Science.gov

Sample records for enamel caries lesions

  1. 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

  2. Enamel caries formation and lesion progression with a fluoride dentifrice and a calcium-phosphate containing fluoride dentifrice: a polarized light microscopic study.

    PubMed

    Hicks, M J; Flaitz, C M

    2000-01-01

    The effects of a fluoride dentifrice (Colgate Total) and a calcium-phosphate containing fluoride dentifrice (Enamelon) on caries-like enamel lesion formation and progression were evaluated in vitro. One quarter from each tooth (n = 12) was assigned to one of the study groups: 1) control group [artificial saliva only]; 2) Colgate Total; and 3) Enamelon. The dentifrices were applied to the enamel windows (3 minutes, 3 time per day for 14 days). Following treatment, enamel lesions were created with an acidified gel. After lesion initiation, sections were obtained for polarized light microscopy. To evaluate lesion progression, enamel windows with caries-like lesions in each test group were treated again for 14 days, returned to acidified gels for lesion progression, and then sections were obtained for polarized light microscopy. Mean lesion depths (polarized light, water imbibition) were as follows: 1) Lesion Initiation: Control 109 +/- 19 microns, Colgate Total 76 +/- 14 microns, Enamelon 63 +/- 17 microns; 2) First Lesion Progression: Control 164; +/- 24 microns, Colgate Total 124 +/- 22 microns, Enamelon 110 +/- 19 microns; 3) Second Lesion Progression: Control 235 +/- 23 microns; Colgate Total 172 +/- 27 microns, Enamelon 153 +/- 18 microns. Both Colgate Total and Enamelon enhanced the resistance of sound enamel and caries-like enamel lesions to a continuous in vitro cariogenic challenge when compared with matched controls (P < .05, ANOVA, DMR). Enamelon provided a further reduction in lesion depth for all periods when compared with Colgate Total (P > .05, ANOVA, DMR). Addition of bioavailable calcium and phosphate ions to a fluoride dentifrice may improve the ability of enamel to resist caries initiation and subsequent lesion progression.

  3. Enamel caries formation and lesion progression with a fluoride dentifrice and a calcium-phosphate containing fluoride dentifrice: a polarized light microscopic study.

    PubMed

    Hicks, M J; Flaitz, C M

    2000-01-01

    The effects of a fluoride dentifrice (Colgate Total) and a calcium-phosphate containing fluoride dentifrice (Enamelon) on caries-like enamel lesion formation and progression were evaluated in vitro. One quarter from each tooth (n = 12) was assigned to one of the study groups: 1) control group [artificial saliva only]; 2) Colgate Total; and 3) Enamelon. The dentifrices were applied to the enamel windows (3 minutes, 3 time per day for 14 days). Following treatment, enamel lesions were created with an acidified gel. After lesion initiation, sections were obtained for polarized light microscopy. To evaluate lesion progression, enamel windows with caries-like lesions in each test group were treated again for 14 days, returned to acidified gels for lesion progression, and then sections were obtained for polarized light microscopy. Mean lesion depths (polarized light, water imbibition) were as follows: 1) Lesion Initiation: Control 109 +/- 19 microns, Colgate Total 76 +/- 14 microns, Enamelon 63 +/- 17 microns; 2) First Lesion Progression: Control 164; +/- 24 microns, Colgate Total 124 +/- 22 microns, Enamelon 110 +/- 19 microns; 3) Second Lesion Progression: Control 235 +/- 23 microns; Colgate Total 172 +/- 27 microns, Enamelon 153 +/- 18 microns. Both Colgate Total and Enamelon enhanced the resistance of sound enamel and caries-like enamel lesions to a continuous in vitro cariogenic challenge when compared with matched controls (P < .05, ANOVA, DMR). Enamelon provided a further reduction in lesion depth for all periods when compared with Colgate Total (P > .05, ANOVA, DMR). Addition of bioavailable calcium and phosphate ions to a fluoride dentifrice may improve the ability of enamel to resist caries initiation and subsequent lesion progression. PMID:10736654

  4. Argon laser irradiation and acidulated phosphate fluoride treatment in caries-like lesion formation in enamel: an in vitro study.

    PubMed

    Flaitz, C M; Hicks, M J; Westerman, G H; Berg, J H; Blankenau, R J; Powell, G L

    1995-01-01

    The purpose of this in vitro study was to determine the combined effects of argon laser irradiation (ArI) and acidulated phosphate fluoride treatment (APF) on caries-like lesion formation in human enamel. Each specimen was divided into tooth quarters with each quarter assigned to one of four groups: 1) control; 2) ArI Only; 3) ArI before APF treatment; 4) APF treatment before ArI. After a fluoride-free prophylaxis, acid-resistant varnish was applied to the tooth quarters, leaving sound enamel windows exposed on buccal and lingual surfaces. Argon laser irradiation was at 2 watts for 10s (100J/cm2). APF treatment was with a 1.23% APF gel for 4 min. Lesions were created in sound enamel windows with an acidified gel. After lesion formation, sections were obtained and imbibed with water for polarized light study. Body of the lesion depths were determined and compared among the four groups. Lesion depths were: 195 +/- 23 microns for control; 129 +/- 17 microns for ArI only; 96 +/- 14 microns for ArI before APF; and 88 +/- 11 microns for APF before ArI. Significant differences (P < 0.05) were found between the control group and all treatment groups, and between the ArI only group and both combined APF and ArI groups. Significant difference (P > 0.05) was not found between the ArI before APF and the APF before ArI groups. Laser irradiation alone reduced lesion depth by 34% compared with control lesions. When ArI was combined with APF treatment, lesion depth decreased by more than 50% compared with control lesions, and by 26 to 32% when compared with lased-only lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. 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

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

    PubMed

    De Campos, Priscila Hernández; Sanabe, Mariane Emi; Rodrigues, Jonas Almeida; Duarte, Danilo Antonio; Santos, Maria Teresa Botti Rodrigues; Guaré, Renata Oliveira; Duque, Cristiane; Lussi, Adrian; Diniz, Michele Baffi

    2015-06-01

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

  7. 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.

  8. Uptake of fluoride by human surface enamel from ammonium bifluoride and consequent reduction in the penetration in vitro by caries-like lesions.

    PubMed

    Tyler, J E; Poole, D F

    1984-01-01

    In-vitro fluoride uptake by mid-coronal, premolar enamel surfaces from topically-applied solutions of NH4HF2 was determined using a multi-electrode system for fluoride and calcium analyses. In tooth surfaces dehydrated with 100 per cent ethanol before the topical application of 1 per cent aqueous NH4HF2, there was a 2-3-fold increase in fluoride concentration up to a depth of 50 microns and fluoride enhancement to a total depth of 100 microns into the enamel. Caries-like lesions were induced in vitro in both treated and untreated enamel by the use of acidified, 6 per cent hydroxymethyl-cellulose gel containing 0.04 per cent hydroxyapatite at pH 4.5. After 120 days exposure, the mean depth of lesion penetration in the controls was 149 (+/- 34) microns. No lesions occurred in half the treated specimens; in specimens with lesions, the mean depth of penetration was 19 (+/- 3) microns. Thus, NH4HF2 was a potent inhibitor of caries-like lesion formation in vitro.

  9. 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

  10. 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. PMID:25874248

  11. 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.

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

    PubMed Central

    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. PMID:21687564

  13. Nanobacteria's potential involvement in enamel repair in caries.

    PubMed

    Jing, Junjun; Lu, Junjun; Hao, Yuqing; Han, Yaolun

    2009-09-01

    Dental caries is the accumulation of numerous episodes of demineralization and remineralization, rather than a unidirectional demineralization process. Demineralization and remineralization occur constantly either simultaneously or alternately and whether a lesion will progress or be repaired depends upon the predominant process over periods. Even if fluoride has demonstrated the anti-caries effect by shifting the demineralization/remineralization balance favorably, little is known about non-fluoride action in favor of the balance and the effect of fluoride could not fully explain enamel repair in caries. Recently, in vitro experiments demonstrated enamel repair by synthetic apatite nanocrystals which showed the strong affinity, excellent biocompatibility, mechanical improvement, and a higher resistance to acids than apatite from teeth. This reminds us of a controversial microorganism called nanobacteria (NB) which form nanocrystalline apatite around themselves. Although NB have been detected in some pathological calcifications, epidemiologic literature suggests that they are widespread present in the healthy people blood. Considering the similarity of synthetic nanocrystalline apatite to that of NB and blood circulation communicating with saliva, we put forward a hypothesis that NB may act in enamel surface just like what the synthetic nanocrystalline apatite does in vitro to repair enamel in caries. PMID:19409717

  14. Combined effects of argon laser irradiation and fluoride treatments in prevention of caries-like lesion formation in enamel: an in vitro study.

    PubMed

    Haider, S M; White, G E; Rich, A

    1999-01-01

    The sample of this study consisted of 10 human permanent molars, which were sectioned into tooth quarters using slow speed diamond saw (Isomet), then a quarter from each tooth was assigned to one of four treatment groups: A) control (no treatment); B) argon laser only; C) argon laser plus neutral sodium fluoride for 4 minutes; D) argon laser with zinc fluoride for 4 minutes; each tooth quarter was coated with acid resistant varnish, leaving a window of 2 mm x 3 mm of sound enamel exposed. The results were that teeth treated with argon laser and then with zinc fluoride for four minutes have significantly reduced white spotting or etching. Zinc fluoride and argon laser combination are particularly effective in compensating for carbonate inclusion. It has a property of stabilizing hydroxyapetite crystal and restoring the structural defects of this crystal. Caries detection dye is a reliable diagnostic tool for white spot lesions. It reduces the false positive and false negative results by 60%, when compared with visual 16x magnification. PMID:10686872

  15. Remineralization of enamel caries can decrease optical reflectivity.

    PubMed

    Jones, R S; Fried, D

    2006-09-01

    The remineralization of enamel caries can lead to distinct optical changes within a lesion. We hypothesized that the restoration of mineral volume would result in a measurable decrease in the depth-resolved reflectivity of polarized light from the lesion. To test this hypothesis, we measured optical changes in artificial caries undergoing remineralization as a function of depth, using Polarization-sensitive Optical Coherence Tomography (PS-OCT). Lesions were imaged non-destructively before and after exposure to a remineralization regimen. After imaging, microradiographs of histological thin sections indicated that the significant reflectivity reduction measured by PS-OCT accurately represented the increase in mineral content within a larger repaired surface zone. Mineral volume changes arising from remineralization can be measured on the basis of the optical reflectivity of the lesion. PMID:16931861

  16. Effect of Fluoride on Artificial Caries Lesion Progression and Repair in Human Enamel: Regulation of Mineral Deposition and Dissolution under In Vivo‐Like Conditions

    PubMed Central

    Yamazaki, Hajime; Litman, Amy; Margolis, Henry C.

    2007-01-01

    Objective This study was carried out to determine in vitro the effect of fluoride on 1) the demineralization of sound human enamel and 2) the progression of artificial caries‐like lesions, under relevant oral conditions. Methods Thin sections of sound human enamel were exposed to solutions undersaturated with respect to tooth enamel to a degree similar to that found in dental plaque fluid following sucrose exposure in vivo, containing fluoride concentrations (0 – 0.38 ppm) found in plaque fluid. Mineral changes were monitored for 98 days, using quantitative microradiography. The effect of fluoride (1.0 – 25.0 ppm) on the progression of artificial caries‐like lesions was similarly studied. Results Fluoride concentrations of 0.19 ppm and greater were found to prevent the demineralization of sound enamel in vitro. However, significantly higher concentrations of fluoride (25.0 ppm) were required to prevent further demineralization of artificial caries‐like lesions. Demineralizing solutions with intermediate fluoride concentrations (2.1 – 10.1 ppm) induced simultaneously remineralization in the outer portion of the lesion and demineralization in the inner portion. Simultaneous remineralization and demineralization were also observed in hydroxyapatite pellets. Conclusions Our results show that the observed effect of fluoride on enamel demineralization is not solely a function of bulk solution properties, but also depends on the caries‐status of the enamel surface. A mechanistic model presented indicates that, in comparison to sound enamel surfaces, higher concentrations of fluoride are required to prevent the progression of artificial caries‐like lesions under in vivo‐like conditions since the diffusion of mineral ions that promote remineralization is rate‐limiting. PMID:17049334

  17. Natural enamel caries: a comparative histological study on biochemical volumes.

    PubMed

    Barbosa de Sousa, F; Dias Soares, J; Sampaio Vianna, S

    2013-01-01

    This study aimed to test the hypothesis that organic volume is the main variable for explaining the optical properties and predictive degree of diffusion of enamel histological points at zones of natural enamel caries (NEC; surface layer, SL, n = 30, and body of the lesion, BL, n = 58) and normal enamel (NE, n = 131). Molars with either NEC or NE were quantitatively analyzed regarding the mineral, organic and water volumes (considered as effective pore volume), opacity (predicted in 94% of cases by water volume in NEC), and water volume more easily available for diffusion, αd (squared water volume divided by the nonmineral volume; related to permeability). NEC presented lower mineral volumes and higher organic volumes, effective pore volume and opacity than NE. External origin of organic volume in NEC was evidenced by an organic gradient decreasing from the surface inward (R2 = -0.7), which was not detected in teeth with NE only; αd values of the SL and NE were similar and both were lower (p < 0.0001) than that of the BL. Comparing the SL from both NEC and artificial enamel caries (AEC; published data; n = 71), with similar mineral volumes, against developing enamel (published data), AEC showed more effective pore volume (3 times higher), higher αd and opacity than NEC mainly due to differences in organic volumes. Our results reasonably matched widely known features of NEC histological zones, and confirmed the organic volume as the main variable for explaining optical properties and αd (related to permeability).

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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

  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. Evaluation of dental enamel caries assessment using Quantitative Light Induced Fluorescence and Optical Coherence Tomography.

    PubMed

    Maia, Ana Marly Araújo; de Freitas, Anderson Zanardi; de L Campello, Sergio; Gomes, Anderson Stevens Leônidas; Karlsson, Lena

    2016-06-01

    An in vitro study of morphological alterations between sound dental structure and artificially induced white spot lesions in human teeth, was performed through the loss of fluorescence by Quantitative Light-Induced Fluorescence (QLF) and the alterations of the light attenuation coefficient by Optical Coherence Tomography (OCT). To analyze the OCT images using a commercially available system, a special algorithm was applied, whereas the QLF images were analyzed using the software available in the commercial system employed. When analyzing the sound region against white spot lesions region by QLF, a reduction in the fluorescence intensity was observed, whilst an increase of light attenuation by the OCT system occurred. Comparison of the percentage of alteration between optical properties of sound and artificial enamel caries regions showed that OCT processed images through the attenuation of light enhanced the tooth optical alterations more than fluorescence detected by QLF System. QLF versus OCT imaging of enamel caries: a photonics assessment.

  6. Survey of Croatian Dentists’ Restorative Treatment Decisions on Approximal Caries Lesions

    PubMed Central

    Baraba, Anja; Anić, Ivica; Doméjean-Orliaguet, Sophie; Espelid, Ivar; Tveit, Anne B.; Miletić, Ivana

    2010-01-01

    Aim To assess Croatian dentists’ restorative treatment decisions on approximal caries lesions, including treatment threshold and restorative methods and materials. Methods Croatian translation of the questionnaire assessing restorative treatment decisions on approximal caries, previously validated and used in Norway and Sweden, was distributed to a random sample (n = 800) of Croatian dentists. A total of 307 (38%) dentists answered the questionnaire. The assessed variables were treatment threshold for hypothetical approximal caries lesion and the most favored types of restorative techniques and materials. Results A third of the respondents (39%, 95% confidence interval [CI], 34-44%) would intervene for an approximal caries lesion at the dentin-enamel junction, but a larger proportion (42%; 95% CI, 36-48%) would treat a caries lesion confined to the enamel. For restoration of approximal caries, the majority (66%; 95% CI, 61-71%) would use composite resin. Conclusion Croatian dentists tend to restore approximal caries lesions when the lesions are confined to the enamel and their development can still be arrested. PMID:21162163

  7. 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.

  8. Enamel caries initiation and progression following low fluence (energy) argon laser and fluoride treatment.

    PubMed

    Hicks, M J; Flaitz, C M; Westerman, G H; Blankenau, R J; Powell, G L; Berg, J H

    1995-01-01

    The aim of this study was to evaluate the effect of low fluence argon laser (AL) and acidulated phosphate fluoride (APF) treatment on caries initiation (CI) and progression (CP) in human enamel. Twenty caries-free molars were divided into tooth quarters. Tooth quarters from each specimen were assigned to one of four groups: 1) Control; 2) AL Only; 3) AL before APF; 4) APF before AL. AL was at 0.25 watts for 10 seconds (12.0 +/- 0.5 J/cm2). APF treatment was with a 1.23% gel for 4 minutes. Lesions were created in two treated, sound enamel windows per tooth quarter with an acidified gel. After CI and CP, sections were obtained and imbibed with water for polarized light study. Mean body of the lesion (BL) depths were determined and compared among groups (ANOVA & DMR). After CI, BL depths were: 189 +/- 29 micrometers for Control, 133 +/- 23 micrometers for AL only; 91 +/- 17 micrometers for AL before APF; and 83 +/- 14 micrometers for APF before AL. After CP, BL depths were: 321 +/- 43 micrometers for Control, 206 +/- 35 micrometers for AL only; 118 +/- 21 micrometers for AL before APF; and 114 +/- 19 micrometers for APF before AL. After CI and CP, argon laser irradiation alone resulted in significant reductions in lesion depth when compared with controls (p<0.05). APF treatment before or after argon laser exposure resulted in a significant reduction in lesion depth when compared with AL alone or control groups (p<0.05). Caries initiation and progression in vitro are affected to a significant extent when low fluence (energy) argon laser irradiation of sound enamel alone or in conjunction with APF treatment is done. This caries-protective effect occurs at an argon laser fluence (energy) that is capable of polymerizing visible light-cured resins. PMID:8634203

  9. 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.

  10. 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.

  11. 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

  12. Nondestructive Clinical Assessment of Occlusal Caries Lesions using Near-IR Imaging Methods

    PubMed Central

    Staninec, Michal; Douglas, Shane M.; Darling, Cynthia L.; Chan, Kenneth; Kang, Hobin; Lee, Robert C.; Fried, Daniel

    2011-01-01

    Objective Enamel is highly transparent in the near-IR (NIR) at wavelengths near 1300-nm, and stains are not visible. The purpose of this study was to use NIR transillumination and optical coherence tomography (OCT) to estimate the severity of caries lesions on occlusal surfaces both in vivo and on extracted teeth. Methods Extracted molars with suspected occlusal lesions were examined with OCT and polarization sensitive OCT (PS-OCT), and subsequently sectioned and examined with polarized light microscopy (PLM) and transverse microradiography (TMR). Teeth in test subjects with occlusal caries lesions that were not cavitated or visible on radiographs were examined using NIR transillumination at 1310 nm using a custom built probe attached to an indium gallium arsenide (InGaAs) camera and a linear OCT scanner. After imaging, cavities were prepared using dye staining to guide caries removal and physical impressions of the cavities were taken. Results The lesion severity determined from OCT and PS-OCT scans in vitro correlated with the depth determined using polarized light microscopy (PLM) and transverse microradiography (TMR). Occlusal caries lesions appeared in NIR images with high contrast in vivo. OCT scans showed that most of the lesions penetrated to dentin and spread laterally below the sound enamel. Conclusion This study demonstrates that both NIR transillumination and OCT are promising new methods for the clinical diagnosis of occlusal caries. PMID:22109697

  13. 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.

  14. Dentin caries activity in early occlusal lesions selected to receive operative treatment

    PubMed Central

    Lehmann, Maryann; Veitz-Keenan, Analia; Matthews, Abigail G.; Vena, Donald; Grill, Ashley; Craig, Ronald G.; Curro, Frederick A.; Thompson, Van P.

    2014-01-01

    Background Members of the practice-based research network Practitioners Engaged in Applied Research and Learning (PEARL) Network investigated the dentin caries activity in early occlusal lesions and its relationship to patient age, preoperative tooth sensitivity and radio-graphic appearance, as well as its influence on preparation depth and volume. Methods PEARL Network practitioner-investigators (P-Is) (n = 45), general dentists who were trained but whose methods were not calibrated, conducted a study regarding postoperative hypersensitivity in resin-based composite restorations. The P-Is enrolled as study participants 613 patients with occlusal carious lesions that, in the P-Is’ clinical judgment, required restoration. The P-Is used baseline radiographs to assess the depth and extent of the lesions. Data for 671 restorations included baseline sensitivity; ranking of dentin caries activity on the opening of the enamel; radiographic visibility (n = 652); and measurements of preparation depth, width and length. Results P-Is found rapidly progressing dentin caries in 38.5 percent (258 of 671) of lesions and slowly progressing (and potentially inactive dentin) caries in the remainder of the lesions. Rapidly progressing caries was not related to the participant’s age or participant-reported preoperative hypersensitivity but was related to the lesion depth as seen radiographically (P < .001) and depth (P < .001) and volume (P < .001) of the preparation. Molars had slightly higher but not statistically significant levels of caries activity. Conclusion Rapidly progressing dentin caries, while present in only 38.5 percent of lesions, was related to the lesion’s radiographic appearance but not to the participant’s age or the study tooth’s pre-operative sensitivity. Clinical Implications On the basis of the low level of rapidly progressing dentin caries in this study population and the fact that slowly progressing caries can be inactive or remineralizing, the

  15. 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.

  16. Quantification of formation and remineralization of artificial enamel lesions with a new portable fluorescence device.

    PubMed

    al-Khateeb, S; ten Cate, J M; Angmar-Månsson, B; de Josselin de Jong, E; Sundström, G; Exterkate, R A; Oliveby, A

    1997-11-01

    Quantitative laser fluorescence has been reported as a useful method for the non-destructive in vitro and in vivo diagnosis of early enamel caries. A portable system for intraoral use has been developed with a new light source and filter system replacing the laser light to facilitate clinical application. This new device was validated with microradiographic and chemical analyses for assessment of mineral changes in enamel during lesion formation and remineralization in vitro and compared with the laser light equipment. A significant correlation was found between fluorescence changes and mineral loss: r = 0.79 (laser system) and r = 0.84 (portable lamp system). The correlation between the two fluorescence methods was r = 0.93. The portable fluorescence device seemed to be a promising new tool for reproducible and sensitive assessment of the severity of incipient enamel lesions.

  17. 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.

  18. 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.

  19. Near-infrared image-guided laser ablation of artificial caries lesions

    NASA Astrophysics Data System (ADS)

    Tao, You-Chen; Fan, Kenneth; Fried, Daniel

    2007-02-01

    Laser removal of dental hard tissue can be combined with optical, spectral or acoustic feedback systems to selectively ablate dental caries and restorative materials. Near-infrared (NIR) imaging has considerable potential for the optical discrimination of sound and demineralized tissue. The objective of this study was to test the hypothesis that two-dimensional NIR images of demineralized tooth surfaces can be used to guide CO II laser ablation for the selective removal of artificial caries lesions. Highly patterned artificial lesions were produced by submerging 5 x 5 mm2 bovine enamel samples in demineralized solution for a 9-day period while sound areas were protected with acid resistant varnish. NIR imaging and polarization sensitive optical coherence tomography (PS-OCT) were used to acquire depth-resolved images at a wavelength of 1310-nm. An imaging processing module was developed to analyze the NIR images and to generate optical maps. The optical maps were used to control a CO II laser for the selective removal of the lesions at a uniform depth. This experiment showed that the patterned artificial lesions were removed selectively using the optical maps with minimal damage to sound enamel areas. Post-ablation NIR and PS-OCT imaging confirmed that demineralized areas were removed while sound enamel was conserved. This study successfully demonstrated that near-IR imaging can be integrated with a CO II laser ablation system for the selective removal of dental caries.

  20. TEA-CO2 laser inhibition of artificial carieslike lesion progression in primary and permanent tooth enamel

    NASA Astrophysics Data System (ADS)

    Tange, Takashi; Fried, Daniel; Featherstone, John D. B.

    2000-03-01

    Several studies during the last 30 years have demonstrated the potential of laser pre-treatment of enamel to inhibit subsequent acid-induced dissolution or artificial caries-like challenge in the laboratory. The aim of the present study was to examine the difference between primary and permanent teeth enamel in the prevention of caries-like lesion progression by long pulsed TEA-carbon dioxide (CO2) laser irradiation in vitro by means of a pH-cycling model. Thirty caries-free permanent tooth crowns and forty caries-free primary tooth crowns were cleaned and varnished with acid-resistant varnish, leaving one exposed window of enamel. Five groups of 10 enamel samples were irradiated in their individual windows by a TEA- CO2 laser at 9.6 micrometer wavelength, 25 pulses per spot, 5 microsecond pulse duration, 0.5,10,15 Hz repetition rates, 1774 micrometer beam diameter and 1.0, 1.5 J/cm2 per pulse fluence. All teeth, including 2 non-irradiated control groups, were subjected to pH-cycling to produce artificial caries-like lesions. Results were assessed by cross-sectional microhardness testing. Inhibition of caries progression of from 29% to 57% was achieved over the range of laser conditions tested. At the same irradiation conditions (repetition rate: 10 Hz, fluence: 1.5 J/cm2), the inhibition rate in primary teeth enamel was 54% compared with 49% in the permanent teeth enamel (significant at p less than 0.05). Safety and efficacy studies will be required before these promising laboratory results can be applied in clinical practice.

  1. 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.

  2. 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.

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

    PubMed Central

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

    2014-01-01

    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. PMID:25075267

  4. 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.

  5. 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.

  6. 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.

  7. Detection activity assessment and diagnosis of dental caries lesions.

    PubMed

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-07-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended additional method available for daily clinical practice.

  8. Assessment of enamel chemistry composition and its relationship with caries susceptibility

    NASA Astrophysics Data System (ADS)

    Azevedo Rodrigues, Lidiany K.; Silva Soares, Luis E.; Martin, Airton A.; Brugnera, Aldo, Jr.; Zanin, Fatima A. A.; Nobre dos Santos, Marines

    2005-03-01

    Enamel components are related to enamel caries susceptibility, thus, non-destructive techniques to be used in selecting homogeneous dental enamel have been studied. This study aimed to determine the enamel components that make it more susceptible to in vitro demineralization. Fourier transform Raman Spectroscopy (FTRS) was used to verify the relative amounts of organic material and enamel mineral before and after being submitted to an 8-day pH cycling model. FTRS was performed in 30 enamel slabs, which were subsequently demineralized; next, the slabs were again analyzed by FTRS. The cross-section microhardness was performed for mineral loss (ΔZ) quantification. Slabs that presented the greatest differences in the caries development pattern, considering the ΔZ mean obtained (ΔZ=1,510.1+/-623.4 n=30), were selected in order to constitute 2 groups with statistically different ΔZ values, more demineralized group (MDG) and less demineralized group (LDG), which had ΔZ=2,368.9+/-421.7a and ΔZ=909.2+/-229.2b (n=8), respectively. The differences between both MDG and LDG, regarding enamel components (phosphate, carbonate and organic matrix) determined by FTRS before and after pHC, were accessed by t test (significance level=0.05). The results showed that all groups presented fewer carbonate and organic contents after demineralization. LDG showed no difference in phosphate content before and after pHC. Before pHC, MDG carbonate content was statistically greater than the one found in LDG. The presence of a correspondent calcium fluoride band was not observed in enamel spectrum. In conclusion, only carbonate quantity influenced enamel susceptibility to in vitro demineralization and FT-RAMAN is an appropriate technique to select homogeneous enamel samples.

  9. 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.

  10. 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

  11. Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration.

    PubMed

    Meyer-Lueckel, H; Paris, S; Kielbassa, A M

    2007-01-01

    The infiltration of proximal enamel lesions with low-viscosity light curing resins could be a viable approach to stop lesion progression. However, penetration of sealant might be hampered by the comparatively highly mineralized surface layers of natural lesions. Therefore, the aim of this study was to compare the efficacy of three different etching gels in removing the surface layer in various etching times. Extracted human molars and premolars showing proximal white spot lesions were cut across the demineralized areas. Ninety-six lesions expected from visual examination to be confined to the outer enamel (C1) were selected. The cut surface and half of each lesion were varnished, thus serving as control. Subsequently, the lesions were etched with either phosphoric (37%) or hydrochloric (5 or 15%) acid gel for 30-120 s (n = 8/group). Specimens were examined using confocal microscopy and transversal microradiography. Surface layer reduction was significantly increased in lesions etched with 15% HCl gel for 90 and 120 s compared to those etched with H(3)PO(4) gel for 30-120 s (p < 0.05). No significant differences regarding the depths of erosion in the lesions compared to sound enamel could be observed (p > 0.05). An effective reduction in the surface layer of natural enamel caries can be achieved by etching with 15% hydrochloric acid gel for 90-120 s.

  12. Confocal laser scanning microscopic analysis of the depth of dentin caries-like lesions in primary and permanent teeth.

    PubMed

    de Carvalho, Fabíola Galbiatti; de Fucio, Suzana Beatriz Portugal; Sinhoreti, Mario Alexandre Coelho; Correr-Sobrinho, Lourenço; Puppin-Rontani, Regina Maria

    2008-01-01

    This study analyzed comparatively, by confocal laser scanning microscopy (CLSM), the depth of caries-like lesions produced by biological and chemical artificial models in permanent and primary dentin. Six primary molars and six premolars were used. The occlusal enamel was removed and a nail polish layer was applied on the specimens, except for a 4 x 2 mm area on dentin surface. Half of specimens were immersed in acid gel for 14 days (chemical model) and the other half was immersed in BHI broth with S. mutans for 14 days (biological model). After development of artificial caries, the crowns were longitudinally sectioned on the center of the carious lesion. Three measurements of carious dentin depth were made in each specimen by CLSM. Measurements depths were compared between the caries models and between tooth types by one-way ANOVA and Tukey test (alpha=5%). For permanent teeth, the biological model showed significantly higher (p<0.05) caries depth values than the chemical model. For primary teeth, no statistically significant difference (p>0.05) was found between the caries models. The artificial caries model influenced caries depth only in permanent teeth. There was no difference in carious dentin depth between permanent and primary teeth, regardless of the artificial caries model. PMID:18568229

  13. 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.

  14. 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.

  15. Distribution and volumetric assessment of initial approximal caries lesions in human premolars and permanent molars using computer-aided three-dimensional reconstruction.

    PubMed

    Arnold, W H; Gaengler, P; Saeuberlich, E

    2000-12-01

    Serial sections from 21 extracted premolars and permanent molars, divided into three age groups (group 1, 10-19 years; group 2, 20-39 years; group 3, 50-69 years.), were viewed by polarized light microscopy for reconstruction of the caries lesions. The volumes of the lesional body and the transparent zone, and the volumes of early dentinal lesions were calculated; and an enamel demineralization index (EDI) and an enamel-dentine demineralization index (EDDI), representing the volumetric ratio of the body of the lesion to the translucent zone, and the body of the lesion to the volume of the early dentinal lesion, respectively, were determined. The method showed that there are three typical sites of individual initial caries lesions at the approximal surface: within the contact area, in the subcontact area, and in the cervical area. Volumetric assessment demonstrated a larger volume of the body of the lesion in older teeth with a smaller volume of the translucent zone relative to the lesional body. From these results it can be concluded that there are usually more than one individual initial caries lesions at the approximal tooth surface. Calculation of demineralization indices demonstrated different features for small lesions with pronounced transparent zones and for large lesions with small transparent zones. The computer-assisted three-dimensional reconstruction technique and the volumetric assessment are of value in investigations of the micromorphology and progression of natural caries lesions in permanent teeth.

  16. Effect of Galla chinensis on the In Vitro Remineralization of Advanced Enamel Lesions

    PubMed Central

    Cheng, Lei; ten Cate, Jacob M

    2010-01-01

    Aim The effect of Galla chinensis on de-/re-mineralization of advanced enamel lesions was investigated by using micro-CT in a prolonged in vitro experiment. Methodology Baseline mineral contents of sound enamels were first analyzed. Then lesions were produced in an acidic buffer solution (2.2 mmol·L−1 Ca(NO3)2, 2.2 mmol·L−1 KH2PO4, and pH=4.5) for 21 days, with thrice daily three-minute treatments, divided into four groups: Group A, 4 000 ppm crude aqueous extract of Galla chinensis (GCE); Group B, 4 000 ppm gallic acid; Group C, 1 000 ppm F aq. (as NaF, positive control); Group D, deionized water (negative control). Next, the blocks were immersed in a remineralization solution (1.5 mmol·L−1 CaCl2, 0.9 mmol·L−1 KH2PO4, 0.1 ppm F, and pH=7.0) for 200 days. Mineral loss (ML) in each region of interest(ROI) and integrated mineral loss (IML) of the lesions were calculated (comparing with baseline mineral content of sound enamel) at different time points. Results After 21 days demineralization, fluoride treatment showed a statistically significant demineralization-inhibiting effect among the four groups, and after 200 days of remineralization, mineral content recovery was ordered (lowest to highest) as A=Cenamel in the surface layer and thereby facilitate ion transport into the lesion body. The mechanism of Galla chinensis in enhancing the remineralization of dental caries is different from fluoride. PMID:20690414

  17. 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.

  18. The use of caries detector dye in diagnosis of occlusal carious lesions.

    PubMed

    al-Sehaibany, F; White, G; Rainey, J T

    1996-01-01

    The purpose of this in vitro study was to compare the accuracy of diagnosis of carious lesions in the occlusal pit, fissure, and groove system of lower molars examined by two methods: examination by using caries detector dye. vs. traditional tactile examination using a dental explorer. Thirty human lower permanent molars were examined in this study. The occlusal surface of each tooth was examined by explorer; a linear measurement in millimeters of carious lesions diagnosed in the pit, fissure and groove system was recorded. The same surface was then stained with caries detection dye. Linear measurements in millimeters were then recorded for areas of stain remaining in the pit, fissure, and groove system. The thirty teeth were then sectioned buccal lingually in three sections, exposing 180 saggital histological cross sections for histological examination. Histological cross section confirmed a ratio of 1:1 (100%) accuracy by caries detection dye in diagnosing decay underlying the occlusal surface. Concurrent examination of the same occlusal surfaces by traditional explorer examination was reliable only in a 1:4 ratio (25%). Other findings of significance revealed by histological examination of the cross sections include: a sub-ridge occlusal transverse ridge of enamel; different shape and direction of occlusal grooves compared to traditional teaching; and unpredictable path of caries underlying the occlusal grooves.

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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

  4. The effect of caries detector dyes and a cavity cleansing agent on composite resin bonding to enamel and dentin.

    PubMed

    el-Housseiny, A A; Jamjoum, H

    2000-01-01

    This study was undertaken to evaluate the effect of caries detector dyes and/or cavity cleanser on composite bonding and etching patterns of enamel and dentin. One hundred and eight non-carious premolars were divided into six groups according to the enamel and dentin pretreatment investigated. The different pretreatment were as follows: Group I: teeth with prophylaxis only, Group II: Sable seek caries detector dye, Groups III: chlorhexidine cavity cleanser, Group IV: the caries detectors dye followed by prophylaxis, Group V: the cavity cleanser followed by the caries detector dye, and Group IV: Snoop caries detector dye. The shear bond strength of composite resin bonded to enamel and dentin was evaluated by the Instron Universal testing machine while, the topographic details of enamel and dentin were examined by the SEM following the different pretreatment and acid etching. Results of the shear bond strength showed no statistically significant difference among the six groups, with no substantial differences in SEM results. It is concluded that using the caries detector dyes and/or chlorhexidine cavity cleanser before acid etching does not significantly affect composite bonding to enamel and dentin.

  5. The Dynamic Behavior of the Early Dental Caries Lesion in Caries-active Adults and Implications

    PubMed Central

    Brown, J P; Amaechi, B T; Bader, J D; Shugars, D; Vollmer, W M; Chen, C; Gilbert, G H; Esterberg, E J

    2015-01-01

    Objective To describe the full range of behavior of the visible, non-cavitated, early caries lesion in caries-active adults with substantial fluoride exposure, and to consider implications. Methods The data were from the Xylitol for Adult Caries Trial (X-ACT), collected annually for 33 months using condensed ICDAS caries threshold criteria. Individual tooth surfaces having a non-cavitated caries lesion were included and the Patterns of transition to each subsequent annual clinical examination to sound, non-cavitated or cavitated, filled or crowned were determined. The resulting sets of Patterns for an individual tooth surface, looking forward from its first appearance as a non-cavitated lesion, were combined into one of four behavior Profiles classified as Reversing, Stable, Oscillating or continuously Progressing, or were excluded if not part of the caries continuum. The distributions of Profile types were assessed using the Rao-Scott Chi square test, which adjusts for clustering of tooth surfaces within teeth. Results Inter-and intra-examiner Kappa scores demonstrated acceptable calibration at baseline and annually. 8084 tooth surfaces from 543 subjects were included. The distribution of Profile types differed significantly between coronal and root surfaces. Overall two-thirds of all coronal non-cavitated lesions were first seen at baseline, half Reversed, over a fifth were Stable, 15% Oscillated and only 8.3% progressed to cavitation, filled or crowned in 33 months or less. (6.3% consistently Progressed plus 2.0% inconsistently, a subset of Oscillating, which oscillated before progressing to cavitation). Approximal, smooth and occlusal coronal surfaces each were significantly different in their individual distributions of Profile types. Xylitol showed no significant and consistent effect on this distribution by tooth surface type. This was in keeping with the X-ACT Trial’s lack of effect of xylitol at the non-cavitated plus cavitated lesion thresholds combined

  6. Regression of white spot enamel lesions. A new optical method for quantitative longitudinal evaluation in vivo.

    PubMed

    Ogaard, B; Ten Bosch, J J

    1994-09-01

    This article describes a new nondestructive optical method for evaluation of lesion regression in vivo. White spot caries lesions were induced with orthodontic bands in two vital premolars of seven patients. The teeth were banded for 4 weeks with special orthodontic bands that allowed plaque accumulation on the buccal surface. The teeth were left in the dentition for 2 or 4 weeks after debanding. Regular oral hygiene with a nonfluoridated toothpaste was applied during the entire experimental period. The optical scattering coefficient of the banded area was measured before banding and in 1-week intervals thereafter. The scattering coefficient returned to the sound value in an exponential manner, the half-value-time for left teeth being 1.1 week, for right teeth 1.8 weeks, these values being significantly inequal (p = 0.035). At the start of the regression period, the scattering coefficient of left teeth lesions was 2.5 as high as of right teeth lesions, values being inequal with p = 0.09. It is concluded that regression of initial lesions in the presence of saliva is a relatively rapid process. The new optical method may be of clinical importance for quantitative evaluation of enamel lesion regression developed during fixed appliance therapy.

  7. 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.

  8. 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).

  9. Effect of a two-solution fluoride mouthrinse on remineralization of enamel lesions in vitro.

    PubMed

    Chow, L C; Takagi, S; Shih, S

    1992-03-01

    A previous study showed that a two-solution fluoride (F) rinse deposited significantly more loosely-bound F on the tooth surface than did a sodium fluoride (NaF) rinse with the same F concentration (12 mmol/L). In the present study, this experimental rinse was evaluated for its ability to cause remineralization of enamel lesions in an in vitro pH-cycling model. Caries-like lesions were formed in the enamel of extracted human molars by means of a pH 4 demineralizing solution. Fifty-one approximately 120-microns-thick sections containing lesions were randomly divided into (1) control, (2) NaF rinse, and (3) two-solution F rinse groups. With the cut surfaces protected, the control samples were immersed in a pH 7 remineralizing solution for 12 days, and twice daily the sections were also exposed to a pH 4 demineralizing solution for 30 min. Samples in the NaF group received an additional one-minute rinse with a NaF (12 mmol/L) solution twice daily. Samples in the two-solution rinse group received the rinse treatment with a 12 mmol/L F solution prepared by combination of a Na2SiF6 and phosphate-containing solution with a calcium solution just before use. The mineral contents of the lesions were assessed by quantitative microradiography. The results showed that (1) no significant de- or remineralization was detected in the controls; (2) a 46% decrease in mineral loss (delta Z) of the lesion was produced by the NaF rinses; and (3) a 94% decrease in delta Z and a 20-microns-thick, mineral-dense surface-coating were produced by the two-solution F rinse treatment.

  10. 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.

  11. 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.

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

    PubMed Central

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

    2014-01-01

    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. PMID:24791129

  13. 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

  14. 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.

  15. 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. PMID:26513918

  16. 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. PMID:25154834

  17. 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.

  18. 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

  19. Pulp-dentin biology in restorative dentistry. Part 4: Dental caries--characteristics of lesions and pulpal reactions.

    PubMed

    Bjørndal, L; Mjör, I A

    2001-10-01

    The infectious disease dental caries results in lesions that may affect enamel, dentin, pulp, and cementum. If a caries lesion has progressed to the stage at which it requires restorative intervention, it is important that the clinician understand the tissue changes in the dentin that are likely to have taken place during lesion development. Until the present, no major distinction between the restorative treatment of active (rapidly progressing) and arrested (slowly progressing) lesions has been made, despite the fact that the two conditions exhibit major differences in tissue changes in the pulp-dentin complex. Intratubular changes and tertiary dentin formation will affect the outcome of the restorative treatment. In unaffected dentin and in rapidly progressing lesions, permeable tubules persist, and when the preparation of carious teeth results in the opening of unaffected dentin, greater care must be taken in all phases of the restorative procedures than if the dentin is impermeable. An active, deep lesion can be changed to an arrested lesion by a two-step excavation approach. Optimal assessment of the prevailing clinical conditions can only be made on the basis of thorough knowledge of the biology of the pulp-dentin organ.

  20. An in vitro dynamic microcosm biofilm model for caries lesion development and antimicrobial dose-response studies.

    PubMed

    Maske, T T; Brauner, K V; Nakanishi, L; Arthur, R A; van de Sande, F H; Cenci, M S

    2016-01-01

    Some dynamic biofilm models for dental caries development are limited as they require multiple experiments and do not allow independent biofilm growth units, making them expensive and time-consuming. This study aimed to develop and test an in vitro dynamic microcosm biofilm model for caries lesion development and for dose-response to chlorhexidine. Microcosm biofilms were grown under two different protocols from saliva on bovine enamel discs for up to 21 days. The study outcomes were as follows: the percentage of enamel surface hardness change, integrated hardness loss, and the CFU counts from the biofilms formed. The measured outcomes, mineral loss and CFU counts showed dose-response effects as a result of the treatment with chlorhexidine. Overall, the findings suggest that biofilm growth for seven days with 0.06 ml min(-1) salivary flow under exposure to 5% sucrose (3 × daily, 0.25 ml min(-1), 6 min) was suitable as a pre-clinical model for enamel demineralization and antimicrobial studies.

