due to limited sensitivity of dental radiography and other traditional diagnostic tools. A new fibre-optic coupled spectroscopic method based on polarized Raman spectroscopy (P-RS) with near-IR laser excitation is introduced which provides contrast for detecting and characterizing incipient caries. Changes in polarized Raman spectra are observed in PO 4 3- vibrations arising from hydroxyapatite of mineralized tooth tissue. Demineralization-induced morphological/orientational alteration of enamel crystallites is believed to be responsible for the reduction of Raman polarization anisotropy observed in the polarized Raman spectra of caries lesions. Supporting evidence obtained by polarized Raman spectral imaging is presented. A specially designed fibre-optic coupled setup for simultaneous measurement of parallel- and cross-polarized tooth Raman spectra is demonstrated in this study.

  10. [Chemical crystal aspects of remineralization of dental enamel].

    PubMed

    Bánóczy, J; Kiss, J; Féherváry, E; Ginter, Z; Albrecht, M

    1990-05-01

    Incipient dental caries at the stage of demineralization is reversible, and remineralization can be achieved by the help of locally applied fluorides. In crystalchemical experiments, however by treating natural apatites with lanthanides Ce, La, Pr, Nd, Sm, Eu, Tb...Y, Sc, a more resistant complex could be developed. In this study extracted human molar teeth were kept for 60 days in Cerium (III)-nitrate solution, in order to investigate the incorporation of Ce3+ into human sound and carious enamel by light-microscopic-, and electronmicroprobe methods. Ce3+ was incorporated in sound enamel as well as into the incipient carious lesions, showing the histological characteristics of a remineralizing lesion. The mean values of the microprobe analysis data showed an increase in Ce3+ changing place with the Ca2+, the developing cerium-apatite being more hard an resistant from a mineralo-physical point of view.

  11. Selective removal of natural caries lesions from dentin and tooth occlusal surfaces using a diode-pumped Er:YAG laser

    NASA Astrophysics Data System (ADS)

    Jew, Jamison; Chan, Kenneth H.; Darling, Cynthia L.; Fried, Daniel

    2017-02-01

    Selective removal of caries lesions with high precision is best accomplished using lasers operating at high pulse repetition rates utilizing small spot sizes. Conventional flash-lamp pumped Er:YAG lasers are poorly suited for this purpose, but new diode-pumped solid-state (DPSS) Er:YAG lasers have become available operating at high pulse repetition rates. Microradiography was used to determine the mineral content of the demineralized dentin of 200-μm thick sections with natural caries lesions prior to laser ablation. The purpose of this study was to explore the use of a DPSS Er:YAG laser for the selective removal of demineralized dentin and natural occlusal lesions on extracted teeth.

  12. Salivary peptidome profiling analysis for occurrence of new carious lesions in patients with severe early childhood caries.

    PubMed

    Tian, Chang; Sun, Xiangyu; Liu, Xiaochen; Huang, Xin; Chen, Feng; Zheng, Shuguo

    2017-01-01

    This study aimed to identify differences of peptide profiles in stimulated whole saliva among children with and without occurrence of new carious lesions, and to provide a simple way for early diagnosis and prevention of the relapse of severe early childhood caries (s-ECC). Overall, 26 children aged 3-4 years were selected out from all the children in the kindergarten to be involved in the present study, among them 13 were diagnosed as s-ECC and underwent dental treatment, whilst the other 13 were matched by age and sex as control. Stimulated whole saliva samples were collected before treatment, and at 10 days and 4 months after treatment. During follow-up, 7 of the 13 children with s-ECC showed a relapse, and the new carious lesions were then treated. Salivary peptides were detected using the technique of magnetic beads combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Fifteen peptides showed significant differences in the group without occurrence of new carious lesions (CH group). On comparing the CH group and the other group with occurrence of new carious lesions (CR group), no significant differences were observed before treatment, whereas certain peptides showed significant differences at both 10 days and 4 months after treatment. Two peptides (experimental m/z values: 3162.0 Da and 3290.4 Da) exhibited a consistent tendency in cross-sectional and longitudinal comparisons among these groups; these may be associated with recurrence of s-ECC. Based on our findings, it is concluded that different saliva peptide peaks can be detected in s-ECC using MALDI-TOF MS combined with magnetic beads. Moreover, 2 specific peptides with m/z values 3162.0 Da and 3290.4 Da could be promising salivary protein biomarkers for diagnosis of recurrence of s-ECC.

  13. [Scanning electron microscopic study of fluorotic permanent teeth enamel].

    PubMed

    Gajić, M

    1990-06-01

    The materia comprised 8 caries-free fluorotic permanent teeth (4 with severe and 4 with very mild fluorosis) and 4 caries-free non-fluorotic permanent teeth. The surface of teeth with severe fluorosis was mainly rought with discrete pitting and small parts of relative sound enamel. The subsurface enamel of teeth with severe fluorosis was with irregular cross-sectional shape of rod and more extensive inter-rod enamel spaces in comparison with other parts of enamel. The surface enamel of teeth with very mild fluorosis was mainly smooth, similar to the sound enamel, with small parts of rough enamel. In subsurface enamel of teeth with very mild fluorosis no difference was found between cross-sectional shape of rod and dimension of inter-rod enamel spaces in comparison with other parts of enamel.

  14. Optical Coherence Tomography as an Auxiliary Tool for the Screening of Radiation-Related Caries

    PubMed Central

    de Oliveira Mota, Cláudia Cristina Brainer; Maia, Ana Marly Araújo; Santos-Silva, Alan Roger; Gomes, Anderson Stevens Leonidas; de Abreu Alves, Fábio; Leão, Jair Carneiro; de Freitas, Anderson Zanardi; Goes, Mário; Lopes, Márcio Ajudarte

    2013-01-01

    Abstract Objective: The aim of this study was to evaluate the morphological alterations of radiation-related caries using optical coherence tomography. Methods: Thirty-six extracted teeth from 11 patients who had undergone radiotherapy were sectioned in the sagittal axis in the center of the carious lesion, and 100 μm thick sections were obtained from each specimen. One sample from each tooth was investigated by an optical coherence tomography (OCT) system, and the results were compared with histological images from polarized light microscopy. Results: In OCT dentin caries images, the demineralized area appeared as a white region, whereas the translucent zone appeared as a dark area, a similar pattern also seen in coronal caries. In noncavitated enamel lesions clinically observed as brown discoloration, the area of high porosity, and also the dark color, absorbs part of the light, resulting in a dark pattern. Finally, the involvement of dentin–enamel junction (DEJ) or cement–enamel junction (CEJ) could be clearly observed, when present and marked alterations along the CEJ could be noted, as junction continuity loss, gap formation, and mineral loss tissue. Conclusions: The OCT technique was able to characterize radiation-related caries, from a morphological point of view. Also demonstrated was its potential benefit for use in the clinical monitoring of radiation-related carious process. PMID:23819504

  15. Optical coherence tomography as an auxiliary tool for the screening of radiation-related caries.

    PubMed

    de Oliveira Mota, Cláudia Cristina Brainer; Gueiros, Luiz Alcino; Maia, Ana Marly Araújo; Santos-Silva, Alan Roger; Gomes, Anderson Stevens Leonidas; Alves, Fábio de Abreu; Leão, Jair Carneiro; de Freitas, Anderson Zanardi; Goes, Mário; Lopes, Márcio Ajudarte

    2013-07-01

    The aim of this study was to evaluate the morphological alterations of radiation-related caries using optical coherence tomography. Thirty-six extracted teeth from 11 patients who had undergone radiotherapy were sectioned in the sagittal axis in the center of the carious lesion, and 100 μm thick sections were obtained from each specimen. One sample from each tooth was investigated by an optical coherence tomography (OCT) system, and the results were compared with histological images from polarized light microscopy. In OCT dentin caries images, the demineralized area appeared as a white region, whereas the translucent zone appeared as a dark area, a similar pattern also seen in coronal caries. In noncavitated enamel lesions clinically observed as brown discoloration, the area of high porosity, and also the dark color, absorbs part of the light, resulting in a dark pattern. Finally, the involvement of dentin-enamel junction (DEJ) or cement-enamel junction (CEJ) could be clearly observed, when present and marked alterations along the CEJ could be noted, as junction continuity loss, gap formation, and mineral loss tissue. The OCT technique was able to characterize radiation-related caries, from a morphological point of view. Also demonstrated was its potential benefit for use in the clinical monitoring of radiation-related carious process.

  16. Accuracy of direct digital radiography for detecting occlusal caries in primary teeth compared with conventional radiography and visual inspection: an in vitro study

    PubMed Central

    Dias da Silva, P R; Martins Marques, M; Steagall, W; Medeiros Mendes, F; Lascala, C A

    2010-01-01

    Objectives The diagnosis of caries lesions is still a matter of concern in dentistry. The diagnosis of dental caries by digital radiography has a number of advantages over conventional radiography; however, this method has not been explored fully in the field of paediatric dentistry. This in vitro research evaluated the accuracy of direct digital radiography compared with visual inspection and conventional radiography in the diagnosis of occlusal caries lesions in primary molars. Methods 50 molars were selected and evaluated under standardized conditions by 2 previously calibrated examiners according to 3 diagnostic methods (visual inspection, conventional radiography and direct digital radiography). Direct digital radiographs were obtained with the Dixi3 system (Planmeca, Helsinki, Finland) and the conventional radiographs with InSight film (Kodak Eastman Co., Rochester, NY). The images were scored and a reference standard was obtained histologically. The interexaminer reliability was calculated using Cohen's kappa test and the specificity, sensitivity and accuracy of the methods were calculated. Results Examiner reliability was good. For lesions limited to the enamel, visual inspection showed significantly higher sensitivity and accuracy than both radiographic methods, but no significant difference was found in specificity. For teeth with dentinal caries, no significant differences were found for any parameter when comparing visual and radiographic evaluation. Conclusions Although less accurate than the visual method for detecting caries lesions confined to the enamel, the direct digital radiographic method is as effective as conventional radiographic examination and visual inspection of primary teeth with occlusal caries when the dentine is involved. PMID:20729186

  17. Comparison of reflectance spectra of sound and carious enamel

    NASA Astrophysics Data System (ADS)

    Analoui, Mostafa; Ando, Masatoshi; Stookey, George K.