  1. An in vitro dynamic microcosm biofilm model for caries lesion development and antimicrobial dose-response studies.

    PubMed

    Maske, T T; Brauner, K V; Nakanishi, L; Arthur, R A; van de Sande, F H; Cenci, M S

    2016-01-01

    Some dynamic biofilm models for dental caries development are limited as they require multiple experiments and do not allow independent biofilm growth units, making them expensive and time-consuming. This study aimed to develop and test an in vitro dynamic microcosm biofilm model for caries lesion development and for dose-response to chlorhexidine. Microcosm biofilms were grown under two different protocols from saliva on bovine enamel discs for up to 21 days. The study outcomes were as follows: the percentage of enamel surface hardness change, integrated hardness loss, and the CFU counts from the biofilms formed. The measured outcomes, mineral loss and CFU counts showed dose-response effects as a result of the treatment with chlorhexidine. Overall, the findings suggest that biofilm growth for seven days with 0.06 ml min(-1) salivary flow under exposure to 5% sucrose (3 × daily, 0.25 ml min(-1), 6 min) was suitable as a pre-clinical model for enamel demineralization and antimicrobial studies. PMID:26905384

  2. Restorative Treatment Thresholds for Proximal Caries in Dental PBRN

    PubMed Central

    Kakudate, N.; Sumida, F.; Matsumoto, Y.; Manabe, K.; Yokoyama, Y.; Gilbert, G.H.; Gordan, V.V.

    2012-01-01

    This study was conducted to assess caries treatment thresholds among Japanese dentists and to identify characteristics associated with their decision to intervene surgically in proximal caries lesions within the enamel. Participants (n = 189) were shown radiographic images depicting interproximal caries and asked to indicate the lesion depth at which they would surgically intervene in both high- and low-caries-risk scenarios. Differences in treatment thresholds were then assessed via chi-square tests, and associations between the decision to intervene and dentist, practice, and patient characteristics were analyzed via logistic regression. The proportion of dentists who indicated surgical intervention into enamel was significantly higher in the high-caries-risk scenario (73.8%, N = 138) than in the low-caries-risk scenario (46.5%, N = 87) (p < 0.001). In multivariate analyses for a high-caries-risk scenario, gender of dentist, city population, type of practice, conducting caries-risk assessment, and administering diet counseling were significant factors associated with surgical enamel intervention. However, for a low-caries-risk scenario, city population, type of practice, and use of a dental explorer were the factors significantly associated with surgical enamel intervention. These findings demonstrate that restorative treatment thresholds for interproximal primary caries differ by caries risk. Most participants would restore lesions within the enamel for high-caries-risk individuals (Clinicaltrials.gov registration number NCT01680848). PMID:23053847

  3. Explorer probing of root caries lesions: an in vitro study.

    PubMed

    Warren, John J; Levy, Steven M; Wefel, James S

    2003-01-01

    Probing with a dental explorer is the preferred method of root caries diagnoses. However, studies suggest that use of a dental explorer in coronal caries detection may damage tooth structure. This pilot study investigated the effect of probing on remineralization of root surface lesions in vitro. Root-surface lesions were created on 10 extracted teeth by exposing them to a demineralizing solution for 21 days. One side of each lesion was then randomly selected and probed with an explorer, while the other side was not probed. The teeth then were placed in a remineralizing solution containing 10 parts per million (ppm) fluoride for 21 days. Of the 9 teeth with usable sections, all showed frank evidence of defects on the probed halves. Sites of remineralization were seen in the non-probed halves and adjacent to the probed defects, but not within or at the base of these defects. These results suggest that probing of root surfaces may create defects that do not fully remineralize.

  4. On the initial propagation of dental caries.

    PubMed

    Fabregas, Rene; Rubinstein, Jacob

    2014-11-01

    A multi-dimensional model for dental caries is applied to study the shape of caries lesions in a realistic tooth geometry and to examine the rate of progress of caries. An upgraded model, taking into account the outer prismless enamel layer, is derived and solved. The model demonstrates the importance of this layer in delaying the onset of caries. The conclusions are discussed in light of experimental results. PMID:25232054

  5. 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.

  6. 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.

  7. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions.

    PubMed

    Kielbassa, Andrej M; Muller, Jan; Gernhardt, Christian R

    2009-09-01

    Dental caries on (proximal) tooth surfaces is still a problem in many industrialized countries. The objectives of this review were to present the scientific basis and the principles of the resin infiltration concept, to discuss the inherent clinical applications, and to describe how these backgrounds can be integrated into the concept of minimal intervention dentistry. Data were identified by searches of the Cochrane Registers, Medline, and Scopus. Articles published in English and German through December 2008 were selected, and most up-to-date or relevant references were chosen. Cross-referencing of significant articles identified additionally relevant articles written in other languages and those of historical value. A total of 23 in vitro studies (focusing on penetration depths or demineralization prevention) were found, and 3 clinical studies (involving 122 subjects) could be retrieved; these studies were not comparable. With an increased understanding of the caries process, it is now recognized that demineralized but noncavitated enamel lesions can be arrested or remineralized in many situations. The clinical research evidence on the resin infiltration technique currently is of moderate extent to reach any decisive conclusions; however, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should reduce (or even stop) the progress of white spot lesions. Combining this ultraconservative restorative approach (which is considered microinvasive) with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long-term restorative needs and costs, thus complementing the concept of minimal intervention dentistry.

  8. 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.

  9. 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.

  10. A conservative approach to esthetically treat stained arrested caries lesions.

    PubMed

    Al-Angari, Sarah S; Hara, Anderson T

    2016-01-01

    Esthetic treatment of stained arrested caries lesions (ACLs) has mostly been done using invasive restorative techniques. The aim of this paper was to propose and report the efficacy of a conservative approach based on dental bleaching to esthetically treat these lesions, both experimentally (extracted teeth) and clinically. In a laboratory experiment, ten extracted human teeth with stained ACLs in either pit and fissure or smooth surface were selected and treated with 15% carbamide peroxide gel, 4 h per day, for a total of 6 days. The second part of the paper reports a clinical case of pit and fissure-stained ACLs in four posterior teeth, which were treated with 40% hydrogen peroxide in-office bleaching. Digital photographs were taken in both parts to document the efficacy of the treatment. The lesions showed noticeable increase in color lightness indicating the efficacy and suitability of the proposed approach. By using the conservative clinical technique presented, the esthetics of most stained ACLs could be improved, eliminating the need for invasive restorative treatments. PMID:27092359

  11. 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

  12. Calcium Prerinse before Fluoride Rinse Reduces Enamel Demineralization: An in situ Caries Study.

    PubMed

    Souza, João Gabriel S; Tenuta, Livia Maria Andaló; Del Bel Cury, Altair Antoninha; Nóbrega, Diego Figueiredo; Budin, Renan R; de Queiroz, Mateus X; Vogel, Gerald L; Cury, Jaime A

    2016-01-01

    A calcium (Ca) prerinse before a fluoride (F) rinse has been shown to increase oral F levels. We tested the anticaries effect of this combination in a dose-response in situ caries model. In a double-blind, crossover experiment, 10 volunteers carried enamel slabs in palatal appliances for 14 days, during which they rinsed twice/day with one of four rinse combinations: (1) a placebo prerinse (150 mM sodium lactate) followed by a distilled water rinse (negative control); (2) a placebo prerinse followed by a 250 ppm F rinse; (3) a placebo prerinse followed by a 1,000 ppm F rinse, or (4) a Ca prerinse (150 mM Ca, as calcium lactate) followed by a 250 ppm F rinse. Sucrose solution was dripped onto the slabs 8×/day to simulate a high cariogenic challenge. The percent surface hardness loss (%SHL) was significantly lower in the Ca prerinse used with the 250 ppm F rinse group (%SHL = 38.0 ± 21.0) when compared with the F rinse alone (%SHL = 59.5 ± 24.1) and similar to the 1,000 ppm F rinse group (%SHL = 42.0 ± 18.3). Compared with the 250 ppm F rinse, the Ca prerinse increased biofilm fluid F only twice (nonsignificant). However, it greatly increased F in biofilm solids (∼22×). The Ca prerinse had little effect on loosely or firmly bound enamel F. The results showed an increased level of protection against demineralization by the use of a Ca prerinse, which seems to be caused by the enhancement of F concentration in the biofilm. PMID:27355353

  13. Effects of pulsed Nd:YAG laser on tensile bond strength and caries resistance of human enamel.

    PubMed

    Wen, X; Zhang, L; Liu, R; Deng, M; Wang, Y; Liu, L; Nie, X

    2014-01-01

    This study aims to evaluate the effects of pulsed Nd:YAG laser on the tensile bond strength (TBS) of resin to human enamel and caries resistance of human enamel. A total of 201 human premolars were used in this in vitro study. A flat enamel surface greater than 4 × 4 mm in area was prepared on each specimen using a low-speed cutting machine under a water coolant. Twenty-one specimens were divided into seven groups for morphology observations with no treatment, 35% phosphoric acid etching (30 seconds), and laser irradiation (30 seconds) of pulsed Nd:YAG laser with five different laser-parameter combinations. Another 100 specimens were used for TBS testing. They were embedded in self-cured acrylic resin and randomly divided into 10 groups. After enamel surface pretreatments according to the group design, resin was applied. The TBS values were tested using a universal testing machine. The other 80 specimens were randomly divided into eight groups for acid resistance evaluation. Scanning electron microscope (SEM) results showed that the enamel surfaces treated with 1.5 W/20 Hz and 2.0 W/20 Hz showed more etching-like appearance than those with other laser-parameter combinations. The laser-parameter combinations of 1.5 W/15 Hz and 1.5 W/20 Hz were found to be efficient for the TBS test. The mean TBS value of 14.45 ± 1.67 MPa in the laser irradiated group was significantly higher than that in the untreated group (3.48 ± 0.35 MPa) but lower than that in the 35% phosphoric acid group (21.50 ± 3.02 MPa). The highest mean TBS value of 26.64 ± 5.22 MPa was identified in the combination group (laser irradiation and then acid etching). Acid resistance evaluation showed that the pulsed Nd:YAG laser was efficient in preventing enamel demineralization. The SEM results of the fractured enamel surfaces, resin/enamel interfaces, and demineralization depths were consistent with those of the TBS test and the acid resistance evaluation. Pulsed Nd:YAG laser as an enamel surface

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. Validity of a portable microhardness testing system (Cariotester) for diagnosis of progression in active caries lesions.

    PubMed

    Iwami, Yukiteru; Yamamoto, Hiroko; Hayashi, Mikako

    2013-01-01

    This study aimed to evaluate the validity of a portable microhardness testing system (Cariotester) for diagnosis of progression in active caries lesions by comparing data from this device and a laser fluorescence device (DIAGNOdent). Carious dentin in 12 specimens (stained clearly with a caries detector dye) was incrementally removed with a round bur at 150 μm depth intervals from the dentin surface in the direction of the pulp chamber. After each increment (total 138 sites), the Knoop hardness (HK) (evaluated with Cariotester) and DIAGNOdent (D) values were measured. HK values increased as D values decreased (regression formula: HK=0.419+238.342/D (p<0.001); coefficient of determination (R(2)): 0.602). Although DIAGNOdent quantitatively evaluates the degree of caries progression and bacterial infection status in caries lesions, our results demonstrate the validity and convenience of alternatively using microhardness measurements during caries removal to evaluate disease progression.

  20. Light-induced fluorescence studies on dehydration of incipient enamel lesions.

    PubMed

    Al-Khateeb, S; Exterkate, R A M; de Josselin de Jong, E; Angmar-Månsson, B; ten Cate, J M

    2002-01-01

    Changes in the hydration state of enamel affect its optical qualities, such as light scattering and fluorescence. In this study, the rate of fluorescence loss was measured when incipient enamel lesions with different de-remineralization history were left to dehydrate. Four groups of lesions were studied. In groups A, B and C, the lesions were prepared in vitro in an acid-gel system. Group A was kept as control, and groups B and C were remineralized (4 weeks) without and with 1 ppm F in solution, respectively. Group D consisted of natural incipient lesions. Enamel fluorescence was measured for all lesions immediately after removal from water and subsequently at short intervals for 30 min. The change in fluorescence with dehydration varied between the groups. In lesions from groups A and B, it followed a double exponential decrease, while in lesions from groups C and D, it followed a mono-exponential decrease. In all groups, the fluorescence of sound surfaces declined mono-exponentially. The 'fractional fluorescence difference', defined as (L(sound) - L(carious) )/L(sound), became constant after periods of dehydration of about 5, 5, 20 and 5 min for groups A to D, respectively. The observation of the change of fluorescence with dehydration should be taken into consideration when planning studies that use fluorescence as an assessment method. However, it might also be used to gain insight into the properties for fluid transport inside the various lesions, relevant to de-remineralization or fluoride treatments.

  1. The natural history of dental caries lesions: a 4-year observational study.

    PubMed

    Ferreira Zandoná, A; Santiago, E; Eckert, G J; Katz, B P; Pereira de Oliveira, S; Capin, O R; Mau, M; Zero, D T

    2012-09-01

    Dental caries is a ubiquitous disease affecting all age groups and segments of the population. It is known that not all caries lesions progress to cavitation, but little is known regarding the progression pattern of caries lesions. This study's purpose was to evaluate the natural history of dental caries using a standardized, visually based system, the International Caries Detection and Assessment System (ICDAS). The study population consisted of 565 consenting children, who were enrolled and examined at baseline and at regular intervals over 48 months with ICDAS and yearly bitewing radiographs. Of these, 338 children completed all examinations. Not all lesions cavitated at the same rate, differing by surface type and baseline ICDAS severity score and activity status. With increasing severity, the percentage of lesions progressing to cavitation increased: 19%, 32%, 68%, and 66% for ICDAS scores 1, 2, 3, and 4, respectively. Lesions on occlusal surfaces were more likely to cavitate, followed by buccal pits, lingual grooves, proximal surfaces, and buccal and lingual surfaces. Cavitation was more likely on molars, followed by pre-molars and anterior teeth. Predictors of cavitation included age, gender, surfaces and tooth types, and ICDAS severity/activity at baseline. In conclusion, characterization of lesion severity with ICDAS can be a strong predictor of lesion progression to cavitation.

  2. 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.

  3. Enhancing Effects Of Nd:YAG Laser On Remineralization Of Incipient Dental Caries

    NASA Astrophysics Data System (ADS)

    Morioka, Toshio; Tagomori, Shoko

    1989-09-01

    Artificial caries lesions were made on the buccal surface of human premolars, and the enamel was then treated with laser and fluoride. The acid resistance of the enamel was examined by demineralization in acidic solution. An increase in acid resistance and fluoride uptake was caused by fluoride treatment after laser irradiation. In addition, remarkable remineralization of artificial caries lesions was seen in these specimens after exposure to calcifying fluid.

  4. Update on nonsurgical, ultraconservative approaches to treat effectively non-cavitated caries lesions in permanent teeth.

    PubMed

    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

    2011-04-01

    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

  5. 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

  6. 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

  7. 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.

  8. EFFECT OF FLUORIDE VARNISHES CONTAINING DIFFERENT CALCIUM PHOSPHATE SOURCES ON MINERALIZATION OF INITIAL PRIMARY ENAMEL LESIONS.

    PubMed

    Rirattanapong, Praphasri; Vongsavan, Kadkao; Saengsirinavin, Chavengkiat; Pornmahala, Tuenjai

    2014-11-01

    This study was conducted to evaluate the effect of fluoride varnishes containing different calcium phosphate sources on demineralization of initial primary enamel lesions. Forty-eight sound primary incisors were completely coated with nail varnish except for two 1 x 1 mm windows before being placed in demineralizing solution for 4 days. After demineralization, one of the windows in each tooth was coated with nail varnish. The teeth were randomly divided into four groups (A to D; n = 12), and then the other (exposed) window was treated with: Group A: deionized water, Group B: Duraphat® fluoride varnish, Group C: Clinpro™ White varnish and Group D: Enamel Pro® varnish. The pH-cycling regimen was carried out consisting of demineralization (6 hours) and remineralization (18 hours) for 7 days. Polarized light microscopy was used to evaluate the lesion depth initially and then after a seven-day pH cycle. Lesion depth was measured using a computerized method with the Image-Pro® Plus Program. The pair t-test was used to compare lesion depths before and after treatment. Differences in mean lesion depths among the groups were compared with the one-way ANOVA and Tukey's multiple comparison tests with 95% confidence intervals. The lesion depths had a significant difference between before and after treatment of the all groups. There was a significant increase in lesion depth in Group A compared to the other groups. No significant differences were seen among Groups B, C and D, containing fluoride and the different calcium phosphate sources in inhibiting progression of initial primary enamel lesions. PMID:26466437

  9. Effect of Chicken Egg Shell Powder Solution on Early Enamel Carious Lesions: An Invitro Preliminary Study

    PubMed Central

    Ebenezar, A.V. Rajesh; Ghani, Mohamed Fayas; Narayanan, Ashwin; S., Anand; Mohan, Ajit George

    2015-01-01

    Aim: To evaluate the remineralization potential of enamel surface lesion using chicken eggshell powder (CESP) solution. Materials and Methods: Ten freshly extracted un-erupted third molars decoronated at cement-enamel junction (CEJ) used in this study. Each decoronated tooth was sectioned to get 4 samples of enamel blocks such that 40 blocks were obtained which were then subjected to demineralization protocol and grouped as: Group 1-untreated group, Group 2-subsurface demineralization, Group 3-subsurface demineralization + 7 days CESP immersion, Group 4- subsurface demineralization + clinpro application. The samples were evaluated for X-ray fluorescence spectroscopy analysis, microhardness testing and atomic analyses using energy dispersive X-ray spectroscopy. The data were statistically analysed by using one-way ANOVA and Tukey – Kramer multiple comparison test. Results: X-ray Fluorescence spectroscopy shows Calcium concentration of 98% and 0.46% of phosphate. Group 4 (Clinpro) shows the highest efficacy in enhancing the remineralization followed by Group 3 (CESP). The results of atomic analyses showed that quantitative amounts of Ca weight % and P weight % is statistically greater for all the three groups except the demineralized group. Conclusion: CESP with higher calcium content can remineralise enamel surface lesion. PMID:25954701

  10. 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. PMID:27223133

  11. Laser-Casein phosphopeptide effect on remineralization of early enamel lesions in primary teeth

    PubMed Central

    Najafpour, Ebrahim; Samiei, Mohammad; Erfanparast, Leila; Anoush, Somayeh; Jamali, Zahra; Pournaghi-Azar, Fatemeh; Ghertasi-Oskouei, Sina

    2015-01-01

    Background The aim of this study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. Material and Methods Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. Results The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A (P < 0.001, P < 0.001), B (P < 0.001, P < 0.001) and C (P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B (P = 0.002). SEM evaluations confirmed the results. Conclusions The combination of Nd:YAG laser and CPP-ACP crème could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth. Key words:CPP-ACP, enamel remineralization, microhardness, Nd:YAG, primary teeth, SEM. PMID:26155343

  12. 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.

  13. 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

  14. Laser fluorescence quantification of remineralisation in situ of incipient enamel lesions: influence of fluoride supplements.

    PubMed

    al-Khateeb, S; Oliveby, A; de Josselin de Jong, E; Angmar-Månsson, B

    1997-01-01

    The aims of this study were to test the laser fluorescence method for quantification of remineralisation in situ of enamel with incipient lesions and to evaluate the enhancement of remineralisation by fluoride (F) supplements when a F dentifrice was used on a regular basis by healthy young subjects. Enamel samples were cut from extracted premolar teeth with the natural surface kept intact, and subjected to a pH-cycling system to produce subsurface demineralisation in vitro. The enamel blocks were then inserted into composite holders bonded to the buccal surfaces of both upper first molars of 12 panelists. Each panelist participated in 3 separate experiments in a randomised order; each lasted for 5 weeks with washout intervals of 2 weeks between experiments; experiment 1: F dentifrice (0.145% F as NaF) only; experiment 2: F dentrifice + F lozenges (0.25 mg F x 6/day); experiment 3: F dentifrice + F chewing-gum (0.25 mg F x 6/day). Fluorescence radiance was measured before, during, and after in vitro demineralisation, and once a week during the in situ experimental periods. The enamel samples were then sectioned and analysed with transverse microradiography (TMR). Anova and Pearson correlation coefficient were used for the statistical analysis. At the end of the 5-week in situ periods, fluorescence radiance had been regained to a level of 80-100% of the value before in vitro demineralisation, indicating remineralisation of the enamel samples. There were no differences in the fluorescence radiance gain between the 3 different F exposures. However, there was a statistically significant time trend (p < 0.001), and a highly significant linear dependence (p < 0.001) between the final measurements obtained with the laser fluorescence method (LAF) and the data obtained from TMR, r = 0.76. It was concluded that: (1) with the sensitive LAF method it was possible to register the small changes in the enamel week by week during in situ remineralisation: (2) when F dentrifice was

  15. Remineralizing Effect of Child Formula Dentifrices on Artificial Enamel Caries Using a pH Cycling Model

    PubMed Central

    Malekafzali, Beheshteh; Ekrami, Maliheh; Mirfasihi, Armin; Abdolazimi, Zahra

    2015-01-01

    Objectives: Although fluoridated toothpastes are among the most accessible fluoride sources for caries prevention, their remineralization potential remains questionable. This study sought to compare the effects of 5 different child formula dentifrices on remineralization of artificial primary enamel caries using a pH cycling model. Materials and Methods: Twenty sound primary canine teeth were immersed in demineralizing solution for 96 hours to produce 100μm-deep artificial caries. The teeth were then longitudinally sectioned into 100–150 μm-thick slices and randomly divided into 5 groups and treated as follows: group A. Calcium phosphate toothpaste, group B. Pooneh children’s toothpaste, group C. Biotin toothpaste, group D. Crest children’s toothpaste and group E. Darougar children’s toothpaste. The specimens underwent a pH cycling model for 10 days. The degree of demineralization before and after treatment and its changes were evaluated under a polarized light microscope and a stereomicroscope and data were statistically analyzed using repeated measures ANOVA and post-hoc test. Results: Stereomicroscopic analysis showed that only group C had a significant difference with other groups (P<0.001) and no significant differences were found between the remaining groups (P>0.05). Polarized light microscopic analysis revealed that in addition to group C, a significant difference was detected between groups A and B (P=0.02) and calcium phosphate toothpaste showed higher efficacy. Conclusion: All the understudy toothpastes had remineralizing effect but calcium phosphate children’s toothpaste had the highest and biotin toothpaste had the lowest efficacy. PMID:26005449

  16. 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

  17. Early Childhood Caries is Associated with Genetic Variants in Enamel Formation and Immune Response Genes

    PubMed Central

    Abbasoğlu, Zerrin; Tanboğa, İlknur; Küchler, Erika Calvano; Deeley, Kathleen; Weber, Megan; Kaspar, Cigdem; Korachi, May; Vieira, Alexandre R.

    2015-01-01

    Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of unequal contributions of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire and caries experience data were collected by clinical examination. Twenty-three markers in ten genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries-free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene-interactions can act as protective or risk factors for early childhood caries. These factors together contribute to the presence and severity of the disease. PMID:25531160

  18. Remineralization of demineralized enamel via calcium phosphate nanocomposite.

    PubMed

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

    2012-10-01

    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

  19. 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.

  20. 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.

  1. 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. PMID:27188011

  2. 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

  3. Sealing occlusal caries lesions in adults referred for restorative treatment: 2-3 years of follow-up.

    PubMed

    Bakhshandeh, Azam; Qvist, Vibeke; Ekstrand, Kim R

    2012-04-01

    The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25-38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health. PMID:21479565

  4. Effect of tablets containing probiotic bacteria (Lactobacillus reuteri) on early caries lesions in adolescents: a pilot study.

    PubMed

    Keller, M K; Nøhr Larsen, I; Karlsson, I; Twetman, S

    2014-12-01

    The objective of the study was to investigate the effect of tablets containing probiotic lactobacilli on early caries lesions in adolescents with quantitative light-induced fluorescence (QLF). 36 healthy adolescents of both sexes (12-17 years of age) were enrolled and randomly allocated to a placebo-controlled trial with two parallel groups. The test group received two tablets daily containing two strains of Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) for a period of three months, while the control group got identical placebo tablets without live bacteria. The primary outcome was QLF-readings (change in fluorescence, ΔF and lesion area, mm2) at baseline and after 3 months, conducted at two buccal sites of each individual, pre-selected with clearly visible clinical signs of enamel demineralisation (white spots). Significantly more premolars were allocated to the placebo group, while the test group had more incisors (P<0.05). There were no statistically significant differences in fluorescence values between the groups, neither at baseline, nor at the follow-up. There was however a significant decrease in fluorescence over time in the test group, but not in the placebo group (P<0.05). No alterations of the lesion area (ΔA) were found in any group. The inter-examiner intra-class correlation coefficient-value for QLF-readings was excellent. No side- or adverse effects were reported during the intervention period. This pilot study found a significant decrease over time in the test group. However, no statistically significant differences in fluorescence values between the groups were found. Hence, the null hypothesis could not be rejected.

  5. 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. PMID

  6. 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. PMID:26158079

  7. 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

  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. 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.

  10. 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.

  11. Ultrashort echo time (UTE) MRI for the assessment of caries lesions

    PubMed Central

    Bracher, A-K; Hofmann, C; Bornstedt, A; Hell, E; Janke, F; Ulrici, J; Haller, B; Geibel, M-A; Rasche, V

    2013-01-01

    Objective: Direct in vivo MRI of dental hard tissues by applying ultrashort echo time (UTE) MRI techniques has recently been reported. The objective of the presented study is to clinically evaluate the applicability of UTE MRI for the identification of caries lesions. Methods: 40 randomly selected patients (mean age 41 ± 15 years) were enrolled in this study. 39 patients underwent a conventional clinical assessment, dental bitewing X-ray and a dental MRI investigation comprising a conventional turbo-spin echo (TSE) and a dedicated UTE scan. One patient had to be excluded owing to claustrophobia. In four patients, the clinical treatment of the lesions was documented by intraoral pictures, and the resulting volume of the cavity after excavation was documented by dental imprints and compared with the MRI findings. Results: In total, 161 lesions were identified. 157 (97%) were visible in the UTE images, 27 (17%) in the conventional TSE images and 137 (85%) in the X-ray images. In total, 14 teeth could not be analysed by MR owing to artefacts caused by dental fillings. All lesions appear significantly larger in the UTE images as compared with the X-ray and TSE images. In situ measurements confirm the accuracy of the lesion dimensions as observed in the UTE images. Conclusion: The presented data provide evidence that UTE MR imaging can be applied for the identification of caries lesions. Although the current data suggest an even higher sensitivity of UTE MRI, some limitations must be expected from dental fillings. PMID:23420857

  12. 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.

  13. Effect of computer assistance on observer performance of approximal caries diagnosis using intraoral digital radiography.

    PubMed

    Araki, Kazuyuki; Matsuda, Yukiko; Seki, Kenji; Okano, Tomohiro

    2010-06-01

    Logicon Caries Detector (LDDC) is the only commercially available computer-assisted diagnostic system for caries diagnosis. The object of this study is to elucidate the efficacy of LDDC when used by inexperienced dentists. Fifty extracted teeth were imaged using an RVG6000. Seven dentists who had just passed the Japanese National Dental Board Examination observed those images without LDDC (woLDDC) and assessed the probability that caries lesions were present, then re-assessed the same teeth using LDDC (wLDDC). The areas under the receiver operating characteristic curves (Az) were compared. No statistically significant difference was found between woLDDC Az values and wLDDC Az values when caries lesions of all depths were considered. When positive cases were restricted to caries lesions in the inner half of the enamel or to dentine caries lesions, however, wLDDC Az values were significantly larger than woLDDC (p = 0.043 and 0.018, respectively).

  14. 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

  15. 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

  16. 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.

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

    PubMed

    Richards, Derek

    2016-06-01

    Scope and purposeThe guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.MethodologyThe guidance development is based on three reviews(1,2,3) and an interim seminar and workshop organised by the European Academy of Paediatric Dentistry in Brussels in May 2015.Review and updatingNo indication of a review or update schedule is given.RecommendationsSeven recommendations on caries detection and diagnosis, four recommendations on caries risk assessment and 11 on the management of the early carious lesion were made and they are briefly summarised in the table below.Research RecommendationsCaries detection and diagnosisThere is a need for more research in the primary dentition because most of the available studies consider only the permanent dentitionRadiograph subtraction studies need to be conductedOngoing evaluation of new methods and devicesThere is a need for well-designed prevention studies on early childhood caries which will provide sufficient and strong evidence of the cost-effectivenessThere is a significant need to bring the knowledge and learning to regular dental practice, to all the paediatric health care providers, the children and their parents.Caries risk assessmentClinical trials to assess the validity of models and single risk factors, as well as the role of confounding factors (eg age, lifestyle, socio-economy and socio-demography), for predicting caries.Further quantitative and qualitative health professional and parents would be helpful to identify perceptions and barriers to carrying out a CRA and to deliver a risk-based preventive care that could bridge the social inequalities in dental health.More research on the implementation of risk-based caries prevention and to establish the cost-effectiveness of such strategies.

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

    PubMed

    Richards, Derek

    2016-06-01

    Scope and purposeThe guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.MethodologyThe guidance development is based on three reviews(1,2,3) and an interim seminar and workshop organised by the European Academy of Paediatric Dentistry in Brussels in May 2015.Review and updatingNo indication of a review or update schedule is given.RecommendationsSeven recommendations on caries detection and diagnosis, four recommendations on caries risk assessment and 11 on the management of the early carious lesion were made and they are briefly summarised in the table below.Research RecommendationsCaries detection and diagnosisThere is a need for more research in the primary dentition because most of the available studies consider only the permanent dentitionRadiograph subtraction studies need to be conductedOngoing evaluation of new methods and devicesThere is a need for well-designed prevention studies on early childhood caries which will provide sufficient and strong evidence of the cost-effectivenessThere is a significant need to bring the knowledge and learning to regular dental practice, to all the paediatric health care providers, the children and their parents.Caries risk assessmentClinical trials to assess the validity of models and single risk factors, as well as the role of confounding factors (eg age, lifestyle, socio-economy and socio-demography), for predicting caries.Further quantitative and qualitative health professional and parents would be helpful to identify perceptions and barriers to carrying out a CRA and to deliver a risk-based preventive care that could bridge the social inequalities in dental health.More research on the implementation of risk-based caries prevention and to establish the cost-effectiveness of such strategies. PMID:27339231

  19. Caries experience, the caries burden and associated factors in children in England, Wales and Northern Ireland 2013.

    PubMed

    Vernazza, C R; Rolland, S L; Chadwick, B; Pitts, N

    2016-09-23

    Background The 2013 Children's Dental Health Survey is the fifth in a series of national surveys.Aims To describe caries prevalence and severity and factors affecting these, in children in England, Wales and Northern Ireland in 2013.Methodology A representative sample of children (aged 5, 8, 12 and 15 years) in England, Wales and Northern Ireland were invited to participate in dental examinations. Caries was measured at both the dentine ('obvious caries') and dentine plus enamel ('clinical caries') levels and analysis included identifying those with indicators of significant burden of caries and identifying predictive factors.Results In 5-year-olds, 40% had obvious caries experience increasing to 56% when enamel lesions were included. In 15-year-olds, the respective figures were 46% and 63%. Fourteen percent of 5-year-olds and 15% of 15-year-olds had a least one indicator of significant levels of caries and those from deprived backgrounds were more likely to fall into this group.Conclusions Overall, the prevalence of caries in children is continuing to decrease, but the rate is slowing. The level of disease for those with disease is much higher than the average values might suggest and there remain a sizeable minority with a significant burden of caries, associated with deprivation. This complex picture poses significant clinical and public health challenges. PMID:27659635

  20. An in Vitro Evaluation of Remineralization Potential of Novamin® on Artificial Enamel Sub-Surface Lesions Around Orthodontic Brackets Using Energy Dispersive X-Ray Analysis (EDX)

    PubMed Central

    Padmanabhan, Sridevi; Chitharanjan, Arun B

    2014-01-01

    Objective: To evaluate and compare the Ca/P ratio of enamel samples around the orthodontic brackets for time periods of 0, 2 and 10 days in two groups (control group and study group). Materials and Methods: Forty extracted teeth were randomly divided into control group and study group. All samples were demineralized and incubated in artificial saliva at 37°C for a period of 10 days after demineralization. During this phase the enamel samples in the study group were treated with remineralizing paste (NuproNusolution containing Novamin®-Dentsply) for 10 days. At the end of the incubation period, Ca/P ratios were analyzed for both the groupsby EDX analysis. Data obtained was subjected to statistical analysis using student t-test for paired samples and Student t- test for individual samples (p ≤ 0.05). Results: It was found that the mean Ca/P ratio was significantly lower for the control group as compared to the study group (p-value < 0.05) after 10 d of incubation. Conclusion: Novamin® containing remineralization toothpaste showed significant remineralizing potential in inhibition of artificial enamel sub-surface lesion around bracket after 10 days of remineralization phase. EDX element analysis was found to be an efficient method to quantify the changes in mineral content of a sample during in vitro caries studies. PMID:25584326

  1. 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.

  2. Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions: a systematic review.

    PubMed

    Gimenez, Thais; Piovesan, Chaiana; Braga, Mariana M; Raggio, Daniela P; Deery, Chris; Ricketts, David N; Ekstrand, Kim R; Mendes, Fausto Medeiros

    2015-01-01

    Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection.

  3. 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

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

    PubMed Central

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

    2015-01-01

    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. PMID:25914499

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. White defects on enamel: diagnosis and anatomopathology: two essential factors for proper treatment (part 1).

    PubMed

    Denis, Maud; Atlan, Anthony; Vennat, Elsa; Tirlet, Gil; Attal, Jean-Pierre

    2013-06-01

    Early-stage caries (white spots), fluoroses, traumatic hypomineralizations and molar incisive hypomineralization (MIH) all present, to differing degrees, clinical symptoms involving white marks on the enamel. This article shows that proper diagnosis leads to better understanding of the three-dimensional aspects of the lesion, thereby ensuring the appropriate choice of a specific treatment.

  10. Novel lesion detection aids.

    PubMed

    Neuhaus, K W; Longbottom, C; Ellwood, R; Lussi, A

    2009-01-01

    Several non-invasive and novel aids for the detection of (and in some cases monitoring of) caries lesions have been introduced in the field of 'caries diagnostics' over the last 15 years. This chapter focusses on those available to dentists at the time of writing; continuing research is bound to lead to further developments in the coming years. Laser fluorescence is based on measurements of back-scattered fluorescence of a 655-nm light source. It enhances occlusal and (potentially) approximal lesion detection and enables semi-quantitative caries monitoring. Systematic reviews have identified false-positive results as a limitation. Quantitative light-induced fluorescence is another sensitive method to quantitatively detect and measure mineral loss both in enamel and some dentine lesions; again, the trade-offs with lower specificity when compared with clinical visual detection must be considered. Subtraction radiography is based on the principle of digitally superimposing two radiographs with exactly the same projection geometry. This method is applicable for approximal surfaces and occlusal caries involving dentine but is not yet widely available. Electrical caries measurements gather either site-specific or surface-specific information of teeth and tooth structure. Fixed-frequency devices perform best for occlusal dentine caries but the method has also shown promise for lesions in enamel and other tooth surfaces with multi-frequency approaches. All methods require further research and further validation in well-designed clinical trials. In the future, they could have useful applications in clinical practice as part of a personalized, comprehensive caries management system. PMID:19494675

  11. Nanotechnology and its role in caries therapy.

    PubMed

    Hannig, M; Hannig, C

    2012-09-01

    The purpose of this review is to highlight recent nanotechnological developments for remineralization of incipient caries lesions as well as biomimetic strategies for enamel synthesis based on the application of nanotechnology. Analysis of in vitro data indicates that apatite nanoparticles might be effective in reversing lesion progression in the outer but not in the deeper part of early caries lesions. To control caries-induced demineralization, investigators have developed calcium and phosphate or fluoride ion-releasing nanofillers, enabling resin composites to release ions, if the pH decreases under in vitro conditions. Extensive in vitro investigations of apatite crystallization have been performed to mimic the hierarchical topology of natural enamel. Strategies for formation of highly organized biomineralized structures include oriented aggregation of nanocrystallites or the assembly of apatite nanoparticles mediated by organic scaffolds. Despite all these promising in vitro experiments, the effectiveness of such strategies for the control of demineralization processes as well as for caries therapy still needs validation by clinical studies.

  12. [Early childhood caries].

    PubMed

    Nissan, S; Khoury-Absawi, M

    2009-07-01

    ECC was defined by the American Academy of pediatric dentistry at 2003 as the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. This is a virulent type of dental caries that start soon after the tooth erupts and progress rapidly. The prevalence is 1-12% in developed countries and 70% in developing countries, and changes in different cultures, communities, socioeconomic status, etc. The etiology of the disease is multifactorial like in any dental caries. The risk factors include high levels of SM and LB, enamel defects, oral habits, complication at pregnancy and birth, social and demographic factors and the child's age. The disease implications are: high risk of new caries defects in both permanent and deciduous dentitions, insufficient physical development, hospitalization and emergency room visits, loss of school days and increased days with restricted activity, increased treatment costs and time, diminished ability to learn, and diminished oral health-related quality of life. Due to the aggressive pattern of the disease, treatment should be specific for each individual patient, and should be given by an expert dentist with experience who could manage the young child and the process of the disease. Treatment options are: 1. Conservative approach which includes recalls and topical fluoride, 2. Aggressive restorative approach. In both we should first stop the carious habit and encourage prevention. Before choosing the type of treatment, we should consider the severity of the lesions, child's age, caries risk, child's behavior, and parents' cooperation. Prevention at home includes: 1. decreasing the mother's/primary caregiver's mutans streptococci levels, 2. avoid sharing the same utensils in the family, 3. implementing oral hygiene measures as the first primary tooth erupts, 4. dental home, 5. avoid inappropriate feeding practices of

  13. Transversal wavelength-independent microradiography, a method for monitoring caries lesions over time, validated with transversal microradiography.

    PubMed

    Thomas, R Z; Ruben, J L; de Vries, J; ten Bosch, J J; Huysmans, M C D N J M

    2006-01-01

    This paper describes a microradiographic method for measuring mineral concentration in a transversal geometry with thick (< or =3.2 mm) sections: transversal wavelength-independent microradiography (T-WIM). It was tested on bovine enamel and dentin samples in vitro, and the results were validated with those of transversal microradiography (TMR). 48 enamel and 48 dentin samples (3.2 x 3.2 x 1.5 mm) were embedded in acrylic resin, randomly divided into six groups of 8 dentin or 8 enamel samples, and demineralized for 0 (sound control), 1, 2, 3, 4, or 5 weeks. For T-WIM, samples were imaged on film with polychromatic 40-kV Cu X-rays with an Al (0.25 mm)/Ni (0.02 mm) filter together with an aluminium/zinc step wedge. TMR slices (about 80 mum for enamel and about 130 mum for dentine) were subsequently cut from the centre of the samples and subjected to TMR. Microradiographs from both methods were digitized and image analysis software was used to calculate lesion depth and mineral loss. The relations between T-WIM and TMR results for mineral loss (DeltaZ) and lesion depth were nearly linear (r > or = 0.96) for both enamel and dentin. The slopes of the regression lines were between 0.99 and 1.02 except for DeltaZ in dentine, which was 0.89. It was concluded that T-WIM is a suitable method for TMR on thick samples. PMID:16741358

  14. Influence of moisture and plaque on the performance of a laser fluorescence device in detecting caries lesions in primary teeth.

    PubMed

    Bittar, Daniela G; Gimenez, Thaís; Morais, Caroline C; De Benedetto, Monique S; Braga, Mariana M; Mendes, Fausto Medeiros

    2012-11-01

    The aim of this study was to evaluate the influence of dental plaque and moisture on performance of a laser fluorescence device in detecting occlusal and proximal caries lesions in primary teeth. Fifty-five occlusal and 58 proximal sites on primary molars were evaluated using a DIAGNOdent pen (LFpen) device. For the drying time study, the evaluations were performed in: (I) moist teeth; (II) teeth dried for 3 s, or (III) dried for 15 s. For the plaque study, the evaluations were done in sites: (I) without plaque; (II) with plaque, and (III) after cleaning. Evaluation of the teeth sections in stereomicroscope was the reference standard method. LF pen values, sensitivity, specificity, and accuracy were compared. The values obtained after 15 s of drying were higher than those obtained with moist teeth or dried for 3 s at both occlusal and proximal surfaces. However, there was no change in the performance in detecting caries lesions. With regard to the presence of plaque, there was no significant change in the readings of the device, but specificity was decreased in occlusal surfaces with plaque. At proximal surfaces, however, no significant differences were observed. In conclusion, the moisture conditions do not influence significantly the performance of the LFpen, but the presence of plaque can affect its performance in detecting occlusal caries lesions in primary teeth.

  15. 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. PMID:26240030

  16. 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.

  17. Quantitative measurements of remineralization of incipient caries.

    PubMed

    Linton, J L

    1996-12-01

    White demineralized areas after the removal of orthodontic appliances remain a problem for clinicians and patients. The main objective of this study is to assess clinical photography as a method for the evaluation of caries and white spots and the in vivo study of remineralization of carious lesions. The secondary objective was to compare the effect of different levels of both experimental and commercial fluoride solutions on the remineralization of enamel carious lesions. White spot lesions were created with an acid solution on extracted permanent human teeth, and the lesions were remineralized in remineralizing solutions with or without fluoride ions. The changes in the enamel surface during the demineralization and the remineralization processes were recorded with a 35 mm clinical camera. Photographs were taken of the experimentally created white spots, the samples were sectioned for microradiography testing, and the actual mineral contents of the white spot lesions were calculated from the microradiographs. The enamel lesions were further analyzed by powder x-ray diffraction to confirm whether fluoride was incorporated into the lesions during the remineralization period. From this experiment it can be concluded: (1) clinical photography as currently practiced is not an adequate method of monitoring the remineralization of white spots with large lesion depths and (2) the experimental solution that contains 50 ppm fluoride had a higher efficacy for remineralization than the control solution or the commercial mouth rinse, which contained 225 ppm fluoride.

  18. Imaging laser irradiated enamel surfaces with polarization sensitive optical coherence tomography

    PubMed Central

    Hsu, Dennis J.; Darling, Cynthia L.; Fried, Daniel

    2011-01-01

    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 CO2 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. PMID:21909224

  19. 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.

  20. [Novel treatment possibilities for proximal caries].

    PubMed

    Meyer-Lueckel, Hendrik; Fejerskov, Ole; Paris, Sebastian

    2009-01-01

    So far approaches for caries treatment follow a dichotomized scheme: Non invasive options of primary and secondary prevention are contrasted to invasive treatment of caries lesions. Depending on the treatment philosophy of dentists and dental schools an early or late invasive treatment threshold is recommended. Sealing of proximal lesions as done in pit and fissures has only been established in some dental schools, so far. Moreover, infiltration of the enamel part of lesions could close the gap between preventive and invasive measures. Most of these novel treatment options for proximal surfaces are currently in the last stages of product development. With respect to the good clinical results of proximal sealing with conventional sealants, this regimen seems already be recommendable to hamper further lesion progression in clinical practice. Caries infiltration of lesions situated on proximal and other smooth surfaces might even be a more promising approach, if clinical studies corroborate the recent in vitro findings. All these novel limited invasive strategies might be suitable to complete the current dichotomized way of caries treatment.

  1. 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. PMID:25729021

  2. [The morphological study of experimental caries produced in rat molars].

    PubMed

    Tanaka, R

    1989-01-01

    Since there is some disagreement over the validity of using the rat for various experiments of relevance to dental caries in the human. The process of carious formation in the lower first and second molars of the rat was observed histologically. 120 new born Wistar rats were divided into two groups, one on a carious diet and the other on a standard diet. Both control and experimental animals were killed at preselected intervals namely 1 week, 4 weeks and 7 weeks after weaning. The maxillary and mandibular tooth bearing segments were removed and fixed in glutaraldehyde and osmium. After clinical examination and assessment of the caries status made with the aid of a binocular microscope, the material was sectioned without decalcification and prepared for light, electron, or microradiogram. From the results it was concluded that, 1. The caries process in the rat is extremely rapid much faster than in the human for example complete breakdown of the crown occurs within 28 days of weaning. 2. Frequently destruction of the dentin occurs before mineral loss is detectable in the enamel. 3. Rarely are any of the characteristic features of the early human caries lesion, such as the surface zone, body of the lesion, the dark zone and the translucent zone, to be found. 4. When a surface zone is visible, the dentine is usually in an advanced state of destruction. 5. The histopathology of rat caries does not therefore follow the same pattern as in the human. It is deduced that the reasons for these differences with the human lesion are due to. a) Rat molar enamel is extremely thin being only 100 microns in the thickest part of the fissure enamel whereas it is 2.5mm in the human. b) Rat molar enamel has a lower mineral density than the outer two thirds of human enamel, and is even lower (2.74) than the average value for the inner layer deciduous human enamel. (2.85-2.92) (Weidmann, et al., 1967) c) Rat enamel is extremely porous allowing easy diffusion of fluid and dyes. d) This

  3. 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.

  4. 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. PMID:23594784

  5. 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.

  6. 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.

  7. Kinetic cavity preparation effects on secondary caries formation around resin restorations: a polarized light microscopic in vitro evaluation.

    PubMed

    Hicks, M J; Parkins, F M; Flaitz, C M

    2001-01-01

    The purpose of this in vitro study was to compare the effect of conventional handpiece and kinetic cavity preparation (KCP, air abrasion) techniques of cavity preparation on caries-like enamel lesion formation. After a fluoride-free prophylaxis, twelve human molars were examined macroscopically to ensure that buccal and lingual surfaces were caries-free. Unfilled cavities were prepared in mesiobuccal (conventional [CU]) and mesiolingual (air abrasion [AU]) enamel surfaces. Cavities were prepared in distobuccal (conventional [CF]) and distolingual (air abrasion [AF]) enamel surfaces and restored with composite resin following placement of a bonding agent. Acid-etching of cavity walls was performed only with the conventionally prepared cavities restored with resin. Air abrasion (KCP) prepared cavities were restored without acid-etching of the cavity walls. Teeth were thermocycled (500 cycles, 5 degrees to 50 degrees C, 500 cycles) and exposed to an artificial caries medium for caries initiation and progression. After caries formation, two longitudinal sections were taken from unfilled and filled cavity preparations and examined by polarized light microscopy for wall lesion presence and mean surface lesion depth. Surface lesion depths were similar among groups after the caries initiation period (CU = 225 microns; AU = 237 microns; CF = 241 microns; AF = 251 [p > .05, ANOVA, DMR]), and progression (CU = 437 microns; AU = 415 microns; CF = 405 microns; AF = 429 um [p > 0.05, ANOVA, DMR]). Extensive wall lesions were present in all CU and AU; while small wedge-shaped wall lesions were significantly (p < .05, ANOVA, DMR) fewer in CF (19 percent & 21 percent) and AF (17 percent & 21 percent) following caries initiation and progression compared with unfilled controls. Resin restorations placed in cavities prepared by air abrasion (KCP) and conventional handpiece techniques provided similar degrees of protection against a secondary caries-like challenge. PMID:11475686

  8. Kinetic cavity preparation effects on secondary caries formation around resin restorations: a polarized light microscopic in vitro evaluation.

    PubMed

    Hicks, M J; Parkins, F M; Flaitz, C M

    2001-01-01

    The purpose of this in vitro study was to compare the effect of conventional handpiece and kinetic cavity preparation (KCP, air abrasion) techniques of cavity preparation on caries-like enamel lesion formation. After a fluoride-free prophylaxis, twelve human molars were examined macroscopically to ensure that buccal and lingual surfaces were caries-free. Unfilled cavities were prepared in mesiobuccal (conventional [CU]) and mesiolingual (air abrasion [AU]) enamel surfaces. Cavities were prepared in distobuccal (conventional [CF]) and distolingual (air abrasion [AF]) enamel surfaces and restored with composite resin following placement of a bonding agent. Acid-etching of cavity walls was performed only with the conventionally prepared cavities restored with resin. Air abrasion (KCP) prepared cavities were restored without acid-etching of the cavity walls. Teeth were thermocycled (500 cycles, 5 degrees to 50 degrees C, 500 cycles) and exposed to an artificial caries medium for caries initiation and progression. After caries formation, two longitudinal sections were taken from unfilled and filled cavity preparations and examined by polarized light microscopy for wall lesion presence and mean surface lesion depth. Surface lesion depths were similar among groups after the caries initiation period (CU = 225 microns; AU = 237 microns; CF = 241 microns; AF = 251 [p > .05, ANOVA, DMR]), and progression (CU = 437 microns; AU = 415 microns; CF = 405 microns; AF = 429 um [p > 0.05, ANOVA, DMR]). Extensive wall lesions were present in all CU and AU; while small wedge-shaped wall lesions were significantly (p < .05, ANOVA, DMR) fewer in CF (19 percent & 21 percent) and AF (17 percent & 21 percent) following caries initiation and progression compared with unfilled controls. Resin restorations placed in cavities prepared by air abrasion (KCP) and conventional handpiece techniques provided similar degrees of protection against a secondary caries-like challenge.

  9. 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

  10. 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.

  11. Dental enamel around fixed orthodontic appliances after fluoride varnish application.

    PubMed

    Gontijo, Leonardo; Cruz, Roberval de Almeida; Brandão, Paulo Roberto Gomes

    2007-01-01

    Poor oral hygiene has been considered one of the main problems routinely faced in the orthodontic treatment. Orthodontic appliance creates an environment that provides mineral loss from the dental enamel. Such condition is clinically seen as white spot lesions and cavitations in the most severe cases. The aim of this study was to evaluate the effects of a fluoride varnish application as a caries prevention method for clinical orthodontics. The experiment analyzed dental enamel adjacent to orthodontics accessories after treatment. In addition, it was observed the calcium, phosphorus and fluoride contents on enamel treated with a fluoride varnish. The results showed that fluoride varnish application is a simple and fast technique that could be useful in preventing enamel demineralization associated to orthodontic treatment. Scanning electron microscopy revealed significant amount of calcium fluoride-like material deposited on enamel and energy dispersive x-ray analysis demonstrated a large incorporation of calcium and fluoride to the enamel of the treated specimens. It was concluded that fluoride varnish could indeed be considered an efficient preventive method to enhance enamel resistance against the cariogenic challenges during orthodontic therapy.

  12. The oral microbiome in dental caries.

    PubMed

    Struzycka, Izabela

    2014-01-01

    Dental caries is one of the most common chronic and multifactorial diseases affecting the human population. The appearance of a caries lesion is determined by the coexistence of three main factors: acidogenic and acidophilic microorganisms, carbohydrates derived from the diet, and host factors. Socio-economic and behavioral factors also play an important role in the etiology of the disease. Caries develops as a result of an ecological imbalance in the stable oral microbiom. Oral microorganisms form dental plaque on the surfaces of teeth, which is the cause of the caries process, and shows features of the classic biofilm. Biofilm formation appears to be influenced by large scale changes in protein expression over time and under genetic control Cariogenic microorganisms produce lactic, formic, acetic and propionic acids, which are a product of carbohydrate metabolism. Their presence causes a decrease in pH level below 5.5, resulting in demineralization of enamel hydroxyapatite crystals and proteolytic breakdown of the structure of tooth hard tissues. Streptococcus mutans, other streptococci of the so-called non-mutans streptococci group, Actinomyces and Lactobacillus play a key role in this process. Dental biofilm is a dynamic, constantly active metabolically structure. The alternating processes of decrease and increase of biofilm pH occur, which are followed by the respective processes of de- and remineralisation of the tooth surface. In healthy conditions, these processes are in balance and no permanent damage to the tooth enamel surface occurs.

  13. Investigation of Acid-Etched CO2 Laser Ablated Enamel Surfaces Using Polarization Sensitive Optical Coherence Tomography

    PubMed Central

    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. PMID:23539418

  14. 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.

  15. Designing of a Computer Software for Detection of Approximal Caries in Posterior Teeth

    PubMed Central

    Valizadeh, Solmaz; Goodini, Mostafa; Ehsani, Sara; Mohseni, Hadis; Azimi, Fateme; Bakhshandeh, Hooman

    2015-01-01

    .159-0.849) (P = 0.006). Also, the computer program diagnosed 97% of dentin caries and the ICC between the software and histological analysis results for dentin caries was determined as 0.937 (95% CI=0.906-0.958) (P < 0.001). Bland-Altman plot showed an acceptable agreement for measuring the depth of caries in enamel and dentin. Conclusions: The designed software was able to detect a significant number of dentin caries and acceptable measuring of the depth of carious lesions in enamel and dentin. However, the software had limited ability in detecting enamel lesions. PMID:26793287

  16. 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.

  17. Surface substance loss of subsurface bovine enamel lesions after different steps of the resinous infiltration technique: a 3D topography analysis.

    PubMed

    Yang, Fan; Mueller, Jan; Kielbassa, Andrej M

    2012-07-01

    Surface substance loss of subsurface enamel lesions before (baseline/demineralization) and after each step of the infiltration technique was evaluated by means of a three-dimensional focus variation. Eighty enamel specimens were prepared and partially varnished (control). Non-varnished areas were demineralized (pH 4.95; 28 days), and etched with phosphoric acid gel (20%; 5 s). Specimens were randomly assigned to eight groups (n = 10), and were infiltrated using four resinous materials. In subgroups 1, polymerization and finishing with abrasive polishing strips followed. In subgroups 2, excess material was removed before polymerization (E1/E2-Excite, Vivadent; F1/F2-Fortify, Bisco; G1/G2-Glaze & Bond, DMG; I1/I2-Icon, DMG). Topometrical evaluation revealed a negligible substance loss of demineralized enamel. After etching, mean (±SD) differences of height decreased uniformly (-6.6 ± 2.0 μm; p = 0.089; ANOVA). For infiltrated lesions, DH of subgroups 1 was comparable to the etched lesions, with a significant increase (compared to etched lesions) in subgroups 2 (1.1 ± 0.1 μm; p < 0.001; t test). Within the limitations of this study, it is concluded that etching of initial subsurface lesions will result in significant surface substance loss; removal of excess material before light-curing should simplify the infiltration procedure, and this will avoid any abrasion resulting from polishing procedures. PMID:21678019

  18. 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.

  19. Oral arginine metabolism may decrease the risk for dental caries in children.

    PubMed

    Nascimento, M M; Liu, Y; Kalra, R; Perry, S; Adewumi, A; Xu, X; Primosch, R E; Burne, R A

    2013-07-01

    Arginine metabolism by oral bacteria via the arginine deiminase system (ADS) increases the local pH, which can neutralize the effects of acidification from sugar metabolism and reduce the cariogenicity of oral biofilms. To explore the relationship between oral arginine metabolism and dental caries experience in children, we measured ADS activity in oral samples from 100 children and correlated it with their caries status and type of dentition. Supragingival dental plaque was collected from tooth surfaces that were caries-lesion-free (PF) and from dentinal (PD) and enamel (PE) caries lesions. Regardless of children's caries status or type of dentition, PF (378.6) had significantly higher ADS activity compared with PD (208.4; p < .001) and PE (194.8; p = .005). There was no significant difference in the salivary arginolytic activity among children with different caries status. Mixed-model analysis showed that plaque caries status is significantly associated with ADS activity despite children's age, caries status, and dentition (p < .001), with healthy plaque predicting higher ADS activity compared with diseased plaque. Plaque arginine metabolism varies greatly among children and tooth sites, which may affect their susceptibility to caries.

  20. First-choice treatment alternatives for caries removal using the chemomechanical method.

    PubMed

    Ziskind, Daniel; Kupietzky, Ari; Beyth, Nurit

    2005-01-01

    Modern dentistry aims to preserve tooth structure using minimally invasive procedures. Chemomechanical removal of caries is a new method with the advantage of selective removal of severely demineralized dentin. In addition, the method enhances the clinician's ability to diagnose caries. Ensuring chairside caries diagnosis and removal, based on biologic principle, helps to preserve as much healthy tissue as possible. However, while this method is most comfortable for the patient, treatment time is prolonged. In most cases, the method has to be used in combination with a conventional bur. Also, caries lesions in which removal of enamel or a restoration is needed cannot be treated exclusively using the chemomechanical method. This article describes the mechanism of action of the chemomechanical method (CarisolvTM) for caries removal. Indications for use of the chemomechanical method as a first-choice treatment are presented. Clinical cases in which this new approach provides a significant clinical advantage are also described.

  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. [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. PMID:16917587

  5. 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.

  6. 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

  7. 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. PMID:26630491

  8. 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

  9. 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.

  10. 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.

  11. Computer-automated caries detection in digital bitewings: consistency of a program and its influence on observer agreement.

    PubMed

    Wenzel, A

    2001-01-01

    The aim of this study was to evaluate a decision-support, caries detection program and its influence on observer agreement in caries diagnosis. 130 patients were examined by digital bitewing radiography (RVG XL sensor, Trophy Radiologie Inc.). Fifty-four approximal surfaces (27 in premolars and 27 in molars) were selected by the author: 24 surfaces (9 in molars and 15 in premolars) scored as sound, 16 surfaces (9 in molars and 7 in premolars) scored as carious in enamel, and 14 surfaces (9 in molars and 5 in premolars) scored as carious in dentine. The Logicon Caries Detector (LCD) program (Logicon Inc., USA) was assessed by repeating the automated analysis ten times for each surface. The two most varying outcomes for lesion probability (Lp(min) and Lp(max)) were saved. Five observers scored the 54 surfaces independently as sound, caries in enamel or caries in dentine before and after the use of LCD. In more than one third of all surfaces the program indicated different lesion probability, from sound at Lp(min) to the presence of a carious lesion at Lp(max). The 5 observers changed their caries score after the use of LCD in a total of 31 surfaces (only 2 of these were in the same surface). Mean kappa value for inter-observer agreement for caries scores before the use of LCD was 0.47 (range 0. 39-0.61) and after LCD 0.48 (range 0.37-0.69). It was concluded that the automated caries detection program was not very consistent and provided different opinions on the caries status in a surface. Inter-observer agreement in caries diagnosis did not improve using the program.

  12. Image-guided removal of occlusal caries lesions with a λ= 9.3-µm CO2 laser using near-IR transillumination

    PubMed Central

    Chung, Leon C.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Fried, Daniel; Darling, Cynthia L.

    2015-01-01

    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. PMID:25914498

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. Remineralization of Artificial Caries in Primary Teeth by Grape Seed Extract: An In Vitro Study

    PubMed Central

    Mirkarimi, Mahkameh; Eskandarion, Solmauz; Bargrizan, Majid; Delazar, Abbas; Kharazifard, Mohammad Javad

    2013-01-01

    Background and aims. Promoting remineralization is the ultimate goal of clinical prevention of caries lesion. The present in vitro study aimed to investigate the effect of grape seed extract (GSE) on artificial enamel caries in primary human teeth. Materials and methods. Seventeen human sound primary incisors were sectioned mesiodistally. The tooth slices were placed in a demineralizing solution for 96 hours at 37ºC and 50% relative humidity to create lesions. The demineralized fragments of each tooth were randomly divided into two case (immersed in GSE solution in phosphate buffer for 8 days) and control (immersed in distilled water) groups. The samples were subsequently evaluated using a scanning electron microscope and a micro-hardness tester. Data were analyzed using independent t-test. Results. The mean ± SD micro-hardness values for the case and control groups were 358.6±83.42 and 296.51± 69.41, respectively. Grape seed extract significantly increased the micro-hardness of the lesions (P=0.03). The morphology of GSE treated enamel was clearly different from that in the control group, and there were deposits of scaffolding insoluble complexes on the enamel surface. Conclusion. GSE enhanced the remineralization process of artificial enamel lesions of primary teeth, and thus, might be considered an effective natural agent in non-invasive dentistry. PMID:24578818

  19. 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.

  20. 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. PMID:24433821

  1. Effect of a new carbon dioxide laser and fluoride on sound and demineralized enamel

    NASA Astrophysics Data System (ADS)

    dos Santos, Marines N.; Featherstone, John D. B.; Fried, Daniel

    2001-04-01

    The present study aimed to test the hypothesis that irradiation of dental enamel by a TEA carbon dioxide laser together with fluoride, can effectively inhibit caries-like progression in sound and demineralized enamel. Blocks of human sound and demineralized dental enamel were divided into 11 treatment groups. Eighty enamel blocks were partially demineralized in a 50 percent HAP/0.1 M lactic acid/carbopol solution. Samples were treated with/without laser and/or F according to the above groups. The blocks were then submitted to 5 days of pH cycling. Microradiography was performed on 100 micrometers thin sections to determine the relative mineral loss as (Delta) Z and the percentage of caries inhibition for the laser and F treated groups. Mean (Delta) Z values for groups I-X were, respectively: 1043; 683; 614; 2294; 1803; 1708; 1547; 1791; 1656;; and 1385. The percent caries inhibition for groups II, III, V-X was respectively: 35, 41; 49; 62; 42; 53 and 76 percent. The combination of this new TEA CO2 laser and F treatment produced a significant protective effect against lesion progression.

  2. 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. PMID:26179280

  3. 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.

  4. 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.

  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. 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.

  7. Restoration materials and secondary caries using an in vitro biofilm model.

    PubMed

    Kuper, N K; van de Sande, F H; Opdam, N J M; Bronkhorst, E M; de Soet, J J; Cenci, M S; Huysmans, M C D J N M

    2015-01-01

    This in vitro study investigated whether restoration materials and adhesives influence secondary caries formation in gaps using a short-term in vitro biofilm model. Sixty enamel-dentin blocks were restored with 6 different restoration materials with or without adhesives (n = 10 per group) with a gap: 1) Clearfil AP-X composite, 2) Clearfil AP-X composite + SE Bond, 3) Clearfil AP-X composite + ProtectBond, 4) Filtek Silorane composite, 5) Filtek Silorane composite + Silorane System adhesive, or 6) Tytin amalgam. Specimens were subjected to an intermittent 1% sucrose biofilm model for 20 days to create artificial caries lesions. Lesion progression in the enamel-dentin next to the different materials was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography (T-WIM). A regression analysis was used to compare the LD and ML of the different restoration materials at 4 measurement locations: 1 location at the surface of the enamel, 1 location at the wall of the enamel, and 2 locations at the wall of the dentin. A statistically significant effect of AP-X composite with Protect Bond was found for LD and ML at the WallDentin1 location, leading to less advanced wall lesions. An additional finding was that gap size was also statistically significant at the 2 wall locations in dentin, leading to increasing lesion progression with wider gaps. In conclusion, adhesives can influence wall lesion development in gaps. Protect Bond showed significantly less caries progression compared to bare restoration materials or other adhesives in this short-term in vitro biofilm model. PMID:25297114

  8. Restoration materials and secondary caries using an in vitro biofilm model.

    PubMed

    Kuper, N K; van de Sande, F H; Opdam, N J M; Bronkhorst, E M; de Soet, J J; Cenci, M S; Huysmans, M C D J N M

    2015-01-01

    This in vitro study investigated whether restoration materials and adhesives influence secondary caries formation in gaps using a short-term in vitro biofilm model. Sixty enamel-dentin blocks were restored with 6 different restoration materials with or without adhesives (n = 10 per group) with a gap: 1) Clearfil AP-X composite, 2) Clearfil AP-X composite + SE Bond, 3) Clearfil AP-X composite + ProtectBond, 4) Filtek Silorane composite, 5) Filtek Silorane composite + Silorane System adhesive, or 6) Tytin amalgam. Specimens were subjected to an intermittent 1% sucrose biofilm model for 20 days to create artificial caries lesions. Lesion progression in the enamel-dentin next to the different materials was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography (T-WIM). A regression analysis was used to compare the LD and ML of the different restoration materials at 4 measurement locations: 1 location at the surface of the enamel, 1 location at the wall of the enamel, and 2 locations at the wall of the dentin. A statistically significant effect of AP-X composite with Protect Bond was found for LD and ML at the WallDentin1 location, leading to less advanced wall lesions. An additional finding was that gap size was also statistically significant at the 2 wall locations in dentin, leading to increasing lesion progression with wider gaps. In conclusion, adhesives can influence wall lesion development in gaps. Protect Bond showed significantly less caries progression compared to bare restoration materials or other adhesives in this short-term in vitro biofilm model.

  9. 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.

  10. 21 CFR 101.80 - Health claims: dietary noncariogenic carbohydrate sweeteners and dental caries.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... sweeteners and dental caries. 101.80 Section 101.80 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... caries. (a) Relationship between dietary carbohydrates and dental caries. (1) Dental caries, or tooth... development of dental caries. Risk factors include tooth enamel crystal structure and mineral content,...

  11. 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

  12. Detection of Non-Cavitated Occlusal Caries with Impedance Spectroscopy and Laser Fluorescence: an In Vitro Study

    PubMed Central

    Mortensen, Diana; Dannemand, Katrine; Twetman, Svante; Keller, Mette Kirstine

    2014-01-01

    Objective: To evaluate the performance of an impedance spectroscopy technology for detecting non-cavitated occlusal caries lesions in permanent teeth in vitro. The method was compared with a commonly used laser fluorescence device and validated against histology. Material and Methodology: A non-cavitated sample of 100 extracted posterior teeth was randomly selected and assessed for caries on enamel and dentin level with aid of CarioScan PRO (ACIS) and DIAGNOdent pen (LF pen) by three examiners. After the measurements, the extension of the lesion was histologically determined as gold standard. Sensitivity, specificity, accuracy and receiver-operating curves were calculated. Intra- and inter-examiner reproducibility was expressed by intra class correlation coefficients. Results: The histological caries prevalence was 99% and 41% exhibited dentin caries. The ACIS technique displayed high specificities but almost negligible sensitivities at readings >50. A similar pattern was noted for the LF pen at readings >30. The intra- and inter-examiner reproducibility varied between 0.47 and 0.98 and the values were generally lower for the ACIS technique than for the LF pen. The inter-examiner agreement reached excellent levels with both methods. Conclusions: In vitro,the ACIS technique showed a low ability to disclose occlusal caries lesions in the enamel and/or dentin of non-cavitated permanent molars. However, further in vivo studies of permanent occlusal surfaces are needed to mirror the clinical situation. PMID:24799965

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Fluoride toothpaste containing 1.5% arginine and insoluble calcium as a new standard of care in caries prevention.

    PubMed

    ten Cate, J M; Cummins, D

    2013-01-01

    In spite of obvious achievements in prevention, caries remains a prevalent disease. Fluorides are effective by inhibiting enamel and dentin demineralization and enhancing remineralization, but have little or no influence on bacterial processes in dental plaque. Dental caries is a continuum of stages from reversible, early lesions to irreversible, pre-cavitated lesions and, ultimately, to cavities. Prevention should focus on strengthening protective and reducing pathological factors, and careful monitoring of the disease state. While fluoride and the mineral aspects of caries have been in focus for decades, new insights into the etiology of caries have generated novel concepts and approaches to its prevention and treatment. The observation that some plaque bacteria can produce alkali metabolites and, thus, raise pH or neutralize acid formed in plaque has long been known. Such pH rise factors are related to caries susceptibility. Nourishing the plaque with substrates that encourage alkali-producing reactions is a protective factor in the caries continuum. This article reviews the results of clinical studies with a novel toothpaste containing 1.5% arginine, an insoluble calcium compound, and fluoride which have demonstrated superior remineralization of white spot enamel lesions and rehardening of root surface lesions, favorable effects on the de-/remineralization balance, as well as superior cavity prevention efficacy compared to toothpaste with fluoride alone. Studies have also confirmed formation of ammonia and elevated pH levels in subjects using the arginine-containing toothpaste. This novel toothpaste effectively combines the established effects of fluoride on de- and remineralization with reduction of caries-inducing pathological factors resulting from plaque metabolism. PMID:24660269

  19. 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.

  20. Pragmatic RCT on the Efficacy of Proximal Caries Infiltration.

    PubMed

    Meyer-Lueckel, H; Balbach, A; Schikowsky, C; Bitter, K; Paris, S

    2016-05-01

    Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) (P= 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%-98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) (P< 0.001; relative risk reduction, 83; 95% confidence interval, 67%-91%). Thus, resin infiltration seems to be

  1. Noninvasive cross-sectional imaging of proximal caries using swept-source optical coherence tomography (SS-OCT) in vivo.

    PubMed

    Shimada, Yasushi; Nakagawa, Hisaichi; Sadr, Alireza; Wada, Ikumi; Nakajima, Masatoshi; Nikaido, Toru; Otsuki, Masayuki; Tagami, Junji; Sumi, Yasunori

    2014-07-01

    The aim of this study was to determine the diagnostic accuracy of swept-source optical coherent tomography (SS-OCT) in detecting and estimating the depth of proximal caries in posterior teeth in vivo. SS-OCT images and bitewing radiographs were obtained from 86 proximal surfaces of 53 patients. Six examiners scored the locations according to a caries lesion depth scale (0-4) using SS-OCT and the radiographs. The results were compared with clinical observations obtained after the treatment. SS-OCT could detect the presence of proximal caries in tomograms that were synthesized based on the backscatter signal obtained from the proximal carious lesion through occlusal enamel. SS-OCT showed significantly higher sensitivity and larger area under the receiver operating characteristic curve than radiographs for the detection of cavitated enamel lesions and dentin caries (Student's t -test, p < 0.05). SS-OCT appears to be a more reliable and accurate method than bitewing radiographs for the detection and estimation of the depth of proximal lesions in the clinical environment.

  2. 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

  3. Enamel Regeneration in Making a Bioengineered Tooth.

    PubMed

    Xu, Ruoshi; Zhou, Yachuan; Zhang, Binpeng; Shen, Jiefei; Gao, Bo; Xu, Xin; Ye, Ling; Zheng, Liwei; Zhou, Xuedong

    2015-01-01

    Overall enamel is the hard tissue overlying teeth that is vulnerable to caries, congenital defects, and damage due to trauma. Not only is enamel incapable of self-repair in most species, but it is also subject to attrition. Besides the use of artificial materials to restore enamel, enamel regeneration is a promising approach to repair enamel damage. In order to comprehend the progression and challenges in tissue-engineered enamel, this article elaborates alternative stem cells potential for enamel secretion and expounds fined strategies for enamel regeneration in bioengineered teeth. Consequently, more and more cell types have been induced to differentiate into ameloblasts and to secrete enamel, and an increasing number of reports have emerged to provide various potential approaches to induce cells to secrete enamel based on recombination experiments, artificial bioactive nano-materials, or gene manipulation. Accordingly, it is expected to further project more optimal conditions for enamel formation in bioengineering based on a more thorough knowledge of reciprocal epithelial-mesenchymal interactions, by which the procedures of enamel regeneration are able to be practically recapitulated and widely spread for the potential clinical value of enamel repair.

  4. Selective removal of dental caries with a diode-pumped Er:YAG laser

    PubMed Central

    Yan, Ruth; Chan, Kenneth H.; Tom, Henry; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2015-01-01

    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. PMID:25914496

  5. 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.

  6. 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. PMID:25802916

  7. 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.

  8. 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.

  9. Argon laser effect on demineralization of human enamel

    NASA Astrophysics Data System (ADS)

    Powell, G. L.; Higuchi, William I.; Fox, Jeffrey L.; Yu, Duncan; Blankenau, Richard J.

    1992-06-01

    Previous studies have recorded the reduction of caries-like lesions in extracted human teeth that have been irradiated with CO2 laser. Other studies have shown a decrease in dissolution rate of enamel that has been irradiated with CO2 laser and acid resistance. This study was conducted to evaluate the effects of Argon laser irradiation on acid resistance and demineralization of dental enamel. Human enamel was laser irradiated with approximately 60 J/cm2 and 120 J/cm2. The amount of demineralization was determined in a rotating disk assembly (0.1 M acetate buffer, pH-4.5) for 24 hours and the results determined and plotted against the nonlased control using microradiographs and computerized imaging. The amount of dissolution of tooth structure lost to demineralization in 4.5 pH acid bath in a 24 hour period was reduced from approximately 140 micrometers to approximately 70 micrometers . This study show that demineralization is reduced when human enamel is exposed to Argon laser irradiation.

  10. Optical diagnosis and characterization of dental caries with polarization-resolved hyperspectral stimulated Raman scattering microscopy.

    PubMed

    Wang, Zi; Zheng, Wei; Hsu, Stephen Chin-Ying; Huang, Zhiwei

    2016-04-01

    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 10(3) 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 (ν 1-PO4 (3-) 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

  11. 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

  12. Diagnosis of secondary caries.

    PubMed

    Kidd, E A

    2001-10-01

    A systematic review of the diagnosis of dental caries was produced before the conference. It did not include the diagnosis of secondary or recurrent caries. This was a wise decision because what little literature exists on the subject potentially clouds the issue. Diagnosis is a mental resting place on the way to a treatment decision. A vital part of caries diagnosis is to decide whether a lesion is active and rapidly progressing or already arrested. This information is essential to plan logical management. However, lesion activity should be judged in the patient. Thus, research on the diagnosis of secondary caries must be carried out in vivo and this usually precludes histological validation. Even if such validation is possible, it has its own problems, particularly in distinguishing recurrent from residual caries. The diagnosis of secondary caries is very important since so many restorations are replaced because dentists think there is a new decay. It will be important to establish valid criteria for the diagnosis of active secondary caries, which will be facilitated by the suggestion that secondary caries is no different from primary caries except that it occurs next to a filling. This implies that it can be seen clinically and on a radiograph, next to a restoration.

  13. Diagnosis of secondary caries.

    PubMed

    Kidd, E A

    2001-10-01

    A systematic review of the diagnosis of dental caries was produced before the conference. It did not include the diagnosis of secondary or recurrent caries. This was a wise decision because what little literature exists on the subject potentially clouds the issue. Diagnosis is a mental resting place on the way to a treatment decision. A vital part of caries diagnosis is to decide whether a lesion is active and rapidly progressing or already arrested. This information is essential to plan logical management. However, lesion activity should be judged in the patient. Thus, research on the diagnosis of secondary caries must be carried out in vivo and this usually precludes histological validation. Even if such validation is possible, it has its own problems, particularly in distinguishing recurrent from residual caries. The diagnosis of secondary caries is very important since so many restorations are replaced because dentists think there is a new decay. It will be important to establish valid criteria for the diagnosis of active secondary caries, which will be facilitated by the suggestion that secondary caries is no different from primary caries except that it occurs next to a filling. This implies that it can be seen clinically and on a radiograph, next to a restoration. PMID:11700003

  14. Efficacy of Carisolv-assisted caries excavation.

    PubMed

    Cederlund, A; Lindskog, S; Blomlöf, J

    1999-10-01

    As a possible alternative to conventional techniques for excavating caries chemomechanical methods have been developed. Caridex has so far been the dominating product. However, a new system, Carisolv, was recently introduced. The purpose of the present study was to evaluate the caries-dissolving efficacy of Carisolv in vitro. After excavation with Carisolv all dentin surfaces were caries free. However, 6 of the 10 cavities showed residual caries in the dentinoenamel junction. The dentin and enamel surfaces were covered by smear and debris. Since there may be a risk of leaving caries in the dentinoenamel junction proper case selection appears to be of importance to ensure a successful result. PMID:10709512

  15. Effectiveness of plant-derived proanthocyanidins on demineralization on enamel and dentin under artificial cariogenic challenge

    PubMed Central

    da SILVA, Ana Paula Pereira; GONÇALVES, Rafael Simões; BORGES, Ana Flávia Sanches; BEDRAN-RUSSO, Ana Karina; SHINOHARA, Mirela Sanae

    2015-01-01

    Dental caries is considered a disease of high prevalence and a constant problem in public health. Proanthocyanidins (PAs) are substances that have been the target of recent studies aiming to control or treat caries. Objective The aim of this in vitro study was to evaluate the efficacy of a treatment with grape seed extract, under cariogenic challenge, to minimize or even prevent the onset of caries in the enamel and dentin. Material and Methods Blocks of enamel and dentin (6.0x6.0 mm) were obtained from bovine central incisors, polished, and selected by analysis of surface microhardness (SH). The blocks were randomly divided into 3 groups (n=15), according to the following treatments: GC (control), GSE (grape seed extract), GF (fluoride – 1,000 ppm). The blocks were subjected to 6 daily pH cycles for 8 days. Within the daily cycling, the specimens were stored in buffered solution. The blocks were then analyzed for perpendicular and surface hardness and polarized light microscopy. Results The means were subjected to statistical analysis using the ANOVA and Fisher’s PLSD tests (p<0.05). For enamel SH, GF showed the highest hardness values. In the dentin, GF was also the one that showed higher hardness values, followed by GSE. Regarding the cross-sectional hardness values, all groups behaved similarly in both the enamel and dentin. The samples that were treated with GSE and fluoride (GF) showed statistically higher values than the control. Conclusion Based on the data obtained in this in vitro study, it is suggested that grape seed extract inhibits demineralization of artificial carious lesions in both the enamel and dentin, but in a different scale in each structure and in a smaller scale when compared to fluoride. PMID:26221925

  16. Influence of Photoactivation Source on Restorative Materials and Enamel Demineralization

    PubMed Central

    Popoff, Josiane Marques de Sena; Rodrigues, José Augusto; Aras, Wanessa Maria De Freitas

    2014-01-01

    Abstract Objective: The objective of this study was to evaluate the influence of the photoactivation source on the polymerization depth of restorative materials and its effects on resistance to enamel demineralization. Background data: Argon-ion laser (AL) irradiation itself provides a reduced depth of caries lesions in sound enamel. Methods: Eighteen human teeth were sectioned into 36 blocks and distributed into two groups according to the respective restorative material: resin-modified glass ionomer material (RMGI) (Vitremer-3M ESPE; A3; n=18) and composite resin (CR) (Z350-3M ESPE; n=18). Each group was subdivided into three subgroups and activated by a quartz-tungsten-halogen (QTH) lamp, an AL, or a light-emitting diode (LED) (n=6). Knoop microhardness (KHN) analysis of the materials was evaluated at two different depths: 0 and 1.6 mm from the enamel surface. The blocks were thermocycled and submitted to five demineralization–remineralization cycles at 37°C. The KHN values of the enamel surface (0 mm) were evaluated. The specimens were longitudinally sectioned, and the restorative material was evaluated at a depth of 1.6 mm. Data were evaluated by two way analysis of variance (ANOVA) and Tukey tests (p<0.05). The evaluation of subsuperficial enamel demineralization by KHN analysis was conducted by seven indentations located at 100 μm from the restored cavity. Data were evaluated by three way ANOVA and Tukey tests (p<0.05). Results: Comparing the two restorative materials, the KHN values at the surface (0 mm) were greater for CR, whereas at 1.6 mm, they were greater for RMGI. In addition, there was less development of enamel demineralization around RMGI restorations than CR restorations. Moreover, there were statistically significant differences on subsuperficial enamel demineralization between the two restorative materials and between the three photoactivation methods (p<0.05); RMGI presented the highest KHN values, and QTH and AL presented the

  17. Minimal intervention dentistry II: part 7. Minimal intervention in cariology: the role of glass-ionomer cements in the preservation of tooth structures against caries.

    PubMed

    Ngo, H; Opsahl-Vital, S

    2014-05-01

    Glass-ionomer cements (GICs) are essential materials in clinical practice because of their versatility, self-adhesion to enamel and dentine, and good biocompatibility. In addition, being chemically cured, with no shrinkage stress, makes them well suited for minimally invasive restorative techniques. This article looks at some of the clinical situations where the chemical adhesion and high biocompatibility of GIC are important for clinical success: excavation of deep carious lesions, fissure sealing and protection of root surfaces against caries.

  18. Hair keratin mutations in tooth enamel increase dental decay risk.

    PubMed

    Duverger, Olivier; Ohara, Takahiro; Shaffer, John R; Donahue, Danielle; Zerfas, Patricia; Dullnig, Andrew; Crecelius, Christopher; Beniash, Elia; Marazita, Mary L; Morasso, Maria I

    2014-12-01

    Tooth enamel is the hardest substance in the human body and has a unique combination of hardness and fracture toughness that protects teeth from dental caries, the most common chronic disease worldwide. In addition to a high mineral content, tooth enamel comprises organic material that is important for mechanical performance and influences the initiation and progression of caries; however, the protein composition of tooth enamel has not been fully characterized. Here, we determined that epithelial hair keratins, which are crucial for maintaining the integrity of the sheaths that support the hair shaft, are expressed in the enamel organ and are essential organic components of mature enamel. Using genetic and intraoral examination data from 386 children and 706 adults, we found that individuals harboring known hair disorder-associated polymorphisms in the gene encoding keratin 75 (KRT75), KRT75(A161T) and KRT75(E337K), are prone to increased dental caries. Analysis of teeth from individuals carrying the KRT75(A161T) variant revealed an altered enamel structure and a marked reduction of enamel hardness, suggesting that a functional keratin network is required for the mechanical stability of tooth enamel. Taken together, our results identify a genetic locus that influences enamel structure and establish a connection between hair disorders and susceptibility to dental caries.

  19. Hair keratin mutations in tooth enamel increase dental decay risk

    PubMed Central

    Duverger, Olivier; Ohara, Takahiro; Shaffer, John R.; Donahue, Danielle; Zerfas, Patricia; Dullnig, Andrew; Crecelius, Christopher; Beniash, Elia; Marazita, Mary L.; Morasso, Maria I.

    2014-01-01

    Tooth enamel is the hardest substance in the human body and has a unique combination of hardness and fracture toughness that protects teeth from dental caries, the most common chronic disease worldwide. In addition to a high mineral content, tooth enamel comprises organic material that is important for mechanical performance and influences the initiation and progression of caries; however, the protein composition of tooth enamel has not been fully characterized. Here, we determined that epithelial hair keratins, which are crucial for maintaining the integrity of the sheaths that support the hair shaft, are expressed in the enamel organ and are essential organic components of mature enamel. Using genetic and intraoral examination data from 386 children and 706 adults, we found that individuals harboring known hair disorder–associated polymorphisms in the gene encoding keratin 75 (KRT75), KRT75A161T and KRT75E337K, are prone to increased dental caries. Analysis of teeth from individuals carrying the KRT75A161T variant revealed an altered enamel structure and a marked reduction of enamel hardness, suggesting that a functional keratin network is required for the mechanical stability of tooth enamel. Taken together, our results identify a genetic locus that influences enamel structure and establish a connection between hair disorders and susceptibility to dental caries. PMID:25347471

  20. Effect of tooth-bound fluoride on enamel demineralization/ remineralization in vitro.

    PubMed

    Takagi, S; Liao, H; Chow, L C

    2000-01-01

    The effect of tooth-bound fluoride (F) on enamel caries formation was investigated under the condition that loosely bound F was essentially absent. Eighteen thin enamel sections, prepared from the lingual or buccal surfaces of extracted human molars, were embedded in acrylic resin with the enamel surfaces exposed. The sections were placed in a pH 7 remineralizing solution (RS; 1.2 mmol/l Ca, 0.72 mmol/l P, 30 mmol/l KCl, 50 mmol/l HEPES) for 5 days, and were randomly divided into 3 groups: (1) control group that received no treatment, (2) acidulated phosphate fluoride (APF) group that received 5 cycles of a 4 min treatment with APF gel followed by immersion in the RS for 2 days (RS changed daily) and (3) dicalcium phosphate dihydrate (DCPD) - APF group that received 5 cycles of a 4-min pH 2.1 DCPD-forming solution followed by 4 min APF gel and then placed in the RS for 2 days. After the treatment cycles, the sections were washed in a constant composition F titration system to remove loosely bound F. An in vitro model, which consisted of cycles of de- (6 h) and remineralization (18 h) each day for 5 days, was used to produce caries-like lesions in the specimens. The DeltaZ (mineral loss) values, measured by quantitative microradiography, of the lesions formed in the three groups were (mean +/- standard deviation; n = 6) 91.2+/-12.3 microm for the control group, 41.3+/-10.1 microm for the APF group and 21.2+/-4.8 microm for the DCPD-APF group. The same system produced lesions in untreated shark enamel with a mean DeltaZ of 4.4+/-0.3 microm (n = 12). One-way fixed-effects ANOVA indicated that mineral loss was significantly different among the different groups (p<0.05). The results showed that enamel resistance to lesion formation increased with increasing tooth-bound F content. Shark enamel was much more resistant to demineralization than human enamel.

  1. Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques.

    PubMed

    Banerjee, A

    2013-02-01

    When patients present with cavities causing pain, poor aesthetics and/or functional problems restorations will need to be placed. Minimally invasive caries excavation strategies can be deployed depending on the patient's caries risk, lesion-pulp proximity and vitality, the extent of remaining supra-gingival tooth structure and clinical factors (for example, moisture control, access). Excavation instruments, including burs/handpieces, hand excavators, chemo-mechanical agents and/or air-abrasives limiting caries removal selectively to the more superficial caries-infected dentine and partial removal of caries-affected dentine when required, help create smaller cavities with healthy enamel/dentine margins. Using adhesive restorative materials the operator can, if handling with care, optimise the histological substrate coupled with the applied chemistry of the material so helping to form a durable peripheral seal and bond to aid retention of the restoration as well as arresting the carious process within the remaining tooth structure. Achieving a smooth tooth-restoration interface clinically to aid the cooperative, motivated patient in biofilm removal is an essential pre-requisite to prevent further secondary caries.