    2000-03-01

    Development of dental caries is associated with the loss of minerals and change in the enamel structure. In this study, we have measured and compared reflectance spectra of sound and carious enamel, to investigate its utility in detection and analysis of dental caries. One hundred twenty, 3-mm diameter human enamel cores, with no sign of fluorosis, tetracycline stain, hypoplasia, fracture and restorations, were prepared. The enamel surfaces then were ground and polished. Specimens were placed on a fitted holder with either black or white color for background, with no fluorescence. The baseline spectra were measured using a spectrophotometer with enclosed diffused illumination. Spectra measured from 380 to 780 nm at 5 nm intervals. All measurements were corrected to compensate for the spectrum of illumination. The specimens were divided into two groups and exposed to a demineralizing solution, for 48 and 96 hours, respectively. Reflectance spectra of specimens were measured following lesion induction. All specimens were sectioned and analyzed by transverse microradiography (TMR), where lesion depth and mineral loss ((Delta) Z) were measured. Dimensionality of multi-spectral data was reduced through its conversion to L*a*b* color coordinates and principal component analysis (PCA). Multiple linear regression analysis showed low correlation between L*a*b* and lesion depth and mineral loss. PCA analysis showed higher correlation coefficient, compared to L*a*b*. Preliminary results of this study suggest that multi-spectral measurement and analysis of the tooth surface could be useful in predicting the depth and severity of an early carious lesion.

  18. Evidence of an in vitro Coupled Diffusion Mechanism of Lesion Formation within Microcosm Dental Plaque.

    PubMed

    Owens, Gareth J; Lynch, Richard J M; Hope, Christopher K; Cooper, Lee; Higham, Susan M; Valappil, Sabeel P

    2017-03-01

    The purpose of this study was to determine whether or not the dual constant-depth film fermenter (dCDFF) is able to produce caries-like enamel lesions and to ascertain further information regarding the performance of this fully functional biological caries model. Conditions were defined by the continuation (CF) or cessation (FF) of a saliva-type growth medium supply during 50-mM sucrose exposures (8 times daily). Hydroxyapatite (n = 3) and bovine enamel (n = 3) substrata were included within each condition and samples extracted after 2, 4, 8, and 16 days. Community profiles were generated for fastidious anaerobes, Lactobacillus spp., Streptococcus spp., mutans streptococci (MS), and Veillonella spp. using selective culture techniques and enamel demineralisation assessed by transverse microradiography. Results demonstrated that the dCDFF model is able to produce caries-like enamel lesions with a high degree of sensitivity where reduced ionic strength within the FF condition increased surface layer mineral deposition. Between conditions, biofilm communities did not differ significantly, although MS in the biofilms extracted from the FF condition rose to a higher proportion (by 1.5 log10 units), and Veillonella spp. were initially greater within the CF condition (by 2.5 log10 units), indicating an enhanced ability for the clearance of low-pKa acids following exposures to sucrose. However, both conditions retained the ability for caries-like lesion formation.

  19. Evaluation of new treatment for incipient enamel demineralization using 45S5 bioglass.

    PubMed

    Bakry, A S; Takahashi, H; Otsuki, M; Tagami, J

    2014-03-01

    Bioglass 45S5 is a silica-based bioactive glass capable of depositing a layer of hydroxyl carbonate apatite on the surface of the glass when immersed in body fluids. The present paper studies a new technique for treating early human dental enamel caries lesions by using a paste composed of 45S5 bioglass and phosphoric acid. Artificial caries lesions were induced in enamel flat surfaces by means of a decalcification solution. All specimens were exposed to a brushing-abrasion challenge to test the durability of any newly formed layer resulting from the application of 45S5 bioglass paste. The specimens treated with bioglass paste showed complete coverage with a layer of brushite crystals. The brushing-abrasion challenge did not statistically affect the percentage of enamel coverage with the crystalline layer formed by the application of bioglass (p<0.05). These crystals were converted to hydroxyapatite crystals when stored in artificial saliva for 14 days. The current technique suggests the possibility of restoring incipient enamel erosive lesion with an abrasion durable layer of hydroxyapatite crystals.

  20. Validation of different diagnostic aids in detection of occlusal caries in primary molars: An in vitro study.

    PubMed

    Shwetha, G; Chandra, Prakash; Anandakrishna, Latha; Dhananjaya, G; Shetty, Ashmitha K; Kamath, Punitha S

    2017-01-01

    To estimate the accuracy and assess the sensitivity and specificity of direct visual examination (DVE), computerized radiograph (VISTA SCAN mini), and DIAGNOdent (DD) for caries diagnosis in primary molars as compared to histological examination of the teeth. An in vitro comparative study was carried out on 40 freshly extracted primary molars with questionable pit and fissures that yielded 89 examination sites. These samples were mounted on plaster and were subjected to examination methods for caries detection on the occlusal surface by two trained and calibrated examiners. The examination methods used in this study were DVE, computerized radiographic (CR) examination, laser fluorescence examination using DD followed by histological examination which is a gold standard; later, these samples were examined under microscope for caries extent. The scoring criteria given by Nytun et al. were used in this study for scoring the extent of caries. The sensitivity for caries in enamel were 66.10%, 52.86%, and 54.17% for DVE, CR, and DD, respectively, while the specificity for DVE, CR, and DD were found to be 86.67%, 68.42%, and 76.47%, respectively. For dentinal caries, sensitivity for DVE, CR, and DD were 86.67%, 92.86%, and 81.25%, respectively, while the specificity were 66.10%, 56%, and 54.79%, respectively. The accuracy were 73.03%, 61.80%, and 59.55%, respectively, suggesting that the DVE showed highest sensitivity, specificity, and accuracy for enamel caries, whereas for dentinal caries, CR showed highest sensitivity and DVE showed highest specificity and accuracy. The DD exhibited better specificity than sensitivity for enamel lesions and better sensitivity than specificity for lesions into dentin. DD may prove useful as a predictive clinical tool and should only be used in addition to other diagnostic methods such as visual inspection and dental radiographs to avoid false-positive diagnoses.

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

    PubMed

    Memarpour, Mahtab; Soltanimehr, Elham; Sattarahmady, Naghmeh

    2015-09-01

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

  2. Multimodal optical device for early childhood caries: a clinical prototype

    NASA Astrophysics Data System (ADS)

    Zhang, Liang; Ridge, Jeremy S.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

    There is currently a need for a safe and effective way to detect and diagnose early childhood caries. We have developed a multimodal optical clinical prototype for testing in vivo. The device can be used to quickly image and screen for any signs of demineralized enamel by obtaining high-resolution and highcontrast surface images using a 405-nm laser as the illumination source, as well as obtaining autofluorescence and bacterial fluorescence images. Then, when a suspicious region is located, the device can perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitation which is used to compute an autofluorescence ratio. This ratio can be used to quantitatively diagnose enamel health. The device is tested on four in vivo test subjects as well as 17 extracted teeth with clinically diagnosed carious lesions. The device was able to provide detailed images which served to screen for suspected early caries. The autofluorescence ratios obtained from the extracted teeth were able to discriminate between healthy and unhealthy enamel. Therefore, the clinical prototype demonstrates feasibility in screening for and in quantitatively diagnosing healthy from demineralized enamel.

  3. Detection of occlusal caries in primary teeth using swept source optical coherence tomography.

    PubMed

    Nakajima, Yukie; Shimada, Yasushi; Sadr, Alireza; Wada, Ikumi; Miyashin, Michiyo; Takagi, Yuzo; Tagami, Junji; Sumi, Yasunori

    2014-01-01

    This study aimed to investigate swept source optical coherence tomography (SS-OCT) as a detecting tool for occlusal caries in primary teeth. At the in vitro part of the study, 38 investigation sites of occlusal fissures (noncavitated and cavitated) were selected from 26 extracted primary teeth and inspected visually using conventional dental equipment by six examiners without any magnification. SS-OCT cross-sectional images at 1330-nm center wavelength were acquired on the same locations. The teeth were then sectioned at the investigation site and directly viewed under a confocal laser scanning microscope (CLSM) by two experienced examiners. The presence and extent of caries were scored in each observation. The results obtained from SS-OCT and conventional visual inspections were compared with those of CLSM. Consequently, SS-OCT could successfully detect both cavitated and noncavitated lesions. The magnitude of sensitivity for SS-OCT was higher than those for visual inspection (sensitivity of visual inspection and SS-OCT, 0.70 versus 0.93 for enamel demineralization, 0.49 versus 0.89 for enamel cavitated caries, and 0.36 versus 0.75 for dentin caries). Additionally, occlusal caries of a few clinical cases were observed using SS-OCT in vivo. The results indicate that SS-OCT has a great detecting potential for occlusal caries in primary teeth.

  4. Detection of occlusal caries in primary teeth using swept source optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Nakajima, Yukie; Shimada, Yasushi; Sadr, Alireza; Wada, Ikumi; Miyashin, Michiyo; Takagi, Yuzo; Tagami, Junji; Sumi, Yasunori

    2014-01-01

    This study aimed to investigate swept source optical coherence tomography (SS-OCT) as a detecting tool for occlusal caries in primary teeth. At the in vitro part of the study, 38 investigation sites of occlusal fissures (noncavitated and cavitated) were selected from 26 extracted primary teeth and inspected visually using conventional dental equipment by six examiners without any magnification. SS-OCT cross-sectional images at 1330-nm center wavelength were acquired on the same locations. The teeth were then sectioned at the investigation site and directly viewed under a confocal laser scanning microscope (CLSM) by two experienced examiners. The presence and extent of caries were scored in each observation. The results obtained from SS-OCT and conventional visual inspections were compared with those of CLSM. Consequently, SS-OCT could successfully detect both cavitated and noncavitated lesions. The magnitude of sensitivity for SS-OCT was higher than those for visual inspection (sensitivity of visual inspection and SS-OCT, 0.70 versus 0.93 for enamel demineralization, 0.49 versus 0.89 for enamel cavitated caries, and 0.36 versus 0.75 for dentin caries). Additionally, occlusal caries of a few clinical cases were observed using SS-OCT in vivo. The results indicate that SS-OCT has a great detecting potential for occlusal caries in primary teeth.