  2. Ex vivo imaging of early dental caries within the interproximal space

    NASA Astrophysics Data System (ADS)

    Choo-Smith, Lin-P'ing; Hewko, Mark D.; Dufour, Marc L.; Fulton, Crystal; Qiu, Pingli; Gauthier, Bruno; Padioleau, Christian; Bisaillon, Charles-Etienne; Dong, Cecilia; Cleghorn, Blaine M.; Lamouche, Guy; Sowa, Michael G.

    2009-02-01

    Optical coherence tomography (OCT) is emerging as a technology that can potentially be used for the detection and monitoring of early dental enamel caries since it can provide high-resolution depth imaging of early lesions. To date, most caries detection optical technologies are well suited for examining caries at facial, lingual, incisal and occlusal surfaces. The approximal surfaces between adjacent teeth are difficult to examine due to lack of visual access and limited space for these new caries detection tools. Using a catheter-style probe developed at the NRC-Industrial Materials Institute, the probe was inserted into the interproximal space to examine the approximal surfaces with OCT imaging at 1310 nm. The probe was rotated continuously and translated axially to generate depth images in a spiral fashion. The probe was used in a mock tooth arch model consisting of extracted human teeth mounted with dental rope wax in their anatomically correct positions. With this ex vivo model, the probe provided images of the approximal surfaces revealing morphological structural details, regions of calculus, and especially regions of early dental caries (white spot lesions). Results were compared with those obtained from OCT imaging of individual samples where the approximal surfaces of extracted teeth are accessible on a lab-bench. Issues regarding access, regions of interest, and factors to be considered in an in vivo setting will be discussed. Future studies are aimed at using the probe in vivo with patient volunteers.

  3. 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. PMID:25885796

  4. Weaker Dental Enamel Explains Dental Decay

    PubMed Central

    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. PMID:25885796

  5. Protective potential of casein phosphopeptide amorphous calcium phosphate containing paste on enamel surfaces

    PubMed Central

    Somasundaram, Padmini; Vimala, N; Mandke, Lalita Gauri

    2013-01-01

    Background: Dental caries remains the most common dental disease facing mankind. Prevention of initiation and interruption in progression of early lesions are the desirable modes of caries management. There is a scope for agents, which may be used to enhance anti - caries activity. This need has redirected research to develop novel preventive agents that can act as an adjunct to fluoride or independent of it. Casein Phosphopeptide – Amorphous Calcium Phosphate (CPP-ACP) is one such agent that has been proposed to have anti cariogenic properties. Aim: The purpose of this in vitro study was to evaluate the effect of paste containing CPP-ACP, MI Paste, on enamel remineralization. Materials and Methods: This study consisted of 30 samples embedded in orthodontic resin with either the buccal or lingual surface exposed. The samples were assigned to either a CPP-ACP containing paste; Fluoridated toothpaste; or a control group. The groups were then subjected to cycling in a demineralizing solution and a remineralizing solution. Groups II and III received prior application of MI paste and Fluoridated toothpaste respectively followed by cycling in a demineralizing solution and a remineralizing solution. Following 14 days of cycling, the samples were sectioned and examined using confocal microscopy. The lesion depth, were evaluated. Statistical Analysis: Image Proplus software was used to analyze the images. The values were statistically evaluated using one – way ANOVA and Scheffe's Test. Results and Conclusion: Within the limitations of the study it was concluded that enamel surfaces treated with the CPP-ACP paste exhibited the least lesion depths followed by the enamel surfaces treated with the fluoridated tooth paste and control group respectively. PMID:23716969

  6. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm

    PubMed Central

    Mei, May L.; Low, Kan H.; Che, Ching M.; Lo, Edward CM.

    2013-01-01

    Objectives: This in vitro study investigated the effects of silver diamine fluoride (SDF) on dentine carious lesion with cariogenic biofilm. Study Design: Thirty human dentine blocks were inoculated with Streptococcus mutans and Lactobacillus acidophilus dual-species biofilm to create carious lesion. They were equally divided into test and control group to receive topical application of SDF and water. After incubation anaerobically using micro-well plate at 37oC for 7 days, the biofilms were evaluated for kinetics, morphology and viability by colony forming units (CFU), scanning electron microscopy (SEM), and confocal microscopy (CLSM), respectively. The carious lesion underwent crystal characteristics analysis, evaluation of the changes in chemical structure and density of collagen fibrils using x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and immune-labeling. Results: The log CFU of S. mutans and L. acidophilus in the test group was significantly lower than control group. SEM and CLSM showed confluent biofilm in control group, but not in test group. XRD showed the loss of crystallinity of dentine due to the dissolution of hydroxyapatite crystal structure in test group was less than control group. FTIR showed that log [Amide I: HPO42-] for test vs. control group was 0.31±0.10 vs. 0.57±0.13 (p<0.05). The gold-labeling density in test vs. control group was 8.54±2.44/µm2 vs. 12.91±4.24/µm2 (p=0.04). Conclusions: SDF had antimicrobial activity against the cariogenic biofilms and reduced demineralization of dentine. Key words:Caries, caries arrest, dentine, silver, silver diamine fluoride, fluoride, biofilm,cariogenic. PMID:23722131

  7. Transillumination and reflectance probes for in vivo near-IR imaging of dental caries

    NASA Astrophysics Data System (ADS)

    Simon, Jacob C.; Lucas, Seth A.; Staninec, Michal; Tom, Henry; Chan, Kenneth H.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Previous studies have demonstrated the utility of near infrared (NIR) imaging for caries detection employing transillumination and reflectance imaging geometries. Three intra-oral NIR imaging probes were fabricated for the acquisition of in vivo, real time videos using a high definition InGaAs SWIR camera and near-IR broadband light sources. Two transillumination probes provide occlusal and interproximal images using 1300-nm light where water absorption is low and enamel manifests the highest transparency. A third reflectance probe utilizes cross polarization and operates at >1500-nm, where water absorption is higher which reduces the reflectivity of sound tissues, significantly increasing lesion contrast. These probes are being used in an ongoing clinical study to assess the diagnostic performance of NIR imaging for the detection of caries lesions in teeth scheduled for extraction for orthodontic reasons.

  8. A simple dental caries detection system using full spectrum of laser-induced fluorescence

    NASA Astrophysics Data System (ADS)

    Rocha-Cabral, Renata Maciel; Mendes, Fausto Medeiros; Maldonado, Edison Puig; Zezell, Denise Maria

    2015-06-01

    Objectives: to develop an apparatus for the detection of early caries lesions in enamel using the full extent of the tooth fluorescence spectrum, through the integration of a laser diode, fiber optics, filters and one portable spectrometer connected to a computer, all commercially available; to evaluate the developed device in clinical and laboratory tests, and compare its performance with commercial equipment. Methods: clinical examinations were performed in patients with indication for exodontics of premolars. After examinations, the patients underwent surgery and the teeth were stored individually. The optical measurements were repeated approximately two months after extraction, on the same sites previously examined, then histological analysis was carried out. Results: the spectral detector has presented high specificity and moderate sensitivity when applied to differentiate between healthy and damaged tissues, with no significant differences from the performance of the commercial equipment. The developed device is able to detect initial damages in enamel, with depth of approximately 300 μm. Conclusions: we successfully demonstrated the development of a simple and portable system based in laser-induced fluorescence for caries detection, assembled from common commercial parts. As the spectral detector acquires a complete recording of the spectrum from each tissue, it is possible to use it for monitoring developments of caries lesions.

  9. In situ effect of titanium tetrafluoride and sodium fluoride on artificially decayed human enamel.

    PubMed

    Alcântara, Paula Cristina da Costa; Alexandria, Adilis Kalina; Souza, Ivete Pomarico Ribeiro de; Maia, Lucianne Cople

    2014-01-01

    This study compared in situ the application of 4% titanium tetrafluoride (TiF4) solution and 2% sodium fluoride (NaF) gel on artificial white-spot lesions in human enamel. A crossover, double-blind study using in situ caries models was carried out. Eleven volunteers used an intraoral appliance containing five demineralized human enamel blocks. The blocks (n=170) were randomly divided according to treatment into the following groups: TiF4 (n=55), NaF (n=55), positive control (n=55). A negative control group was composed of demineralized specimens (n=5). The microhardness test was performed using a Knoop penetrator. Energy dispersive spectrometer (EDS) was used to analyze the concentration of titanium, calcium, phosphate and oxygen. The enamel microhardness at different depths for TiF4, NaF and positive control samples was not statistically different (p>0.05). The samples from these three groups had statistically higher microhardness values than the negative control samples (p<0.05). EDS analysis did not provide conclusive results about the penetration of titanium in the TiF4 samples. While in some fragments it had substantial penetration, in other fragments it only had superficial penetration. It was possible to conclude that, under in situ conditions, 4% TiF4 solution and 2% NaF gel were able to remineralize artificial white-spot lesions in human enamel. However, the magnitude of the remineralization did not differ between groups.

  10. In situ effect of titanium tetrafluoride and sodium fluoride on artificially decayed human enamel.

    PubMed

    Alcântara, Paula Cristina da Costa; Alexandria, Adilis Kalina; Souza, Ivete Pomarico Ribeiro de; Maia, Lucianne Cople

    2014-01-01

    This study compared in situ the application of 4% titanium tetrafluoride (TiF4) solution and 2% sodium fluoride (NaF) gel on artificial white-spot lesions in human enamel. A crossover, double-blind study using in situ caries models was carried out. Eleven volunteers used an intraoral appliance containing five demineralized human enamel blocks. The blocks (n=170) were randomly divided according to treatment into the following groups: TiF4 (n=55), NaF (n=55), positive control (n=55). A negative control group was composed of demineralized specimens (n=5). The microhardness test was performed using a Knoop penetrator. Energy dispersive spectrometer (EDS) was used to analyze the concentration of titanium, calcium, phosphate and oxygen. The enamel microhardness at different depths for TiF4, NaF and positive control samples was not statistically different (p>0.05). The samples from these three groups had statistically higher microhardness values than the negative control samples (p<0.05). EDS analysis did not provide conclusive results about the penetration of titanium in the TiF4 samples. While in some fragments it had substantial penetration, in other fragments it only had superficial penetration. It was possible to conclude that, under in situ conditions, 4% TiF4 solution and 2% NaF gel were able to remineralize artificial white-spot lesions in human enamel. However, the magnitude of the remineralization did not differ between groups. PMID:24789288

  11. Prevention of enamel demineralization with a novel fluoride strip: enamel surface composition and depth profile

    PubMed Central

    Lee, Bor-Shiunn; Chou, Po-Hung; Chen, Shu-Yu; Liao, Hua-Yang; Chang, Che-Chen

    2015-01-01

    There is no topically applicable low concentration fluoride delivery device available for caries prevention. This study was aimed to assess the use of a low concentration (1450 ppm) fluoride strip as an effective fluoride delivery system against enamel demineralization. The enamel surface composition and calcium-deficient hydroxyapatite or toothpaste treatments were investigated using X-ray photoelectron spectroscopy. In vitro enamel demineralization was assayed using a pH cycling model and the dissolution of calcium ions from the treated specimens was quantified using ion chromatography. After 24-hr fluoride-strip treatment, the enamel was covered with a CaF2 layer which showed a granular morphology of 1 μm in size. Below the CaF2 layer was a region of mixed fluorapatite and CaF2. Fluoride infiltrated extensively in enamel to produce highly fluorinated fluorohydroxyapatite. In comparison, low-fluoride-level fluorinated fluorohydroxyapatite was formed on the enamel specimen exposed to toothpaste. The treatments with the fluoride strip as short as 1 hr significantly inhibited enamel demineralization. The fluoride strip was effective for topical fluoride delivery and inhibited in vitro demineralization of enamel by forming CaF2 and fluoride-containing apatites at the enamel surface. It exhibited the potential as an effective fluoride delivery device for general use in prevention of caries. PMID:26293361

  12. Fluorine uptake into the human enamel surface from fluoride-containing sealing materials during cariogenic pH cycling

    NASA Astrophysics Data System (ADS)

    Yasuhiro, Matsuda; Katsushi, Okuyama; Hiroko, Yamamoto; Hisanori, Komatsu; Masashi, Koka; Takahiro, Sato; Naoki, Hashimoto; Saiko, Oki; Chiharu, Kawamoto; Hidehiko, Sano

    2015-04-01

    To prevent the formation of caries and reduce dentin hypersensitivity, sealing materials, either with or without fluoride, are generally applied on the tooth in clinical practice. Application of fluoride-free sealing materials results in the formation of an acid-resistant layer on the tooth surface. On the other hand, fluoride-containing sealing materials might not only form an acid-resistant layer but could possibly further provide fluoride to enhance remineralization and reduce demineralization. In this study, the demineralization prevention ability and fluorine uptake rate in human enamel of fluoride-containing sealing materials ["MS coats F" (MSF)] and fluoride-free sealing materials ("hybrid coats 2" [HI]) were evaluated using an automatic pH cycling system. Each material was applied to the original tooth surface, the cut surfaces were covered with sticky wax, and the automatic pH-cycling system simulated daily acid changes (pH 6.8-4.5) occurring in the oral cavity for 4 weeks. Caries progression was analyzed using transverse microradiography (TMR) taken pre and post the 4 weeks of pH cycling. The fluorine and calcium distributions in the carious lesion in each specimen were evaluated using the proton-induced gamma emission (PIGE) and proton-induced X-ray (PIXE) techniques, respectively. TMR analysis showed that both MSF and HI had a caries-preventing effect after 4 weeks of pH cycling. PIGE/PIXE analysis demonstrated that only MSF resulted in fluoride uptake in the enamel surface. Therefore, MSF can help to form an acid-resistant layer and provide fluoride to the enamel surface. The presence of fluoride on the enamel surface suggested that MSF could prevent demineralization, even if the acid-resistant layer was removed, in clinical settings. The data obtained using the PIGE and PIXE techniques are useful for understanding the benefits of the use of a fluoride-containing sealing material for preventing caries.

  13. Comparison of Blue Wavelengths and Scan Velocity Effects on the Detection of Enamel Surface Caries Using Steady-State Laser-Induced Autofluorescence Spectroscopy

    NASA Astrophysics Data System (ADS)

    Khosroshahi, M. E.; Khoi, N. Taghizadeh

    2014-05-01

    The results of sound and carious enamel fl uorescence emission study using (i) different blue wavelengths, (ii) different scan velocity, and (iii) spectral ratio are reported. The samples were irradiated using a tunable argon laser emitting at 459 and 488 nm and a 405 nm laser at two different scan velocities of 0.23 and 0.5 mm/s. The results showed a spectral band of 443-492 nm for 405 nm, 493-522 nm for 459 nm, and 526-625 nm for 488 nm lasers for sound teeth. It was found from the emission spectra that with increase in the excitation wavelength, the corresponding primary peaks of the carious samples showed Stokes shifts of 4, 6, and 2 nm, respectively. No signifi cant change was observed for the secondary peaks. Also, in all cases, the intensity of fl uorescence signals of sound teeth was higher than those of carious teeth. The highest shape factor of 1.82 and integrated intensity ratio of 1.20 were achieved at 405 nm, which provides relatively better tissue discrimination. Also, increasing the scan velocity reduced the signal amplitudes in both sound and carious samples.

  14. In vitro evaluation of remineralization efficacy of different calcium- and fluoride-based delivery systems on artificially demineralized enamel surface

    PubMed Central

    Gangrade, Aparajita; Gade, Vandana; Patil, Sanjay; Gade, Jaykumar; Chandhok, Deepika; Thakur, Deepa

    2016-01-01

    Background: Caries is the most common dental disease facing the world population. Caries can be prevented by remineralizing early enamel lesions. Aim: To evaluate remineralization efficacy of stannous fluoride (SnF2), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and calcium sucrose phosphate (CaSP). Materials and Methods: Fifty enamel samples were taken; they were divided into five groups (n = 10). Demineralization was carried out with Groups A, B, C, and E. Remineralization was carried out with Groups A, B, and C for 7 days using SnF2, CPP-ACPF, and CaSP, respectively. In Group D, no surface treatment was carried out, to mark as positive control whereas Group E was kept as negative control with only surface demineralization of enamel. Enamel microhardness was tested using Vickers's microhardness tester after 7 day remineralization regime. Statistical Analysis: One-way analysis of variance and post hoc Tukey tests were performed. Results: The mean microhardness values in descending order: Positive control > SnF2> CaSP > CPP-ACPF > negative control. Conclusion: All remineralizing agents showed improved surface remineralization. However, complete remineralization did not occur within 7 days. SnF2 showed the highest potential for remineralization followed by CaSP and CPP-ACPF. PMID:27563180

  15. Comparison of three lasers on demineralization of human enamel

    NASA Astrophysics Data System (ADS)

    Powell, G. L.; Yu, Duncan; Higuchi, William I.; Fox, Jeffrey L.

    1993-07-01

    Previous studies have recorded the reduction of caries-like lesions or demineralization in extracted human teeth that had been irradiated with CO2 laser, Nd:YAG laser, and Argon laser. This study was conducted to evaluate the effects of three different cw lasers on acid resistance and demineralization of dental enamel. Human enamel was laser irradiated with either Argon, CO2, or Nd:YAG energy densities of 60 - 65 J/cm2 or 120 - 130 J/cm2. The amount of demineralization was determined in a rotating disk assembly (0.1 M acetate buffer, pH - 4.5) for 24 hours and the results determined and plotted against the non-lased control using microradiographs and computerized imaging. The amount of dissolution of tooth structure lost to demineralization in 4.5 pH acid bath in a 24 hour period was reduced from approximately 140 microns for the unlased control to approximately 90 microns for the Argon laser and 70 microns for the CO2 laser at 60 - 65 J/cm2. At 120 - 130 J/cm2 the results were: 120 microns for the Nd:YAG, 70 microns for the Argon, and 45 microns for the CO2 laser. This study shows that demineralization is reduced significantly in vitro when human enamel is exposed to Argon and CO2 laser irradiation.

  16. Influence of Cavity Preparation with Er,Cr:YSGG Laser and Restorative Materials on In Situ Secondary Caries Development

    PubMed Central

    Jorge, Ana Carolina Tedesco; Cassoni, Alessandra; de Freitas, Patrícia Moreira; Reis, André Figueiredo; Junior, Aldo Brugnera

    2015-01-01

    Abstract Objective: The aim of this study was to evaluate the influence of cavity preparation and restorative materials containing fluorides in the prevention of secondary caries lesion development in situ. Methods: A total of 120 blocks obtained from human teeth were divided into two groups and standardized cavities were prepared using diamond burs (DB) or Er,Cr:YSGG-laser [20 Hz, 4.0W, 55% water, 65% air (LA)]. They were divided into three subgroups according to the restorative material (n=20): glass-ionomer cement (GI), resin modified glass-ionomer (RM) or composite resin (CR). Blocks were fixed in palatal intra-oral appliances worn in situ by 20 human volunteers, who dropped 20% sucrose solution eight times daily. After 21 days, blocks were removed and restorations were cross-sectioned to evaluate microhardness [Knoop hardness number (KHN)] underneath enamel surface from 30 to 200 μm. Factors “cavity preparation,” “restorative materials,” and “depth” were evaluated by three way ANOVA, followed by Tukey test (p<0.05). Results: The results showed lower microhardness in cavities prepared with DB than in cavities prepared with LA. At 30 μm, there were no statistical significant differences with regard to “cavity preparation” or “restorative materials” factors. In depth evaluation, the enamel microhardness progressively increased as a function of depth for the GI groups. In the groups prepared with LA at 60 μm/90 μm, there were no significant differences between GI and RM materials, whose microhardnesses were significantly higher than that of CR. Conclusions: Cavity preparation using Er,Cr:YSGG laser increases caries resistance of enamel walls, and reduce caries lesion depth development regardless of fluoride presence in the restorative material. CR showed higher caries lesion development than GI, and RM showed intermediate results. PMID:25654424

  17. Restoration Materials and Secondary Caries Using an In Vitro Biofilm Model

    PubMed Central

    van de Sande, F.H.; Opdam, N.J.M.; Bronkhorst, E.M.; de Soet, J.J.; Cenci, M.S.; Huysmans, M.C.D.J.N.M.

    2015-01-01

    This in vitro study investigated whether restoration materials and adhesives influence secondary caries formation in gaps using a short-term in vitro biofilm model. Sixty enamel–dentin blocks were restored with 6 different restoration materials with or without adhesives (n = 10 per group) with a gap: 1) Clearfil AP-X composite, 2) Clearfil AP-X composite + SE Bond, 3) Clearfil AP-X composite + ProtectBond, 4) Filtek Silorane composite, 5) Filtek Silorane composite + Silorane System adhesive, or 6) Tytin amalgam. Specimens were subjected to an intermittent 1% sucrose biofilm model for 20 days to create artificial caries lesions. Lesion progression in the enamel–dentin next to the different materials was measured in lesion depth (LD) and mineral loss (ML) using transversal wavelength independent microradiography (T-WIM). A regression analysis was used to compare the LD and ML of the different restoration materials at 4 measurement locations: 1 location at the surface of the enamel, 1 location at the wall of the enamel, and 2 locations at the wall of the dentin. A statistically significant effect of AP-X composite with Protect Bond was found for LD and ML at the WallDentin1 location, leading to less advanced wall lesions. An additional finding was that gap size was also statistically significant at the 2 wall locations in dentin, leading to increasing lesion progression with wider gaps. In conclusion, adhesives can influence wall lesion development in gaps. Protect Bond showed significantly less caries progression compared to bare restoration materials or other adhesives in this short-term in vitro biofilm model. PMID:25297114

  18. Estimation of lesion progress in artificial root caries by swept source optical coherence tomography in comparison to transverse microradiography.

    PubMed

    Natsume, Yuko; Nakashima, Syozi; Sadr, Alireza; Shimada, Yasushi; Tagami, Junji; Sumi, Yasunori

    2011-07-01

    This study aimed to investigate whether swept source optical coherence tomography (SS-OCT) could estimate the lesion depth and mineral loss quantitatively without the use of polarization sensitivity, and to examine a relationship between OCT data and transverse microradiography (TMR) lesion parameters. Twenty-four bovine root dentin specimens were allocated to three groups of 4-, 7-, and 14-day demineralization. Cross-sectional images of the specimens before and after the demineralization were captured by OCT at 1319 nm center wavelength. Following the demineralization, these specimens were cut into sections for TMR analysis. Correlations between the OCT data and TMR lesion parameters were examined. TMR images of the specimens showed cavitated lesions (lesion depth or LD(TMR): 200 to 500 μm, ΔZ or mineral loss: 10,000 to 30,000 vol % μm). The OCT images showed "boundaries," suggesting the lesion front. Integrated dB values before and after the demineralization and their difference (R(D), R(S), and ΔR, respectively) were calculated from the lesion surface to the corrected depth of boundary (LD(OCT)). A statistically significant correlation was found between LD(OCT) and LD(TMR) (p < 0.05, r = 0.68). Similarly, statistically significant correlations were found between ΔZ and R(D) or ΔR. The OCT showed a potential for quantitative estimation of lesion depth and mineral loss with cavitated dentin lesions in vitro.

  19. Estimation of lesion progress in artificial root caries by swept source optical coherence tomography in comparison to transverse microradiography

    NASA Astrophysics Data System (ADS)

    Natsume, Yuko; Nakashima, Syozi; Sadr, Alireza; Shimada, Yasushi; Tagami, Junji; Sumi, Yasunori

    2011-07-01

    This study aimed to investigate whether swept source optical coherence tomography (SS-OCT) could estimate the lesion depth and mineral loss quantitatively without the use of polarization sensitivity, and to examine a relationship between OCT data and transverse microradiography (TMR) lesion parameters. Twenty-four bovine root dentin specimens were allocated to three groups of 4-, 7-, and 14-day demineralization. Cross-sectional images of the specimens before and after the demineralization were captured by OCT at 1319 nm center wavelength. Following the demineralization, these specimens were cut into sections for TMR analysis. Correlations between the OCT data and TMR lesion parameters were examined. TMR images of the specimens showed cavitated lesions (lesion depth or LDTMR: 200 to 500 μm, ΔZ or mineral loss: 10,000 to 30,000 vol % μm). The OCT images showed ``boundaries,'' suggesting the lesion front. Integrated dB values before and after the demineralization and their difference (RD, RS, and ΔR, respectively) were calculated from the lesion surface to the corrected depth of boundary (LDOCT). A statistically significant correlation was found between LDOCT and LDTMR (p < 0.05, r = 0.68). Similarly, statistically significant correlations were found between ΔZ and RD or ΔR. The OCT showed a potential for quantitative estimation of lesion depth and mineral loss with cavitated dentin lesions in vitro.

  20. The association between social deprivation and the prevalence and severity of dental caries and fluorosis in populations with and without water fluoridation

    PubMed Central

    2012-01-01

    Background To determine the association between social deprivation and the prevalence of caries (including caries lesions restricted to enamel) and enamel fluorosis in areas that are served by either fluoridated or non-fluoridated drinking water using clinical scoring, remote blinded, photographic scoring for caries and fluorosis. The study also aimed to explore the use of remote, blinded methodologies to minimize the effect of examiner bias. Methods Subjects were male and female lifetime residents aged 11–13 years. Clinical assessments of caries and fluorosis were performed on permanent teeth using ICDAS and blind scoring of standardized photographs of maxillary central incisors using TF Index (with cases for fluorosis defined as TF > 0). Results Data from 1783 subjects were available (910 Newcastle, 873 Manchester). Levels of material deprivation (Index of Multiple Deprivation) were comparable for both populations (Newcastle mean 35.22, range 2.77-78.85; Manchester mean 37.04, range 1.84-84.02). Subjects in the fluoridated population had significantly less caries experience than the non-fluoridated population when assessed by clinical scores or photographic scores across all quintiles of deprivation for white spot lesions: Newcastle mean DMFT 2.94 (clinical); 2.51 (photo), Manchester mean DMFT 4.48 (clinical); 3.44 (photo) and caries into dentine (Newcastle Mean DMFT 0.65 (clinical); 0.58 (photo), Manchester mean DMFT 1.07 (clinical); 0.98 (photo). The only exception being for the least deprived quintile for caries into dentine where there were no significant differences between the cities: Newcastle mean DMFT 0.38 (clinical); 0.36 (photo), Manchester mean DMFT 0.45 (clinical); 0.39 (photo). The odds ratio for white spot caries experience (or worse) in Manchester was 1.9 relative to Newcastle. The odds ratio for caries into dentine in Manchester was 1.8 relative to Newcastle. The odds ratio for developing fluorosis in Newcastle was 3.3 relative to

  1. Selective ablation of pit and fissure caries from occlusal surfaces using λ=355-nm laser pulses and air-abrasion demonstrated using PS-OCT and near-IR imaging

    NASA Astrophysics Data System (ADS)

    Ross, Steven T.; Fan, Kenneth; Fried, Daniel

    2006-02-01

    Several past studies have suggested that lasers with and without added chromophores can be used for the selective removal of dental caries from stained pit and fissures in preparation for composite sealant placement with minimal damage to sound, unstained tooth structure. Polarization sensitive optical coherence tomography (PS-OCT) is a new nondestructive imaging technology that can be used to acquire images of caries lesions in occlusal surfaces. PSOCT is ideally suited to measure the caries depth and severity before and after selective removal from occlusal surfaces. In this study, λ=355-nm laser pulses of 5-ns duration at irradiation intensities ranging from 0.5-1.3 J/cm2 were scanned across tooth surfaces to selectively remove decayed enamel with and without the addition of India ink. PS-OCT images were acquired before and after removal. The laser removal was also compared to air abrasion in order to compare selectivity of these two conservative caries removal technologies.

  2. Dentin Caries Zones

    PubMed Central

    Pugach, M.K.; Strother, J.; Darling, C.L.; Fried, D.; Gansky, S.A.; Marshall, S.J.; Marshall, G.W.

    2009-01-01

    Caries Detector staining reveals 4 zones in dentin containing caries lesions, but characteristics of each zone are not well-defined. We therefore investigated the physical and microstructural properties of carious dentin in the 4 different zones to determine important differences revealed by Caries Detector staining. Six arrested dentin caries lesions and 2 normal controls were Caries-Detector-stained, each zone (pink, light pink, transparent, apparently normal) being analyzed by atomic force microscopy (AFM) imaging for microstructure, by AFM nano-indentation for mechanical properties, and by transverse digital microradiography (TMR) for mineral content. Microstructure changes, and nanomechanical properties and mineral content significantly decreased across zones. Hydrated elastic modulus and mineral content from normal dentin to pink Caries-Detector-stained dentin ranged from 19.5 [10.6-25.3] GPa to 1.6 [0.0-5.0] GPa and from 42.9 [39.8-44.6] vol% to 12.4 [9.1-14.2] vol%, respectively. Even the most demineralized pink zone contained considerable residual mineral. PMID:19131321

  3. Enamel fusion using a carbon dioxide laser: A technique for sealing pits and fissures

    SciTech Connect

    Walsh, L.J.; Perham, S.J. )

    1991-05-01

    The well-established enhanced resistance of lased enamel to demineralization is the basis for clinical application of the carbon dioxide laser to caries prevention. This in vitro study examined the effect of focused infrared laser radiation on sound enamel and early pit and fissure caries. Low power levels (2-5 W) induced localized melting and resolidification of enamel with little surface destruction. For sound fissures, fusion of enamel from the lateral walls of the fissure eliminated the fissure space, providing a sealant effect; while in carious fissures, carious enamel was vaporized and adjacent sound enamel fused to partially eliminate the defect. The technique for enamel fusion using CO2 lasers has potential application for sealing pits and fissures and producing physicochemical alterations in enamel which may have preventive benefits.

  4. Intensive fluoride varnish program in Swedish adolescents: economic assessment of a 7-year follow-up study on proximal caries incidence.

    PubMed

    Petersson, L G; Westerberg, I

    1994-01-01

    The aim of this study was to assess the long-term effect after 7 years of an intensive fluoride varnish program in the age interval 11-14 compared to a standard biannual fluoride varnish program. Special reference was made to factors explaining the individual variance in caries incidence between 11-14 and 11-17 years as well as the net benefit of the intensified fluoride varnish program. Two caries measures, one unweighted (DFS0) and one weighted (DFS1), were used. Besides three caries measures D1-D3 were used to distinguish different grades of decay where D1 is enamel lesion and D3 dentinal lesion. The results show statistically significant differences for the age interval 11-17 years according to mean values of DFS0, DFS1 and D1. Regression analyses for caries incidence in the time interval 11-14 gives only explanation (i.e. significant estimated coefficient value) for caries prevalence at 11 years of age irrespective of caries measure, but in the age interval 11-17 years regression analysis also gives explanation for the variable father's education and the fluoride preventive measures in the age interval 11-14. The cost/benefit analysis shows net total costs of 3,880 SEK and net total benefits of 5,000 SEK over a time span of 10 years discounted to 1982 using an annual discount rate of 5%.

  5. Maize dependence or market integration? Caries prevalence among indigenous Maya communities with maize-based versus globalized economies.

    PubMed

    Vega Lizama, Elma Maria; Cucina, Andrea

    2014-02-01

    The relationship between diet and oral health is widely known, yet data on dental caries prevalence is lacking for many indigenous groups with traditional or rapidly modernizing diets. This research documents caries prevalence in two Maya communities from northern Yucatán (Mexico) with significantly different levels of market integration, subsistence, and diet: Yalsihón, with a traditional, maize-based subsistence economy, and Dzilam, with access to globalized food markets. Each sample was subdivided by sex into 15-19, 20-24, and 25-30 years-of-age classes. Caries prevalence was considered separately both when the lesion affected the enamel superficially (grade 1+) and when it reached the dentin (grade 2+). In both villages, females of all age classes manifest more caries than males. Results show higher prevalence of caries at Dzilam than at Yalsihón, except for grade 1+ caries among 15-19-year-old males and grade 2+ caries among 15-19-year-old females. Though differences are not significant, earlier pregnancies among 15-19-year-old females at Yalsihón could be a causative factor. A survey indicated a more balanced diet at Yalsihón despite a heavier intake of maize than at Dzilam. Striking differences were documented in the ingestion of soda and globalized foods; sodas were virtually absent at Yalsihón, while at Dzilam they were ingested daily in great quantities. The decline in oral health at Dzilam is inferred to result from consumption of industrially processed foods and drinks, while a traditional diet leads to less caries despite daily heavy consumption of maize, which must be considered when interpreting caries rates in archaeological samples.

  6. Bacteria of Dental Caries in Primary and Permanent Teeth in Children and Young Adults▿

    PubMed Central

    Aas, Jørn A.; Griffen, Ann L.; Dardis, Sara R.; Lee, Alice M.; Olsen, Ingar; Dewhirst, Floyd E.; Leys, Eugene J.; Paster, Bruce J.

    2008-01-01

    Although Streptococcus mutans has been implicated as a major etiological agent of dental caries, our cross-sectional preliminary study indicated that 10% of subjects with rampant caries in permanent teeth do not have detectable levels of S. mutans. Our aims were to use molecular methods to detect all bacterial species associated with caries in primary and permanent teeth and to determine the bacterial profiles associated with different disease states. Plaque was collected from 39 healthy controls and from intact enamel and white-spot lesions, dentin lesions, and deep-dentin lesions in each of 51 subjects with severe caries. 16S rRNA genes were PCR amplified, cloned, and sequenced to determine species identities. In a reverse-capture checkerboard assay, 243 samples were analyzed for 110 prevalent bacterial species. A sequencing analysis of 1,285 16S rRNA clones detected 197 bacterial species/phylotypes, of which 50% were not cultivable. Twenty-two new phylotypes were identified. PROC MIXED tests revealed health- and disease-associated species. In subjects with S. mutans, additional species, e.g., species of the genera Atopobium, Propionibacterium, and Lactobacillus, were present at significantly higher levels than those of S. mutans. Lactobacillus spp., Bifidobacterium dentium, and low-pH non-S. mutans streptococci were predominant in subjects with no detectable S. mutans. Actinomyces spp. and non-S. mutans streptococci were predominant in white-spot lesions, while known acid producers were found at their highest levels later in disease. Bacterial profiles change with disease states and differ between primary and secondary dentitions. Bacterial species other than S. mutans, e.g., species of the genera Veillonella, Lactobacillus, Bifidobacterium, and Propionibacterium, low-pH non-S. mutans streptococci, Actinomyces spp., and Atopobium spp., likely play important roles in caries progression. PMID:18216213

  7. Progression of non-cavitated lesions in dentin through a nonsurgical approach: a preliminary 12-month clinical observation

    PubMed Central

    da Silveira, Ana Daniela Silva; Borges, Boniek Castillo Dutra; de Almeida Varela, Hugo; de Lima, Kenio Costa; Pinheiro, Isauremi Vieira de Assunção

    2012-01-01

    Objective: Considering the minimally invasive approach to dentistry, the scientific community has focused on non-invasive treatments for caries lesions. The aim of this study was to evaluate the efficacy of a nonsurgical approach to arrest occlusal non-cavitated dentin lesions through glass ionomer sealing. Methods: In this controlled clinical trial, 51 teeth with clinically non-cavitated occlusal caries radiographically located beneath the enamel-dentine junction (radiolucent area) were selected among patients presenting a moderate to high risk of caries. The teeth were randomly divided into two groups: an experimental group receiving an application of Vidrion-R (SS White) glass ionomer and a control group not submitted to any clinical intervention. Caries progression was monitored by clinical and radiographic examination at 4-monthly intervals over a period of one year. In addition, marginal integrity of the sealant was evaluated in the experimental group. Results: Clinical examination showed no statistical difference between the groups (P=.13). On the other hand, sealed teeth presented lower caries progression when analyzed by radiographic examination (P=.004). Conclusion: A glass ionomer sealant over non-cavitated occlusal caries lesions in dentin may not be sufficiently effective in arresting their progression. PMID:22229005

  8. Casein phosphopeptide-amorphous calcium phosphate products in caries prevention.

    PubMed

    Hani, Thikrayat Bani; O'Connell, Anne C; Duane, Brett

    2016-06-01

    Data sourcesMedline, Embase, PreMedline and Cochrane Central Register of Controlled Trials.Study selectionClinical trials, investigating only clinical caries outcomes on participants of any age comparing the use of Tooth Mousse(®) or Tooth Mousse Plus(®) to a routine oral care regimen for the prevention of dental caries with or without comparison to additional preventive products. Studies that used other formulations of CCP-ACP were excluded. Trials using split-mouth design were also excluded. Only English language papers were considered.Data extraction and synthesisPapers were assessed independently by both authors using the Cochrane Collaboration tool for assessing risk of bias in randomised trials.1 Meta-analysis was not possible due to study heterogeneity.ResultsTwelve studies were available for the final review; three studies on caries prevention were assessed as having low risk of bias. The remaining nine studies, with high risk of bias, reported on treatment or regression of early carious lesions. Two RCTs reported no significant benefits in the use of Tooth Mousse(®) over brushing with a fluoride toothpaste, a third study demonstrated a statistically significant increase in enamel microhardness for the Tooth Mousse(®) group compared to control group but no difference to the group who had fluoride gel treatment. Overall the authors concluded that Tooth Mousse(®) performs no better than fluoride in the prevention of carious lesions.Seven of nine studies evaluated caries lesion severity in orthodontic patients, with four demonstrating statistically significant white spot regression. Two trials in non-orthodontic patients showed statistically significant remineralising potential of Tooth Mousse(®) over fluoride mouthrinse or the regular use of fluoride toothpaste in 14-30 days.ConclusionsThe authors found no evidence to support the use of Tooth Mousse(®) over brushing with a fluoride toothpaste for the prevention of early caries. ToothMousse(®) appeared

  9. Human enamel structure studied by high resolution electron microscopy

    SciTech Connect

    Wen, S.L. )

    1989-01-01

    Human enamel structural features are characterized by high resolution electron microscopy. The human enamel consists of polycrystals with a structure similar to Ca10(PO4)6(OH)2. This article describes the structural features of human enamel crystal at atomic and nanometer level. Besides the structural description, a great number of high resolution images are included. Research into the carious process in human enamel is very important for human beings. This article firstly describes the initiation of caries in enamel crystal at atomic and unit-cell level and secondly describes the further steps of caries with structural and chemical demineralization. The demineralization in fact, is the origin of caries in human enamel. The remineralization of carious areas in human enamel has drawn more and more attention as its potential application is realized. This process has been revealed by high resolution electron microscopy in detail in this article. On the other hand, the radiation effects on the structure of human enamel are also characterized by high resolution electron microscopy. In order to reveal this phenomenon clearly, a great number of electron micrographs have been shown, and a physical mechanism is proposed. 26 references.

  10. The Prevalence of Early Childhood Caries among 24 to 36 Months Old Children of Iran: Using the Novel ICDAS-II Method

    PubMed Central

    Toutouni, Hediyeh; Nokhostin, Mohammad-Reza; Amaechi, Bennett Tochukwu; Zafarmand, Abdol Hamid

    2015-01-01

    Statement of the Problem Early childhood caries is an important oral health issue. Finding its prevalence would predict the need for oral health promotion disciplines for specific age groups.    Purpose The aim of this study was to assess the caries experience of children living in Tehran, Iran. It also would evaluate the impact of gender, ethnicity, and socioeconomic status (SES) on this oral condition. Materials and Method This epidemiological cross-sectional study was based upon stratified cluster random sampling. The samples consisted of 239 children (2- to 3- years old) registered in Tehran’s public healthcare centers for “Healthy Child Program”. Mothers of the recruited children were interviewed for the background data; then children were examined for the oral health status according to ICDAS-II (International Caries Detection and Assessment System) and WHO (World Health Organization) criteria. Statistical analyses were conducted using STATA.11 for SES classification considering six socioeconomic variables, and SPSS.21 for descriptive/analytical analyses. Results Primary Component Analysis (PCA) demonstrated five classes of SES ranging from the lowest to the highest. The distribution of caries-free (CF) children was 10.87%, non-cavitated enamel caries (codes 01-02) were 28.03%, and about 61.1% had cavitated caries (codes 03-06). There was no significant difference in caries experience between the two genders. Cavitated lesions were more prevalent among Kurdish, who also had the least CF children. Caries prevalence, especially code 02, was more among children from 3rd class SES (moderate level). Gender, ethnicity, or SES had no impact on the CF status of the children; however, ethnicity showed significant impact on the prevalence of extensive caries (codes 05-06). Conclusion The result of the present study is indicative of high caries prevalence among 2 to 3 years old children residing in Tehran. It highlights the need for comprehensive oral health

  11. Effect of a low-fluoride-content, two-component rinse on fluoride uptake and on de--and remineralization of enamel lesions: an in vitro study.

    PubMed

    Takagi, S; Liao, H; Chow, L C

    2001-01-01

    The effect of calcium (Ca) concentrations and added ethanol on fluoride (F) depositions by experimental two-component rinses, each consisting of a Ca-containing and an F-containing component, was evaluated in an in vitro system. Among the tested rinses, a 3 mmol/l F two-component rinse with 200 mmol/l Ca and 10% v/v ethanol was found to produce the greatest F deposition relative to the F concentration in the rinse. Specifically, this rinse produced an F deposition that was about 7 times greater than a conventional 13.2-mmol/l sodium fluoride (NaF) rinse. In a second experiment, an in vitro pH cycling model was used to evaluate the potential anti-caries effects of 4 rinses: (1) placebo rinse (no F), (2) 13.2-mmol/l NaF rinse, (3) 52.6-mmol/l NaF rinse, and (4) the 3-mmol/l F two-component rinse in a 7-day in vitro pH cycling model. The changes in lesion mineral contents, delta(DeltaZ), as assessed by quantitative microradiographic measurements, were as follows [mean +/- standard deviation, n = 10]: (1) 72.5+/-10.2 microm, (2) 43.4+/-5.6 microm, (3) 17.3+/-10.2 microm and (4) 45.3+/-5.2 microm. These results showed that the 3-mmol/l F two-component rinse produced the same (p>0.05) protection against demineralization as did the 13.2-mmol/l NaF rinse which had 4 times the fluoride content. The results suggest that it is possible to formulate an effective low-F two-component rinse.

  12. Oral Lactobacilli and Dental Caries

    PubMed Central

    Caufield, P.W.; Schön, C.N.; Saraithong, P.; Li, Y.; Argimón, S.

    2015-01-01

    Lactobacilli have been associated with dental caries for over a century. Here, we review the pertinent literature along with findings from our own study to formulate a working hypothesis about the natural history and role of lactobacilli. Unlike most indigenous microbes that stably colonize a host, lactobacilli appear to be planktonic, opportunistic settlers that can gather and multiply only in certain restrictive niches of the host, at least within the oral cavity. We postulate that the following essential requirements are necessary for sustained colonization of lactobacilli in humans: 1) a stagnant, retentive niche that is mostly anaerobic; 2) a low pH milieu; and 3) ready access to carbohydrates. Three sites on the human body meet these specifications: caries lesions, the stomach, and the vagina. Only a handful of Lactobacillus species is found in caries lesions, but they are largely absent in caries-free children. Lactobacilli present in caries lesions represent both a major contributor to caries progression and a major reservoir to the gastrointestinal (GI) tract. We extend the assertion from other investigators that lactobacilli found in the GI tract originate in the oral cavity by proposing that lactobacilli in the oral cavity arise from caries lesions. This, in turn, leads us to reflect on the health implications of the lactobacilli in the mouth and downstream GI and to ponder whether these or any of the Lactobacillus species are truly indigenous to the human GI tract or the oral cavity. PMID:25758458

  13. Use of new minimum intervention dentistry technologies in caries management.

    PubMed

    Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

    2013-06-01

    Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the

  14. Use of new minimum intervention dentistry technologies in caries management.

    PubMed

    Tassery, H; Levallois, B; Terrer, E; Manton, D J; Otsuki, M; Koubi, S; Gugnani, N; Panayotov, I; Jacquot, B; Cuisinier, F; Rechmann, P

    2013-06-01

    Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the

  15. Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization.

    PubMed

    Azevedo, Danielle Torres; Faraoni-Romano, Juliana Jendiroba; Derceli, Juliana Dos Reis; Palma-Dibb, Regina Guenka

    2012-01-01

    Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm² area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher's LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period. PMID:22666766

  16. [Optimization of dental caries prevention].

    PubMed

    Makeeva, I M; Polyakova, M A; Avdeenko, O E; Paramonov, Yu O; Kondrat'ev, S A; Pilyagina, A A

    2016-01-01

    The aim of the study was to evaluate the efficacy of toothpaste «Apadent Total Care» containing nanocalciumhydroxyapatite and its influence on caries resistance of tooth enamel and teeth sensitivity. The study involved 30 people: 15 patients aged 17-25 years and 15 aged 35-44 years. Study participants used «Apadent Total Care» toothpaste with nanocalciumhydroxyapatite. To evaluate the effectiveness of toothpastes clinical assessment of enamel remineralization rate was carried out, as well as the dynamics of enamel acid resistance and teeth sensitivity (Shiff index). Clinical evaluation of tooth enamel before the procedure and after 3 months of use of toothpaste with nanohydroxyapatite showed the improvement of all indices. Time for complete remineralisation of enamel in both groups did not exceed 3 days. Acid resistance of tooth enamel increased by 1.65 in group I and 1,75 in group II. The Schiff index after 3 months of using «Apadent» toothpaste also decreased in both groups.

  17. [Optimization of dental caries prevention].

    PubMed

    Makeeva, I M; Polyakova, M A; Avdeenko, O E; Paramonov, Yu O; Kondrat'ev, S A; Pilyagina, A A

    2016-01-01

    The aim of the study was to evaluate the efficacy of toothpaste «Apadent Total Care» containing nanocalciumhydroxyapatite and its influence on caries resistance of tooth enamel and teeth sensitivity. The study involved 30 people: 15 patients aged 17-25 years and 15 aged 35-44 years. Study participants used «Apadent Total Care» toothpaste with nanocalciumhydroxyapatite. To evaluate the effectiveness of toothpastes clinical assessment of enamel remineralization rate was carried out, as well as the dynamics of enamel acid resistance and teeth sensitivity (Shiff index). Clinical evaluation of tooth enamel before the procedure and after 3 months of use of toothpaste with nanohydroxyapatite showed the improvement of all indices. Time for complete remineralisation of enamel in both groups did not exceed 3 days. Acid resistance of tooth enamel increased by 1.65 in group I and 1,75 in group II. The Schiff index after 3 months of using «Apadent» toothpaste also decreased in both groups. PMID:27636759

  18. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model.

    PubMed

    Morais, A P; Pino, A V; Souza, M N

    2016-08-01

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites. PMID:27587136

  19. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    NASA Astrophysics Data System (ADS)

    Morais, A. P.; Pino, A. V.; Souza, M. N.

    2016-08-01

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  20. Aesthetic approach for anterior teeth with enamel hypoplasia

    PubMed Central

    Martos, Josué; Gewehr, Andréa; Paim, Emanuele

    2012-01-01

    Enamel hypoplasia is a developmental defect of the enamel that is produced by a disturbance in the formation of the organic enamel matrix, clinically visible as enamel defects. Disorders that occur during the stages of enamel development and maturation reduce the amount or thickness of the enamel, resulting in white spots, tiny grooves, depressions and fissures in the enamel surface. The complexity and intensity of the dental deformity lesions will conduct the ideal treatment-associating conservative techniques. This article presents a case report of a restorative treatment of enamel hypoplasia using hybrid composite resin to mask color alteration and enamel defects. An aesthetic appearance that respects the tooth polychromatic and the self-esteem of the patient can be achieved with this approach. PMID:22629075

  1. The specificity of caries detector dyes in cavity preparation.

    PubMed

    Yip, H K; Stevenson, A G; Beeley, J A

    1994-06-11

    The specificity of two caries detector dyes (0.5% basic fuchsin and 1.0% acid red) was investigated in vitro using extracted human permanent and deciduous teeth. Although the dyes stained carious dentine, sound circumpulpal dentine and the enamel-dentine junction could also be stained. Backscattered electron imaging showed that the level of mineralisation in these two parts of the tooth was lower than in normal dentine. Susceptibility to dye staining therefore appears to be a feature of reduced mineral content rather than being specific for a carious lesion. Whilst use of basic fuchsin should be avoided in view of its carcinogenic potential and ability to stain sound coronal dentine, acid red should also be used with caution and its use on the pulpal surface of deep cavity preparations would appear to be contraindicated. Use of these dyes may result in the unnecessary removal of sound dentine.

  2. Prevalence of dental caries and caries-related risk factors in premature and term children.

    PubMed

    Cruvinel, Vanessa Resende Nogueira; Gravina, Danuze Batista Lamas; Azevedo, Tatiana Degani Paes Leme; Bezerra, Ana Cristina Barreto; Toledo, Orlando Ayrton de

    2010-01-01

    This study evaluated the prevalence of enamel defects and dental caries and their risk factors on primary and permanent dentitions of prematurely-born children and term children. Eighty children were examined, 40 born prematurely (G1) and 40 born term (G2), in the age group between 5 and 10 years. The demographic variables, medical history and oral health behaviors were recorded on a questionnaire. The teeth were examined for presence of deficiencies of the enamel and caries that were registered. The caries were registered, focusing on the indices dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth). The results showed that 75% of the total sample had enamel defects. The logistic regression model showed that other risk factors such as per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases had no correlation with enamel defects and caries. A smaller value of total DMFT (0.95) was found in the group of premature children in comparison to the term children (2.07) p = 0.0164. There was no difference concerning the permanent dentition between the two groups (p = 0.9926). One concludes that prematurity can't be a predisposing factor for the presence of dental caries. PMID:20877971

  3. Caries diagnosis using laser fluorescence

    NASA Astrophysics Data System (ADS)

    Zanin, Fatima A. A.; Pinheiro, Antonio L. B.; Souza-Campos, Dilma H.; Brugnera, Aldo, Jr.; Pecora, Jesus D.

    2000-03-01

    Caries prevention is a goal to be achieved by dentist in order to promote health. There are several methods used to detect dental caries each one presenting advantages and disadvantages, especially regarding hidden occlusal caries. The improvement of laser technology has permitted the use of laser fluorescence for early diagnosis of hidden occlusal caries. The aim of this study was to assess the efficacy of the use of 655 nm laser light on the detection of hidden occlusal caries. Forty molar teeth from patients of both sexes which ages ranging from 10 - 18 years old were used on this study. Following manufacture's instructions regarding the use of the equipment, the teeth had their occlusal surface examined with the DIAGNOdent. Twenty six of 40 teeth had hidden occlusal caries detected by the DIAGNOdent. However only 17 of these 26 teeth showed radiographic signs of caries the other 9 teeth showed no radiological signs of the lesion. Radiographic examination was able to identify 34,61% of false negative cases. This means that many caries would be left untreated due to the lack of diagnosis using both visual and radiographic examination. The use of the DIAGNOdent was effective in successfully detecting hidden occlusal caries.

  4. Etiology of nursing caries: a microbiologic perspective.

    PubMed

    Berkowitz, R

    1996-01-01

    A compelling body of scientific evidence supports the concept that nursing caries is an infectious and transmissible disease. This evidence makes a strong case to support the tenet that infants who are colonized by mutans streptococci, and who have feeding habits characterized by frequent and prolonged oral exposure to cariogenic substrates, are likely to have a drastic increase in their oral mutans streptococci populations. Such an increase is associated with a high risk for rampant dental caries. This evidence strongly suggests that the first step in the etiology of nursing caries is primary infection by mutans streptococci; the second step is accumulation of these organisms to pathogenic levels as a consequence of frequent and prolonged oral exposure to cariogenic substrates; and the third step is rapid demineralization and cavitation of enamel resulting in rampant dental caries. This three-step model might provide an important framework for the design of clinical trials targeted at prevention of nursing caries.

  5. Clinical trial for detection of dental caries using laser-induced fluorescence ratio reference standard

    NASA Astrophysics Data System (ADS)

    Thomas, Shiny Sara; Mohanty, Soumyakant; Jayanthi, J. L.; Varughese, Jolly Mary; Balan, Anitha; Subhash, Narayanan

    2010-03-01

    We present the clinical applicability of fluorescence ratio reference standard (FRRS) to discriminate different stages of dental caries. Toward this, laser-induced autofluorescence emission spectra are recorded in vivo in the 400- to 800-nm spectral range on a miniature fiber optic spectrometer from 65 patients, with a 404-nm diode laser as the excitation source. Autofluorescence spectra of sound teeth consist of a broad emission at 500 nm that is typical of natural enamel, whereas in caries teeth additional peaks are seen at 635 and 680 nm due to emission from porphyrin compounds in oral bacteria. Scatter plots are developed to differentiate sound teeth from enamel caries, sound teeth from dentinal caries, and enamel caries from dentinal caries using the mean fluorescence intensity (FI) and ratios F500/F635 and F500/F680 measured from 25 sites of sound teeth and 65 sites of carious teeth. The sensitivity and specificity of both the FI and FRRS are determined. It is observed that a diagnostic algorithm based on FRRS scatter plots is able to discriminate enamel caries from sound teeth, dentinal caries from sound teeth, and enamel from dentinal caries with overall sensitivities of 85, 100, and 88% and specificities of 90, 100, and 77%, respectively.

  6. Resin infiltration of fissure caries with various techniques of pretreatment in vitro.

    PubMed

    Lausch, Julian; Paris, Sebastian; Selje, Timo; Dörfer, Christof E; Meyer-Lueckel, Hendrik

    2015-01-01

    The resin infiltration technique might be used for occlusal caries lesions in order to arrest their progression. This in vitro study evaluated the influence of various modifications of the infiltration technique on the penetration abilities of the infiltrant into occlusal lesions. Extracted human molars and premolars (n = 140) with non-cavitated white spot lesions were randomly allocated to 7 groups. As control, specimens were etched with 15% hydrochloric acid (HCl) gel for 120 s and resin infiltrated for 180 s (Icon; DMG). As modification HCl gel reduced in surface tension and viscosity with and without abrasives was applied using 3 different types of brushes either to oscillate or rub the HCl gel onto the enamel surface. The median maximum lesion depth was 1,232 µm (interquartile range 882-1,513). Compared with the control procedure [23% (16/50)] a higher percentage penetration was observed if the HCl gel was mixed with a small amount of abrasives were rubbed into the fissures using a modified brush with stiff bristles that were adjusted to the fissure relief for either 120 s [100% (64/100)] or 30 s [98% (61/100); p < 0.05; Mann-Whitney test]. All other experimental treatments resulted in penetration results in-between. It can be concluded that the use of an abrasive HCl gel in conjunction with a modified brush mostly enhances resin infiltration into fissure caries lesions. PMID:25427531

  7. Effect of dentifrices on their remineralizing potential in artificial carious lesions: An in situ study

    PubMed Central

    Damle, Satyawan Gangaramji; Bector, Aditi; Damle, Dhanashree; Kaur, Simranjeet

    2016-01-01

    Background: The eventual sequel of dental caries is determined by the dynamic equilibrium between pathological factors which lead to demineralization and protective elements, which in turn leads to remineralization. Remineralization is the natural process for noncavitated demineralized lesions and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. Hence, the present study was designed to evaluate the efficacy of fluoride dentifrices in remineralizing artificial caries-like lesions in situ. Materials and Methods: A double-blind, randomized study with an initial washout period of 7 days was carried out for 3 weeks. Twenty volunteers were enrolled, who wore the intraoral cariogenicity test appliance having enamel slabs incorporated into them, for 3 weeks. 10 participants were instructed to use Group A dentifrice (fluoride) and the other 10 Group B dentifrice (nonfluoride) for brushing their teeth. The enamel slabs were analyzed by surface microhardness testing and scanning electron microscopy (SEM) at 3 intervals. Results: No significant differences was seen in the microhardness values recorded for Group A and Group B at baseline and after demineralization (P > 0.05); however Group B exhibited lesser microhardness compared to Group A, after intra-oral exposure (P < 0.05). In the SEM analysis, the Group A enamel surfaces had more regular and longer crystallites to those of the Group B. Conclusion: Fluoride dentifrices avert the decrease in enamel hardness and loss of minerals from the enamel surface to a large extent as compared to the nonfluoride dentifrices. PMID:26962320

  8. Early hominid dental pathology: interproximal caries in 1.5 million-year-old Paranthropus robustus from Swartkrans.

    PubMed

    Grine, F E; Gwinnett, A J; Oaks, J H

    1990-01-01

    Carious lesions on the mesial and distal aspects of a RM1 of a young adult 'robust' australopithecine. Paranthropus robustus, are described. The specimen is from Member 1 sediments of the Swartkrans cave, which are dated to between about 1.8 and 1.5 million years before present. The mesial lesion, located cervically, had progressed further than the two distal lesions, which were situated along the cervix and in the enamel of the interproximal contact facet. This is the third specimen of P. robustus to be discovered with dental caries, but the other two cases were associated with occlusal and buccal enamel hypoplasia. Caries is present in less than about 3.0% of the approx. 116-128 P. robustus specimens at Swartkrans, and this incidence is noticeably lower than in the small Homo erectus sample from the same site. While this difference may simply be a sampling artefact, it may reflect dietary differences between these two synchronic and presumably sympatric early hominid species. PMID:2196866

  9. Influence of cadmium on caries and the cariostatic properties of fluoride in rats

    SciTech Connect

    Shearer, T.R.; Britton, J.L.; DeSart, D.J.; Johnson, J.R.

    1980-05-01

    Cadmium injections during molar tooth development in the rat were strongly caries-promoting in female rats. Cadmium also partially negated the cariostatic effect of fluoridated drinking water in both male and female rats. The mechanism for the caris-promoting propeties of cadmium is unknown, but may be related to cadmium uptake into enamel and dentin. Cadmium was taken up into molar enamel and dentin in proportion to the amount of cadmium administered, but cadmium did not influence uptake of fluoride onto erupted enamel. Calcium and ash concentrations in molar enamel were not altered by cadmium administration.

  10. A construction of standardized near infrared hyper-spectral teeth database: a first step in the development of reliable diagnostic tool for quantification and early detection of caries

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

    Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentin and pulp. If left untreated, the disease can lead to pain, infection and tooth loss. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Several papers reported on near infrared (NIR) spectroscopy to be a potentially useful noninvasive spectroscopic technique for early detection of caries lesions. However, the conducted studies were mostly qualitative and did not include the critical assessment of the spectral variability of the sound and carious dental tissues and influence of the water content. Such assessment is essential for development and validation of reliable qualitative and especially quantitative diagnostic tools based on NIR spectroscopy. In order to characterize the described spectral variability, a standardized diffuse reflectance hyper-spectral database was constructed by imaging 12 extracted human teeth with natural lesions of various degrees in the spectral range from 900 to 1700 nm with spectral resolution of 10 nm. Additionally, all the teeth were imaged by digital color camera. The influence of water content on the acquired spectra was characterized by monitoring the teeth during the drying process. The images were assessed by an expert, thereby obtaining the gold standard. By analyzing the acquired spectra we were able to accurately model the spectral variability of the sound dental tissues and identify the advantages and limitations of NIR hyper-spectral imaging.

  11. Recovery of crystallographic texture in remineralized dental enamel.

    PubMed

    Siddiqui, Samera; Anderson, Paul; Al-Jawad, Maisoon

    2014-01-01

    Dental caries is the most prevalent disease encountered by people of all ages around the world. Chemical changes occurring in the oral environment during the caries process alter the crystallography and microstructure of dental enamel resulting in loss of mechanical function. Little is known about the crystallographic effects of demineralization and remineralization. The motivation for this study was to develop understanding of the caries process at the crystallographic level in order to contribute towards a long term solution. In this study synchrotron X-ray diffraction combined with scanning electron microscopy and scanning microradiography have been used to correlate enamel crystallography, microstructure and mineral concentration respectively in enamel affected by natural caries and following artificial demineralization and remineralization regimes. In particular, the extent of destruction and re-formation of this complex structure has been measured. 2D diffraction patterns collected at the European Synchrotron Radiation Facility were used to quantify changes in the preferred orientation (crystallographic texture) and position of the (002) Bragg reflection within selected regions of interest in each tooth slice, and then correlated with the microstructure and local mineral mass. The results revealed that caries and artificial demineralization cause a large reduction in crystallographic texture which is coupled with the loss of mineral mass. Remineralization restores the texture to the original level seen in healthy enamel and restores mineral density. The results also showed that remineralization promotes ordered formation of new crystallites and growth of pre-existing crystallites which match the preferred orientation of healthy enamel. Combining microstructural and crystallographic characterization aids the understanding of caries and erosion processes and assists in the progress towards developing therapeutic treatments to allow affected enamel to regain

  12. Recovery of Crystallographic Texture in Remineralized Dental Enamel

    PubMed Central

    Siddiqui, Samera; Anderson, Paul; Al-Jawad, Maisoon

    2014-01-01

    Dental caries is the most prevalent disease encountered by people of all ages around the world. Chemical changes occurring in the oral environment during the caries process alter the crystallography and microstructure of dental enamel resulting in loss of mechanical function. Little is known about the crystallographic effects of demineralization and remineralization. The motivation for this study was to develop understanding of the caries process at the crystallographic level in order to contribute towards a long term solution. In this study synchrotron X-ray diffraction combined with scanning electron microscopy and scanning microradiography have been used to correlate enamel crystallography, microstructure and mineral concentration respectively in enamel affected by natural caries and following artificial demineralization and remineralization regimes. In particular, the extent of destruction and re-formation of this complex structure has been measured. 2D diffraction patterns collected at the European Synchrotron Radiation Facility were used to quantify changes in the preferred orientation (crystallographic texture) and position of the (002) Bragg reflection within selected regions of interest in each tooth slice, and then correlated with the microstructure and local mineral mass. The results revealed that caries and artificial demineralization cause a large reduction in crystallographic texture which is coupled with the loss of mineral mass. Remineralization restores the texture to the original level seen in healthy enamel and restores mineral density. The results also showed that remineralization promotes ordered formation of new crystallites and growth of pre-existing crystallites which match the preferred orientation of healthy enamel. Combining microstructural and crystallographic characterization aids the understanding of caries and erosion processes and assists in the progress towards developing therapeutic treatments to allow affected enamel to regain

  13. Effect of dentifrice containing fluoride and/or baking soda on enamel demineralization/remineralization: an in situ study.

    PubMed

    Cury, J A; Hashizume, L N; Del Bel Cury, A A; Tabchoury, C P

    2001-01-01

    The additive effect of baking soda on the anticariogenic effect of fluoride dentifrice is not well established. To evaluate it, a crossover in situ study was done in three phases of 28 days. Volunteers, using acrylic palatal appliances containing four human enamel blocks, two sound (to evaluate demineralization) and two with artificial caries lesions (to evaluate remineralization), took part in this study. During each phase, 10% sucrose solution was dripped (3 times a day) only onto the sound blocks. After 10 min, a slurry of placebo, fluoride (F) or fluoride and baking soda (F+NaHCO(3)) dentifrice was dripped onto all enamel blocks. The results showed a higher F concentration in dental plaque formed during treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The enamel demineralization was lower, and remineralization was greater, after treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The data suggest that baking soda neither improves nor impairs the effect of F dentifrice on reduction of demineralization and enhancement of remineralization of enamel. PMID:11275669

  14. Effect of dentifrice containing fluoride and/or baking soda on enamel demineralization/remineralization: an in situ study.

    PubMed

    Cury, J A; Hashizume, L N; Del Bel Cury, A A; Tabchoury, C P

    2001-01-01

    The additive effect of baking soda on the anticariogenic effect of fluoride dentifrice is not well established. To evaluate it, a crossover in situ study was done in three phases of 28 days. Volunteers, using acrylic palatal appliances containing four human enamel blocks, two sound (to evaluate demineralization) and two with artificial caries lesions (to evaluate remineralization), took part in this study. During each phase, 10% sucrose solution was dripped (3 times a day) only onto the sound blocks. After 10 min, a slurry of placebo, fluoride (F) or fluoride and baking soda (F+NaHCO(3)) dentifrice was dripped onto all enamel blocks. The results showed a higher F concentration in dental plaque formed during treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The enamel demineralization was lower, and remineralization was greater, after treatment with F+NaHCO(3) than placebo (p<0.05), but the difference related to F dentifrice was not significant. The data suggest that baking soda neither improves nor impairs the effect of F dentifrice on reduction of demineralization and enhancement of remineralization of enamel.

  15. Rampant Caries

    ERIC Educational Resources Information Center

    Guzman-Armstrong, Sandra

    2005-01-01

    Although dental caries in the pediatric and adolescent population has consistently declined in the United States, it is still the most common childhood disease. Dental problems are the number one reason for missing school next to the common cold. Dental caries are an infectious, communicable disease resulting in destruction of tooth structure by…

  16. A microtensile bond strength evaluation of a single-bottle adhesive to caries-affected dentin in conventional versus minimal invasive caries removal techniques: An in-vitro study

    PubMed Central

    Naik, Saraswathi V; Shashikiran, N D; Chaitra, N L; Syed, Ghousia

    2014-01-01

    Background and Objective: The current dental restorative concepts are characterized by an increased effort towards a less invasive treatment of carious lesions. Minimally invasive cavity preparation techniques are intended to preserve as much sound enamel and dentin as possible, during the treatment of carious lesions. The objective of this in vitro study is to evaluate the microtensile bond strength of single-etch adhesives (Adper Easy one) on caries-affected dentin, following three different caries removal techniques, namely, Carisolv, Conventional carbide bur at slow speed, and aqueous calcium hydroxide. Materials and Methods: A total of 30 teeth were divided into three groups and arranged with 10 samples in each group - round bur (Group A), Carisolv (Group B), Aqueous calcium hydroxide (Group C). Following caries excavation by using the three above -mentioned techniques, application of the bonding agent and composite buildup was done. Following sectioning of the samples with the help of a hard tissue microtome, Group A, B, and C were again trimmed into an hour-glass shape, maintaining a width of 1.2 mm in the center of an hour glass. These were debonded under a microtensile load at failure, using the Instron Universal Testing Machine. Results: There was a significantly lower microtensile bond strength in the group where the caries was removed by the round bur, as compared to the group where the caries was removed by using Carisolv and calcium hydroxide, which showed higher microtensile bond strength, that is, the significant pairing of Groups were Group A to Group B and Group A to Group C, exhibiting statistically significant difference with a P < 0.001. However, there was no statistically significant difference between Group B and Group C. Interpretation and Conclusion: Carisolv and aqueous calcium hydroxide have proven to be good methods of caries removal for achieving a higher microtensile bond strength of the single-bottle self-etch adhesive on dentin. PMID

  17. In vivo imaging of enamel by reflectance confocal microscopy (RCM): non-invasive analysis of dental surface.

    PubMed

    Contaldo, Maria; Serpico, Rosario; Lucchese, Alberta

    2014-07-01

    The aim is to establish the feasibility to image in vivo microscopic dental surface by non-invasive, real-time, en face Reflectance Confocal Microscopy (RCM). Fifteen healthy volunteers referred at the Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples, Naples, Italy, were enrolled. A commercially available hand-held RCM (Vivascope(®)3000, Lucid, Rochester, NY, USA) was used to image in vivo the dental surface of the upper right and left central incisors of each volunteer. Totally, thirty vestibular surfaces of upper central incisors were imaged in vivo by RCM to preliminary image the dental surface and assess the feasibility of a more extended study on teeth. In vivo RCM was able to image the dental surface within the enamel, at a maximum depth imaging of 300 μm, with images good in quality and the capability to detect enamel structures such as enamel lamellae and enamel damages, such as unevenness and cracks. In conclusion, enamel "optical biopsy", gained by RCM imaging, revealed to be a non-invasive real-time tool valid to obtain architectural details of the dental surface with no need for extraction or processing the samples. RCM appears to be an optimum auxiliary device for investigating the architectural pattern of superficial enamel, therefore inviting further experiments aimed to define our knowledge about damages after etching treatments or bracket removal and the responsiveness to fluoride seals and the morphology of the tooth/restoration interface. Moreover, this device could also be used to detect relevant diseases like caries, or to assess surface properties to evaluate lesion activity.

  18. Guided fluorescence diagnosis of childhood caries: preliminary measures correlate with depth of carious decay

    NASA Astrophysics Data System (ADS)

    Timoshchuk, Mari-Alina; Zhang, Liang; Dickinson, Brian A.; Ridge, Jeremy S.; Kim, Amy S.; Baltuck, Camille T.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

    2014-02-01

    The current rise in childhood caries worldwide has increased the demand for portable technologies that can quickly and accurately detect and diagnose early stage carious lesions. These lesions, if identified at an early stage, can be reversed with remineralization treatments, education, and improvements in home care. A multi-modal optical prototype for detecting and diagnosing occlusal caries demineralization in vivo has been developed and pilot tested. The device uses a 405-nm laser as a scanned illumination source to obtain high resolution and high surface contrast reflectance images, which allows the user to quickly image and screen for any signs of demineralized enamel. When a suspicious region is located, the device can be switched to perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitations. These spectra are used to compute an auto-fluorescence (AF) ratio of the suspicious region and the percent difference of AF ratios from a healthy region of the same tooth. The device was tested on 7 children's teeth in vivo with clinically diagnosed carious lesions. Lesion depth was then visually estimated from the video image using the 405-nm scanned light source, and within a month the maximum drill depth was assessed by a clinician. The researcher and clinicians were masked from previous measurements in a blinded study protocol. Preliminary results show that the ratiometric percent difference measurement of the AF spectrum of the tooth correlates with the severity of the demineralization as assessed by the clinician after drilling.

  19. [Caries preventive effectiveness of Fluor Protector and fluoride lacquer, Duraphat under very cariogenic conditions].

    PubMed

    De Bruyn, H; Buskes, H

    1988-06-01

    Fluoride varnishes Durpahat and Fluor Protector are commonly used and have proven to be effective as caries preventive agents. In the first part of this paper the features of fluoride varnishes in terms of fluoride uptake, caries prevention and toxicological safety are discussed. The effect of both varnishes under high cariogenic conditions is discussed in the second part. In the presented study, 8 patients carried 3 enamel specimens (Fluor Protector, Duraphat, Control) intra-orally during 4 months. They kept plaque accumulation intact on the specimen and avoided fluoride administration from other sources. After 4 months of substantial cariogenic challenge, the enamel was analysed by microradiography and the degree of caries protection obtained for each varnish type was calculated. The results show that under high-risk caries conditions enamel treated with Fluor Protector was significantly better protected (65%) than enamel treated with Duraphat (3%).

  20. In vitro remineralization of enamel by polymeric amorphous calcium phosphate composite: Quantitative micro-radiographic study

    PubMed Central

    Langhorst, S.E.; O'Donnell, J.N.R.; Skrtic, D.

    2009-01-01

    Objective: This study explores the efficacy of an experimental orthodontic amorphous calcium phosphate (ACP) composite to remineralize in vitro subsurface enamel lesions microradiographically similar to those seen in early caries. Methods: Lesions were artificially created in extracted human molars. Single tooth sections a minimum of 120 μm thick were cut and individually placed in holders exposing only the carious enamel surface. The exposed surfaces were either left untreated (control) or coated with a 1 mm thick layer of the experimental ACP composite (mass fraction 40 % zirconiahybridized ACP and 60 % photo-activated resin), or a commercial fluoride-releasing orthodontic cement. The composite-coated sections were then photo-cured and microradiographic images were taken of all three groups of specimens before the treatment. Specimens were then cyclically immersed in demineralizing and remineralizing solutions for one month at 37 °C to simulate the pH changes occurring in the oral environment. Microradiographs of all specimens were taken before and after treatment. Results: Quantitative digital image analysis of matched areas from the contact microradiographs taken before and after treatment indicated higher mineral recovery with ACP composites compared to the commercial orthodontic F-releasing cement (14.4 % vs. 4.3 %, respectively), while the control specimens showed an average of 55.4 % further demineralization. Significance: Experimental ACP composite efficiently established mineral ion transfer throughout the body of the lesions and restored the mineral lost due to acid attack. It can be considered a useful adjuvant for the control of caries in orthodontic applications. PMID:19215975

  1. Effects of common beverages on the development of cervical erosion lesions.

    PubMed

    Bassiouny, Mohamed A

    2009-01-01

    Dental erosion is a demineralization process that affects hard dental tissues (such as enamel and dentin), independent of any microbial action. This study evaluated certain common beverages and their abilities to initiate cervical erosion lesions. The progression of these lesions was monitored in an accelerated test condition over the duration of 20 weeks. Morphotopographic and radiographic profile assessments of the disassociated human teeth in vitro illustrated the differences of each tested fluid's potential to cause erosion. The outcome of the erosion process was found to be acidic fluid-specific. Unlike caries, which progresses in a triangulated fashion, the erosion lesions in enamel and dentin both appeared to progress in a pattern characterized by incremental decalcification in a parallel plane. The disparity between the changes of the radiographic and photographic images of the involved tissues (enamel and dentin) reflected the differences in terms of the inorganic and organic contents of each one. Close examination of the dynamic changes in the cervical region of the disassociated human teeth revealed the mechanism of cervical erosion lesion formation that was a coincidental finding of this study's results.

  2. Clinical validation of the use of fluorescence for the early detection of dental caries

    NASA Astrophysics Data System (ADS)

    Stookey, George K.; Isaacs, Roger L.; Ferreira Zandona, Andrea G.; Ando, Masatoshi; Gonzalez, Carlos; Mau, Melissa S.; Kelly, Sue A.; Analoui, Mostafa

    1999-05-01

    A clinical investigation was conducted in children to validate the use of fluorescence for the early detection of dental caries. A total of 150 children were examined for the presence of dental caries at baseline and at 4-month intervals for one year using conventional visual-tactile with and without a dental explorer, electrical conductivity and light fluorescence methods on the occlusal, buccal and lingual tooth surfaces. Interproximal tooth surfaces were examined using conventional film and direct digital radiography at baseline and 12 months. Validation of the clinical methods was performed by the histologic examination of exfoliated primary teeth. The results indicate that visual-tactile examinations with an explorer detected more carious lesions than similar examinations without an explorer. The use of quantitative light fluorescence permitted the detection of a substantially greater number of enamel lesions or demineralized areas than the conventional visual-tactile-radiographic diagnostic procedure. Further, the use of the quantitative light fluorescence permitted the monitoring of both the progression of regression of early carious lesions.

  3. Dental depth profilometry using simultaneous frequency-domain infrared photothermal radiometry and laser luminescence for the diagnosis of dental caries

    NASA Astrophysics Data System (ADS)

    Nicolaides, Lena; Garcia, Jose A.; Mandelis, Andreas; Abrams, Stephen H.

    2001-04-01

    Frequency-domain IR photothermal radiometry is introduced as a dynamic dental diagnostic tool and its main features are compared with modulated laser luminescence for quantifying sound and carious enamel or dentin. Dental caries found in the fissures or grooves of teeth is very difficult to diagnose or quantify with the present clinical techniques. Visual examination and dental radiographs do not detect the presence of decay until there has been significant carious destruction of the tooth. A high-spatial-resolution dynamic experimental imaging set-up, which can provide simultaneous measurements of laser-induced frequency-domain IR photothermal radiometric and luminescence signals form defects in teeth, was developed. Following optical absorption of laser photons, the new set-up can monitor simultaneously and independently the non-radiative conversion, and the radiative de-excitation in turbid media such as hard dental tissue. This work is intended to show the complementarity between modulated luminescence and photothermal frequency scans in detecting carious lesions in teeth. A sound extracted molar with a dentin-enamel interface was introduced to examine the depth profilometric abilities of the method. Occlusal surfaces of teeth with potential areas of demineralization or carious destruction in the fissures were examined and compared to the signals produced by the sound enamel establishing the depth profilometric abilities of the method. The significance to clinical dentistry lies in the potential of this technique to detect and monitor early carious lesions in the pits and fissures of teeth.

  4. Nondestructive monitoring of the repair of enamel artificial lesions by an acidic remineralization model using polarization – sensitive optical coherence tomography

    PubMed Central

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

    2011-01-01

    Objectives It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Methods Artificial lesions approximately 100–150 µm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT. Results Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion. Conclusion This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone. PMID:22204914

  5. The aetiology of dental caries--an outline of current thought.

    PubMed

    Levine, R S

    1977-12-01

    Nearly 90 years after being put forward by W.D. Miller, the acidogenic theory of dental caries aetiology is supported by a wealth of experimental evidence. However, while explaining the basic mechanism of caries, it does not indicate how the effect of the mechanism is modified to give the observable pattern of caries attack. This explanation is attempted on the basis of the interaction of two groups of variable factors. Firstly, those which affect the tooth's resistance to caries attack, which include the chemical, microstructural and morphological nature of the enamel surface. Secondly the factors which determine the cariogenicity of the tooth's environment. These include the nature of the diet, plaque and saliva. Finally the caries initiation is considered at an atomic level in terms of the dynamic ionic exchange between enamel and plaque. This brief review highlights the need for considerably more research to shed more light on the nature of the variable aetiological factors of caries.

  6. Approaches to Arresting Dental Caries: An Update

    PubMed Central

    Puranik, Manjunath P.; K.R., Sowmya

    2015-01-01

    Background Dental caries is one of the most prevalent chronic oral diseases across the globe that can be both treated and prevented. Preventive management strategies can effectively arrest and even completely reverse the caries process. This article aimed to review the literature on different approaches explored towards arresting caries progression. Materials and Methods Literature search of publications in Pubmed/Medline was carried out. Total 73 articles including clinical trials, invitro studies, case reports and review articles were reviewed. Results Twenty-two clinical trials and invitro studies were selected for review. Most studies suggested use of Silver Diamine Fluoride (SDF) as simple and effective caries arresting approach. Fluoride varnish treatment effectively arrests caries by inhibiting demineralization, resulting in highly significant caries reductions. Arginine with an insoluble calcium compound enhances arresting and reversing buccal, coronal and root caries. A few clinical studies have shown that sealants placed in caries fissures can arrest the caries process. Conclusion Various fluoride containing agents are clinically effective in arresting progression of carious lesion. However, these materials should be used appropriately understanding their scope and limitations to arrest dental caries. PMID:26155592

  7. Evaluation of cross-polarized near infrared hyperspectral imaging for early detection of dental caries

    NASA Astrophysics Data System (ADS)

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

    2012-01-01

    Despite major improvements in dental healthcare and oral hygiene, dental caries remains one of the most prevalent oral diseases and represents the primary cause of oral pain and tooth loss. The initial stages of dental caries are characterized by demineralization of enamel crystals and are difficult to diagnose. Near infrared (NIR) hyperspectral imaging is a new promising technique for detection of early changes in the surfaces of carious teeth. This noninvasive imaging technique can characterize and differentiate between the sound tooth surface and initial or advanced tooth caries. The absorbing and scattering properties of dental tissues reflect in distinct spectral features, which can be measured, quantified and used to accurately classify and map different dental tissues. Specular reflections from the tooth surface, which appear as bright spots, mostly located around the edges and the crests of the teeth, act as a noise factor which can significantly interfere with the spectral measurements and analysis of the acquired images, degrading the accuracy of the classification and diagnosis. Employing cross-polarized imaging setup can solve this problem, however has yet to be systematically evaluated, especially in broadband hyperspectral imaging setups. In this paper, we employ cross-polarized illumination setup utilizing state-of-the-art high-contrast broadband wire-grid polarizers in the spectral range from 900 nm to 1700 nm for hyperspectral imaging of natural and artificial carious lesions of various degrees.

  8. Light-emitting diode and laser fluorescence-based devices in detecting occlusal caries.

    PubMed

    Rodrigues, Jonas A; Hug, Isabel; Neuhaus, Klaus W; Lussi, Adrian

    2011-10-01

    The aim of this study was to assess the performance of two light-emitting diode (LED)- and two laser fluorescence-based devices in detecting occlusal caries in vitro. Ninety-seven permanent molars were assessed twice by two examiners using two LED- (Midwest Caries - MID and VistaProof - VP) and two laser fluorescence-based (DIAGNOdent 2095 - LF and DIAGNOdent pen 2190 - LFpen) devices. After measuring, the teeth were histologically prepared and classified according to lesion extension. At D1 the specificities were 0.76 (LF and LFpen), 0.94 (MID), and 0.70 (VP); the sensitivities were 0.70 (LF), 0.62 (LFpen), 0.31 (MID), and 0.75 (VP). At D(3) threshold the specificities were 0.88 (LF), 0.87 (LFpen), 0.90 (MID), and 0.70 (VP); the sensitivities were 0.63 (LF and LFpen), 0.70 (MID), and 0.96 (VP). Spearman's rank correlations with histology were 0.56 (LF), 0.51 (LFpen), 0.55 (MID), and 0.58 (VP). Inter- and intraexaminer ICC values were high and varied from 0.83 to 0.90. Both LF devices seemed to be useful auxiliary tools to the conventional methods, presenting good reproducibility and better accuracy at D(3) threshold. MID was not able to differentiate sound surfaces from enamel caries and VP still needs improvement on the cut-off limits for its use.

  9. Caries Experience and Periodontal Status during Pregnancy in a Group of Pregnant Women with HIV+ Infections from Puerto Rico

    PubMed Central

    López, Lydia M; Guerra, María Elena

    2016-01-01

    Objectives The aim of this study was to determine the caries rate and periodontal status in a sample of pregnant women with HIV+ infections from Puerto Rico. Methods A pilot study was conducted on a cross sectional convenience sample of 25 pregnant women with HIV+ infections from Puerto Rico who visit the CEMI clinic (Centro de Estudios Materno Infantil) at the University of Puerto Rico. The women subjects were evaluated for caries, DMFT (D: Decay tooth; M: Missing tooth due to caries; F: Filled tooth) index, oral lesions associated with HIV+/AIDS and periodontal disease parameters, with a Florida probe by a calibrated dentist on periodontal indexes such as as bleeding on probing, CEJ (cemento-enamel junction) and pocket depth. Periodontal disease was classified as having 4 sites with pocket depth greater than 4 mm and caries were identified following the Radike criteria. Data was statistically analyzed using the SSPS Program (Statistical Software Program for Social Sciences) and descriptive statistics were calculated. Results Mean DT (decayed teeth), MT (missing teeth due to caries), FT (filled teeth) and DMFT (decay, missing and filled teeth) were 4.8, 1.86, 5.3 and 12, respectively; mean sites of bleeding on probing=12.06; mean sites with pocket depth>4 mm=6.95 and mean sites with loss of attachment greater than 4 mm=7.66. [Almost 50% of the patients had generalized chronic periodontitis. A 72% prevalence of periodontal disease was found. No oral lesions related to HIV+/AIDS were reported. CD4 and viral load was statistically associated with bleeding on probing and severe signs of periodontal disease. Conclusions High levels of dental disease were found in pregnant women with HIV+/AIDS infections from Puerto Rico, and these women were in need of substantial dental services.

  10. Near-IR imaging of interproximal lesions from occlusal surfaces and the influence of stains and plaque

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Bühler, Christopher M.; Ngaotheppitak, Patara; Darling, Cynthia L.

    2006-02-01

    Dental enamel manifests high transparency in the near-IR (NIR). Our previous work demonstrated that NIR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) and that it can also be used to image decay in the pits and fissures of the occlusal (biting) surfaces of posterior teeth where most new dental decay occurs. Early occlusal lesions cannot be detected by x-rays during the early stages of lesion development due to the overlapping topography of the crown of the tooth. Stains and non-calcified plaque are not visible in the NIR enabling better discrimination of demineralized areas. We also demonstrate that interproximal lesions can be imaged from the occlusal surface (from above). Moreover, multiple illumination and detector angles can be exploited for optimal contrast between caries and sound tissue. These measurements suggest that NIR imaging offers significant advantages over the conventional visual, tactile and radiographic caries detection methods and other optical caries detection and imaging techniques.

  11. In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate effect on the shear bond strength of dental adhesives to enamel

    PubMed Central

    Shadman, Niloofar; Ebrahimi, Shahram Farzin; Shoul, Maryam Azizi; Sattari, Hasti

    2015-01-01

    Background: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is applied for remineralization of early caries lesions or tooth sensitivity conditions and may affect subsequent resin bonding. This in vitro study investigated the effect of CPP-ACP on the shear bond strength of dental adhesives to enamel. Materials and Methods: Sixty extracted human molar teeth were selected and randomly divided into three groups and six subgroups. Buccal or lingual surfaces of teeth were prepared to create a flat enamel surface. Adhesives used were Tetric N-Bond, AdheSE and AdheSE One F. In three subgroups, before applying adhesives, enamel surfaces were treated with Tooth Mousse CPP-ACP for one hour, rinsed and stored in 37°C temperature with 100% humidity. This procedure was repeated for 5 days and then adhesives were applied and Tetric N-Ceram composite was adhered to the enamel. This procedure was also fulfilled for the other three subgroups without CPP-ACP treatment. After 24 hour water storage, samples were tested for shear bond strength test in a universal testing machine. Failure modes were determined by stereomicroscope. Data were analyzed by t-test and one-way analysis of variance with P < 0.05 as the level of significance. Results: In comparison between applied and non-applied CPP-ACP subgroups, there was no significant decrease in the shear bond strength to enamel only in Tetric N-Bond (P > 0.05). In non-applied CPP-ACP subgroups, there were statistically significant differences among all subgroups. Tetric N-Bond had the highest and AdheSE One F had the lowest shear bond strength. Conclusion: CPP-ACP application reduces the shear bond strength of AdheSE and AdheSE One F to enamel but not Tetric N-Bond. PMID:25878683

  12. Enamel of primary teeth--morphological and chemical aspects.

    PubMed

    Sabel, Nina

    2012-01-01

    degree of mineralization and the chemical content of the enamel exposed. In a more porous enamel, deeper lesions will develop. The posteruptive maturation has a beneficial effect on the enamel's resistance to demineralization.