  5. Use of laser fluorescence for the early detection of dental caries

    NASA Astrophysics Data System (ADS)

    Stookey, George K.; Analoui, Mostafa

    1998-04-01

    Dental caries continues to be the most prevalent oral disease in spite of remarkable progress made during the past half- century to reduce its prevalence. Conventional procedures for caries detection are unable to detect the lesions until they are well advanced and involve about one-third of the thickness of enamel. Laboratory research on alternative caries detection methods based upon alterations in the conductance and optical properties associated with enamel demineralization has shown significant promise in recent years. Of these alternative measures, quantitative laser/light fluorescence appears to show the greatest promise for the detection of dental caries at a much earlier stage of development than is currently possible. A clinical trial was initiated in 150 children to evaluate, compare and validate several caries detection methods; in addition to the conventional diagnostic procedure, these detection methods involved quantitative light fluorescence, electrical conductivity, and direct digital radiography. Although the clinical trial is not yet complete, early results suggest the possibility for the earlier detection of dental caries with these alternative methods.

  6. Dental caries in Rome, 50-100 AD.

    PubMed

    Fejerskov, O; Guldager Bilde, P; Bizzarro, M; Connelly, J N; Skovhus Thomsen, J; Nyvad, B

    2012-01-01

    Scarce information exists on the clinical features of dental caries in the Imperial Roman population and no structural data on caries lesions from this period have so far been published. We report on the findings of 86 teeth (50-100 AD) found during archaeological excavations of the temple of Castor and Pollux in the Forum Romanum. We found that nearly all teeth had large carious cavities extending into the pulp. The distribution and size of the caries lesions were similar to those found in contemporary adult populations in Africa and China living without access to dental care. Most lesions had a hypermineralized zone in the dentin at the advancing front of the carious cavities as revealed by micro-computed tomography. This biological dentin reaction combined with the morphology of the cavities might indicate that some temporary topical pain relief and intervention treatment slowed down the rate of lesion progression. This is indirectly supported by examination of cavities of similar size and depth from a contemporary population without access to dental health care. In contrast to the lesions in the Roman teeth, these lesions did not exhibit a hypermineralized dentin reaction. We investigated whether the Pb isotopic composition of enamel and/or dentin of a single tooth matched that of a sample of an ancient Forum water lead pipe. The Pb isotopic composition of the tooth did not match that of the tube, suggesting that the subjects were exposed to different Pb sources during their lifetime other than the lead tubes.

  7. All-optical photoacoustic imaging and detection of early-stage dental caries

    NASA Astrophysics Data System (ADS)

    Sampathkumar, Ashwin; Hughes, David A.; Longbottom, Chris; Kirk, Katherine J.

    2015-02-01

    Dental caries remain one of the most common oral diseases in the world. Current detection methods, such as dental explorer and X-ray radiography, suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease because of the small size (< 100 microns) of early-stage lesions. We have developed a fine-resolution (480 nm), ultra-broadband (1 GHz), all-optical photoacoustic imaging (AOPAI) system to image and detect early stages of tooth decay. This AOPAI system provides a non-contact, non-invasive and non-ionizing means of detecting early-stage dental caries. Ex-vivo teeth exhibiting early-stage, white-spot lesions were imaged using AOPAI. Experimental scans targeted each early-stage lesion and a reference healthy enamel region. Photoacoustic (PA) signals were generated in the tooth using a 532-nm pulsed laser and the light-induced broadband ultrasound signal was detected at the surface of the tooth with an optical path-stabilized Michelson interferometer operating at 532 nm. The measured time-domain signal was spatially resolved and back-projected to form 2D and 3D maps of the lesion using k-wave reconstruction methods. Experimental data collected from areas of healthy and diseased enamel indicate that the lesion generated a larger PA response compared to healthy enamel. The PA-signal amplitude alone was able to detect a lesion on the surface of the tooth. However, time- reversal reconstructions of the PA scans also quantitatively depicted the depth of the lesion. 3D PA reconstruction of the diseased tooth indicated a sub-surface lesion at a depth of 0.6 mm, in addition to the surface lesion. These results suggest that our AOPAI system is well suited for rapid clinical assessment of early-stage dental caries. An overview of the AOPAI system, fine-resolution PA and histology results of diseased and healthy teeth will be presented.

  8. [Distribution of Bifidobacterium in oral cavities of children and the relations with caries].

    PubMed

    Zhai, Jing-Jing; Zou, Jing; Lu, Li-Ying

    2009-12-01

    To explore a selected-media of Bifidobacterium from oral cavity, to detect the distribution of Bifidobacterium in different sites of children and primarily investigate the relationship between oral Bifidobacterium and early childhood caries. 70 children aged from 3 to 5-year-old were selected, 30 children were caries-free and 40 were severe early childhood caries (S-ECC). Saliva was collected and plaque samples from the 30 healthy subjects were pooled. For S-ECC group, plaques were collected separately from four different sites as follows: Saliva, surfaces of intact enamel, surfaces of white spot-lesions, and deep dentin-lesions. Samples would be grown in the selected-media, and the whole DNA of bacteria was extracted. Polymerase chain reaction was performed with specific primers and the results were analyzed by the electrophoresis. Bifidobacterium were detected 0 in the caries-free children, while 47.5% in the S-ECC group. There was significant difference between two groups (P < 0.05) and there was no difference between different sites of teeth in S-ECC group (P > 0.05). 27.5% Bifidobacterium were detected in saliva, 27.5% on surfaces of intact enamel, 20.0% on surfaces of white spot-lesions and 22.5% in deep dentin-lesions. 10% Bifidobacterium dentium were detected in saliva, 7.5% on surfaces of intact enamel, 7.5% on surfaces of white spot-lesions and 10.0% in deep dentin-lesions. One type of modified selected media of Bifidobacterium in oral cavity was explored. Bifidobacterium may be related to the occurrence of the S-ECC and has nothing to do with different sites of teeth in children.

  9. Influence of dental materials used for sealing caries lesions on laser fluorescence measurements.

    PubMed

    Celiberti, Paula; Carvalho, Thiago S; Raggio, Daniela P; Mendes, Fausto M

    2012-03-01

    The aim of this study was to determine the influence of thickness and aging on the intrinsic fluorescence of sealing materials and their ability to block fluorescence from the underlying surface as assessed using a laser fluorescence device. Cavities of 0.5 mm and 1 mm depth were drilled into acrylic boards which were placed over two surfaces with different fluorescence properties: a low-fluorescence surface, to assess the intrinsic fluorescence of the sealing materials, and a high-fluorescence surface, to assess the fluorescence-blocking ability of the sealing materials. Ten cavities of each depth were filled with different sealing materials: Adper Scotchbond Multi-Purpose, Adper Single Bond 2, FluroShield, Conseal f and UltraSeal XT Plus. Fluorescence was measured with a DIAGNOdent pen at five different time points: empty cavity, after polymerization, and 1 day, 1 week and 1 month after filling. The individual values after polymerization, as well as the area under the curve for the different periods were submitted to ANOVA and the Tukey test (p < 0.05). At 0.5 mm, Scotchbond, FluroShield and UltraSeal showed insignificant changes in intrinsic fluorescence with aging and lower fluorescence after polymerization than Single Bond and Conseal. At 1 mm, Scotchbond and FluroShield showed the lowest intrinsic fluorescence, but only Scotchbond showed no chagnes in fluorescence with aging. At both depths, Scotchbond blocked significantly less fluorescence. All sealing materials blocked more fluorescence when applied to a depth of 1 mm. At 0.5 mm, fissure sealants blocked more fluorescence than adhesives, and did not show significant changes with aging. Scotchbond had the least affect on the fluorescence from the underlying surface and would probably have the least affect on the monitoring of sealed dental caries by laser fluorescence.

  10. Prevalence of Dental Caries among School Children in Chennai, Based on ICDAS II

    PubMed Central

    Arangannal, Ponnudurai; Jayaprakash, Jeevarathan

    2016-01-01

    Introduction Dental caries is a common dental disease, which occurs during childhood and continues to be a major public health problem. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. Aim The purpose of this study was to assess the prevalence of dental caries in school children aged between 6-14 years using the International Caries Detection and Assessment System (ICDAS II). Materials and Methods The study population consisted of 2796 school children living in Pallikkaranai, Chennai, India and studying in government recognized schools. Each student was examined by a single examiner using ICDAS system under natural light during normal school hours. Results The prevalence of dental caries was 68.8% in the total surveyed population. The gender-wise prevalence of dental caries shows, females to have slightly higher prevalence than male. The prevalence of dental caries at the age group of 6 years was 57%, seven year 67%, eight year 63%, nine year 74%, 10 year 76%, 11 year 74%, 12 year 69%, 13 year 71%, and 14 year 69%. The distribution of CARS (Caries associated with Sealants and Restorations) in the surveyed population was only 1.4% Conclusion The distribution of non-cavitated/early enamel lesions was higher in the studied population and indicated a requirement of a sustained dental health preventive program targeting specific segments of the population. PMID:27190939

  11. Influence of the mineral content and morphological pattern of artificial root caries lesion on composite resin bond strength.

    PubMed

    Hara, Anderson T; Queiroz, Celso S; Giannini, Marcelo; Cury, Jaime A; Serra, Mônica C

    2004-02-01

    Dentine substrates with different mineral contents and morphological patterns were created by submitting root slabs to the following treatments: (A) immersion in artificial saliva during the experimental period (control), (B) demineralization for 32 h to induce caries lesion (demineralized group), and (C) demineralization for 32 h followed by remineralization for 8 d (remineralized group). The slabs were longitudinally sectioned, the mineral content was determined by cross-sectional microhardness, and the bond strength of an adhesive system/composite resin was assessed using a microtensile bond strength test. The dentine morphology after the treatments as well as the failure pattern of the debonded specimens was examined by scanning electron microscopy. Statistically significant differences were found in mineral content. Morphological analysis showed marked differences between the patterns of demineralized and remineralized substrates. The bond strength mean value of the control A did not differ from the group B, but was statistically higher than the group C. Since no linear relationship was found between dentine mineral content and bond strength values, it could be suggested that the morphological pattern may be more relevant than the mineral content to explain the bond strength of composite resin to dentine.

  12. Approximal caries increment in adolescents after a visual aid in combination with a comprehensive open discussion.

    PubMed

    Häggblom, Anita; Naimi-Akbar, Aron; Lith, Agneta; Karlsson, Lena

    2013-01-01

    To achieve greater motivation for behavioural changes; educating, motivating and supporting the patient's ability to change lifestyle factors related to the caries disease are important tasks in the prevention of the disease. The aim of this study was to evaluate whether a visual aid (Visual Caries Dialogue, VCD) in combination with a comprehensive open discussion has a beneficial effect on approximal caries development among a population of young adolescents. The study subjects were randomized to either an intervention group (n = 118), where VCD was conducted, or a control group (n = 112) receiving traditional oral healthcare information, at the annual dental health examination. The number of caries lesions reaching through the entire enamel (D2) and dentin caries reaching through the enamel into the dentin (D3) were recorded from bitewing radiographs each year, from 2001-2004. Differences between the study groups regarding at least two new approximal surfaces with caries (D2-D3) were tested using logistic regression. The caries increment was lower in the intervention group compared to the control group. During the 3-year follow-up, 18 (15.3%) patients in the intervention group and 40 (35.7%) patients in the control group demonstrated a DS-approximal increment of at least two surfaces with a risk ratio of 2.34 (95% CI = 1.43-3.83). Visual Caries Dialogue in combination with a comprehensive open discussion reduced approximal caries increment among young individuals. The method provides an innovative simple and low-cost way of delivering information to patients and guides busy dental healthcare personnel in the approach.

  13. Histological validation of near-infrared reflectance multispectral imaging technique for caries detection and quantification

    NASA Astrophysics Data System (ADS)

    Salsone, Silvia; Taylor, Andrew; Gomez, Juliana; Pretty, Iain; Ellwood, Roger; Dickinson, Mark; Lombardo, Giuseppe; Zakian, Christian

    2012-07-01

    Near infrared (NIR) multispectral imaging is a novel noninvasive technique that maps and quantifies dental caries. The technique has the ability to reduce the confounding effect of stain present on teeth. The aim of this study was to develop and validate a quantitative NIR multispectral imaging system for caries detection and assessment against a histological reference standard. The proposed technique is based on spectral imaging at specific wavelengths in the range from 1000 to 1700 nm. A total of 112 extracted teeth (molars and premolars) were used and images of occlusal surfaces at different wavelengths were acquired. Three spectral reflectance images were combined to generate a quantitative lesion map of the tooth. The maximum value of the map at the corresponding histological section was used as the NIR caries score. The NIR caries score significantly correlated with the histological reference standard (Spearman's Coefficient=0.774, p<0.01). Caries detection sensitivities and specificities of 72% and 91% for sound areas, 36% and 79% for lesions on the enamel, and 82% and 69% for lesions in dentin were found. These results suggest that NIR spectral imaging is a novel and promising method for the detection, quantification, and mapping of dental caries.

  14. Histological validation of near-infrared reflectance multispectral imaging technique for caries detection and quantification.

    PubMed

    Salsone, Silvia; Taylor, Andrew; Gomez, Juliana; Pretty, Iain; Ellwood, Roger; Dickinson, Mark; Lombardo, Giuseppe; Zakian, Christian

    2012-07-01

    Near infrared (NIR) multispectral imaging is a novel noninvasive technique that maps and quantifies dental caries. The technique has the ability to reduce the confounding effect of stain present on teeth. The aim of this study was to develop and validate a quantitative NIR multispectral imaging system for caries detection and assessment against a histological reference standard. The proposed technique is based on spectral imaging at specific wavelengths in the range from 1000 to 1700 nm. A total of 112 extracted teeth (molars and premolars) were used and images of occlusal surfaces at different wavelengths were acquired. Three spectral reflectance images were combined to generate a quantitative lesion map of the tooth. The maximum value of the map at the corresponding histological section was used as the NIR caries score. The NIR caries score significantly correlated with the histological reference standard (Spearman's Coefficient=0.774, p<0.01). Caries detection sensitivities and specificities of 72% and 91% for sound areas, 36% and 79% for lesions on the enamel, and 82% and 69% for lesions in dentin were found. These results suggest that NIR spectral imaging is a novel and promising method for the detection, quantification, and mapping of dental caries.

  15. Demineralization of Enamel in Primary Second Molars Related to Properties of the Enamel

    PubMed Central

    Sabel, N.; Robertson, A.; Nietzsche, S.; Norén, J. G.

    2012-01-01

    Enamel structure is of importance in demineralization. Differences in porosity in enamel effect the rate of demineralization, seen between permanent and deciduous teeth. Individual differences have been shown in the mean mineral concentration values in enamel, the role of this in demineralization is not thoroughly investigated. The aim of this study was to study variations of depths of artificial lesions of demineralization and to analyze the depth in relation to variations in the chemical and mineral composition of the enamel. A demineralized lesion was created in second primary molars from 18 individuals. Depths of lesions were then related to individual chemical content of the enamel. Enamel responded to demineralization with different lesion depths and this was correlated to the chemical composition. The carbon content in sound enamel was shown to be higher where lesions developed deeper. The lesion was deeper when the degree of porosity of the enamel was higher. PMID:22629152

  16. Imaging of occlusal dental caries (decay) with near-IR light at 1310-nm

    NASA Astrophysics Data System (ADS)

    Bühler, Christopher M.; Ngaotheppitak, Patara; Fried, Daniel

    2005-01-01

    Dental enamel manifests high transparency in the near-IR. Previous work demonstrated that near-IR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) [1]. However, most new dental decay occurs in the pits and fissures of the occlusal (biting) surfaces of posterior teeth. These caries lesions cannot be detected by x-rays during the early stages of decay due to the overlapping topography of the crown of the tooth. In this study, a near- IR imaging system operating at 1310-nm was used to acquire occlusal images by launching the near-IR light into the buccal surface of the tooth just above the gingival margin (gum-line). The near-IR light diffuses through the highly scattering dentin providing uniform back illumination of the enamel of the crowns allowing imaging of the occlusal surfaces. The near-IR images show high contrast between sound and demineralized areas. Demineralization (decay) can be easily differentiated from stains, pigmentation, and hypomineralization (fluorosis). Moreover, the high transparency of the enamel enables imaging at greater depth for the detection of subsurface decay hidden under the enamel. These early images suggest that the near-IR offers significant advantages over conventional visual, tactile and radiographic caries detection methods.

  17. Imaging of occlusal dental caries (decay) with near-IR light at 1310-nm.

    PubMed

    Bühler, Christopher; Ngaotheppitak, Patara; Fried, Daniel

    2005-01-24

    Dental enamel manifests high transparency in the near-IR. Previous work demonstrated that near-IR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) [1]. However, most new dental decay occurs in the pits and fissures of the occlusal (biting) surfaces of posterior teeth. These caries lesions cannot be detected by x-rays during the early stages of decay due to the overlapping topography of the crown of the tooth. In this study, a near- IR imaging system operating at 1310-nm was used to acquire occlusal images by launching the near-IR light into the buccal surface of the tooth just above the gingival margin (gum-line). The near-IR light diffuses through the highly scattering dentin providing uniform back illumination of the enamel of the crowns allowing imaging of the occlusal surfaces. The near-IR images show high contrast between sound and demineralized areas. Demineralization (decay) can be easily differentiated from stains, pigmentation, and hypomineralization (fluorosis). Moreover, the high transparency of the enamel enables imaging at greater depth for the detection of subsurface decay hidden under the enamel. These early images suggest that the near-IR offers significant advantages over conventional visual, tactile and radiographic caries detection methods.

  18. Biomimetic Remineralization of Carious Lesions by Self-Assembling Peptide.

    PubMed

    Kind, L; Stevanovic, S; Wuttig, S; Wimberger, S; Hofer, J; Müller, B; Pieles, U

    2017-07-01

    Caries is the most common disease in the world. Great efforts have been undertaken for prevention and to identify a regenerative treatment solution for dental caries. Self-assembling β-sheet forming peptides have previously shown to form 3-dimensional fiber networks supporting tissue regeneration. In particular, the self-assembling peptide P11-4 has shown potential in the treatment and prevention of dental caries. It has previously been shown that application of monomeric P11-4 solution to early carious lesions can increase net mineral gain by forming de novo hydroxyapatite crystals. The hypothesis for the mode of action was that monomeric self-assembling peptide P11-4 diffuses into the subsurface lesion body and assembles therein into higher order fibrils, facilitating mineralization of the subsurface volume by mimicking the natural biomineralization of the tooth enamel, and it remains within the lesion body as a scaffold built-in by the newly formed hydroxyapatite. The aim of the present study was to investigate the mechanism of action of the self-assembling peptide P11-4 supporting mineralization of carious enamel. By various analytical methods, it could be shown that the self-assembling peptide P11-4 diffuses into the subsurface lesion, assembles into higher formed aggregates throughout the whole volume of the lesion, and supports nucleation of de novo hydroxyapatite nanocrystals and consequently results in increased mineral density within the subsurface carious lesion. The results showed that the application of self-assembling peptide P11-4 can facilitate the subsurface regeneration of the enamel lesion by supporting de novo mineralization in a similar mode of action as has been shown for the natural formation of dental enamel.

  19. Influence of microleakage, surface roughness and biofilm control on secondary caries formation around composite resin restorations: an in situ evaluation.