  13. Developmental Defects of Enamel in Children with Intellectual Disability

    PubMed Central

    Erika, Vesna; Modrić; Karlović, Zoran

    2016-01-01

    Objectives To investigate the frequency of developmental defects of enamel (DDE) in children with intellectual disability. Subjects and methods Children aged 5–18 years (72 children with intellectual disabilities and 72 controls) were included in the study. All the teeth were screened for developmental defects of enamel using the modified Developmental defects of enamel (mDDE) index. Results Out of the 72 children with intellectual disabilities in this study, 20 (27.78%) presented dental defects of enamel, compared with 8 (11.11%) of those in the control group, which was considered statistically significant (p = 0.021). The majority of children in both groups had white demarcated opacities. Children in both groups were more likely to have maxillary teeth affected than the mandibular teeth and the asymmetrical demarcated enamel defects were more common than the symmetric ones. Majority of opacities in children in both groups were on the maxillary incisors. Conclusions Children with intellectual disabilities have more developmental defects of enamel than children in the control group. Enamel defects increase caries risk and cause reduction in enamel mechanical properties leading to restoration failures.

  14. Developmental Defects of Enamel in Children with Intellectual Disability

    PubMed Central

    Erika, Vesna; Modrić; Karlović, Zoran

    2016-01-01

    Objectives To investigate the frequency of developmental defects of enamel (DDE) in children with intellectual disability. Subjects and methods Children aged 5–18 years (72 children with intellectual disabilities and 72 controls) were included in the study. All the teeth were screened for developmental defects of enamel using the modified Developmental defects of enamel (mDDE) index. Results Out of the 72 children with intellectual disabilities in this study, 20 (27.78%) presented dental defects of enamel, compared with 8 (11.11%) of those in the control group, which was considered statistically significant (p = 0.021). The majority of children in both groups had white demarcated opacities. Children in both groups were more likely to have maxillary teeth affected than the mandibular teeth and the asymmetrical demarcated enamel defects were more common than the symmetric ones. Majority of opacities in children in both groups were on the maxillary incisors. Conclusions Children with intellectual disabilities have more developmental defects of enamel than children in the control group. Enamel defects increase caries risk and cause reduction in enamel mechanical properties leading to restoration failures. PMID:27688428

  15. Alterations in enamel remineralization in vitro induced by blue light

    NASA Astrophysics Data System (ADS)

    Kato, I. T.; Zezell, D. M.; Mendes, F. M.; Wetter, N. U.

    2010-06-01

    Blue light, especially from LED devices, is a very frequently used tool in dental procedures. However, the investigations of its effects on dental enamel are focused primarily on enamel demineralization and fluoride retention. Despite the fact that this spectral region can inhibit enamel demineralization, the effects of the irradiation on demineralized enamel are not known. For this reason, we evaluated the effects of blue LED on remineralization of dental enamel. Artificial lesions were formed in bovine dental enamel blocks by immersing the samples in undersaturated acetate buffer. The lesions were irradiated with blue LED (455 nm, 1.38 W/cm2, 13.75 J/cm2, and 10 s) and remineralization was induced by pH-cycling process. Cross-sectional hardness was used to asses mineral changes after remineralization. Non-irradiated enamel lesions presented higher mineral content than irradiated ones. Furthermore, the mineral content of irradiated group was not significantly different from the lesion samples that were not submitted to the remineralization process. Results obtained in the present study show that the blue light is not innocuous for the dental enamel and inhibition of its remineralization can occur.

  16. Selective removal of demineralized enamel using a CO2 laser coupled with near-IR reflectance imaging

    NASA Astrophysics Data System (ADS)

    Tom, Henry; Chan, Kenneth H.; Saltiel, Daniel; Fried, Daniel

    2015-02-01

    Detection and diagnosis of early dental caries lesions can be difficult due to variable tooth coloration, staining of the teeth and poor contrast between sound and demineralized enamel. These problems can be overcome by using near-infrared (NIR) imaging. Previous studies have demonstrated that lasers can be integrated with NIR imaging devices, allowing image-guided ablation. The aim of this study was to demonstrate that NIR light at 1500 - 1700 nm can be used to guide a 9.3-μm CO2 laser for the selective ablation of early demineralization on tooth occlusal surfaces. The occlusal surfaces of ten sound human molars were used in this in-vitro study. Shallow simulated caries lesions of varying depth and position were produced on tooth occlusal surfaces using a demineralization solution. Sequential NIR reflectance images at 1500 - 1700 nm were used to guide the laser for selective ablation of the lesion areas. Digital microscopy and polarization sensitive optical coherence tomography (PS-OCT) were used to assess the selectivity of removal. This study demonstrates that high contrast NIR reflectance images can be used for the image-guided laser ablation of early demineralization from tooth occlusal surfaces.

  17. Caries, Periodontal Disease, Supernumerary Teeth and Other Dental Disorders in Swedish Wild Boar (Sus scrofa).

    PubMed

    Malmsten, A; Dalin, A-M; Pettersson, A

    2015-07-01

    Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated.

  18. Caries, Periodontal Disease, Supernumerary Teeth and Other Dental Disorders in Swedish Wild Boar (Sus scrofa).

    PubMed

    Malmsten, A; Dalin, A-M; Pettersson, A

    2015-07-01

    Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated. PMID:25979683

  19. The caries assessment spectrum and treatment (CAST) instrument: its reproducibility in clinical studies.

    PubMed

    de Souza, Ana Luiza; Bronkhorst, Ewald M; Creugers, Nico H J; Leal, Soraya C; Frencken, Jo E

    2014-08-01

    A new caries assessment instrument, the Caries Assessment Spectrum and Treatment (CAST), was developed. It covers carious lesion progression from no lesion, sealants and restorations to lesions in enamel and dentine, advanced stages in pulpal and tooth-surrounding tissues, and tooth loss owing to dental caries, in nine codes. The objective of this study was to determine the reproducibility of the CAST instrument in primary and permanent dentitions, using three age groups. Two epidemiological surveys were conducted in Brazil, covering three age groups: 2-6-year-old and 6-9-year-old children and 19-30-year-old adults. Four trained and calibrated examiners performed the examinations. Reproducibility was calculated for intra- and inter-examiner at surface and tooth levels and expressed as unweighted kappa-coefficient value (κ) and percentage of agreement (Po) for CAST codes (0-7) and for the categories healthy (0-2) versus diseased (3-7), and non-cavitated (0-3) versus cavitated (4-7) teeth. Using CAST codes (0-7) for the 2-6-year-old age group in primary dentitions, inter-examiner consistency was κ = 0.74 and Po was 98.3%. In the 6-9-year-old age group in primary dentitions, inter-examiner consistency ranged from κ = 0.68 to κ = 0.86 and Po was ≥ 93.7%. In the 19-30-year-old age group inter-examiner consistency was κ = 0.87 and Po was 94.1%. The reproducibility of the CAST instrument for use in the primary dentition of 2-6-year olds and of 6-9-year olds was 'substantial' to 'almost perfect'. The reproducibility for its use in the permanent dentition of 19-30-year olds was 'almost perfect'. The CAST instrument can reliably be applied in epidemiological studies covering these ages.

  20. Esthetic improvement of white spot lesions and non-pitted fluorosis using resin infiltration technique: series of four clinical cases.

    PubMed

    Gugnani, Neeraj; Pandit, I K; Goyal, Virinder; Gugnani, Shalini; Sharma, Jyoti; Dogra, Shikha

    2014-01-01

    White opacities have always been a major concern of esthetics for patients and can have varying etiology. In general, white discolorations of enamel might be due to dental fluorosis, early caries (white spot lesions), developmental defects etc. Conventional treatment options available for such opacities include non-invasive and invasive approaches. Recently, a new "micro-invasive" technique has been introduced as an alternative therapeutic approach that improves such opacities esthetically, in a single sitting, is painless and exhibits no complications. This case series illustrates the use of resin infiltration to treat fluorosis stains and WSLs, exhibiting significant improvement in esthetics.

  1. Investigation of EPR signals on tooth enamel

    NASA Astrophysics Data System (ADS)

    Pavlenko, A.; Mironova-Ulmane, N.; Polakov, M.; Riekstina, D.

    2007-12-01

    Calcified tissues are involved in continues metabolic process in human organism exchanging a number of chemical elements with environment. The rate of biochemical reactions is tissue dependent and the slowest one at the tooth enamel, the most mineralized tissue of human organism. The long time stability and unique chemical composition make tooth enamel suitable for number of application. The assessment of individual radiation dose by Electron Paramagnetic Resonance (EPR) and evaluations of elemental composition by Instrumentation Neutron Activation Analysis (INAA) are the well known procedures where properties of tooth enamel intensively used. The current work is focused on investigation of EPR signals and determination of chemical composition on several teeth samples having different origin. The EPR spectra and INAA element content of milk tooth, caries tooth, and paradantose tooth have been compared to each other. The results showed that the intensity of EPR signal is much higher for the caries tooth than the for paradantose tooth that is in agreement with depleted Ca content.

  2. COMPARISON OF CHILDREN'S FOLLOW-ON INSTANT POWDERED COW'S MILK FORMULA, BUFFALO MILK FORMULA AND CHICKEN-BASED FORMULA ON ENAMEL MICROHARDNESS OF BOVINE TEETH IN VITRO.

    PubMed

    Vongsavan, Kadkao; Rirattanapong, Praphasri; Surarit, Rudee

    2016-03-01

    Dental caries are a major public health problem worldwide. The aim of this study was to compare the effects of children's follow-on instant powdered cow's milk formula, buffalo milk formula and a chicken-based formula on microhardness of bovine enamel with artificial caries-like lesions. Forty bovine teeth were each placed in acrylic blocks and the enamel surfaces were polished to create flat 5 x 5 millimeter surfaces. The teeth surfaces were then demineralized using 0.1M lactic acid (pH 4.5) to achieve an enamel microhardness of 35-65 Vickers Hardness Numbers (VHN). All specimens were then randomly allocated into one of 4 groups (n=10/group). For remineralization, each group was soaked in a different kind of milk formula for 2 hours at 37°C except group 1 which was a negative control (artificial saliva) group. Group 2 was soaked in Murrah™ buffalo milk formula (a positive control ), group 3 in S-26-Promil-Gold™ (cow's milk formula) and group 4 in a chicken-based formula (Siriraj Hospital, Mahidol University). The microhardness of the specimens was then measured again. Data were analyzed using a one-way ANOVA and paired t-test with a 95% confidence interval. After exposure to the formula, the mean VHN for each study group was significantly higher (paired t-test, p < 0.05) except for group 1 (p = 0.345). The mean VHN for the the Murrah™ buffalo milk formula, the chicken-based formula and the S-26-Promil-Gold™ formula group were not significantly different from each other (one-way ANOVA, p > 0.05). In conclusion, S-26-Promil-Gold™ follow-on cow milk formula, Murrah™ buffalo milk formula and the chicken-based formula all increased bovine enamel microhardness after soaking for 2 hours. PMID:27244971

  3. Detection of early caries by laser-induced breakdown spectroscopy

    NASA Astrophysics Data System (ADS)

    Sasazawa, Shuhei; Kakino, Satoko; Matsuura, Yuji

    2015-07-01

    To improve sensitivity of dental caries detection by laser-induced breakdown spectroscopy (LIBS) analysis, it is proposed to utilize emission peaks in the ultraviolet. We newly focused on zinc whose emission peaks exist in ultraviolet because zinc exists at high concentration in the outer layer of enamel. It was shown that by using ratios between heights of an emission peak of Zn and that of Ca, the detection sensitivity and stability are largely improved. It was also shown that early caries are differentiated from healthy part by properly setting a threshold in the detected ratios. The proposed caries detection system can be applied to dental laser systems such as ones based on Er:YAG-lasers. When ablating early caries part by laser light, the system notices the dentist that the ablation of caries part is finished. We also show the intensity of emission peaks of zinc decreased with ablation with Er:YAG laser light.

  4. Contribution to the physicochemical rationale for the caries reducing effect of fluoride.

    PubMed

    Driessens, F C; Van Dijk, J W; Borggreven, J M; Verbeeck, R M

    1980-09-01

    The effect of fluoride on the stability of apatites containing Na+ and CO3(2)- ions is described qualitatively. Also the boundaries of the apatite stability field in the quasi-septary system CaO - P2O5 - H2O - Na2O - CO2 - NaF - MX are presented. At these boundaries brushite (or monetite), octocalciumphosphate, calcite and calcium fluoride can become stable solid phases. As a consequence, certain mechanisms for the caries reducing effect of fluoride gain probability over other proposed mechanisms. First, it is likely that endemic fluoride yields more fully mineralized enamel which in turn results in a lower initial rate of the caries process. Second, after eruption the mineral in the tooth superficial layer is bound to accumulate fluoride on the surface of its crystals. This causes a slower rate of the crystal surface dissolution at that site and, hence, a thicker and denser intact superficial layer over the lesion. Finally, the formation of a precipitate of fluorhydroxyapatite and perhaps also of calcium fluoride is promoted in the plaque during cycles of metabolic activity. Subsequent dissolution of the CaF2 and transformation of the fluorhydroxyapatite sets free Ca+ and F- ions. Both of these ions promote the remineralization of the lesion during periods of metabolic rest whereby brushite or monetite are transformed back into apatite.

  5. Biological synthesis of tooth enamel instructed by an artificial matrix.

    PubMed

    Huang, Zhan; Newcomb, Christina J; Bringas, Pablo; Stupp, Samuel I; Snead, Malcolm L

    2010-12-01

    The regenerative capability of enamel, the hardest tissue in the vertebrate body, is fundamentally limited due to cell apoptosis following maturation of the tissue. Synthetic strategies to promote enamel formation have the potential to repair damage, increase the longevity of teeth and improve the understanding of the events leading to tissue formation. Using a self-assembling bioactive matrix, we demonstrate the ability to induce ectopic formation of enamel at chosen sites adjacent to a mouse incisor cultured in vivo under the kidney capsule. The resulting material reveals the highly organized, hierarchical structure of hydroxyapatite crystallites similar to native enamel. This artificially triggered formation of organized mineral demonstrates a pathway for developing cell fabricated materials for treatment of dental caries, the most ubiquitous disease in man. Additionally, the artificial matrix provides a unique tool to probe cellular mechanisms involved in tissue formation further enabling the development of tooth organ replacements.

  6. Australopithecine enamel prism patterns.

    PubMed

    Vrba, E S; Grine, F E

    1978-11-24

    Following a recent suggestion that tooth enamel prism shape differs within Hominoidea, the teeth of a number of extinct and extant hominoid species were analyzed by scanning electron microscopy. The enamel prism patterns of some gracile and robust australopithecine specimens from Sterkfontein, Swartkrans, and Kromdraai are recorded. The characteristic arrangements of enamel prisms in all modern and extinct hominoid species were found to be essentially similar. The implications of enamel prisms for phylogenetic deduction in Hominoidea are discussed. PMID:102032

  7. Caries infiltration with resins: a novel treatment option for interproximal caries.

    PubMed

    Phark, Jin-Ho; Duarte, Sillas; Meyer-Lueckel, Hendrik; Paris, Sebastian

    2009-10-01

    Noninvasive (preventive) measures involving fluoridation, dietary control, and oral hygiene instruction, as well as invasive restorative methods, are the standard treatment options for interproximal caries. Intermediate treatment options, similar to pit-and-fissure sealing on occlusal surfaces that has been shown to be effective in preventing and inhibiting caries, have not yet been established on interproximal surfaces. Recently, the application of resins on interproximal caries lesions has been studied and improved, leading to the development of new materials, which infiltrate and seal the carious lesion, improving the inhibition of caries progression. Clinical data show this new technique complements existing treatment options for interproximal caries by delaying the time point for a restoration and consequently closing the gap between noninvasive and invasive treatment options.

  8. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    NASA Astrophysics Data System (ADS)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  9. Development of Amelogenin-chitosan Hydrogel for In Vitro Enamel Regrowth with a Dense Interface

    PubMed Central

    Ruan, Qichao; Moradian-Oldak, Janet

    2014-01-01

    Biomimetic enamel reconstruction is a significant topic in material science and dentistry as a novel approach for the treatment of dental caries or erosion. Amelogenin has been proven to be a critical protein for controlling the organized growth of apatite crystals. In this paper, we present a detailed protocol for superficial enamel reconstruction by using a novel amelogenin-chitosan hydrogel. Compared to other conventional treatments, such as topical fluoride and mouthwash, this method not only has the potential to prevent the development of dental caries but also promotes significant and durable enamel restoration. The organized enamel-like microstructure regulated by amelogenin assemblies can significantly improve the mechanical properties of etched enamel, while the dense enamel-restoration interface formed by an in situ regrowth of apatite crystals can improve the effectiveness and durability of restorations. Furthermore, chitosan hydrogel is easy to use and can suppress bacterial infection, which is the major risk factor for the occurrence of dental caries. Therefore, this biocompatible and biodegradable amelogenin-chitosan hydrogel shows promise as a biomaterial for the prevention, restoration, and treatment of defective enamel. PMID:25046057

  10. Near Infrared Imaging as a Diagnostic Tool for Detecting Enamel Demineralization: An in vivo Study

    NASA Astrophysics Data System (ADS)

    Lucas, Seth Adam

    Background and Objectives: For decades there has been an effort to develop alternative optical methods of imaging dental decay utilizing non-ionizing radiation methods. The purpose of this in-vivo study was to demonstrate whether NIR can be used as a diagnostic tool to evaluate dental caries and to compare the sensitivity and specificity of this method with that of conventional methods, including bitewing x-rays and visual inspection. Materials and Methods: 31 test subjects (n=31) from the UCSF orthodontic clinic undergoing orthodontic treatment with planned premolar extractions were recruited. Calibrated examiners performed caries detection examinations using conventional methods: bitewing radiographs and visual inspection. These findings were compared with the results from NIR examinations: transillumination and reflectance. To confirm the results found in the two different detection methods, a gold standard was used. After teeth were extracted, polarized light microscopy and transverse microradiography were performed. Results: A total of 87 premolars were used in the study. NIR identified the occlusal lesions with a sensitivity of 71% and a specificity of 77%, whereas, the visual examination had a sensitivity of only 40% and a specifity of 39%. For interproximal lesions halfway to DEJ, specificity remained constant, but sensitivity improved to 100% for NIR and 75% for x-rays. Conclusions: The results of this preliminary study demonstrate that NIR is just as effective at detecting enamel interproximal lesions as standard dental x-rays. NIR was more effective at detecting occlusal lesions than visual examination alone. NIR shows promise as an alternative diagnostic tool to the conventional methods of x-rays and visual examination and provides a non-ionizing radiation technique.

  11. Type VII collagen deficiency causes defective tooth enamel formation due to poor differentiation of ameloblasts.

    PubMed

    Umemoto, Hiroko; Akiyama, Masashi; Domon, Takanori; Nomura, Toshifumi; Shinkuma, Satoru; Ito, Kei; Asaka, Takuya; Sawamura, Daisuke; Uitto, Jouni; Uo, Motohiro; Kitagawa, Yoshimasa; Shimizu, Hiroshi

    2012-11-01

    Recessive dystrophic epidermolysis bullosa (RDEB) is caused by mutations in the gene encoding type VII collagen (COL7), a major component of anchoring fibrils in the epidermal basement membrane zone. Patients with RDEB present a low oral hygiene index and prevalent tooth abnormalities with caries. We examined the tooth enamel structure of an RDEB patient by scanning electron microscopy. It showed irregular enamel prisms, indicating structural enamel defects. To elucidate the pathomechanisms of enamel defects due to COL7 deficiency, we investigated tooth formation in Col7a1(-/-) and COL7-rescued humanized mice that we have established. The enamel from Col7a1(-/-) mice had normal surface structure. The enamel calcification and chemical composition of Col7a1(-/-) mice were similar to those of the wild type. However, transverse sections of teeth from the Col7a1(-/-) mice showed irregular enamel prisms, which were also observed in the RDEB patient. Furthermore, the Col7a1(-/-) mice teeth had poorly differentiated ameloblasts, lacking normal enamel protein-secreting Tomes' processes, and showed reduced mRNA expression of amelogenin and other enamel-related molecules. These enamel abnormalities were corrected in the COL7-rescued humanized mice expressing a human COL7A1 transgene. These findings suggest that COL7 regulates ameloblast differentiation and is essential for the formation of Tomes' processes. Collectively, COL7 deficiency is thought to disrupt epithelial-mesenchymal interactions, leading to defective ameloblast differentiation and enamel malformation in RDEB patients.

  12. Early detection of dental caries using photoacoustics

    NASA Astrophysics Data System (ADS)

    Kim, K.; Witte, R.; Koh, I.; Ashkenazi, S.; O'Donnell, M.

    2006-02-01

    For decades, visual, tactile and radiographic examinations have been the standard for diagnosing caries. Nonetheless, the extent of variation in the diagnosis of dental caries is substantial among dental practitioners using these traditional techniques. Therefore, a more reliable standard for detecting incipient caries would be desirable. Using photoacoustics, near-infrared (NIR) optical contrast between sound and carious dental tissues can be relatively easily and accurately detected at ultrasound resolution. In this paper, a pulsed laser (Nd:YAG, Quanta-Ray) was used to probe extracted human molars at different disease stages determined from periapical radiographs. Both fundamental (1064nm) and first harmonic (532nm) pulses (15ns pulse length, 100mJ at fundamental and 9mJ at first harmonic , 10Hz pulse repetition rate) were used to illuminate the occlusal surface of tooth samples placed in a water tank. The photoacoustic signal was recorded with an unfocused wideband single-element piezoelectric transducer (centered at 12 MHz, bandwidth 15 MHz) positioned at small angle (less than 30 degrees) to the laser beam close to the occlusal surface. At the fundamental wavelength, total photoacoustic energy increases from normal to incipient stage disease by as much as a factor of 10. Differences between photoacoustic energy at the fundamental and first harmonic wavelength further indicate spectral absorption changes of the underlying structure with disease progression. Using a focused laser beam, an extracted molar with suspected incipient caries was scanned along the occulusal surface to help localize the caries inside enamel and dentin. The significantly increasing photoacoustic signal at a specific scan line both at fundamental and first harmonic indicates the local development of the incipient caries. The photoacoustic results compare well with visual inspection after layer by layer dissection. Preliminary results demonstrate the feasibility of detecting incipient

  13. Photodynamic therapy on bacterial reduction in dental caries: in vivo study

    NASA Astrophysics Data System (ADS)

    Baptista, Alessandra; Araujo Prates, Renato; Kato, Ilka Tiemy; Amaral, Marcello Magri; Zanardi de Freitas, Anderson; Simões Ribeiro, Martha

    2010-04-01

    The reduction of pathogenic microorganisms in supragingival plaque is one of the principal factors in caries prevention and control. A large number of microorganisms have been reported to be inactivated in vitro by photodynamic therapy (PDT). The purpose of this study was to develop a rat model to investigate the effects of PDT on bacterial reduction in induced dental caries. Twenty four rats were orally inoculated with Streptococcus mutans cells (ATCC 25175) for three consecutive days. The animals were fed with a cariogenic diet and water with 10% of sucrose ad libitum, during all experimental period. Caries lesion formation was confirmed by Optical Coherence Tomography (OCT) 5 days after the beginning of the experiment. Then, the animals were randomly divided into two groups: Control Group: twelve animals were untreated by either light or photosensitizer; and PDT Group: twelve animals were treated with 100μM of methylene blue for 5min and irradiated by a Light Emitting Diode (LED) at λ = 640+/-30nm, fluence of 172J/cm2, output power of 240mW, and exposure time of 3min. Microbiological samples were collected before, immediately after, 3, 7 and 10 days after treatment and the number of total microaerophiles was counted. OCT images showed areas of enamel demineralization on rat molars. Microbiological analysis showed a significant bacterial reduction after PDT. Furthermore, the number of total microaerophiles in PDT group remained lower than control group until 10 days posttreatment. These findings suggest that PDT could be an alternative approach to reduce bacteria in dental caries.

  14. Enamel craze lines.

    PubMed

    Larson, Thomas D

    2014-01-01

    Enamel craze lines are a common clinical finding, especially in older patients and in patients who brux. These craze lines frequently are discolored and may present as clear in color, grey, or brown. The clinical question is, when do enamel craze lines need restoration and when should we leave them untreated? This review will look at enamel structure and the effects of occlusion, bruxing, temperature, and restorations on enamel structure. Recommendations will be made on how and when to deal with these cosmetic defects of enamel.

  15. Increased enamel hypoplasia and very low birthweight infants.

    PubMed

    Nelson, S; Albert, J M; Geng, C; Curtan, S; Lang, K; Miadich, S; Heima, M; Malik, A; Ferretti, G; Eggertsson, H; Slayton, R L; Milgrom, P

    2013-09-01

    Birth cohort studies of developmental defects of enamel (DDE) and early childhood caries (ECC) in very low birthweight (VLBW) and normal birthweight (NBW) infants are rare. In this birth cohort of 234 VLBW and 234 NBW infants, we report the incidence of ECC and DDE at 8 and 18-20 mos of corrected age. Infant medical and maternal socio-demographic data were abstracted from medical records at birth. Dental assessments for ECC and DDE (enamel hypoplasia, demarcated and diffuse opacities) were completed at 8 and 18-20 mos. The incidence of hypoplasia was significantly higher in VLBW compared with NBW infants (8 mos, 19% vs. 2%; 18 mos, 31% vs. 8%). The incidence of ECC (International Caries Detection and Assessment System: ICDAS ≥ 2) was 1.4% (8 mos) and 12% (18-20 mos) and was similar between the VLBW and NBW groups. At both ages, using a beta-binomial regression model to control for potential confounders (maternal and infant characteristics), we found increased risk for enamel hypoplasia among the VLBW infants compared with the NBW infants. African Americans had a lower risk for enamel hypoplasia at 18-20 mos. The VLBW infants should be monitored for ECC due to the presence of enamel hypoplasia. PMID:23857641

  16. Amelogenin and Enamel Biomimetics

    PubMed Central

    Ruan, Qichao; Moradian-Oldak, Janet

    2015-01-01

    Mature tooth enamel is acellular and does not regenerate itself. Developing technologies that rebuild tooth enamel and preserve tooth structure is therefore of great interest. Considering the importance of amelogenin protein in dental enamel formation, its ability to control apatite mineralization in vitro, and its potential to be applied in fabrication of future bio-inspired dental material this review focuses on two major subjects: amelogenin and enamel biomimetics. We review the most recent findings on amelogenin secondary and tertiary structural properties with a focus on its interactions with different targets including other enamel proteins, apatite mineral, and phospholipids. Following a brief overview of enamel hierarchical structure and its mechanical properties we will present the state-of-the-art strategies in the biomimetic reconstruction of human enamel. PMID:26251723

  17. Multimodal imaging system for dental caries detection

    NASA Astrophysics Data System (ADS)

    Liang, Rongguang; Wong, Victor; Marcus, Michael; Burns, Peter; McLaughlin, Paul

    2007-02-01

    Dental caries is a disease in which minerals of the tooth are dissolved by surrounding bacterial plaques. A caries process present for some time may result in a caries lesion. However, if it is detected early enough, the dentist and dental professionals can implement measures to reverse and control caries. Several optical, nonionized methods have been investigated and used to detect dental caries in early stages. However, there is not a method that can singly detect the caries process with both high sensitivity and high specificity. In this paper, we present a multimodal imaging system that combines visible reflectance, fluorescence, and Optical Coherence Tomography (OCT) imaging. This imaging system is designed to obtain one or more two-dimensional images of the tooth (reflectance and fluorescence images) and a three-dimensional OCT image providing depth and size information of the caries. The combination of two- and three-dimensional images of the tooth has the potential for highly sensitive and specific detection of dental caries.

  18. Lactobacillus-mediated interference of mutans streptococci in caries-free vs. caries-active subjects.

    PubMed

    Simark-Mattsson, Charlotte; Emilson, Claes-Göran; Håkansson, Eva Grahn; Jacobsson, Catharina; Roos, Kristian; Holm, Stig

    2007-08-01

    In order to assess whether naturally occurring oral lactobacilli have probiotic properties, lactobacilli were isolated from saliva and plaque from children and adolescents, with or without caries lesions. The interference capacities of these lactobacilli were investigated against a panel of 13 clinical isolates and reference strains of Streptococcus mutans and Streptococcus sobrinus, as well as against the subject's autologous mutans streptococci, using the agar-overlay technique. Lactobacillus-mediated inhibition differed significantly between the three subject groups (no caries, arrested caries, or active caries), demonstrating increased inhibition in subjects without present or previous caries experience compared to subjects with arrested caries or subjects presenting with frank lesions. Lactobacilli from subjects lacking S. mutans inhibited the growth of the test panel of mutans streptococci significantly better than lactobacilli from subjects who were colonized. Furthermore, subjects without caries experience harbored lactobacilli that more effectively repressed the growth of their autologous mutans streptococci. Twenty-three Lactobacillus spp. completely inhibited the growth of all mutans streptococci tested. Species with maximum interference capacity against mutans streptococci included Lactobacillus paracasei, Lactobacillus plantarum, and Lactobacillus rhamnosus. Naturally occurring oral lactobacilli significantly inhibited the growth of both test strains of mutans streptococci and the subject's autologous mutans streptococci in vitro, and this effect was more pronounced in caries-free subjects.

  19. Use of laser fluorescence in dental caries diagnosis: a fluorescence x biomolecular vibrational spectroscopic comparative study.

    PubMed

    Carvalho, Fabíola Bastos de; Barbosa, Artur Felipe Santos; Zanin, Fátima Antonia Aparecida; Brugnera Júnior, Aldo; Silveira Júnior, Landulfo; Pinheiro, Antonio Luiz Barbosa

    2013-01-01

    The aim of this work was to verify the existence of correlation between Raman spectroscopy readings of phosphate apatite (~960 cm-1), fluoridated apatite (~575 cm-1) and organic matrix (~1450 cm-1) levels and Diagnodent® readings at different stages of dental caries in extracted human teeth. The mean peak value of fluorescence in the carious area was recorded and teeth were divided in enamel caries, dentin caries and sound dental structure. After fluorescence readings, Raman spectroscopy was carried out on the same sites. The results showed significant difference (ANOVA, p<0.05) between the fluorescence readings for enamel (16.4 ± 2.3) and dentin (57.6 ± 23.7) on carious teeth. Raman peaks of enamel and dentin revealed that ~575 and ~960 cm-1 peaks were more intense in enamel caries. There was significant negative correlation (p<0.05) between the ~575 and ~960 cm-1 peaks and dentin caries. It may be concluded that the higher the fluorescence detected by Diagnodent the lower the peaks of phosphate apatite and fluoridated apatite. As the early diagnosis of caries is directly related to the identification of changes in the inorganic tooth components, Raman spectroscopy was more sensitive to variations of these components than Diagnodent.

  20. Dental caries and caries-related periodontitis in type 2 diabetic mice.

    PubMed

    Sano, T; Matsuura, T; Ozaki, K; Narama, I

    2011-03-01

    Diabetic patients are predisposed to periodontal disease as well as dental caries; however, there are contradictory reports about the possible association between dental caries and diabetes. Thus, the authors set out to determine whether diabetes affects onset of dental caries and periodontal disease and to clarify whether dental caries and periodontal disease are associated with each other in diabetic db/db mice. Oral tissue was examined from 68 male mice (diabetic db/db and nondiabetic db/+; aged 20, 30, 40, and 50 weeks) and 20 female mice (db/db and db/+; aged 50 weeks). Macroscopically, caries were seen developing in the diabetic mice by 20 weeks of age. The number of teeth with dental lesions increased with age in the db/db mice at a significantly higher incidence than that of db/+ mice. Histologically, dental caries were detected in 30 of 120 molars in 17 of 20 db/db mice at 50 weeks of age and in 4 of 108 molars in 4 of 18 db/+ mice of the same age. The severity of dental caries in db/db mice was significantly higher than it was in db/+ mice. Dental caries were a primary change that led to bacterial gingivitis and pulpitis. These lesions spread to the dental root and periodontal connective tissue through the apical foramen. Apical periodontitis was more frequent and severe when occurring in close association with dental caries. In conclusion, there is a strong relationship between diabetes and dental caries, but in this model, it is highly probable that the onset of periodontal disease was a secondary change resulting from dental caries.

  1. Comparing potential early caries assessment methods for teledentistry

    PubMed Central

    2013-01-01

    Background Optical caries detection has the potential to be incorporated in telehealth medicine for preventive dental screening. The objective of this study was to evaluate and compare visible and near infrared detection methods for identifying early non-cavitated ex vivo occlusal demineralization. Methods Six blinded examiners were used to compare the accuracy of the following three examinations in detecting occlusal demineralization: Midwest Caries ID™ (MID), visual photographic examination (CAM) and Cross Polarization Optical Coherence Tomography (CP-OCT). For each diagnostic method, two examiners assessed the extracted tooth samples 1–2 weeks apart. Teeth were then sectioned and lesion depth was confirmed (n = 42) by a blinded histological examination using a glycol based caries indicator dye. The sensitivity (Sen), specificity (Sp), Intraclass Correlation Coefficient (ICC), and Area under the Receiver Operator Curve (AUC) were calculated. Results For detecting any demineralization versus sound pit and fissure enamel, the mean Sen/Sp found was 46.9/85.0 for MID, 80.5/52.5 for CAM, and 83.4/45.0 for CP-OCT. For detecting non-cavitated demineralization that progressed into the dentin, the mean Sen/Sp found was 17.3/88.0 for MID, 48.0/57.8 for CAM, and 44.2/72.7 for CP-OCT. AUC values were statistically significant (P < 0.05) in three out of four examiner assessments when MID and CP-OCT were used to detect any demineralization. AUC values were significant for a single CAM examination. When assessing deeper non-cavitated lesions, none of the assessment methods were able to yield AUC values that were significantly different than a random ‘coin flip’ test. When examining reliability, MID demonstrated the highest ICC score (0.83) and CP-OCT had the lowest (0.49). Conclusion Although MID and CP-OCT were useful in detecting the presence of demineralization, examiners were not able to utilize these devices to adequately assess the depth of the

  2. Optical coherence tomography use in the diagnosis of enamel defects

    NASA Astrophysics Data System (ADS)

    Al-Azri, Khalifa; Melita, Lucia N.; Strange, Adam P.; Festy, Frederic; Al-Jawad, Maisoon; Cook, Richard; Parekh, Susan; Bozec, Laurent

    2016-03-01

    Molar incisor hypomineralization (MIH) affects the permanent incisors and molars, whose undermineralized matrix is evidenced by lesions ranging from white to yellow/brown opacities to crumbling enamel lesions incapable of withstanding normal occlusal forces and function. Diagnosing the condition involves clinical and radiographic examination of these teeth, with known limitations in determining the depth extent of the enamel defects in particular. Optical coherence tomography (OCT) is an emerging hard and soft tissue imaging technique, which was investigated as a new potential diagnostic method in dentistry. A comparison between the diagnostic potential of the conventional methods and OCT was conducted. Compared to conventional imaging methods, OCT gave more information on the structure of the enamel defects as well as the depth extent of the defects into the enamel structure. Different types of enamel defects were compared, each type presenting a unique identifiable pattern when imaged using OCT. Additionally, advanced methods of OCT image analysis including backscattered light intensity profile analysis and enface reconstruction were performed. Both methods confirmed the potential of OCT in enamel defects diagnosis. In conclusion, OCT imaging enabled the identification of the type of enamel defect and the determination of the extent of the enamel defects in MIH with the advantage of being a radiation free diagnostic technique.

  3. Optical coherence tomography use in the diagnosis of enamel defects.

    PubMed

    Al-Azri, Khalifa; Melita, Lucia N; Strange, Adam P; Festy, Frederic; Al-Jawad, Maisoon; Cook, Richard; Parekh, Susan; Bozec, Laurent

    2016-03-01

    Molar incisor hypomineralization (MIH) affects the permanent incisors and molars, whose undermineralized matrix is evidenced by lesions ranging from white to yellow/brown opacities to crumbling enamel lesions incapable of withstanding normal occlusal forces and function. Diagnosing the condition involves clinical and radiographic examination of these teeth, with known limitations in determining the depth extent of the enamel defects in particular. Optical coherence tomography (OCT) is an emerging hard and soft tissue imaging technique, which was investigated as a new potential diagnostic method in dentistry. A comparison between the diagnostic potential of the conventional methods and OCT was conducted. Compared to conventional imaging methods, OCT gave more information on the structure of the enamel defects as well as the depth extent of the defects into the enamel structure. Different types of enamel defects were compared, each type presenting a unique identifiable pattern when imaged using OCT. Additionally, advanced methods of OCT image analysis including backscattered light intensity profile analysis and enface reconstruction were performed. Both methods confirmed the potential of OCT in enamel defects diagnosis. In conclusion, OCT imaging enabled the identification of the type of enamel defect and the determination of the extent of the enamel defects in MIH with the advantage of being a radiation free diagnostic technique. PMID:26968386

  4. Effectiveness of chemomechanical caries removal agents Papacarie® and Carie-Care™ in primary molars: An in vitro study

    PubMed Central

    Sahana, Suzan; Vasa, Aron Arun Kumar; Geddam, Divya; Reddy, Vamsi Krishna; Nalluri, Sowjanya; Velagapudi, Nagajyothi

    2016-01-01

    Aims and Objectives: The chemomechanical caries removal system is made presently available containing a natural proteolytic enzyme for ease in the excavation of infected dentin. The aim of the study was to evaluate the efficacy and efficiency of caries removal using Papacarie® and Carie-Care™. Materials and Methods: A total of 30 extracted deciduous molars with proximal caries were collected, and each tooth was sectioned mesiodistally in the center of the carious lesion so that the two halves (buccal and lingual or palatal) have similar carious lesions, thus 30 teeth yielded 60 specimens. The specimens from each tooth were divided alternatively into two groups for caries excavation either using Papacarie® or Carie-Care™ so as to avoid selection bias. Paired t-test was used to compare mean time taken for caries removal and Fischer's exact test was done for comparing bacterial remnants after caries excavation. Results: Mean time taken for caries removal was significantly higher for Carie-Care™ (427.13 s) when compared to Papacarie® (385.8 s). Papacarie® was found to be significantly more efficient in caries removal with marked reduction in the bacterial remnants following excavation. However, both gels were found to be conservative as dentinal tubule destruction was not evident in either of them. Conclusion: Both Papacarie® and Carie-Care™ were found to be conservative in caries removal. Papacarie® was more efficient in removing bacteria in lesser time from the infected carious lesion. PMID:27195222

  5. Assessing caries removal by undergraduate dental students using quantitative light-induced fluorescence.

    PubMed

    Adeyemi, Adejumoke A; Jarad, Fadi D; Komarov, Gleb N; Pender, Neil; Higham, Susan M

    2008-11-01

    The purpose of this study was to compare detection of enamel and dentinal caries by dental students' and faculty members' visual inspection and by quantitative light-induced fluorescence (QLF). The overall aim was to determine whether QLF is an appropriate technique for use in clinical skills laboratories as a teaching aid for dental undergraduates to detect and assess the removal of enamel and dentinal caries. Sixty students who had no clinical experience with dental caries were asked to select . suitably decayed teeth and mount them in plaster. After recording baseline QLF images, students removed caries according to instructions given by the clinical tutor. On completion of the exercise, the teeth were visually determined to be caries-free by the student, then confirmed by the clinical tutor. A fluorescein in alcohol solution was injected into the cavity for two minutes, rinsed, and dried before QLF images were captured. The images were visually analyzed by two examiners for the presence or absence of caries. From seventy-four images recorded, seventeen were excluded due to exposure of the pulp chamber. The remaining fifty-seven teeth, which by clinical visual examination were judged to be caries-free, were examined using QLF. Fifty-three percent were found to be caries-free, while 47 percent were carious. In this sample of fifty-seven teeth judged to be caries-free by both dental students and faculty members, QLF thus detected caries in almost half of these teeth. These findings suggest that QLF is a useful, noninvasive, nondestructive technique for the detection of caries and can serve as an adjunct to chair-side diagnosis and management of dental caries, which is typically accomplished by visual inspection. QLF may be useful and appropriate as an objective clinical teaching aid for the assessment of dental caries.

  6. FT-Raman Spectroscopy Study of the Remineralization of Microwave-Exposed Artificial Caries.

    PubMed

    Kerr, J E; Arndt, G D; Byerly, D L; Rubinovitz, R; Theriot, C A; Stangel, I

    2016-03-01

    Dental caries is a microbially mediated disease that can result in significant tooth structure degradation. Although the preponderance of lesions is treated by surgical intervention, various strategies have been developed for its noninvasive management. Here, we use a novel approach for noninvasive treatment based on killing Streptococcus mutans with high-frequency microwave energy (ME). The rationale for this approach is based on modulating the pH of caries to a physiological state to enable spontaneous tooth remineralization from exogenous sources. In the present study, after demonstrating that ME kills >99% of S. mutans in planktonic cultures, 8 enamel slabs were harvested from a single tooth. Baseline mineral concentration at each of 12 points per slab was obtained using Fourier transform (FT)-Raman spectroscopy. Surface demineralization was subsequently promoted by subjecting all samples to an S. mutans acidic biofilm for 6 d. Half of the samples were then exposed to high-frequency ME, and the other half were used as controls. All samples were next subjected to a remineralization protocol consisting of two 45-min exposures per 24-h period in tryptic soy broth followed by immersion in a remineralizing solution for the remaining period. After 10 d, samples were removed and cleaned. FT-Raman spectra were again obtained at the same 12 points per sample, and the mineral concentration was determined. The effect of the remineralization protocol on the demineralized slabs was expressed as a percentage of mineral loss or gain relative to baseline. The mineral concentration of the microwave-exposed group collectively approached 100% of baseline values, while that of the control group was in the order of 40%. Differences between groups were significant (P = 0.001, Mann-Whitney U test). We concluded that killing of S. mutans by ME promotes effective remineralization of S. mutans-demineralized enamel compared with controls. PMID:26647390

  7. Dental caries imaging using hyperspectral stimulated Raman scattering microscopy

    NASA Astrophysics Data System (ADS)

    Wang, Zi; Zheng, Wei; Jian, Lin; Huang, Zhiwei

    2016-03-01

    We report the development of a polarization-resolved hyperspectral stimulated Raman scattering (SRS) imaging technique based on a picosecond (ps) laser-pumped optical parametric oscillator system for label-free imaging of dental caries. In our imaging system, hyperspectral SRS images (512×512 pixels) in both fingerprint region (800-1800 cm-1) and high-wavenumber region (2800-3600 cm-1) are acquired in minutes by scanning the wavelength of OPO output, which is a thousand times faster than conventional confocal micro Raman imaging. SRS spectra variations from normal enamel to caries obtained from the hyperspectral SRS images show the loss of phosphate and carbonate in the carious region. While polarization-resolved SRS images at 959 cm-1 demonstrate that the caries has higher depolarization ratio. Our results demonstrate that the polarization resolved-hyperspectral SRS imaging technique developed allows for rapid identification of the biochemical and structural changes of dental caries.