    PubMed

    Lima, Fábio Garcia; Romano, Ana Regina; Correa, Marcos Britto; Demarco, Flávio Fernando

    2009-01-01

    This study was carried out to evaluate in situ the influence of microleakage, surface roughness and biofilm control on caries formation around composite resin restorations. During 28 days, 12 volunteers wore palatal devices containing bovine enamel slabs restored with composite resin. Restorations were made without leakage, when the adhesive system was applied, or with leakage, when adhesive system was omitted. Half of the restorations in each group were finished and the remaining were finished and polished. In one side of the palatal device, biofilm was left to accumulate over the restored slabs, and in the other side dental slabs were brushed, to allow biofilm removal. There was an extraoral application of 20% sucrose solution (8x/day) over the enamel slabs. The formation of caries lesions (white spots) was evaluated by visual inspection under stereomicroscopy. Additionally, the dental slabs were sectioned and observed under polarized light microscopy. Data were submitted to Kruskal-Wallis test and Spearman's correlation test at 5% significance level. Polishing and bonding were not significant factors regarding white spot formation (p>0.05). Biofilm control (brushing) was associated with reduction of caries formation close to the restorations (p<0.01). Polarized light microscopy confirmed the visual inspection findings. These results suggest that while microleakage and surface roughness did not influence caries lesion formation, biofilm control may prevent the enamel demineralization.

  20. INFLUENCE OF MICROLEAKAGE, SURFACE ROUGHNESS AND BIOFILM CONTROL ON SECONDARY CARIES FORMATION AROUND COMPOSITE RESIN RESTORATIONS: AN IN SITU EVALUATION

    PubMed Central

    Lima, Fábio Garcia; Romano, Ana Regina; Correa, Marcos Britto; Demarco, Flávio Fernando

    2009-01-01

    This study was carried out to evaluate in situ the influence of microleakage, surface roughness and biofilm control on caries formation around composite resin restorations. During 28 days, 12 volunteers wore palatal devices containing bovine enamel slabs restored with composite resin. Restorations were made without leakage, when the adhesive system was applied, or with leakage, when adhesive system was omitted. Half of the restorations in each group were finished and the remaining were finished and polished. In one side of the palatal device, biofilm was left to accumulate over the restored slabs, and in the other side dental slabs were brushed, to allow biofilm removal. There was an extraoral application of 20% sucrose solution (8x/day) over the enamel slabs. The formation of caries lesions (white spots) was evaluated by visual inspection under stereomicroscopy. Additionally, the dental slabs were sectioned and observed under polarized light microscopy. Data were submitted to Kruskal-Wallis test and Spearman's correlation test at 5% significance level. Polishing and bonding were not significant factors regarding white spot formation (p>0.05). Biofilm control (brushing) was associated with reduction of caries formation close to the restorations (p<0.01). Polarized light microscopy confirmed the visual inspection findings. These results suggest that while microleakage and surface roughness did not influence caries lesion formation, biofilm control may prevent the enamel demineralization. PMID:19148408

  1. Surface variations affecting human dental enamel studied using nanomechanical and chemical analysis

    NASA Astrophysics Data System (ADS)

    Dickinson, Michelle Emma

    The enamel surface is the interface between the tooth and its ever changing oral environment. Cavity (caries) formation and extrinsic tooth staining are due, respectively, to degradation of the enamel structure under low pH conditions and interactions between salivary pellicle and dietary elements. Both of these occur at the enamel surface and are caused by the local environment changing the chemistry of the surface. The results can be detrimental to the enamel's mechanical integrity and aesthetics. Incipient carious lesions are the precursor to caries and form due to demineralisation of enamel. These carious lesions are a reversible structure where ions (e.g. Ca2+, F -) can diffuse in (remineralisation) to preserve the tooth's structural integrity. This investigation used controlled in vitro demineralisation and remineralisation to study artificial carious lesion formation and repair. The carious lesions were cross-sectioned and characterised using nanoindentation, electron probe micro-analysis and time of flight secondary ion mass spectrometry. Mechanical and chemical maps showed the carious lesion had a significantly reduced hardness and elastic modulus, and the calcium and phosphate content was lower than in sound enamel. Fluoride based remineralisation treatments gave a new phase (possibly fluorohydroxyapatite) within the lesion with mechanical properties higher than sound enamel. The acquired salivary pellicle is a protein-rich film formed by the physisorption of organic molecules in saliva onto the enamel surface. Its functions include lubrication during mastication and chemical protection. However, pellicle proteins react with dietary elements such as polyphenols (tannins in tea) causing a brown stain. This study has used in vitro dynamic nanoindentation and atomic force microscopy to examine normal and stained pellicles formed in vivo. The effects of polyphenols on the pellicle's mechanical properties and morphology have been studied. It was found that the

  2. EFFECT OF DIFFERENT PROPHYLAXIS METHODS ON SOUND AND DEMINERALIZED ENAMEL

    PubMed Central

    Honório, Heitor Marques; Rios, Daniela; Abdo, Ruy César Camargo; Machado, Maria Aparecida de Andrade Moreira

    2006-01-01

    Considering the importance of professional plaque control for caries prevention, this study comprised an in vitro evaluation of wear by two prophylaxis methods (sodium bicarbonate jet – Profident and pumice and brush) on sound bovine enamel and with artificial carious lesions. Sixty enamel fragments were employed (4x4mm), which were divided into 4 groups: GI – 15 sound blocks treated with pumice and brush; GII – 15 sound blocks treated with Profident; GIII – 15 demineralized blocks treated with pumice and brush, and GIV – 15 demineralized blocks treated with Profident. In the fragments of Groups III and IV, artificial carious lesions were simulated by immersion in 0.05M acetic acid solution 50% saturated with bovine enamel powder at 37oC for 16h. The specimens were submitted to the prophylactic treatments for 10 seconds. Wear analysis was performed by profilometer and revealed the following results: 0.91μm – GI; 0.42μm – GII; 1.6μm – GIII, and 0.94μm – GIV. The two-way ANOVA and Tukey's test (p<0.05) revealed significant difference between all groups. Scanning electron microscopy images were employed to illustrate the wear pattern, with observation of larger alteration on the demineralized enamel surface (GIII; GIV), round-shaped wear on GI and GIII and blasted aspect on GII and GIV. The study indicated that the demineralized enamel presented more wear than the sound enamel, and the brush led to larger wear when compared to Profident. PMID:19089042

  3. Occurrence and severity of enamel decalcification adjacent to bracket bases and sub-bracket lesions during orthodontic treatment with two different lingual appliances

    PubMed Central

    Klang, Elisabeth; Helms, Hans-Joachim; Wiechmann, Dirk

    2016-01-01

    Summary Background: Using lingual enamel surfaces for bracket placement not only has esthetic advantages, but may also be suitable in terms of reducing frequencies of enamel decalcifications. Objective: To test the null-hypothesis that there is no significant difference in enamel decalcification or cavitation incidence adjacent to and beneath bracket bases between two lingual multi-bracket (MB) appliances that are different in terms of design, material composition, and manufacturing technology (group A: WIN, DW-LingualSystems; group B: Incognito, 3M-Unitek), taking into account patient- and treatment-related variables on white spot lesion (WSL) formation. Methods: Standardized, digital, top-view photographs of 630 consecutive subjects (16214 teeth; n Incognito = 237/6076 teeth; n WIN = 393/10138 teeth; mean age: 17.47±7.8; m/f 43.2/56.8%) with completed lingual MB treatment of the upper and lower permanent teeth 1–7 were screened for decalcification or cavitation adjacent to and beneath the bracket bases before and after treatment, scored from 0 to 7. Non-parametric ANOVA was used for main effects ‘appliance type’, ‘gender’, ‘treatment complexity’, ‘grouped age’ (≤16/>16 years), and ‘treatment duration’ as covariable, at an α-level of 5%. Results: About 2.57% [5.94%] of all teeth in group A [B] developed decalcifications. Subject-related incidence was 9.59% [16.17%] for upper incisors in group A [B], and 12.98% [25.74%] for all teeth 16–46. There were significant effects by gender, age, and treatment duration. Conclusion: The null-hypothesis was rejected: sub-bracket lesions were significantly less frequent in group A, while frequencies of WSL adjacent to brackets were not significantly affected by appliance type. In view of the overall low incidences of lingual post-orthodontic white-spot lesions, the use of lingual appliances is advocated as a valid strategy for a reduction of enamel decalcifications during orthodontic treatment. PMID

  4. Novel calcium phosphate nanocomposite with caries-inhibition in a human in situ model

    PubMed Central

    Melo, Mary Anne S.; Weir, Michael D.; Rodrigues, Lidiany K.A.; Xu, Hockin H.K.

    2013-01-01

    Objectives Secondary caries at the restoration margins remains the main reason for failure. Although calcium phosphate (CaP) composites are promising for caries inhibition, there has been no report of CaP composite to inhibit caries in situ. The objectives of this study were to investigate the caries-inhibition effect of nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP) in a human in situ model for the first time, and to determine colony-forming units (CFU) and Ca and P ion concentrations of biofilms on the composite restorations. Methods NACP with a mean particle size of 116 nm were synthesized via a spray-drying technique. Two composites were fabricated: NACP nanocomposite, and control composite filled with glass particles. Twenty-five volunteers wore palatal devices containing bovine enamel slabs with cavities restored with NACP or control composite. After 14 days, the adherent biofilms were collected for analyses. Transverse microradiography determined the enamel mineral profiles at the margins, and the enamel mineral loss ! Z was measured. Results NACP nanocomposite released Ca and P ions and the release significantly increased at cariogenic low pH (p < 0.05). Biofilms on NACP nanocomposite contained higher Ca (p = 0.007) and P ions (p = 0.005) than those of control (n = 25). There was no significant difference in biofilm CFU between the two composites (p > 0.1). Microradiographs showed typical subsurface lesions in enamel next to control composite, but much less lesion around NACP nanocomposite. Enamel mineral loss ! Z (mean ± sd; n = 25) around NACP nanocomposite was 13.8 ± 9.3 μm, much less than 33.5 ± 19.0 μm of the control (p = 0.001). Significance Novel NACP nanocomposite substantially reduced caries formation in a human in situ model for the first time. Enamel mineral loss at the margins around NACP nanocomposite was less than half of the mineral loss around control composite. Therefore, the Ca and P ion-releasing NACP

  5. Novel calcium phosphate nanocomposite with caries-inhibition in a human in situ model.

    PubMed

    Melo, Mary Anne S; Weir, Michael D; Rodrigues, Lidiany K A; Xu, Hockin H K

    2013-02-01

    Secondary caries at the restoration margins remains the main reason for failure. Although calcium phosphate (CaP) composites are promising for caries inhibition, there has been no report of CaP composite to inhibit caries in situ. The objectives of this study were to investigate the caries-inhibition effect of nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP) in a human in situ model for the first time, and to determine colony-forming units (CFU) and Ca and P ion concentrations of biofilms on the composite restorations. NACP with a mean particle size of 116 nm were synthesized via a spray-drying technique. Two composites were fabricated: NACP nanocomposite, and control composite filled with glass particles. Twenty-five volunteers wore palatal devices containing bovine enamel slabs with cavities restored with NACP or control composite. After 14 days, the adherent biofilms were collected for analyses. Transverse microradiography determined the enamel mineral profiles at the margins, and the enamel mineral loss ΔZ was measured. NACP nanocomposite released Ca and P ions and the release significantly increased at cariogenic low pH (p<0.05). Biofilms on NACP nanocomposite contained higher Ca (p=0.007) and P ions (p=0.005) than those of control (n=25). There was no significant difference in biofilm CFU between the two composites (p>0.1). Microradiographs showed typical subsurface lesions in enamel next to control composite, but much less lesion around NACP nanocomposite. Enamel mineral loss ΔZ (mean±sd; n=25) around NACP nanocomposite was 13.8±9.3 μm, much less than 33.5±19.0 μm of the control (p=0.001). Novel NACP nanocomposite substantially reduced caries formation in a human in situ model for the first time. Enamel mineral loss at the margins around NACP nanocomposite was less than half of the mineral loss around control composite. Therefore, the Ca and P ion-releasing NACP nanocomposite is promising for caries-inhibiting restorations

  6. [Caries severity and associated factors in preschool children aged 3-6 years old in Campeche City, Mexico].

    PubMed

    Segovia-Villanueva, América; Estrella-Rodríguez, Ramon; Medina-Solís, Carlo Eduardo; Maupomé, Gerardo

    2005-01-01

    To identify individuals affected by severe carious lesions, according to the size of lesion, and to determine the associated factors. A cross-sectional study was carried out in 1303 children aged 3 to 6 from 10 public preschools with a public preventive dental program. Presence and severity of dental caries were diagnosed using standard criteria (magnitude of carious lesion), which contained four lesion types based on their severity or size. The mothers completed questionnaires to supply information on hygienic habits of the child, and socio-demographics and socioeconomic status variables for the family. Children were examined by one of three calibrated and standardized examiners (kappa>0.85). Adjusted ordinal logistic regression (odds proportional model) was performed to identify associations between caries severity and risk indicators. The percentages of subjects in severity groups I, II, III and IV were 77.3%, 4.8%, 12% and 5.9%, respectively. We observed that subjects with dmft>4 (sum of decayed, indicated for extraction, and filled primary teeth), presented the severest carious lesions (71.4% vs 6.7%; p<0.001). The variables associated to caries severity were: older age of the child, mother's negative attitude toward dental health, regular and inadequate level of oral hygiene, and an interaction between low socioeconomic level and presence of structural enamel defects. We observed a low percentage (17.8%) of subjects affected by severe lesion of dental caries (groups III & IV). Well-defined arrays of variables were associated with caries severity.

  7. Suitability of ART approach for managing caries lesions in people with disability-Experts' opinion.

    PubMed

    Molina, Gustavo F; Faulks, Denise; Frencken, Jo E

    2013-11-01

    This study aimed to obtain the opinions of experts in Special Care Dentistry (SCD) regarding the suitability of the Atraumatic Restorative Treatment (ART) approach for the treatment of carious lesions in persons with disability. Thirty expert participants from around the world, joining the SCD Task Force meeting, Education Committee of the International Association of Disability and Oral Health (Antalya, Turkey, 2011), completed a questionnaire survey. Frequency distributions of variables were analysed using Chi-Square test for differences between variables. All respondents reported having full or moderate knowledge of ART (23.3% and 63.3%, respectively) and 66.7% indicated that they felt the technique was useful for this population. However, only 50% of respondents used the technique regularly in their practice and five (16.7%) replied that they would never use it, even if a favourable evidence base for ART use in this population became available. The barriers to the introduction of ART to SCD are discussed and the need for training and further research highlighted. Barriers to the implementation of ART in practice were placement of the restoration under difficult conditions and the dentist's pre-conception of the technique as being 'lower quality dentistry'. Experts suggested that some of these barriers might be overcome by improving the evidence base in favour of the technique, specifically in the population with disability.

  8. Fluoride use in caries prevention in the primary care setting.

    PubMed

    Clark, Melinda B; Slayton, Rebecca L

    2014-09-01

    Dental caries remains the most common chronic disease of childhood in the United States. Caries is a largely preventable condition, and fluoride has proven effectiveness in the prevention of caries. The goals of this clinical report are to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians in using fluoride to achieve maximum protection against dental caries while minimizing the likelihood of enamel fluorosis.

  9. Evaluation of Fluorescence Imaging with Reflectance Enhancement (FIRE) for Quantifying Enamel Demineralization In vitro.

    PubMed

    Xiao, Qiang; Tu, Rui; He, Tao; Yin, Wei; Li, Xue; Hu, Deyu; Zhang, Ximu

    2015-01-01

    To assess the ability of fluorescence imaging with reflectance enhancement (FIRE) to quantify early enamel demineralization in vitro. A total of 30 bovine enamel specimens were immersed in demineralizing solution to produce artificial caries. Specimens were examined by FIRE, quantitative light-induced fluorescence (QLF), and polarized light microscopy (PLM) at baseline and after 0.5, 1, 2, 4, 8, 24, 48 and 72 h of immersion. Fluorescence loss measured by FIRE and QLF was compared with lesion depth measurements by PLM. Over all time points, measurement of fluorescence loss by FIRE correlated well with the measurement of x0394;F by QLF and of x0394;Q by QLF. Both FIRE and QLF techniques showed significant correlation with PLM. FIRE technology may be useful for quantifying enamel demineralization in vitro. © 2015 S. Karger AG, Basel.

  10. Practitioner, patient, and caries lesion characteristics associated with type of material used to restore carious teeth: findings from The Dental PBRN

    PubMed Central

    Makhija, Sonia K; Gordan, Valeria V.; Gilbert, Gregg H.; Litaker, Mark S.; Rindal, D. Brad; Pihlstrom, Daniel J.; Qvist, Vibeke

    2011-01-01

    Background The authors conducted a study to identify factors associated with material use by dentists in The Dental Practice-Based Research Network (DPBRN) when placing the first restoration on permanent tooth surfaces. Methods A total of 182 DPBRN practitioner-investigators provided data on 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist’s age, gender, practice workload, practice type, and years since graduation. When a consented patient presented with a previously un-restored carious surface, practitioner-investigators recorded patient and tooth characteristics. Results Amalgam was used more often than direct resin-based composite (RBC) for posterior carious lesions. Practitioner/practice characteristics (years since graduation and type of practice); patient characteristics (gender, race, age, and dental insurance); and lesion characteristics (tooth location and surface, pre-and post-operative depth) were associated with the type of restorative material used. Conclusions There are several practitioner/practice, patient, and lesion characteristics significantly associated with use of amalgam and RBC: region, years since graduation, dental insurance, tooth location and surface, and pre-and post-operative depth. Clinical implications Amalgam remains a material commonly used by United States dentists to restore posterior caries lesions. PMID:21628683

  11. Effects of different amine fluoride concentrations on enamel remineralization.

    PubMed

    Naumova, E A; Niemann, N; Aretz, L; Arnold, W H

    2012-09-01

    The aim of this study was to investigate the effects of decreasing fluoride concentrations on repeated demineralizing challenges on human enamel. In 24 teeth, 3mm×3mm windows were prepared on the buccal and lingual sides and treated in a cycling demineralization-remineralization model. Remineralization was achieved with 100, 10 and 0.1 ppm fluoride from anime fluoride. Coronal sections were cut through the artificial lesions, and three sections per tooth were investigated using polarized light microscopy and scanning electron microscopy with quantitative element analysis. The morphology of the lesions was studied, and the extensions of the superficial layer and the body of the lesion were measured. Using element analysis, the Ca, P and F content were determined. The body of the lesion appeared remineralized after application of 100 ppm fluoride, while remineralization of the lesion was less successful after application of 10 and 0.1 ppm fluoride. The thickness of the superficial layer increased with decreasing fluoride concentrations, and also the extension of the body of the lesion increased. Ca and P content increased with increasing fluoride concentrations. The effectiveness of fluoride in enamel remineralization increased with increasing fluoride concentration. A consistently higher level of fluoride in saliva should be a goal in caries prevention. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Resin infiltrant for non-cavitated caries lesions: evaluation of color stability

    PubMed Central

    Ceci, Matteo; Rattalino, Davide; Viola, Matteo; Beltrami, Riccardo; Chiesa, Marco; Colombo, Marco

    2017-01-01

    Background The objective of this in vitro study was to evaluate the over time color stability of one resin infiltrant (Icon) upon exposure to staining solutions (coffee and wine) compared with one nano-hybrid sealant (Grandio Seal), one transparent fissure sealant with fluoride (Control Seal) and one nanofilled composite (Filtek Supreme XTE). Material and Methods All materials were polymerized according to manufacturers’ instructions into silicon rings (height 1 mm; internal diameter 6 mm; external diameter 8 mm) to obtain specimens identical in size. The specimens were immersed in staining solutions at room temperature over a 28-day test period. The control samples have not been subjected to the staining process. A colorimetric evaluation according to the CIE L*a*b* system was performed by a blind trained operator at 7, 14, 21, 28 days of the staining process. Shapiro Wilk test and Kruskal Wallis ANOVA were applied to assess significant differences among different materials. Means were compared with Scheffe’s multiple-comparison test at the 0.05 level of significance. Results In the case of all materials, immersion in solutions resulted in clinically perceivable color changes after 1 week (∆E < 3.3). Lowest CIE L* variation was registered for Control Seal and Grandio Seal both after 1 week and after 1 month, while Icon showed significantly higher variation (P < 0.05). Color coordinate CIE a* varied significantly more for Icon samples (P > 0.05). Color coordinate CIE b* varied similarly for all materials tested (P > 0.05). Conclusions Immersion in coffee or red wine resulted in clinically perceivable color changes for all materials tested. Icon showed the highest color variations both after 1 week and 1 month. Icon can fix the initial esthetic problem associated with white spot lesions, but the resin may become more discolored than other materials over time. Key words:CIE Lab, color stability, resin infiltrant. PMID:28210441

  13. Deep carious lesions and other consequences of caries among 18-year-olds at Public Dental Health Service in Northern Norway: A cross-sectional age cohort study.