  8. Earliest evidence of dental caries manipulation in the Late Upper Palaeolithic

    PubMed Central

    Oxilia, Gregorio; Peresani, Marco; Romandini, Matteo; Matteucci, Chiara; Spiteri, Cynthianne Debono; Henry, Amanda G.; Schulz, Dieter; Archer, Will; Crezzini, Jacopo; Boschin, Francesco; Boscato, Paolo; Jaouen, Klervia; Dogandzic, Tamara; Broglio, Alberto; Moggi-Cecchi, Jacopo; Fiorenza, Luca; Hublin, Jean-Jacques; Kullmer, Ottmar; Benazzi, Stefano

    2015-01-01

    Prehistoric dental treatments were extremely rare, and the few documented cases are known from the Neolithic, when the adoption of early farming culture caused an increase of carious lesions. Here we report the earliest evidence of dental caries intervention on a Late Upper Palaeolithic modern human specimen (Villabruna) from a burial in Northern Italy. Using Scanning Electron Microscopy we show the presence of striations deriving from the manipulation of a large occlusal carious cavity of the lower right third molar. The striations have a “V”-shaped transverse section and several parallel micro-scratches at their base, as typically displayed by cutmarks on teeth. Based on in vitro experimental replication and a complete functional reconstruction of the Villabruna dental arches, we confirm that the identified striations and the associated extensive enamel chipping on the mesial wall of the cavity were produced ante-mortem by pointed flint tools during scratching and levering activities. The Villabruna specimen is therefore the oldest known evidence of dental caries intervention, suggesting at least some knowledge of disease treatment well before the Neolithic. This study suggests that primitive forms of carious treatment in human evolution entail an adaptation of the well-known toothpicking for levering and scratching rather than drilling practices. PMID:26179739

  9. Enamel hypoplasia: challenges of esthetic restorative treatment.

    PubMed

    Ruschel, Vanessa Carla; Araújo, Élito; Bernardon, Jussara Karina; Lopes, Guilherme Carpena

    2016-01-01

    Enamel defects, such as white or yellow-brown spots, usually cause problems that are more esthetic than functional. Enamel hypoplasia may be the result of hereditary, systemic, or local factors. Dental trauma is a local etiologic factor. It is relatively common in the primary dentition and can cause defects on the surface of permanent successors. Treatment for such defects can differ, depending on the depth of the spots. For deeper white-spot lesions, a composite resin restoration may be necessary. This is an excellent mode of treatment, due to both its low cost and its conservation of healthy tooth structure. The objective of this case report is to describe composite resin restoration of a maxillary central incisor affected by enamel hypoplasia.

  10. Enamel hypoplasia: challenges of esthetic restorative treatment.

    PubMed

    Ruschel, Vanessa Carla; Araújo, Élito; Bernardon, Jussara Karina; Lopes, Guilherme Carpena

    2016-01-01

    Enamel defects, such as white or yellow-brown spots, usually cause problems that are more esthetic than functional. Enamel hypoplasia may be the result of hereditary, systemic, or local factors. Dental trauma is a local etiologic factor. It is relatively common in the primary dentition and can cause defects on the surface of permanent successors. Treatment for such defects can differ, depending on the depth of the spots. For deeper white-spot lesions, a composite resin restoration may be necessary. This is an excellent mode of treatment, due to both its low cost and its conservation of healthy tooth structure. The objective of this case report is to describe composite resin restoration of a maxillary central incisor affected by enamel hypoplasia. PMID:27599287

  11. Dentin caries zones: mineral, structure, and properties.

    PubMed

    Pugach, M K; Strother, J; Darling, C L; Fried, D; Gansky, S A; Marshall, S J; Marshall, G W

    2009-01-01

    Caries Detector staining reveals 4 zones in dentin containing caries lesions, but characteristics of each zone are not well-defined. We therefore investigated the physical and microstructural properties of carious dentin in the 4 different zones to determine important differences revealed by Caries Detector staining. Six arrested dentin caries lesions and 2 normal controls were Caries-Detector-stained, each zone (pink, light pink, transparent, apparently normal) being analyzed by atomic force microscopy (AFM) imaging for microstructure, by AFM nano-indentation for mechanical properties, and by transverse digital microradiography (TMR) for mineral content. Microstructure changes, and nanomechanical properties and mineral content significantly decreased across zones. Hydrated elastic modulus and mineral content from normal dentin to pink Caries-Detector-stained dentin ranged from 19.5 [10.6-25.3] GPa to 1.6 [0.0-5.0] GPa and from 42.9 [39.8-44.6] vol% to 12.4 [9.1-14.2] vol%, respectively. Even the most demineralized pink zone contained considerable residual mineral.

  12. X-linked hypophosphatemic rickets: enamel abnormalities and oral clinical findings.

    PubMed

    Cremonesi, Ilaria; Nucci, Cesare; D'Alessandro, Giovanni; Alkhamis, Nadia; Marchionni, Silvia; Piana, Gabriela

    2014-01-01

    X-linked hypophosphatemia (XLH) is a genetic disorder related to alterations in bones and teeth formation, due to low levels of phosphate in blood. Oral findings in XLH have been enamel and dentine abnormalities, high pulp horns, large pulp chambers, and some cases of periapical abscesses related to teeth without caries or traumatic injuries. The aim of our study was to assess the presence of enamel alterations, such as microclefts and/or structure defects in patients with XLH and give guidelines of prevention of XLH dental complications. History taking, oral clinical and radiological examination in 10 young patients affected by XLH (average age of 9) and in 6 patients without XLH (average age of 8). Impressions were performed on the vestibular surfaces of teeth in order to obtain replicas. The replicas were analyzed using scanning electron microscope (SEM) and compared to replicas of control group. The images of replicas of XLH patients showed deep microclefts and irregular enamel surface structure compared to replicas of control group. The replica of a patient with spontaneous periapical abscesses showed numerous enamel crater-shaped depressions and deep microcleavages penetrating into the enamel thickness. In absence of caries or fractures, the abscesses pathogenesis may be related to microcleavages of the enamel and dentin, which allow bacterial invasion of the pulp. There could be a relationship between XLH disease and enamel abnormalities. PMID:24677288

  13. Kinetics of fluorine in deciduous enamel after application of fluoride-containing varnish (Duraphat).

    PubMed

    Koch, G; Petersson, L G; Gleerup, A; Löwstedt, E

    1982-01-01

    The fluorine concentration in tooth enamel was determined in vivo after one single application of Duraphat fluoride varnish from 24 hours up to six months after treatment. A micro-acid-drop technique was used in 68 clinically intact deciduous upper central incisors in 34 pre-school children 4-5 years of age to determined the fluoride concentration in the enamel. The experimental data from the biopsy procedures were analysed by means of analysis of variance. The application of fluoride varnish results in an increase in fluoride in surface as well as subsurface enamel 24 hours after treatment. Thereafter a releasing process of fluorine from the enamel seems to start. Therefore the results indicate that there might be a caries inhibiting effect of fluoride varnish in primary enamel based more upon the kinetics of fluorine rather than a permanent uptake.

  14. Liquid White Enamel.

    ERIC Educational Resources Information Center

    Widmar, Marge

    1985-01-01

    A secondary teacher describes how she has her students use liquid white enamel. With the enameling process, students can create lasting, exciting artwork. They can exercise an understanding of design and color while learning the value of careful, sustained craft skills. (RM)

  15. Detection of approximal caries with a new laser fluorescence device.

    PubMed

    Lussi, A; Hack, A; Hug, I; Heckenberger, H; Megert, B; Stich, H

    2006-01-01

    The laser device DIAGNOdent developed for the detection of occlusal caries has limited value on approximal surfaces. The aim of this study was to develop and to test a new laser fluorescence (LF) device for the detection of approximal caries. Light with a wavelength of 655 nm was transported to the approximal surface using two different sapphire fibre tips. Seventy-five teeth were selected from a pool of extracted permanent human molars, frozen at -20 degrees C until use. Before being measured, they were defrosted, cleaned and calculus was removed with a scaler. The molars were set in blocks simulating the contact area of adults. Bitewing radiographs were obtained using Kodak Insight films. After two independent assessments with the new LF device, the teeth were histologically prepared, and assessed for caries extension. Using the laser, specificity values for D1 threshold (outer half of enamel), D2 threshold (inner half of enamel), D3 threshold (dentine) ranged between 0.81 and 0.93, sensitivity between 0.84 and 0.92 with no difference between the two tips. Bitewing radiography showed an inferior performance compared to LF (p<0.05). Intraex aminer reproducibility was high (kappa>.74). The new LF system might be a useful additional tool in detecting approximal caries. Because of its good reproducibility, it could be used to monitor caries regression or progression on approximal surfaces.

  16. Deciduous teeth occlusal caries detection with 655-nm diode laser confirmed by surface scanning electron microscopy

    NASA Astrophysics Data System (ADS)

    Duarte, Danilo; Fonseca, Yara P. C.; Zanin, Fatima A. A.; Brugnera, Aldo, Jr.

    2000-03-01

    The morphological complexity of the occlusal surface of deciduous molar teeth is considered as a factor to increase vulnerability to caries lesion. Occlusal surface of these teeth shows sulcus, pits and fissures which allow retention of both micro-organisms and food debris which make them more susceptible to caries. In the last decades there was a significant reduction on caries of smooth surface but not on the occlusal surface where dentinal caries develops under fissures which are apparently caries-free under eye observation. This is known as a hidden caries. The occlusal surface of sound extracted deciduous molar teeth were examined using a 655 nm diode laser (DIAGNOdent - KaVo) in order to detect hidden caries. When there was indication of a hidden caries, the area was examined using SEM and confirm or not the diagnosis. The authors concludes that the diagnosis of caries using 655 diode laser is reliable and precise method.

  17. A mathematical model for the progression of dental caries.

    PubMed

    Fabregas, L Rene I; Rubinstein, J

    2014-12-01

    A model for the progression of dental caries is derived. The analysis starts at the microscopic reaction and diffusion process. The local equations are averaged to derive a set of macroscopic equations. The global system includes features such as anisotropic diffusion and local changes in the geometry due to the melting of the enamel. The equations are then solved numerically. The simulations highlight the effect of anisotropy. In addition, we draw conclusions on the progression rate of caries, and discuss them in light of a number of experiments. PMID:23803287

  18. Factors influencing caries incidence in permanent teeth in children/adolescents under and after anti-neoplastic treatment

    PubMed Central

    Brożyna, Agnieszka; Dembowska-Bagińska, Bożenna; Olczak-Kowalczyk, Dorota

    2016-01-01

    Aim of the study To determine reasons for the increase in caries among children/adolescents treated for neoplasms. Material and methods Health promoting behaviour, oral hygiene (PLI), gingiva (GI), dentition (DMFt/DMFs), number of teeth with white spot lesions (WSL), and enamel defects (ED) were assessed in three groups of 60 patients each. The three groups were as follows: under chemotherapy (CH), after chemotherapy (PCH), and generally healthy (CG). Medical files supplied information on neoplasm type, chemotherapeutic type and dose, age at treatment start, chemotherapy duration, and complications. Statistical analysis was performed with Mann-Whitney U test and Spearman's rho test. Results The age at which chemotherapy was started/its duration was 5.9 ±4.0/1.3 ±0.5 years in PCH and 9.12 ±4.44/0.8 ±0.3 years in CH; PCH completed treatment 4.9 ±3.4 years ago. Chemotherapy most often included vincristine (VCR), etoposide (VP-16), adriamycin (ADM), cyclophosphamide (CTX), cisplatin (CDDP), and ifosphamide (IF). Mucositis occurrence was 28.33% in PCH and 45.00% in CH; vomiting occurrence was 43.33% and 50.00%, respectively. Nutrition and prophylaxis mistakes occurred more often in CH/PCH than in CG; PLI, GI, caries incidence and severity, and the number of teeth with WSL were higher. Correlation between caries incidence and chemotherapeutic type and dose, age at treatment start and treatment duration, mucositis, emesis, PLI, GI, ED, no fluoride prophylaxis, and nutritional mistakes was established. Ifosphamide and mucositis treatment played a major role in chemotherapy; after chemotherapy – ED and CTX, ADM, IF, and VP-16. Conclusions Caries in permanent teeth in children/adolescents undergoing chemotherapy result from nutritional mistakes, poor prophylaxis, and indirectly from chemotherapy complications (first mucositis and emesis, and later developmental ED). PMID:27095939

  19. Dental caries: an updated medical model of risk assessment.

    PubMed

    Kutsch, V Kim

    2014-04-01

    Dental caries is a transmissible, complex biofilm disease that creates prolonged periods of low pH in the mouth, resulting in a net mineral loss from the teeth. Historically, the disease model for dental caries consisted of mutans streptococci and Lactobacillus species, and the dental profession focused on restoring the lesions/damage from the disease by using a surgical model. The current recommendation is to implement a risk-assessment-based medical model called CAMBRA (caries management by risk assessment) to diagnose and treat dental caries. Unfortunately, many of the suggestions of CAMBRA have been overly complicated and confusing for clinicians. The risk of caries, however, is usually related to just a few common factors, and these factors result in common patterns of disease. This article examines the biofilm model of dental caries, identifies the common disease patterns, and discusses their targeted therapeutic strategies to make CAMBRA more easily adaptable for the privately practicing professional.

  20. In-vitro near-infrared imaging of natural secondary caries

    NASA Astrophysics Data System (ADS)

    Simon, Jacob C.; Lucas, Seth; Lee, Robert; Darling, Cynthia L.; Staninec, Michal; Vanderhobli, Ram; Pelzner, Roger; Fried, Daniel

    2015-02-01

    Secondary caries stands as the leading reason for the failure of composite restorations and dentists spend more time replacing existing restorations than placing new ones. Current clinical strategies, and even modern visible light methods designed to detect decay, lack the sensitivity to distinguish incipient lesions, are confounded by staining on the surface and within the tooth, or are limited to detecting decay on the tooth surface. Near-IR (NIR) imaging methods, such as NIR reflectance and transillumination imaging, and optical coherence tomography are promising strategies for imaging secondary caries. Wavelengths longer than 1300-nm avoid interference from stain and exploit the greater transparency of sound enamel and dental composites, to provide increased contrast with demineralized tissues and improved imaging depth. The purpose of this study was to determine whether NIR transillumination (λ=1300-nm) and NIR crosspolarized reflectance (λ=1500-1700-nm) images can serve as reliable indicators of demineralization surrounding composite restorations. Twelve composite margins (n=12) consisting of class I, II and V restorations were chosen from ten extracted teeth. The samples were imaged in vitro using NIR transillumination and reflectance, polarization sensitive optical coherence tomography (PS-OCT) and a high-magnification digital visible light microscope. Samples were serially sectioned into 200-μm slices for histological analysis using polarized light microscopy (PLM) and transverse microradiography (TMR). The results presented demonstrate the utility of NIR light for detecting recurrent decay and suggest that NIR images could be a reliable screening tool used in conjunction with PS-OCT for the detection and diagnosis of secondary caries.

  1. Intranasal immunization against dental caries with a Streptococcus mutans-enriched fimbrial preparation.

    PubMed

    Fontana, M; Dunipace, A J; Stookey, G K; Gregory, R L

    1999-05-01

    Streptococcus mutans has been identified as the major etiological agent of human dental caries. The first step in the initiation of infection by this pathogenic bacterium is its attachment (i.e., through bacterial surface proteins such as glucosyltransferases, P1, glucan-binding proteins, and fimbriae) to a suitable receptor. It is hypothesized that a mucosal vaccine against a combination of S. mutans surface proteins would protect against dental caries by inducing specific salivary immunoglobulin A (IgA) antibodies which may reduce bacterial pathogenesis and adhesion to the tooth surface by affecting several adhesins simultaneously. Conventional Sprague-Dawley rats, infected with S. mutans at 18 to 20 days of age, were intranasally immunized with a mixture of S. mutans surface proteins, enriched for fimbriae and conjugated with cholera toxin B subunit (CTB) plus free cholera toxin (CT) at 13, 15, 22, 29, and 36 days of age (group A). Control rats were either not immunized (group B) or immunized with adjuvant alone (CTB and CT [group C]). At the termination of the study (when rats were 46 days of age), immunized animals (group A) had significantly (P < 0.05) higher salivary IgA and serum IgG antibody responses to the mixture of surface proteins and to whole bacterial cells than did the other two groups (B and C). No significant differences were found in the average numbers of recovered S. mutans cells among groups. However, statistically fewer smooth-surface enamel lesions (buccal and lingual) were detected in the immunized group than in the two other groups. Therefore, a mixture of S. mutans surface proteins, enriched with fimbria components, appears to be a promising immunogen candidate for a mucosal vaccine against dental caries.

  2. The use of a caries detector dye in cavity preparation.

    PubMed

    Kidd, E A; Joyston-Bechal, S; Smith, M M; Allan, R; Howe, L; Smith, S R

    1989-08-19

    The aim of this study was to compare the conventional visual and tactile method of detecting carious dentine during cavity preparation using a mirror, probe and excavator with a visual method enhanced by a dye. The dye, 1% acid red in propylene glycol, was used on 100 cavities prepared by dental students and passed as clinically satisfactory by their teachers. Results showed dye stain at the enamel-dentine junction in 57 cavities (57%) which had been assessed as caries-free in this area using conventional visual and tactile means. Subsequent laboratory work on extracted carious teeth confirmed histologically that the dye stains demineralised dentine. If clinicians consider it important to render the enamel-dentine junction caries-free, it might be prudent to use the dye as an aid to diagnosis in this area.

  3. Sex differences in dental caries experience: clinical evidence, complex etiology.

    PubMed

    Lukacs, John R

    2011-10-01

    A sex difference in oral health has been widely documented through time and across cultures. Women's oral health declines more rapidly than men's with the onset of agriculture and the associated rise in fertility. The magnitude of this disparity in oral health by sex increases during ontogeny: from childhood, to adolescence, and through the reproductive years. Representative studies of sex differences in caries, tooth loss, and periodontal disease are critically reviewed. Surveys conducted in Hungary, India, and in an isolated traditional Brazilian sample provide additional support for a significant sex bias in dental caries, especially in mature adults. Compounding hormonal and reproductive factors, the sex difference in oral health in India appears to involve social and religious causes such as son preference, ritual fasting, and dietary restrictions during pregnancy. Like the sex difference in caries, tooth loss in women is greater than in men and has been linked to caries and parity. Results of genome wide association studies have found caries susceptible and caries protective loci that influence variation in taste, saliva, and enamel proteins, affecting the oral environment and the micro-structure of enamel. Genetic variation, some of which is X-linked, may partly explain how sex differences in oral health originate. A primary, but neglected, factor in explaining the sex differential in oral health is the complex and synergistic changes associated with female sex hormones, pregnancy, and women's reproductive life history. Caries etiology is complex and impacts understanding of the sex difference in oral health. Both biological (genetics, hormones, and reproductive history) and anthropological (behavioral) factors such culture-based division of labor and gender-based dietary preferences play a role.

  4. Enamel structure in odontocete whales.

    PubMed

    Ishiyama, M

    1987-09-01

    With regard to the enamel structure of mammals, a large number of studies have been reported in the past. Of them, however, the enamel structure of odontocetes has not yet been sufficiently elucidated. The author therefore observed the enamel structure of 11 species in 7 families of living odontocetes. A clear prism structure in the enamel is noted in delphinids and Pontoporia blainvillei. Neophocaena phocaenoides has a very simple-structured prism, but even this structure is obvious only in the deep layer of the enamel, disappearing gradually from the mid layer to surface layer. The prism pattern of delphinids differs significantly depending on the site of the enamel; that of Pontoporia shows as a whole pattern 1. On the other hand, the enamel of Physeter catodon, Berardius bairdi, Phocoena phocoena, Phocoenoides dalli and Delphinapterus leucus is prismless. The enamel of Physeter and Phocoena shows pseudoprisms; that of Phocoenoides contains enamel tubuli. The enamel of Berardius and Delphinapterus is 3 to 8 micron thick, which is extremely thin for mammalian enamel. No enamel was noted in Monodon monoceros teeth. The enamel structure of living odontocetes is thus very variable. Several characteristic structures having been present during the evolutionary course of this tissue are still present in some of them. As the results of comparative histologic study, it is considered that the variable enamel structure of living odontocetes is a secondary phenomenon produced during the degenerative history of the enamel. PMID:3659855

  5. Stereomicroscopic study of the human tooth caries: clinical and morphological correlations

    NASA Astrophysics Data System (ADS)

    Oancea, Roxana; Vasile, Liliana; Marchese, Cristian; Sava-Rosianu, Ruxandra

    2012-06-01

    Objectives: Stereomicroscopy allows a three-dimensional study of the images and of laterality at superior quality in comparison with other methods. Those advantages are given by the large examination fields and the wide work distances. The adding of the clinical and morphological data at the results gathered with stereomicroscopy and the stereo micrometry is useful in order to appreciate the deepness and the widening of the carious process, and the necessity to reconsider the therapeutically strategy. Materials and methods: During 2009-2011 the study material was represented by 10 surgically removed impacted third molars, and by 20 premolars extracted for orthodontic purposes, with closed and macroscopically apparently integer surfaces. 13 premolars with different degrees of carious affectation and periodontal lesions, which were surgically extracted without trauma, were also selected. The in situ measurements at the occlusal site were realized through the utilization of a fluorescent laser device - DIAGNOdent. The basic principles in stereomicroscopy stood at the base of the obliquely and circularly coaxial illumination techniques, one with optical alignment adjustment of the optical microscope and mechanical adjustment for the optimal illumination and micrometry. The Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom has been used to study the samples in stereomicroscopy and through polarized light it. Results: The DiagnoDent measured the following data: out of 43 apparently healthy teeth, 18 presented values between 2 and 13 (D1), 13 showed values between 14 and 24 (D2), 12 measured values over 24 (D3). After the histological examination in stereomicroscopy and in the polarized light: 25 teeth were healthy, 10 presented caries extended in dental enamel and 8 presented dentinal caries. Stereomicroscopy has allowed the morphological study, the color absorption, the appreciation of the lesions' deepness and substance

  6. Aciduric microbial taxa including Scardovia wiggsiae and Bifidobacterium spp. in caries and caries free subjects.

    PubMed

    Henne, Karsten; Rheinberg, Anke; Melzer-Krick, Beate; Conrads, Georg

    2015-10-01

    Actinobacteria came into focus of being potential caries-associated pathogens and could, together with the established Streptococcus mutans and lactobacilli thus function as caries indicator species. Here we analyzed the role and diagnostic predictive value of the acidogenic-aciduric species Scardovia wiggsiae and Bifidobacterium dentium together with S. mutans, lactobacilli and bifidobacteria in biofilm of non-cavitated (n = 20) and cavitated (n = 6) caries lesions versus controls (n = 30). For the genus Bifidobacterium and for B. dentium new sets of primers were designed. Based on real-time quantitative PCR and confirmed by DNA sequencing we found a higher prevalence (61.5%) of S. wiggsiae in caries lesions than in controls (40%). However, among the controls we found three individuals with both the highest absolute and relative S. wiggsiae numbers. Testing for S. mutans revealed the same prevalence as S. wiggsiae in caries lesions (61.5%) but in controls its prevalence was only 10%. B. dentium was never found in healthy plaque but in 30.8% of clinical cases, with the highest numbers in cavitated lesions. The Bifidobacterium-genus specific PCR had less discriminative power as more control samples were positive. We calculated the relative abundances and applied receiver operating characteristic analyses. The top results of specificity (93% and 87%) and sensitivity (100% and 88%) were found when the constraint set was "Lactobacillus relative abundance ≥0.02%" and "two aciduric species with a relative abundance of each ≥0.007%". Combinatory measurement of several aciduric taxa may be useful to reveal caries activity or even to predict caries progression. PMID:25933689

  7. Caries Risk Assessment/Treatment Programs in U.S. Dental Schools.

    ERIC Educational Resources Information Center

    Yorty, Jack S.; Brown, K. Birgitta

    1999-01-01

    A survey of 42 U.S. dental schools was conducted to identify the number and characteristics of caries risk- assessment/treatment programs. Findings address lectures about caries risk, use of variable recall programs, categorization of risk level, early detection and treatment of lesions, and restoration of radiographically visible lesions. (DB)

  8. Protein- mediated enamel mineralization

    PubMed Central

    Moradian-Oldak, Janet

    2012-01-01

    Enamel is a hard nanocomposite bioceramic with significant resilience that protects the mammalian tooth from external physical and chemical damages. The remarkable mechanical properties of enamel are associated with its hierarchical structural organization and its thorough connection with underlying dentin. This dynamic mineralizing system offers scientists a wealth of information that allows the study of basic principals of organic matrix-mediated biomineralization and can potentially be utilized in the fields of material science and engineering for development and design of biomimetic materials. This chapter will provide a brief overview of enamel hierarchical structure and properties as well as the process and stages of amelogenesis. Particular emphasis is given to current knowledge of extracellular matrix protein and proteinases, and the structural chemistry of the matrix components and their putative functions. The chapter will conclude by discussing the potential of enamel for regrowth. PMID:22652761

  9. Laser-induced fluorescence in diagnosis of dental caries

    NASA Astrophysics Data System (ADS)

    Drakaki, Eleni A.; Makropoulou, Mersini I.; Khabbaz, Maruan; Serafetinides, Alexandros A.

    2003-09-01

    The autofluorescence spectra of hard dental tissues, both in normal and pathological areas were investigated in this study. The measurements were performed both on the intact hard tissues of the examined teeth, such as enamel, dentine, cementum, and root canal, and on the tissues pathologically affected by caries (superficial, intermediate, and deep). Various laser wavelengths (337 nm, 488 nm, and 514 nm) were used to irradiate the dental surfaces and a computer-controlled spectrograph captured the fluorescent spectra. The emission signals were stored, measured, analyzed and quantified in terms of wavelength distribution and the relative photon intensity. Results indicated that the fluorescent spectra from healthy enamel, dentine, and cementum were almost identical in form, depending on the excitation wavelength. The intact and affected hard tissues were greatly different in the integral fluorescent intensity. Healthy areas were found to produce the most pronounced fluorescent intensity, whereas the carious regions produced the weaker fluorescent intensity. Independently of the laser excitation wavelength, dentin regions were found to produce the most pronounced fluorescent intensity than any other dental component. The fluorescence signal of carious affected dental structure revealed a reed shifted spectral curve, more pronounced after 488 nm excitation. There was a pronounced red shift for deep caries (crown -- root caries), after ultraviolet laser excitation. Excitation with visible wavelengths did not produce such differences between intact and cervical, deep carious affected tissue. Using a monochromatic light source without any light output at the wavelengths of fluorescence, e.g. a laser with the appropriate filters, the difference in fluorescence between intact and carious enamel was generally easy to observe. Finally, we found that the blue line of an argon ion laser is preferable for superficial caries detection, while the ultraviolet emitting nitrogen

  10. How the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management.

    PubMed

    Pitts, N B

    2009-01-01

    This chapter provides an overview of how the detection, assessment, diagnosis and monitoring of caries integrate with personalized caries management. The background includes the continuing burden of preventable disease that dental caries represents on a global scale. Despite this, and evidence that a purely restorative approach will not 'cure' the disease, preventive caries control has been slow to be adopted in many countries. Following a series of initiatives in the last decade, there is now a range of clinical criteria and tools that can be employed to help clinicians plan patient-centred comprehensive and preventively biased care for their patients. At the core is a sound foundation of lesion detection, assessment and diagnosis which, when combined with appropriate patient level risk information and monitoring, enables effective treatment planning. The International Caries Detection and Assessment System (ICDAS) can enable this process. The ICDAS provides clinical criteria and codes, together with a framework to support and enable personalized comprehensive caries management for improved long-term health outcomes. The target audience for this book comprises those with an interest in dental caries and its clinical management; this should in no way detract from the parallel missions in the domains of dental public health, research or education. If progress is to be made in this field, it is important that a compatible series of terms can be shared across the dental domains and across countries. This will ensure better clinical and patient understanding and help facilitate getting research findings into clinical practice in a more efficient way.

  11. Diet and the microbial aetiology of dental caries: new paradigms.

    PubMed

    Bradshaw, David J; Lynch, Richard J M

    2013-12-01

    The microbial and dietary factors that drive caries have been studied scientifically for 120 years. Frequent and/or excessive sugar (especially sucrose) consumption has been ascribed a central role in caries causation, while Streptococcus mutans appeared to play the key role in metabolising sucrose to produce lactic acid, which can demineralise enamel. Many authors described caries as a transmissible infectious disease. However, more recent data have shifted these paradigms. Streptococcus mutans does not fulfil Koch's postulates - presence of the organism leading to disease, and absence of the organism precluding disease. Furthermore, molecular microbiological methods have shown that, even with a sugar-rich diet, a much broader spectrum of acidogenic microbes is found in dental plaque. While simple sugars can be cariogenic, cooked starches are also now recognised to be a caries threat, especially because such starches, while not 'sticky in the hand', can be highly retentive in the mouth. Metabolism of starch particles can yield a prolonged acidic challenge, especially at retentive, caries-prone sites. These changes in the paradigms of caries aetiology have important implications for caries control strategies. Preventing the transmission of S. mutans will likely be inadequate to prevent caries if a sufficiently carbohydrate-rich diet continues. Similarly, restriction of sucrose intake, although welcome, would be unlikely to be a panacea for caries, especially if frequent starch intake persisted. Instead, approaches to optimise fluoride delivery, to target plaque acidogenicity or acidogenic microbes, to promote plaque alkali generation, to increase salivary flow or replace fermentable carbohydrates with non-fermentable alternatives may be more promising.

  12. A hypothetical role for vitamin K2 in the endocrine and exocrine aspects of dental caries.

    PubMed

    Southward, Ken

    2015-03-01

    The growing interest in oral/systemic links demand new paradigms to understand disease processes. New opportunities for dental research, particularly in the fields of neuroscience and endocrinology will emerge. The role of the hypothalamus portion of the brain cannot be underestimated. Under the influence of nutrition, it plays a significant role in the systemic model of dental caries. Currently, the traditional theory of dental caries considers only the oral environment and does not recognize any significant role for the brain. The healthy tooth, however, has a centrifugal fluid flow to nourish and cleanse it. This is moderated by the hypothalamus/parotid axis which signals the endocrine portion of the parotid glands. High sugar intake creates an increase in reactive oxygen species and oxidative stress in the hypothalamus. When this signaling mechanism halts or reverses the dentinal fluid flow, it renders the tooth vulnerable to oral bacteria, which can now attach to the tooth's surface. Acid produced by oral bacteria such as Strep Mutans and lactobacillus can now de-mineralize the enamel and irritate the dentin. The acid attack stimulates an inflammatory response which results in dentin breakdown from the body's own matrix metalloproteinases. Vitamin K2 (K2) has been shown to have an antioxidant potential in the brain and may prove to be a potent way to preserve the endocrine controlled centrifugal dentinal fluid flow. Stress, including oxidative stress, magnifies the body's inflammatory response. Sugar can not only increase oral bacterial acid production but it can concurrently reduce the tooth's defenses through endocrine signaling. Saliva production is the exocrine function of the salivary glands. The buffering capacity of saliva is critical to neutralizing the oral environment. This minimizes the de-mineralization of enamel and enhances its re-mineralization. K2, such as that found in fermented cheese, improves salivary buffering through its influence on

  13. Caries Management Strategies for Primary Molars

    PubMed Central

    Santamaria, R.M.; Innes, N.P.T.; Machiulskiene, V.; Evans, D.J.P.; Splieth, C.H.

    2014-01-01

    Minimal invasive approaches to managing caries, such as partial caries removal techniques, are showing increasing evidence of improved outcomes over the conventional complete caries removal. There is also increasing interest in techniques where no caries is removed. We present the 1-yr results of clinical efficacy for 3 caries management options for occlusoproximal cavitated lesions in primary molars: conventional restorations (CR; complete caries removal and compomer restoration), Hall technique (HT; no caries removal, sealing in with stainless steel crowns), and nonrestorative caries treatment (NRCT; no caries removal, opening up the cavity, teaching brushing and fluoride application). In sum, 169 children (3-8 yr old; mean, 5.56 ± 1.45 yr) were enrolled in this secondary care–based, 3-arm, parallel-group, randomized clinical trial. Treatments were carried out by specialist pediatric dentists or postgraduate trainees. One lesion per child received CR, HT, or NRCT. Outcome measures were clinical failure rates, grouped as minor failure (restoration loss/need for replacement, reversible pulpitis, caries progression, etc.) and major failure (irreversible pulpitis, abscess, etc.). There were 148 children (87.6%) with a minimum follow-up of 11 mo (mean, 12.23 ± 0.98 mo). Twenty teeth were recorded as having at least 1 minor failure: NRCT, n = 8 (5%); CR, n = 11 (7%); HT, n = 1 (1%) (p = .002, 95% CI = 0.001 to 0.003). Only the comparison between NRCT and CR showed no significant difference (p = .79, 95% CI = 0.78 to 0.80). Nine (6%) experienced at least 1 major failure: NRCT, n = 4 (2%); CR, n = 5 (3%); HT, n = 0 (0%) (p = .002, 95% CI = 0.001 to 0.003). Individual comparison of NRCT and CR showed no statistically significant difference in major failures (p = .75, 95% CI = 0.73 to 0.76). Success and failure rates were not significantly affected by pediatric dentists’ level of experience (p = .13, 95% CI = 0.12 to 0.14). The HT was significantly more successful

  14. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for adults.

    PubMed

    Evans, R W; Pakdaman, A; Dennison, P J; Howe, E L C

    2008-03-01

    In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Water fluoridation resulted in a declining caries incidence which decreased further following the advent of fluoridated toothpaste. The challenge today is to develop a non-invasive model of practice that will sustain a low level of primary caries experience in the younger generation and reduce risk of caries experience in the older generations. The Caries Management System is a ten step non-invasive strategy to arrest and remineralize early lesions. The governing principle of this system is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Since the attainment and maintenance of oral health is determined mainly by controlling both caries and periodontal disease, the implementation of the Caries Management System in general practice will promote both outcomes.

  15. Assessment of remineralized dentin lesions with thermal and near-infrared reflectance imaging

    PubMed Central

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

    2016-01-01

    Accurate detection and measurement of the highly mineralized surface layer that forms on caries lesions is important for the diagnosis of lesion activity. Previous studies have demonstrated that optical imaging methods can be used to measure the degree of remineralization on enamel lesions. The purpose of this study was to determine if thermal and near-IR reflectance imaging could be used to assess the remineralization process in simulated dentin lesions. Artificial bovine (n=15) dentin lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for up to 12 days. The samples were dehydrated using an air spray for 30 seconds and imaged using thermal and InGaAs cameras. The area enclosed by the time-temperature curve, ΔQ, from thermal imaging decreased significantly with longer periods of remineralization. However, near-IR reflectance intensity differences, ΔI, before and after dehydration failed to show any significant relationship with the degree of remineralization. This study shows that thermal imaging can be used for the assessment of the remineralization of dentin lesions. PMID:27006522

  16. Assessment of remineralized dentin lesions with thermal and near-infrared reflectance imaging

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

    Accurate detection and measurement of the highly mineralized surface layer that forms on caries lesions is important for the diagnosis of lesion activity. Previous studies have demonstrated that optical imaging methods can be used to measure the degree of remineralization on enamel lesions. The purpose of this study was to determine if thermal and near-IR reflectance imaging could be used to assess the remineralization process in simulated dentin lesions. Artificial bovine (n=15) dentin lesions were prepared by immersion in a demineralization solution for 24 hours and they were subsequently placed in an acidic remineralization solution for up to 12 days. The samples were dehydrated using an air spray for 30 seconds and imaged using thermal and InGaAs cameras. The area enclosed by the time-temperature curve, ΔQ, from thermal imaging decreased significantly with longer periods of remineralization. However, near-IR reflectance intensity differences, ΔI, before and after dehydration failed to show any significant relationship with the degree of remineralization. This study shows that thermal imaging can be used for the assessment of the remineralization of dentin lesions.

  17. Caries-preventive Effect of Supervised Toothbrushing and Sealants.

    PubMed

    Hilgert, L A; Leal, S C; Mulder, J; Creugers, N H J; Frencken, J E

    2015-09-01

    To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y.

  18. Diet and Caries-associated Bacteria in Severe Early Childhood Caries

    PubMed Central

    Palmer, C.A.; Kent, R.; Loo, C.Y.; Hughes, C.V.; Stutius, E.; Pradhan, N.; Dahlan, M.; Kanasi, E.; Arevalo Vasquez, S.S.; Tanner, A.C.R.

    2010-01-01

    Frequent consumption of cariogenic foods and bacterial infection are risk factors for early childhood caries (ECC). This study hypothesized that a short diet survey focused on frequency of foods, categorized by putative cariogenicity, would differentiate severe ECC (S-ECC) from caries-free children. Children’s diets were obtained by survey and plaque bacteria detected by PCR from 72 S-ECC and 38 caries-free children. S-ECC children had higher scores for between-meal juice (p < 0.01), solid-retentive foods (p < 0.001), eating frequency (p < 0.005), and estimated food cariogenicity (p < 0.0001) than caries-free children. S-ECC children with lesion recurrence ate fewer putative caries-protective foods than children without new lesions. Streptococcus mutans (p < 0.005), Streptococcus sobrinus (p < 0.005), and Bifidobacteria (p < 0.0001) were associated with S-ECC, and S. mutans with S. sobrinus was associated with lesion recurrence (p < 0.05). S. mutans-positive children had higher food cariogenicity scores. Food frequency, putative cariogenicity, and S. mutans were associated with S-ECC individually and in combination. PMID:20858780

  19. A polarized light and scanning electron microscopic study of human fissure and lingual enamel of unerupted mandibular third molars.

    PubMed

    Ekstrand, K; Holmen, L; Qvortrup, K

    1999-01-01

    Using histological and ultrastructural techniques the aims of this study were to investigate whether the mineralization pattern and surface microanatomy of the caries-susceptible fissure enamel were different from those on the caries-inactive lingual surface. The material consisted of 31 unerupted third mandibular molars. The specimens were initially grouped into four categories: (1) without, (2) with initial, (3) with almost completed and (4) with completed root formation. One ground section with fissure-like morphology was selected from each tooth. Using water as a medium the observed birefringence was negative along the lingual and fissure transverses in specimens with almost completed and with completed root formation, while the observed birefringence was positive at different distances in the enamel in sections representing less maturation stages. Qualitative imbibition studies revealed hypomineralized enamel in the lower part of the fissures in specimens representing almost and completed root formation. Imbibed in quinoline, parts of the hypomineralized enamel behaved like a molecular sieve due to the presence of micropores, indicating that the structural arrangement is different from that in the enamel adjacent to this areas. After division of the sections into a lingual and a buccal part, SEM features were described from lower and upper parts of the buccal fissure wall and on lingual enamel in the area corresponding to the bottom part of the fissure. The surface microanatomy varied greatly. Negative developmental irregularities such as fissures and holes were associated with the immature enamel, while matured enamel - particularly fissures - housed many positive developmental irregularities such as enamel caps and protrusions. The crystal size in the mature specimens appeared smaller and more uniform than the crystals from the immature specimens. Apart from the occurrence of hypomineralized enamel in fissures and numerous positive developmental

  20. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  1. [Test of an electronic fissure caries detector].

    PubMed

    Pieper, K; Visser, H; Hülsmann, M; Wahner, M

    1990-11-01

    The reliability of an electronic detector for caries in pits and fissures was tested by means of physical measurements, histological sections and clinical evaluation. The device measures the ohmic resistance of the tooth, technical data are given. First we compared measurements and histological sections of teeth due for extraction. The results indicated a high sensitivity of the device for caries, false positive diagnoses did not occur. Based on this, a clinical evaluation on 179 teeth was performed. Under practical conditions the sensitivity of the electronic detector (0.77) was lower than in the first part of the study; conventional diagnosis revealed more carious lesions in dentine (sensitivity: 0.82).

  2. Modern approaches to caries management of the primary dentition.

    PubMed

    Innes, N P T; Evans, D J P

    2013-06-01

    When prevention of dental caries fails, and a child is exposed to the risk of pain and infection, the disease must be managed to reduce this risk. There is growing evidence supporting more 'biological' and fewer 'surgical' approaches to managing dental caries in primary teeth. These biological methods include partial and stepwise caries removal procedures, as well as techniques where no caries is removed. An overview of clinical trials comparing these biological methods to complete caries removal shows that they perform as well as traditional methods and have the advantage of reducing the incidence of iatrogenic pulpal exposures. The Hall Technique is one biological approach to managing caries in primary molars which involves sealing caries beneath preformed metal (stainless steel) crowns. The crown is cemented over the tooth without caries removal, tooth preparation or use of local anaesthesia. The clinical steps for the Hall Technique are straightforward but, as with all dental care provision, appropriate treatment planning for the procedure requires skill. The Hall Technique offers another method of managing early to moderately advanced, active carious lesions in primary molars, with good evidence of effectiveness and acceptability. This evidence aligns with the positive findings of other studies on biological strategies for managing caries in primary teeth.