    PubMed

    Stangvaltaite, Lina; Kundzina, Rita; Bolstad, Napat Limchaichana; Eriksen, Harald M; Kerosuo, Eero

    2015-08-01

    To document deep carious lesions and other consequences of caries (DCL-CC) in molars of 18-year olds leaving the free-of-charge Public Dental Health Service (PDHS). To explore the association between background factors and DCL-CC. The final study sample (n=1876) comprised 95% of individuals born in 1993 and registered in the PDHS in Troms County, Northern Norway. The most recent digital bitewing radiographs of each subject were examined for DCL-CC (deep untreated carious lesions, deep restorations, root canal obturations or extractions due to caries). Inter- and intra-observer kappa scores were 0.62 and 0.87, respectively. Information on background factors (gender, clinic location, history of medical problems, bitewing examination interval, DMFT score and planned recalls) were retrieved from dental records. About one-quarter of subjects (488) had at least one molar with DCL-CC. There were 848 molars in total with DCL-CC; the majority were deep restorations (70%), but 4% were deep untreated carious lesions. More than a quarter of DCL-CC were either root canal obturations (14%) or extractions (12%). Multivariable logistic regression analyses showed that a 1-unit increase in DMFT score was associated with deep untreated carious lesions and extractions due to caries. There was no association between urban/rural clinic location, which indicated socio-economic status, and either DMFT score or DCL-CC. Despite the existence of a free-of-charge dental service, more than one-quarter of the subjects in the present study had at least one molar with DCL-CC.

  14. Selective removal of dental caries with a diode-pumped Er:YAG laser

    NASA Astrophysics Data System (ADS)

    Yan, Ruth; Chan, Kenneth H.; Tom, Henry; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2015-02-01

    Selective removal of caries lesions with high precision is best accomplished using lasers operating at high pulse repetition rates utilizing small spot sizes. Conventional flash-lamp pumped Er:YAG lasers are poorly suited for this purpose, but new diode-pumped Er:YAG lasers have become available operating at high pulse repetition rates. The purpose of this study was to measure the ablation rate and selectivity of sound and demineralized enamel and dentin for a 30 W diode-pumped Er:YAG laser operating with a pulse duration of 20-30-μs and evaluate it's potential for the selective removal of natural occlusal lesions on extracted teeth. Microradiography was used to determine the mineral content of the demineralized enamel and dentin of 300-μm thick sections with natural caries lesions prior to laser ablation. The ablation rate was calculated for varying mineral content. In addition, near-IR reflectance measurements at 1500-1700- nm were used to guide the laser for the selective ablation of natural occlusal caries lesions on extracted teeth.

  15. Diagnosis and Management of Hidden Caries in a Primary Molar Tooth

    PubMed Central

    Gera, Arwa

    2017-01-01

    Hidden caries is a dentinal lesion beneath the dentinoenamel junction, visible on radiographs. A single report described this lesion in primary dentition. This case report describes a case of hidden caries in a mandibular second primary molar, misdiagnosed as malignant swelling. A 3-year-old white girl was referred to the Department of Pediatric Dentistry with a chief complaint of pain and extraoral swelling on the right side of the mandible for the last 3 months. She was earlier referred to the surgical department for biopsy of the lesion. Radiographic and computed tomography scan examination showed a periapical lesion with buccal plate resorption and radiolucency beneath the enamel on the mesial part of tooth 85. The tooth was extracted, and follow-up of 2 years showed normal development of tooth 45. The main problem is early detection and treatment, since the outer surface of enamel may appear intact on tactile examination. How to cite this article Gera A, Zilberman U. Diagnosis and Management of Hidden Caries in a Primary Molar Tooth. Int J Clin Pediatr Dent 2017;10(1):99-102. PMID:28377664

  16. Clinical and radiographic diagnosis of approximal and occlusal dental caries in a low risk population.

    PubMed

    Galcerá Civera, Verónica; Almerich Silla, José M; Montiel Company, José M; Forner Navarro, Leopoldo

    2007-05-01

    Determine the agreement between visual detection, conventional radiology and digital radiology methods in the diagnosis of interproximal and occlusal caries in the posterior teeth of a group of patients with low caries prevalence. Visual, conventional radiographic and digital radiographic (Digora, Soredex, Sweden) caries diagnosis was performed in a group of patients (n=30) of both sexes with ages ranging from 15 to 65 years (x = 34 years). Agreement was estimated by the linear weighted kappa index. Kappa = 0.17 was obtained between the visual examination and the conventional radiographic examination and Kappa = 0.16 between the visual examination and the radiovisiography. Between conventional and digital radiography the Kappa indices were 0.81 overall, 0.87 in the dentine and 0.66 in the enamel. Compared to visual examination, 3.23 times more caries lesions were diagnosed with digital radiology and 2.88 times more with conventional radiography. 94% of the new caries detected were interproximal. The use of radiographic techniques, whether conventional or digital, increases the number of caries diagnosed in comparison with conventional clinical examination. The two radiographic techniques show high agreement in lesion diagnosis.

  17. Preparation of fluoride substituted apatite cements as the building blocks for tooth enamel restoration

    NASA Astrophysics Data System (ADS)

    Wei, Jie; Wang, Jiecheng; Liu, Xiaochen; Ma, Jian; Liu, Changsheng; Fang, Jing; Wei, Shicheng

    2011-06-01

    Fluoride substituted apatite cement (fs-AC) was synthesized by using the cement powders of tetracalcium phosphate (TTCP) and sodium fluoride (NaF), and the cement powders were mixed with diluted phosphoric acid (H 3PO 4) as cement liquid to form fs-AC paste. The fs-AC paste could be directly filled into the carious cavities to repair damaged dental enamel. The results indicated that the fs-AC paste was changed into fluorapatite crystals with the atom molar ratio for calcium to phosphorus of 1.66 and the F ion amount of 3 wt% after self-hardening for 2 days. The solubility of fs-AC in Tris-HCl solution (pH 6) was slightly lower than hydroxyapatite cement (HAC) that was similar to the apatite in enamel, indicating the fs-AC was much insensitive to the weakly acidic solution than the apatite in enamel. The fs-AC was tightly combined with the enamel surface because of the chemical reaction between the fs-AC and the apatite in enamel after the caries cavities was filled with fs-AC. The extracts of fs-AC caused no cytotoxicity on L929 cells, which satisfied the relevant criterion on dental biomaterials, revealing good cytocompatibility. The fs-AC had potential prospect for the reconstitution of carious lesion of dental enamel.

  18. [The study on chemical composition and crystalline structure of hypoplastic primary dental enamel].

    PubMed

    Zheng, S; Deng, H; Gao, X

    1997-11-01

    The present study, firstly, analyzed chemical composition of hypoplastic primary teeth by electron probe analyzer and compared the hypoplastic part with the normal part in the same tooth; secondly, by X-ray diffraction analyzer, studied the hypoplastic dental enamel and the normal dental enamel, and compared the crystalline structure between different dental enamel and with that of the hydroxyapatite. The aim was to find out any change of crystalline structure. Two exfoliated hypoplastic deciduous anterior teeth were used for the electron probe study. The normal part of each tooth served as control. Determinations of weight percentage (wt%) were made for P, Al, Mg, Ca, Mn, Fe, Zn, Sr, Na, K and F. Four exfoliated hypoplastic deciduous anterior teeth and eight exfoliated normal deciduous anterior teeth were used for the X-ray diffraction study. We found by X-ray diffraction that the length of the alpha-axis of enamel crystallite and the distance of lattice plane (corresponding 300) were increased in defective enamel and could be associated with the increased content of magnesium detected by electron probe. Thus, the present study demonstrated that there were both quantity and quality changes in the enamel hypoplasia lesion, which may increase the susceptibility of the defective teeth to caries.

  19. Diagnostic Value of Conventional and Digital Radiography for Detection of Cavitated and Non-Cavitated Proximal Caries.

    PubMed

    Dehghani, Mahdieh; Barzegari, Rasool; Tabatabai, Hosein; Ghanea, Sahar

    2017-01-01

    This study aimed to assess the diagnostic value of conventional and digital radiography for detection of cavitated and non-cavitated proximal caries. Fifty extracted human premolars and molars were mounted in a silicone block. Charge-coupled device (CCD) and photostimulable phosphor plate (PSP) receptors and intra-oral films were exposed with 60 and 70 kVp with parallel technique. Two observers interpreted the radiographs twice with a two-week interval using a 5-point scale. Teeth were then serially sectioned in mesiodistal direction and evaluated under a stereomicroscope (gold standard). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Sensitivity of all three receptors for detection of enamel lesions was low (5.5-44.4%) but it was higher for dentin lesions (42.8-62.8%); PSP with 70 kVp and 0.03s exposure time had the highest sensitivity for enamel lesions, but the difference among receptors was not statistically significant (P>0.05). Sensitivity of all three receptors for detection of non-cavitated lesions was lower than that for cavitated lesions; PSP with 60 kVp and 0.07s exposure time had higher sensitivity and lower patient radiation dose for detection of cavitated and non-cavitated lesions, but the difference was not significant (P>0.05). Digital radiography using PSP receptor with 70 kVp is recommended to detect initial enamel caries. For detection of non-cavitated and cavitated dentin caries, PSP with 60 kVp is more appropriate. Change in kVp did not affect the diagnostic accuracy for detection of caries, and type of receptor was a more important factor.