  3. Current status of dental caries diagnosis using cone beam computed tomography

    PubMed Central

    Park, Young-Seok; Ahn, Jin-Soo; Kwon, Ho-Beom

    2011-01-01

    Purpose The purpose of this article is to review the current status of dental caries diagnosis using cone beam computed tomography (CBCT). Materials and Methods An online PubMed search was performed to identify studies on caries research using CBCT. Results Despite its usefulness, there were inherent limitations in the detection of caries lesions through conventional radiograph mainly due to the two-dimensional (2D) representation of caries lesions. Several efforts were made to investigate the three-dimensional (3D) image of lesion, only to gain little popularity. Recently, CBCT was introduced and has been used for diagnosis of caries in several reports. Some of them maintained the superiority of CBCT systems, however it is still under controversies. Conclusion The CBCT systems are promising, however they should not be considered as a primary choice of caries diagnosis in everyday practice yet. Further studies under more standardized condition should be performed in the near future. PMID:21977474

  4. Effects of Treatment with Various Remineralizing Agents on the Microhardness of Demineralized Enamel Surface

    PubMed Central

    Salehzadeh Esfahani, Kiana; Mazaheri, Romina; Pishevar, Leila

    2015-01-01

    Background and aims. Remineralization of incipient caries is one of the goals in dental health care. The present study aimed at comparing the effects of casein phosphopeptide-amorphous calcium phosphate complex (CPP-ACP), Remin Pro®, and 5% sodium fluoride varnish on remineralization of enamel lesions. Materials and methods. In this in vitro study, 60 enamel samples were randomly allocated to six groups of 10. After four days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 underwent one-time treatment with fluoride varnish, CPP-ACP, and Remin Pro®, respectively. Microhardness of groups 4-6 was measured not only after one-month treatment with the above-mentioned materials (for eight hours a day), but also after re-exposing to the demineralizing solution. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Fisher’s least significant difference (LSD) test. Results. None of the regimens could increase microhardness in groups 1-3. However, one-month treatment regimens in groups 4-6 caused a significant increase in microhardness. The greatest microhardness was detected in the group treated with CPP-ACP (P = 0.001). In addition, although microhardness reduced following re-demineralization in all three groups, the mean reduction was minimum in the CPP-ACP-treated group (P < 0.001). Conclusion. While long-term repeated application of all compounds improved microhardness, the remineralization potential of CPP-ACP was significantly higher than that of Remin Pro® and sodium fluoride varnish. PMID:26889361

  5. Effects of Treatment with Various Remineralizing Agents on the Microhardness of Demineralized Enamel Surface.

    PubMed

    Salehzadeh Esfahani, Kiana; Mazaheri, Romina; Pishevar, Leila

    2015-01-01

    Background and aims. Remineralization of incipient caries is one of the goals in dental health care. The present study aimed at comparing the effects of casein phosphopeptide-amorphous calcium phosphate complex (CPP-ACP), Remin Pro(®), and 5% sodium fluoride varnish on remineralization of enamel lesions. Materials and methods. In this in vitro study, 60 enamel samples were randomly allocated to six groups of 10. After four days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 underwent one-time treatment with fluoride varnish, CPP-ACP, and Remin Pro(®), respectively. Microhardness of groups 4-6 was measured not only after one-month treatment with the above-mentioned materials (for eight hours a day), but also after re-exposing to the demineralizing solution. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Fisher's least significant difference (LSD) test. Results . None of the regimens could increase microhardness in groups 1-3. However, one-month treatment regimens in groups 4-6 caused a significant increase in microhardness. The greatest microhardness was detected in the group treated with CPP-ACP (P = 0.001). In addition, although microhardness reduced following re-demineralization in all three groups, the mean reduction was minimum in the CPP-ACP-treated group (P < 0.001). Conclusion. While long-term repeated application of all compounds improved microhardness, the remineralization potential of CPP-ACP was significantly higher than that of Remin Pro(®) and sodium fluoride varnish. PMID:26889361

  6. Genetic Variation in Ameloblastin Is Associated with Caries in Asthmatic Children

    PubMed Central

    Ergöz, Nihan; Seymen, Figen; Gencay, Koray; Tamay, Zeynep; Deeley, Kathleen; Vinski, Sarah; Vieira, Alexandre R.

    2014-01-01

    Aim Evidence suggests caries experience is higher in children with asthma. In this study, we compared caries experience in asthmatic and non-asthmatic children and defined whether variation in the distribution of caries experience differs between the two groups and is dependent of the presence of genetic variation in enamel formation genes. Methods Children with asthma were recruited at the Istanbul University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Allergy and Pulmonary Diseases, and non-affected children were recruited at the Istanbul University, Faculty of Dentistry, Department of Pedodontics. Cases (N=100) were defined as children between the ages of 6 and 12 years with asthma and controls (N=100) as children without asthma. Cases and controls were matched by sex and age. All study subjects received a complete dental exam, provided demographic and other caries and asthma risk factors data, and a saliva sample for DNA extraction. Caries experience was defined based on DMFT/dmft and DMFS/dmfs scores. Genotypes of 11 SNPs were selected in intronic regions of enamel development genes. PCR with TaqMan chemistry were used for genotyping all selected markers. Association between caries experience (caries free versus caries affected) depending on asthma status and SNPs was tested with PLINK by logistic regression, adjusting by risk, and other preventive measures. P-values below 0.0045 (0.05/11) were considered statistically significant. Results Logistic regression analysis showed an association between AMBN rs4694075 and caries experience (p=2.525e-007). Conclusions Our study provides, for the first time, evidence that ameloblastin is associated with caries in asthmatic children. PMID:24203249

  7. [Fluoride contents of rat molars following the administration of amine-fluoride-containing caries preventives (author's transl)].

    PubMed

    Novikov, L L; Treide, A; Kolesnik, A G; Novikova, N V; Jacobi, J

    1979-01-01

    Experiments on fifty Wistar rats were conducted with the object of studying the incorporation of fluoride into the enamel of molars subsequent to the administration of amine-fluoride-containing caries preventives. - Use of two toothpastes with low fluoride contents of 0.125% and 0.18% F, respectively, and two higher-fluoride (1% F) solutions resulted in a marked increase in the concentration of fluoride in the superficial layers of dental enamel.

  8. Effect of carbon dioxide laser treatment on lesion progression in an intraoral model

    NASA Astrophysics Data System (ADS)

    Featherstone, John D. B.; Fried, Daniel; Gansky, Stuart A.; Stookey, George K.; Dunipace, Ann J.

    2001-04-01

    Previous studies have shown that pretreatment of dental enamel by specific carbon dioxide laser conditions inhibited subsequent progression of caries-like lesions in vitro. The aim of the present study was to use an intra-oral model to determine whether similar inhibition is observed in the human mouth. A cross over study with 23 subjects and three regimens was used. Pre-formed varies-like lesions were made in extracted human enamel and exposed intra-orally in partial dentures in each subject to A) placebo dentifrice and no laser treatment, B) placebo dentifrice following laser pretreatment, or C) sodium fluoride dentifrice and no laser treatment during each of three study periods. Samples were assessed by micro radiography to compare the mineral loss before and after each treatment and drive a net change in mineral value. Overall P was not significantly different form L but both P and L were different from F. For those subjects who demineralized in P, L and F were significantly better than P, with L showing an 84 percent inhibition of further demineralization, but no enhancement of demineralization.

  9. Cary Woods Elementary School.

    ERIC Educational Resources Information Center

    Havens, Glenda

    1994-01-01

    Describes the school reading program at Cary Woods Elementary School (in Auburn, Alabama), one of several school reading programs designated by the International Reading Association as exemplary. (SR)

  10. Does ozone enhance the remineralizing potential of nanohydroxyapatite on artificially demineralized enamel? A laser induced fluorescence study

    NASA Astrophysics Data System (ADS)

    Srinivasan, Samuelraj; Prabhu, Vijendra; Chandra, Subhash; Koshy, Shalini; Acharya, Shashidhar; Mahato, Krishna K.

    2014-02-01

    The present era of minimal invasive dentistry emphasizes the early detection and remineralization of initial enamel caries. Ozone has been shown to reverse the initial demineralization before the integrity of the enamel surface is lost. Nano-hydroxyapatite is a proven remineralizing agent for early enamel caries. In the present study, the effect of ozone in enhancing the remineralizing potential of nano-hydroxyapatite on artificially demineralized enamel was investigated using laser induced fluorescence. Thirty five sound human premolars were collected from healthy subjects undergoing orthodontic treatment. Fluorescence was recorded by exciting the mesial surfaces using 325 nm He-Cd laser with 2 mW power. Tooth specimens were subjected to demineralization to create initial enamel caries. Following which the specimens were divided into three groups, i.e ozone (ozonated water for 2 min), without ozone and artificial saliva. Remineralization regimen was followed for 3 weeks. The fluorescence spectra of the specimens were recorded from all the three experimental groups at baseline, after demineralization and remineralization. The average spectrum for each experimental group was used for statistical analysis. Fluorescence intensities of Ozone treated specimens following remineralization were higher than that of artificial saliva, and this difference was found to be statistically significant (P<0.0001). In a nutshell, ozone enhanced the remineralizing potential of nanohydroxyapatite, and laser induced fluorescence was found to be effective in assessing the surface mineral changes in enamel. Ozone can be considered an effective agent in reversing the initial enamel caries there by preventing the tooth from entering into the repetitive restorative cycle.

  11. Dental caries: A complete changeover, PART III: Changeover in the treatment decisions and treatments

    PubMed Central

    Carounanidy, Usha; Sathyanarayanan, R

    2010-01-01

    Comprehensive management of dental caries should involve the management of disease as well as the lesion. Current decision making process in cariology is influenced by numerous factors such as the size/ depth/ activity of the carious lesion and age/ the caries risk status of the patient. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. Apart from these two responsibilities, a clinician should also be knowledgeable enough to decide when not to interfere in the caries dynamics and how frequently to recall the patient for follow-ups. The non-operative treatment prescriptions vary in dose, intensity and mode of delivery according to the caries risk status. Minimal invasion and maximal conservation of tooth structure has become the essence of current operative treatments. This part of the series elaborates on the paradigm shift in the management of dental caries. PMID:21217948

  12. Incidence of dental caries in primary dentition and risk factors: a longitudinal study.

    PubMed

    Corrêa-Faria, Patrícia; Paixão-Gonçalves, Suzane; Paiva, Saul Martins; Pordeus, Isabela Almeida

    2016-05-20

    The objectives of this prospective, longitudinal, population-based study were to estimate the incidence of dental caries in the primary dentition, identify risk factors and determine the proportion of children receiving dental treatment, through a two-year follow up. The first dental exam was conducted with 381 children aged one to five years, at health centers during immunization campaigns; 184 of them had dental caries and 197 had no caries experience. The second exam was carried out two years later at a nursery or at home with the same individuals who participated in the first exam. The diagnosis of dental caries was performed using the dmft criteria. Parents were interviewed regarding socioeconomic indicators. Descriptive, bivariate and adjusted Poisson regression analyses were performed. Among the 381 children, 234 were reexamined after two years (non-exposed: 139; exposed: 95). The overall incidence of dental caries was 46.6%. The greatest incidence of dental caries was found in the group of children with previous caries experience (61.1%). Among the children without dental caries in the first exam, 36.7% exhibited caries in the second exam. The majority of children (72.6%) received no treatment for carious lesions in the two-year interval between examinations. Children with previous dental caries (RR: 1.52, 95%CI: 1.12-2.05) had a greater risk of developing new lesions, compared with the children without previous dental caries. The incidence of dental caries was high and most of children's caries were untreated. Previous caries experience is a risk factor for developing new carious lesions in children.

  13. International Caries Detection and Assessment System (ICDAS): A New Concept

    PubMed Central

    Pandit, IK; Srivastava, Nikhil; Gupta, Monika; Sharma, Megha

    2011-01-01

    Dental caries is a complex multifactorial disease of the calcified tissues of the teeth, caused by interaction of various factors including the host, agent, substrate and time as demonstrated by the Keyes circle. Detecting carious lesion at the earliest possible stage of its development is definitely helpful in appropriate treatment planning for the same. The lack of consistency among the contemporary criteria systems for detecting carious lesions limits the comparability of outcomes measured in epidemiological and clinical studies. Therefore, the ICDAS criteria was developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. It is a clinical scoring system for use in dental education, clinical practice, research, and epidemiology, and provides a framework to support and enable personalized total caries management for improved long-term health outcomes.

  14. Efficacy of Two Caries Detector Dyes in the Diagnosis of Dental Caries

    PubMed Central

    Javaheri, M.; Maleki-Kambakhsh, S.; Etemad-Moghadam, Sh.

    2010-01-01

    Objective: The aim of the present study was to evaluate the efficacy of two caries detector dyes in the diagnosis of dental caries. Materials and Methods: Twenty extracted human posterior teeth without pulpal exposure were sectioned mesiodistally through the center of the lesions using a water-cooled disk. The tooth halves were randomly divided into two groups and treated with Caries Detector (CD) and Caries Check (CC) detector dyes. Access cavities were prepared followed by caries removal and dye application. All cavities were arbitrarily divided into two right and left sections and excavation of the stained areas was performed on the left parts, while the right sections remained untouched. Bacterial penetration into dentinal tubules was evaluated using Gram-stained decalcified sections under light microscopy. Sensitivity and specificity of both dyes were calculated. Results: The sensitivity of CD and CC were 74% and 71%, respectively. The specificity obtained for both dyes was 100%. Conclusion: Considering the low sensitivity of the dyes evaluated in the present study, it seems that they may not be reliable when used as the sole diagnostic technique for detection of carious lesions in posterior teeth. PMID:21998778

  15. Effect of adsorption time on the adhesion strength between salivary pellicle and human tooth enamel.

    PubMed

    Zhang, Y F; Zheng, J; Zheng, L; Zhou, Z R

    2015-02-01

    Salivary pellicle is a biofilm that is formed by the selective adsorption of salivary proteins. Almost all the functions of the salivary pellicle (lubricating properties, anti-caries properties, etc.) are closely associated with its adhesion strength to tooth surface. The objective of this study was to investigate the effect of adsorption time on the adhesion strength between salivary pellicle and human tooth enamel, aiming to understand what act as the determinant of the interfacial adhesion. In this study, human tooth enamel samples were immersed in human whole saliva in vitro to obtain a salivary pellicle on the surface of enamel. Immersion treatments lasting up to 1, 3, 10 and 60 min were conducted, respectively. Nano-scratch tests were conducted on the surface of enamel after different adsorption times. The wettability of enamel surface was measured through water contact angle. Results showed that the shear energy between salivary pellicle and enamel surface increased exponentially with the adsorption time. The adhesion force between salivary pellicle and bare enamel surface was more than twice that between salivary pellicle and salivary pellicle. It was found that both the wettability and zeta potential of enamel increased obviously after 1 min saliva-adsorption treatment, and then they almost kept stable as the adsorption time further increased. In summary, the adhesion strength between initial salivary pellicle and enamel surface was much higher than that between initial salivary pellicle and outer salivary pellicle. It seemed that electrostatic interaction contributed to the adhesion between the initial salivary pellicle and enamel surface, but not to the adhesion between the initial and outer salivary pellicle. The results would be helpful to extend the understanding of the adhesion mechanism of salivary pellicle and then to develop new artificial saliva and dental restorative materials.

  16. Caries correlates strongly to salivary levels of matrix metalloproteinase-8.

    PubMed

    Hedenbjörk-Lager, Anders; Bjørndal, Lars; Gustafsson, Anders; Sorsa, Timo; Tjäderhane, Leo; Åkerman, Sigvard; Ericson, Dan

    2015-01-01

    The caries process in dentin involves the degradation of both mineral and organic matrix. The demineralization has been demonstrated to be caused by bacterial acids. However, the collagen degradation is considered to be initiated by endogenous proteolytic enzymes, mainly collagenolytic matrix metalloproteinases (MMPs). This paper aims to relate salivary MMP-8 (or salivary collagenase-2) and tissue inhibitor of MMP (TIMP-1) levels to manifest caries in a large number of subjects. A random sample of 451 adults (aged 18-87 years) living in the south of Sweden was included in this study. Standard clinical examinations were performed, and stimulated saliva was collected and analyzed for concentrations of MMP-8, TIMP-1 and total protein, using an immunofluorometric assay, an enzyme-linked immunosorbent assay and the Bradford assay, respectively. Salivary numbers of mutans streptococci and lactobacilli were determined using a chair-side kit. Subjects with manifest caries lesions presented with elevated levels of MMP-8 (p < 0.001) as well as total protein, MMP-8/TIMP-1 ratio, bleeding on probing and plaque index (p = 0.05) compared with subjects without manifest caries. Multiple linear regression analysis with caries as the dependent variable revealed MMP-8 as the only significant explanatory variable (p < 0.001). TIMP-1 was not significant in any case. Using MMP-8 as the dependent variable revealed total protein concentration, caries lesions (p ≤ 0.001) and salivary secretion rate (p = 0.05) as explanatory variables. In conclusion, our data reveal that subjects with manifest caries lesions have elevated levels of salivary MMP-8 relative to subjects with no caries lesions.

  17. The implications of the new paradigm of dental caries.

    PubMed

    Kidd, Edwina

    2011-12-01

    The caries process is the ubiquitous, natural metabolism in the biofilm that causes numerous fluctuations in pH. The interaction of this biofilm with the dental tissues may result in a caries lesion. However, lesion formation and progression can be controlled, particularly by disturbing plaque regularly with a fluoride containing toothpaste. This paradigm implies that everyone with teeth is at risk to lesion development. Treatment of caries is principally non-operative, involving plaque control, fluoride and a sensible diet. Operative dentistry repairs un-cleansable cavities and is part of plaque control. A diagnosis is a mental resting place on the way to a treatment decision. The relevant diagnostic features with respect to caries are lesion activity (active lesions require active management) and un-cleansable cavities. When teaching undergraduates, it is important that they are credited for the non-operative treatment of caries as well as for operative dentistry. This is equally important in dental practice where an appropriate skills mix of the dental team is required to deliver dental health cost-effectively. Training more dentists may be an expensive mistake as far as disease control is concerned. It is ironic that dentists make most money from operative care and specialist treatment when disease control could be delivered relatively cheaply. The key to dental health is regular and effective plaque control with a fluoride containing toothpaste, from cradle to grave.

  18. Validation of a Cariogenic Biofilm Model to Evaluate the Effect of Fluoride on Enamel and Root Dentine Demineralization.

    PubMed

    Fernández, Constanza E; Tenuta, Livia M A; Cury, Jaime A

    2016-01-01

    Due to gingival recession both enamel and root dentine are at risk of developing caries. Both tissues are exposed to a similar environment, however there is not a validated model to evaluate the effect of fluoride on these dental substrates simultaneously. Hence, this study aimed to validate a caries model to evaluate the effect of fluoride to prevent demineralization on enamel and root-dentine. Streptococcus mutans UA159 biofilms were formed on saliva-coated bovine enamel and root dentine slabs (n = 12 per group) mounted in the same well of culture plates. The biofilms were exposed 8×/day to 10% sucrose and treated 2×/day with fluoridated solutions containing 0, 150, 450, or 1,350 ppm F; thus, simulating the use of low to high fluoride concentration toothpastes. The pH values of the culture medium was monitored 2×/day as a biofilm acidogenicity indicator. After 96 h, biofilms were collected for fluoride concentration analysis. The percentage of surface hardness loss (%SHL) was calculated for slabs. The fluoride uptake by the enamel and dentine was also determined. The model showed a dose-response because the biofilm and fluoride uptake increased and %SHL decreased at increasing fluoride concentrations (p < 0.05). Fluoride in the biofilm formed on dentine and fluoride uptake by dentine were higher than those for enamel. With the same fluoride concentration treatment, the percentage of reduction of demineralization was lower for dentine than for enamel. In conclusion, the model was validated in terms of a dose-response effect of fluoride on enamel and root dentine. Furthermore, the findings support the clinical data, suggesting that higher fluoride concentrations are necessary to control caries of root dentine than of enamel.

  19. Validation of a Cariogenic Biofilm Model to Evaluate the Effect of Fluoride on Enamel and Root Dentine Demineralization

    PubMed Central

    2016-01-01

    Due to gingival recession both enamel and root dentine are at risk of developing caries. Both tissues are exposed to a similar environment, however there is not a validated model to evaluate the effect of fluoride on these dental substrates simultaneously. Hence, this study aimed to validate a caries model to evaluate the effect of fluoride to prevent demineralization on enamel and root-dentine. Streptococcus mutans UA159 biofilms were formed on saliva-coated bovine enamel and root dentine slabs (n = 12 per group) mounted in the same well of culture plates. The biofilms were exposed 8×/day to 10% sucrose and treated 2×/day with fluoridated solutions containing 0, 150, 450, or 1,350 ppm F; thus, simulating the use of low to high fluoride concentration toothpastes. The pH values of the culture medium was monitored 2×/day as a biofilm acidogenicity indicator. After 96 h, biofilms were collected for fluoride concentration analysis. The percentage of surface hardness loss (%SHL) was calculated for slabs. The fluoride uptake by the enamel and dentine was also determined. The model showed a dose-response because the biofilm and fluoride uptake increased and %SHL decreased at increasing fluoride concentrations (p < 0.05). Fluoride in the biofilm formed on dentine and fluoride uptake by dentine were higher than those for enamel. With the same fluoride concentration treatment, the percentage of reduction of demineralization was lower for dentine than for enamel. In conclusion, the model was validated in terms of a dose-response effect of fluoride on enamel and root dentine. Furthermore, the findings support the clinical data, suggesting that higher fluoride concentrations are necessary to control caries of root dentine than of enamel. PMID:26731743

  20. Validation of a Cariogenic Biofilm Model to Evaluate the Effect of Fluoride on Enamel and Root Dentine Demineralization.

    PubMed

    Fernández, Constanza E; Tenuta, Livia M A; Cury, Jaime A

    2016-01-01

    Due to gingival recession both enamel and root dentine are at risk of developing caries. Both tissues are exposed to a similar environment, however there is not a validated model to evaluate the effect of fluoride on these dental substrates simultaneously. Hence, this study aimed to validate a caries model to evaluate the effect of fluoride to prevent demineralization on enamel and root-dentine. Streptococcus mutans UA159 biofilms were formed on saliva-coated bovine enamel and root dentine slabs (n = 12 per group) mounted in the same well of culture plates. The biofilms were exposed 8×/day to 10% sucrose and treated 2×/day with fluoridated solutions containing 0, 150, 450, or 1,350 ppm F; thus, simulating the use of low to high fluoride concentration toothpastes. The pH values of the culture medium was monitored 2×/day as a biofilm acidogenicity indicator. After 96 h, biofilms were collected for fluoride concentration analysis. The percentage of surface hardness loss (%SHL) was calculated for slabs. The fluoride uptake by the enamel and dentine was also determined. The model showed a dose-response because the biofilm and fluoride uptake increased and %SHL decreased at increasing fluoride concentrations (p < 0.05). Fluoride in the biofilm formed on dentine and fluoride uptake by dentine were higher than those for enamel. With the same fluoride concentration treatment, the percentage of reduction of demineralization was lower for dentine than for enamel. In conclusion, the model was validated in terms of a dose-response effect of fluoride on enamel and root dentine. Furthermore, the findings support the clinical data, suggesting that higher fluoride concentrations are necessary to control caries of root dentine than of enamel. PMID:26731743

  1. Effects of ammonium hexafluorosilicate application on demineralized enamel and dentin of primary teeth.

    PubMed

    Hosoya, Yumiko; Watanabe, Eiko; Tadokoro, Katsumi; Inoue, Takashi; Miyazaki, Masashi; Tay, Franklin R

    2012-09-01

    Silver diamine fluoride (Ag(NH(3))(2)F) arrests caries but stains teeth black. To overcome this drawback, we applied ammonium hexafluorosilicate (AHF; (NH(4))(2)SiF(6)) and observed changes in the color and structure of demineralized enamel and dentin of extracted primary teeth. Enamel and dentin were demineralized in 10% EDTA solution for 90 s followed by 35% phosphoric acid gel for 60 s, then soaked in AHF solution for 60 s. Before analysis by scanning electron microscopy (SEM) and energy-dispersive X-ray spectrometry (EDS), enamel and dentin were demineralized in 10% EDTA for 90 s. Teeth were divided into 4 groups according to AHF application and artificial saliva immersion status and then examined. The data were statistically analyzed using one-way ANOVA and Fisher's PLSD test at a significance level of P < 0.05. AHF treatment did not cause visible discoloration. Enamel prisms and dental tubules appeared by demineralization were covered with precipitates by AHF application. A sphere-filled membranous structure was observed in the saliva immersion groups. EDS analysis showed that AHF application had no effect on enamel; however, F% and Ca/P ratio were significantly higher on dentin surfaces after AHF application without artificial saliva immersion. Further study on arresting caries treatment is required. PMID:23047038

  2. The use of a caries detector dye during cavity preparation: a microbiological assessment.

    PubMed

    Kidd, E A; Joyston-Bechal, S; Beighton, D

    1993-04-10

    During cavity preparation conventional tactile and optical criteria are used to assess the caries status of the enamel-dentine junction, cavity preparation being considered complete when this area is hard to a sharp probe and stain free. In the present study 201 cavities were prepared under rubber dam. When caries removal was considered complete using the conventional tactile and optical criteria, a caries detector dye (1% acid red in propylene glycol), which is claimed to stain 'infected' tissue red, was applied. Fifty-two per cent of cavities showed caries dye stain in some part of the enamel-dentine junction. Subsequent microbiological sampling of dye-stained and dye-unstained sites resulted in the recovery of low numbers of bacteria and revealed no difference in the level of infection of the two sites. It is concluded that the conventional tactile and optical criteria are satisfactory assessments of the caries status of tissue during cavity preparation and that subsequent use of a caries detector dye on hard and stain-free dentine will result in unnecessary tissue removal.

  3. Dental biothermophotonics: How photothermal methods are winning the race with X-rays for dental caries diagnostic needs of clinical dentistry

    NASA Astrophysics Data System (ADS)

    Mandelis, A.; Jeon, R.; Matvienko, A.; Abrams, S. H.; Amaechi, B. T.

    2008-01-01

    Recent trends in biothermophotonics of teeth are presented. The presentation is centered on the development of clinical-level frequency-domain photothermal radiometry and modulated luminescence to address issues associated with the early diagnosis of demineralization caries in human teeth. Biothermophotonic principles and applications to the detection of the carious state in human teeth as embodied by laser photothermal radiometry are presented and further supported by modulated luminescence. The emphasis is on recent developments with regard to abilities of these techniques to diagnose interproximal lesions between teeth, etching with phosphoric acid and with an artificial demineralization gel in order to simulate early demineralization, as well as demineralization and remineralization of dental crown enamel and root dentin. These are lesions which normally go undetected by X-ray radiographs. Comparisons with X rays, Micro-Computed Tomography (μ-CT) and Transverse Micro-Radiography (TMR) are discussed. A theoretical model involving coupled diffuse photon density and thermal-wave fields is developed and applied to frequency scans from demineralized artificial lesions to produce quantitative values for optical and thermophysical parameters of teeth as well as the thickness of the induced lesion.

  4. Influence of radiopacity of dental composites on the diagnosis of secondary caries: the correlation between objective and subjective analyses.

    PubMed

    Cruz, A D; Esteves, R G; Poiate, I A V P; Portero, P P; Almeida, S M

    2014-01-01

    This study aimed to objectively evaluate the radiopacity of different dental composites and their subjective influence on diagnosing secondary caries-like lesions and how these results correlate. For objective analysis, three resin specimens (1 mm thick, with a 4-mm internal diameter) were made with four composites: 1) Charisma; 2) Filtek Z250; 3) Prisma AP.H; and 4) Glacier. Three human teeth were selected and then mesio-distally sectioned (1 mm thick) to make the dental specimens. An aluminum (Al) wedge (12 steps, 1 mm thick, 99.8% purity) was used as an internal standard to calculate the radiopacity. For subjective analysis, 20 human teeth were selected and then prepared with a mesio-occluso-distal (MOD) inlay cavity, with half the teeth receiving a round cavity to simulate the carious lesion. The MOD was restored using the composites at four different times. Standardized radiographs were acquired and then digitized (300 dpi and eight-bit TIFF) for both analyses. A histogram objectively measured the pixel intensity values of the images, which were converted into millimeters of Al using linear regressions. Eight observers subjectively evaluated the images using a five-point rating scale to diagnose the caries. The data were statistically analyzed using the Student t-test, the Kappa test, diagnostic testing, and the Pearson correlation coefficient (α=0.05). All materials showed radiopacity values compatible with dental tissues (p>0.05); Glacier was similar to dentin and Prisma AP.H was similar to enamel, while the remaining materials showed a middle radiopacity. Prisma AP.H and Glacier differed (p<0.05) in relation to their accuracy to caries diagnosis, with Glacier having greater accuracy. There was a correlation between objective and subjective analyses with negative linear dependence. An increase in the material's radiopacity could have a subjectively negative influence on the diagnosis of secondary caries; thus, an ideal radiopacity for a dental composite is

  5. Enamel formation and amelogenesis imperfecta.

    PubMed

    Hu, Jan C-C; Chun, Yong-Hee P; Al Hazzazzi, Turki; Simmer, James P

    2007-01-01

    Dental enamel is the epithelial-derived hard tissue covering the crowns of teeth. It is the most highly mineralized and hardest tissue in the body. Dental enamel is acellular and has no physiological means of repair outside of the protective and remineralization potential provided by saliva. Enamel is comprised of highly organized hydroxyapatite crystals that form in a defined extracellular space, the contents of which are supplied and regulated by ameloblasts. The entire process is under genetic instruction. The genetic control of amelogenesis is poorly understood, but requires the activities of multiple components that are uniquely important for dental enamel formation. Amelogenesis imperfecta (AI) is a collective designation for the variety of inherited conditions displaying isolated enamel malformations, but the designation is also used to indicate the presence of an enamel phenotype in syndromes. Recently, genetic studies have demonstrated the importance of genes encoding enamel matrix proteins in the etiology of isolated AI. Here we review the essential elements of dental enamel formation and the results of genetic analyses that have identified disease-causing mutations in genes encoding enamel matrix proteins. In addition, we provide a fresh perspective on the roles matrix proteins play in catalyzing the biomineralization of dental enamel.

  6. Scanning ablation of root caries with acoustic feedback control

    NASA Astrophysics Data System (ADS)

    Fan, Kenneth; Fried, Daniel

    2007-02-01

    It has been previously demonstrated that short λ=355-nm laser pulses can be used for the selective removal of caries lesions and composite restorative materials from occlusal surfaces with minimal damage to the peripheral sound tooth structure. One advantage of laser-systems is they can be integrated with acoustic and optical feedback systems for the automated discrimination of dental caries and restorative materials. The objective of this study was to test the hypothesis that root caries could be selectively removed from tooth surfaces using a computer controlled laserscanning system coupled with an acoustic feedback system. Dental root caries surfaces on extracted teeth were scanned with λ=355-nm laser pulses at irradiation intensities ranging from 0.6 to 0.8 J/cm2. Acoustic feedback signals were acquired and used to control the laser output and scanning stages were used to position the laser over carious dentin until all the caries were removed to a fixed depth. Polarization optical coherence tomography (PSOCT) was used to acquire images of the root caries lesions before and after removal by the laser in order to assess if ablation was selective. The amplitude of the acoustic waves generated during the ablation of carious dentin was higher than for sound dentin allowing the acoustic feedback system to discriminate between sound and carious dentin. PS-OCT showed that caries were removed to a depth of up to 1.5-mm with minimal peripheral damage to peripheral sound dentin. The acoustic feedback was successfully used to distinguish between root caries and sound dentin, enabling the selective removal of caries from dentin surfaces using a λ=355-nm, Nd:YAG Q-switched laser system.

  7. The residual caries dilemma.

    PubMed

    Weerheijm, K L; Groen, H J

    1999-12-01

    Restorative dentistry is based on the assumption that bacterial infection of demineralized dentine should prompt operative intervention. One of the concepts of practical dentistry is to create a favourable environment for caries arrest with minimal operative intervention. The progress of remaining primary caries is key to any discussion of this concept. This discussion is important for the atraumatic restorative treatment (ART) approach, since the removal of all carious dentine is sometimes difficult using hand instruments only. In this paper the results of possible measures to guard against the effects of residual carious and its consequences are reviewed, in order to obtain an impression of the justification for (in)complete excavation of occlusal dentinal caries. Three types of measure are considered: isolating the caries process from the oral environment, excavating the carious dentine, and using a cariostatic filling material. Each of these measures contributes to the arrest of the caries process. However, none of these measures can arrest this process by itself. A combination of all three seems necessary. It is concluded that although residual caries does not seem to be the criterion for rerestoration, one has to strive for as complete caries removal as possible. If this cannot be fulfilled the sealing capacities of the filling material seem to be more important than its cariostatic properties. PMID:10600078

  8. Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass.

    PubMed

    Yang, S-Y; Kwon, J-S; Kim, K-N; Kim, K-M

    2016-05-01

    Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting

  9. Enamel Surface with Pit and Fissure Sealant Containing 45S5 Bioactive Glass.

    PubMed

    Yang, S-Y; Kwon, J-S; Kim, K-N; Kim, K-M

    2016-05-01

    Enamel demineralization adjacent to pit and fissure sealants leads to the formation of marginal caries, which can necessitate the replacement of existing sealants. Dental materials with bioactive glass, which releases ions that inhibit dental caries, have been studied. The purpose of this study was to evaluate the enamel surface adjacent to sealants containing 45S5 bioactive glass (BAG) under simulated microleakage between the material and the tooth in a cariogenic environment. Sealants containing 45S5BAG filler were prepared as follows: 0% 45S5BAG + 50.0% glass (BAG0 group), 12.5% 45S5BAG + 37.5% glass (BAG12.5 group), 25.0% 45S5BAG + 25.0% glass (BAG25.0 group), 37.5% 45S5BAG + 12.5% glass (BAG37.5 group), and 50.0% 45S5BAG + 0% glass (BAG50.0 group). A cured sealant disk was placed over a flat bovine enamel disk, separated by a 60-µm gap, and immersed in lactic acid solution (pH 4.0) at 37 °C for 15, 30, and 45 d. After the storage period, each enamel disk was separated from the cured sealant disk, and the enamel surface was examined with optical 3-dimensional surface profilometer, microhardness tester, and scanning electron microscopy. The results showed a significant increase in roughness and a decrease in microhardness of the enamel surface as the proportion of 45S5BAG decreased (P< 0.05). In the scanning electron microscopy images, enamel surfaces with BAG50.0 showed a smooth surface, similar to those in the control group with distilled water, even after prolonged acid storage. Additionally, an etched pattern was observed on the surface of the demineralized enamel with a decreasing proportion of 45S5BAG. Increasing the 45S5BAG filler contents of the sealants had a significant impact in preventing the demineralization of the enamel surface within microgaps between the material and the tooth when exposed to a cariogenic environment. Therefore, despite some marginal leakage, these novel sealants may be effective preventive dental materials for inhibiting

  10. Er:YAG and CTH:YAG laser radiation: contact versus non-contact enamel ablation and sonic-activated bulk composite placement

    NASA Astrophysics Data System (ADS)

    Buckova, M.; Kasparova, M.; Dostalova, T.; Jelinkova, H.; Sulc, J.; Nemec, M.; Fibrich, M.; Bradna, P.; Miyagi, M.

    2013-05-01

    Laser radiation can be used for effective caries removal and cavity preparation without significant thermal effects, collateral damage of tooth structure, or patient discomfort. The aim of this study was to compare the quality of tissue after contact or non-contact Er:YAG and CTH:YAG laser radiation ablation. The second goal was to increase the sealing ability of hard dental tissues using sonic-activated bulk filling material with change in viscosity during processing. The artificial caries was prepared in intact teeth to simulate a demineralized surface and then the Er:YAG or CTH:YAG laser radiation was applied. The enamel artificial caries was gently removed by the laser radiation and sonic-activated composite fillings were inserted. A stereomicroscope and then a scanning electron microscope were used to evaluate the enamel surface. Er:YAG contact mode ablation in enamel was quick and precise; the cavity was smooth with a keyhole shaped prism and rod relief arrangement without a smear layer. The sonic-activated filling material was consistently regularly distributed; no cracks or microleakage in the enamel were observed. CTH:YAG irradiation was able to clean but not ablate the enamel surface; in contact and also in non-contact mode there was evidence of melting and fusing of the enamel.

  11. The Caries Phenomenon: A Timeline from Witchcraft and Superstition to Opinions of the 1500s to Today's Science.

    PubMed

    Ruby, John D; Cox, Charles F; Akimoto, Naotake; Meada, Nobuko; Momoi, Yasuko

    2010-01-01

    This historical treatise follows the documented timeline of tooth decay into today's understanding, treatment, and teaching of caries biology. Caries has been attributed to many different causes for several millennia, however, only since the late 1900s has research revealed its complex multifactorial nature. European writers of the 1600s to 1700s held views that general health, mechanical injuries, trauma, and sudden temperature changes all caused caries-holding a common belief that decay was due to chemical agents, faulty saliva, and food particles. Until the early 1800s most writers believed that caries was due to inflammation from surrounding diseased alveolar bone. Today's science has demonstrated that caries is caused by indigenous oral microorganisms becoming a dynamic biofilm, that in the presence of fermentable sugars produce organic acids capable of dissolving inorganic enamel and dentin followed by the proteolytic destruction of collagen leaving soft infected dentin. As bacteria enter the pulp, infection follows.

  12. Microstructure of enamel.

    PubMed

    Boyde, A

    1997-01-01

    Enamel is a composite material consisting of mineral and organic phases. The properties of the mineral phase are modulated dramatically by its division into microscopic crystals, cemented together by the organic matrix protein polymer. A good concept of the 3D orientations of the crystals derives from visualizing their growth perpendicular to the surface in which they develop, which is pitted by the secretory poles of the ameloblasts. The arrangement of the crystals is the cause of the discontinuities, known as the prism boundaries or junctions, in the otherwise continuous structure. These locations acquire a more concentrated organic matrix during maturation, and they are both crack stoppers and crack propagation tracks in the adult tissue. Any tendency of prisms to cleave may be reduced by their varicosities, which reflect daily variations in the rate of production; their cross-sectional shape; the non-parallelism of adjacent groups, which develops through translocation of groups of cells across the surface during development; and the support of any one microscopic tissue element by other tissue, including dentine, placed to resist an applied load. Incremental growth lines are preferential cleavage planes within the enamel. Failure patterns of enamel in normal and abnormal use can be explained by these parameters, with additional consideration of functional variation and fatigue.

  13. Caries management by risk assessment.

    PubMed

    Young, Douglas A; Featherstone, John D B

    2013-02-01

    Caries disease is multifactorial. Whether caries disease will be expressed and damage dental hard tissue is dependent on the patient's own unique make-up of pathogenic risk factors and protective factors. Objectives This manuscript will review the science of managing caries disease based on assessing caries risk. Methods The caries balance/imbalance model and a practical caries risk assessment procedure for patients aged 6 years through adult will illustrate how treatment options can be based on caries risk. Results Neither the forms nor the clinical protocols are meant to imply there is currently only one correct way this can be achieved, rather are used in this manuscript as examples only. Conclusions It is important to have the forms and protocols simple and easy to understand when implementing caries management by risk assessment into clinical practice. The science of CAMBRA based on the caries balance/imbalance model was reviewed and an example protocol was presented.

  14. Dental caries in rats associated with Candida albicans.

    PubMed

    Klinke, T; Guggenheim, B; Klimm, W; Thurnheer, T

    2011-01-01

    In addition to occasional opportunistic colonization of the oral mucosa, Candida albicans is frequently found in carious dentin. The yeast's potential to induce dental caries as a consequence of its pronounced ability to produce and tolerate acids was investigated. Eighty caries-active Osborne-Mendel rats were raised on an ampicillin-supplemented diet and exposed to C. albicans and/or Streptococcus mutans, except for controls. Throughout the 28-day test period, the animals were offered the modified cariogenic diet 2000a, containing 40% various sugars. Subsequently, maxillary molars were scored for plaque extent. After dissection, the mandibular molars were evaluated for smooth surface and fissure caries. Test animals exposed to C. albicans displayed considerably more advanced fissure lesions (p < 0.001) than non-exposed controls. While S. mutans yielded similar results, a combined association of C. albicans and S. mutans had no effect on occlusal caries incidence. Substituting dietary sucrose by glucose did not modify caries induction by C. albicans. However, animals fed a diet containing 20% of both sugars showed no differences to non-infected controls. Smooth surface caries was not generated by the yeast. This study provides experimental evidence that C. albicans is capable of causing occlusal caries in rats at a high rate.

  15. Are All Dentiform Teeth with Simulated Caries the Same? A Six-Year Retrospective Study in Preclinical Operative Dentistry.

    PubMed

    Delgado, Alex J; Walter, Ricardo; Behar-Horenstein, Linda S; Boushell, Lee W

    2015-11-01

    Dentiform teeth with simulated caries (DTSC), frequently used in preclinical courses, should show no variability in the amount of simulated caries from tooth to tooth. However, the level of caries variability among DTSC is currently unknown. The aim of this study was to assess the variation in simulated caries levels in one group of DTSC and determine whether variation among DTSC impacted the preclinical performance of dental students. In the study, 80 commercially available mandibular first molar DTSC with simulated mesio-occluso-distal caries were sectioned in coronal (n=40) and sagittal (n=40) planes where the caries depth/width was greatest. Section images were analyzed for variation in levels of simulated caries using image-processing software. Three years of practical performance data using DTSC were compared with three years of practical performance data using dentiform teeth without simulated caries, for a total of six years (students' performance on two exams, Practical 1 and Practical 2). The results showed that 70% of the coronally sectioned teeth had manufacturing defects that resulted in caries overextension at the dentino-enamel junctions (DEJs). Overextensions were found at the DEJ in 41.3% of the sagittally sectioned teeth. There was a statistically significant decrease in Practical 1 performance of the students who used DTSC as compared with students who used teeth without simulated caries (p=0.0001); there was no statistically significant difference on Practical 2 performance. Of the DTSC evaluated in this study, 56.6% contained manufacturing defects, and more than 80% were found to have excessive caries variation. Prediction of which DTSC will have caries overextension is not possible. Students preparing DTSC that contain caries overextension are therefore at increased risk of receiving undeserved negative summative assessment on practical examinations.

  16. Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion.

    PubMed

    Lussi, Adrian; Bossen, Anke; Höschele, Christoph; Beyeler, Barbara; Megert, Brigitte; Meier, Christoph; Rakhmatullina, Ekaterina

    2012-09-01

    The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro.

  17. Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion

    NASA Astrophysics Data System (ADS)

    Lussi, Adrian; Bossen, Anke; Höschele, Christoph; Beyeler, Barbara; Megert, Brigitte; Meier, Christoph; Rakhmatullina, Ekaterina

    2012-09-01

    The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro.

  18. Effects of enamel abrasion, salivary pellicle, and measurement angle on the optical assessment of dental erosion.

    PubMed

    Lussi, Adrian; Bossen, Anke; Höschele, Christoph; Beyeler, Barbara; Megert, Brigitte; Meier, Christoph; Rakhmatullina, Ekaterina

    2012-09-01

    The present study assessed the effects of abrasion, salivary proteins, and measurement angle on the quantification of early dental erosion by the analysis of reflection intensities from enamel. Enamel from 184 caries-free human molars was used for in vitro erosion in citric acid (pH 3.6). Abrasion of the eroded enamel resulted in a 6% to 14% increase in the specular reflection intensity compared to only eroded enamel, and the reflection increase depended on the erosion degree. Nevertheless, monitoring of early erosion by reflection analysis was possible even in the abraded eroded teeth. The presence of the salivary pellicle induced up to 22% higher reflection intensities due to the smoothing of the eroded enamel by the adhered proteins. However, this measurement artifact could be significantly minimized (p<0.05) by removing the pellicle layer with 3% NaOCl solution. Change of the measurement angles from 45 to 60