  20. Diagnostic Value of Conventional and Digital Radiography for Detection of Cavitated and Non-Cavitated Proximal Caries

    PubMed Central

    Dehghani, Mahdieh; Barzegari, Rasool; Tabatabai, Hosein

    2017-01-01

    Objectives: This study aimed to assess the diagnostic value of conventional and digital radiography for detection of cavitated and non-cavitated proximal caries. Materials and Methods: Fifty extracted human premolars and molars were mounted in a silicone block. Charge-coupled device (CCD) and photostimulable phosphor plate (PSP) receptors and intra-oral films were exposed with 60 and 70 kVp with parallel technique. Two observers interpreted the radiographs twice with a two-week interval using a 5-point scale. Teeth were then serially sectioned in mesiodistal direction and evaluated under a stereomicroscope (gold standard). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Sensitivity of all three receptors for detection of enamel lesions was low (5.5–44.4%) but it was higher for dentin lesions (42.8–62.8%); PSP with 70 kVp and 0.03s exposure time had the highest sensitivity for enamel lesions, but the difference among receptors was not statistically significant (P>0.05). Sensitivity of all three receptors for detection of non-cavitated lesions was lower than that for cavitated lesions; PSP with 60 kVp and 0.07s exposure time had higher sensitivity and lower patient radiation dose for detection of cavitated and non-cavitated lesions, but the difference was not significant (P>0.05). Conclusions: Digital radiography using PSP receptor with 70 kVp is recommended to detect initial enamel caries. For detection of non-cavitated and cavitated dentin caries, PSP with 60 kVp is more appropriate. Change in kVp did not affect the diagnostic accuracy for detection of caries, and type of receptor was a more important factor. PMID:28828014

  1. Mineralisation of developmentally hypomineralised human enamel in vitro.

    PubMed

    Crombie, F A; Cochrane, N J; Manton, D J; Palamara, J E A; Reynolds, E C

    2013-01-01

    Molar-incisor hypomineralisation (MIH) is a problematic and costly condition. Caries remineralising agents are often recommended for MIH management despite the lack of evidence that these lesions have the capacity for increasing their mineral content. Following surface layer removal ± NaOCl pre-treatment and 14-day exposure to a CPP-ACFP solution at pH 5.5, MIH lesions were analysed using transverse microradiography and polarised light microscopy. Lesions were highly variable but treatment with the remineralising solution increased mineral content (1,828 ± 461 vol% min · µm, %R = 17.7 ± 5.7) and porosity decreased demonstrating the proof of concept that the mineral content of developmentally hypomineralised enamel can be improved after eruption.

  2. Drugs that promote dental caries.

    PubMed

    2015-02-01

    Dental caries result from erosion of tooth enamel or cementum by acidic substances produced by bacteria found in dental plaque. Caries can lead to pulp necrosis and tooth loss. Risk factors include certain dietary habits, poor oral hygiene, and dry mouth. Diabetes and Sjogren's syndrome can also promote dental caries. Psychotropic substances such as cocaine, methamphetamine, heroin and cannabis can promote dental caries. Many medicinal drugs facilitate the formation of dental caries, through various mechanisms; they include formulations with a high sugar content; drugs that cause dry mouth (especially antimuscarinics); drugs that lower the buccal pH (inhaled powders, etc.); and drugs that cause demineralisation (tetracyclines, etc.). In practice, patients (and parents) should be informed that some drugs can increase the risk of dental caries. They should be encouraged to adapt and reinforce dental hygiene, and advised to visit a dentist regularly.

  3. Optical diagnosis and characterization of dental caries with polarization-resolved hyperspectral stimulated Raman scattering microscopy

    PubMed Central

    Wang, Zi; Zheng, Wei; Hsu, Stephen Chin-Ying; Huang, Zhiwei

    2016-01-01

    We report the utility of a rapid polarization-resolved hyperspectral stimulated Raman scattering (SRS) imaging technique developed for optical diagnosis and characterization of dental caries in the tooth. Hyperspectral SRS images (512 × 512 pixels) of the tooth covering both the fingerprint (800-1800 cm−1) and high-wavenumber (2800-3600 cm−1) regions can be acquired within 15 minutes, which is at least 103 faster in imaging speed than confocal Raman mapping. Hyperspectral SRS imaging uncovers the biochemical distributions and variations across the carious enamel in the tooth. SRS imaging shows that compared to the sound enamel, the mineral content in the body of lesion decreases by 55%; while increasing up to 110% in the surface zone, indicating the formation of a hyper-mineralized layer due to the remineralization process. Further polarized SRS imaging shows that the depolarization ratios of hydroxyapatite crystals (ν1-PO43- of SRS at 959 cm−1) of the tooth in the sound enamel, translucent zone, body of lesion and the surface zone are 0.035 ± 0.01, 0.052 ± 0.02, 0.314 ± 0.1, 0.038 ± 0.02, respectively, providing a new diagnostic criterion for discriminating carious lesions from sound enamel in the teeth. This work demonstrates for the first time that the polarization-resolved hyperspectral SRS imaging technique can be used for quantitatively determining tooth mineralization levels and discriminating carious lesions from sound enamel in a rapid fashion, proving its promising potential of early detection and diagnosis of dental caries without labeling. PMID:27446654

  4. The anti-caries activity and toxicity of an experimental propolis-containing varnish.

    PubMed

    DE Luca, Mariana Passos; Freires, Irlan Almeida; Gala-García, Alfonso; Santos, Vagner Rodrigues; Vale, Miriam Pimenta; Alencar, Severino Matias de; Rosalen, Pedro Luiz

    2017-06-05

    We investigated the anti-caries effects of an experimental propolis varnish in vivo, and further tested its toxicity against fibroblasts. Fifty-six SPF female Wistar rats were infected with Streptococcus mutans UA159 (SM) and allocated into four groups (n = 14/group): G1, propolis varnish (15%/PV); G2, chitosan varnish (CV/vehicle); G3, gold standard (GS/Duraphat®); and G4, untreated. The animals received a single varnish application on their molars and were submitted to a high cariogenic challenge (Diet-2000, 56% sucrose, and 5% sucrose-added water, ad libitum) for 4 weeks. Total cultivable microbiota and SM were counted, and smooth-surface and sulcal caries were scored. PV, CV and GS cytotoxic effects were tested against fibroblasts. The data were analyzed using ANOVA with the Tukey-Kramer test (p ≤ 0.05). Total microbiota and SM counts did not differ among the treatments (p = 0.78), or in relation to the untreated group (p = 0.52). PV reduced development of smooth-surface enamel caries compared with the untreated group (p = 0.0018), with no significant difference from GS (p = 0.92); however, the PV effects were no longer observed when the dentin was affected. Neither PV nor GS prevented enamel sulcal lesion onset, but GS significantly reduced the severity of dentinal sulcal lesions (p < 0.0001). No significant difference was observed in fibroblast viability between PV and GS (p < 0.0001). In conclusion, PV prevented smooth-surface enamel caries and showed low cell toxicity. Nevertheless, due to the high cariogenic challenge, its effects were not sustained throughout the experiment. Further studies are encouraged to establish a protocol to sustain the long-term anti-caries activity of PV in the oral cavity.

  5. In vivo effectiveness of enamel sealants around orthodontic brackets.

    PubMed

    Bechtold, T E; Sobiegalla, A; Markovic, M; Berneburg, M; Göz, G R

    2013-11-01

    In this randomized study, the caries-protective effect on vestibular enamel of two fluoride-containing sealants (Protecto® and Light Bond®) during multibracket treatment was investigated. In all, 40 orthodontic patients about to receive a multibracket appliance with the brackets bonded to the vestibular tooth surfaces were randomly included in this study. Each one was randomly assigned to one of four groups. A crossover design was selected in which a sealed quadrant was contralateral to an unsealed quadrant, then choosing the reverse configuration in the opposite jaw. Two sealants were, thus, tested on vestibular enamel on left and right anterior teeth and premolars in both jaws of each patient over 6 months of multibracket treatment. A DIAGNOdent® pen measuring laser fluorescence was used to analyze the relevant enamel surfaces both at baseline and after 6 months. Neither the incidence nor the characteristics of the demineralization we observed during the study differed between the 4 groups. Single application of smooth-surface sealants did not protect enamel around brackets from incipient carious lesions during the first 6 months of multibracket treatment.

  6. Laser-matrix-fluoride effects on enamel demineralization.

    PubMed

    Hsu, C Y; Jordan, T H; Dederich, D N; Wefel, J S

    2001-09-01

    Laser and fluoride have been shown to inhibit enamel demineralization. However, the role of organic matrix and their interactions remains unclear. This study investigated the interaction among CO2 laser irradiation, fluoride, and the organic matrix on the demineralization of human enamel. Twenty-four molars were selected and cut into halves. One half of each tooth was depleted of its lipid and protein. The other half served as a matched control. Each tooth half had two window areas, treated with a 2.0% NaF gel. All left windows then received a laser treatment. Next, the tooth halves were subjected to a four-day pH-cycling procedure that created caries-like lesions. Tooth sections were cut from the windows, and microradiographs were used for quantification of the demineralization. The combined fluoride-laser treatment led to 98.3% and 95.1% reductions in mineral loss for enamel with and without organic matrix, respectively, when compared with sound enamel.

  7. Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students’ Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study

    PubMed Central

    Ferreira, Fernanda Rosche; Mendes, Fausto Medeiros; Raggio, Daniela Prócida; Imparato, José Carlos; Bonecker, Marcelo; Magalhães, Ana Carolina; Wang, Linda; Rios, Daniela; Pessan, Juliano Pelim; Duque, Cristiane; Rebelo, Maria Augusta Bessa; Alves Filho, Ary Oliveira; Lima, Marina De Deus Moura; Moura, Marcoeli Silva; De Carli, Alessandro Diogo; Sanabe, Mariane Emi; Cenci, Maximiliano Sergio; Oliveira, Elenara Ferreira; Correa, Marcos Britto; Rocha, Rachel Oliveira; Zenkner, Julio Eduardo; Murisí, Pedroza Uribe; Martignon, Stefania; Lara, Juan Sebastian; Aquino, Fatima Gabriela; Carrillo, Alfredo; Chu, Chun Hung; Deery, Chris; Ricketts, David; Melo, Paulo; Antunes, José Leopoldo Ferreira; Ekstrand, Kim Rud

    2017-01-01

    Background Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. Objective To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Methods Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. Results This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical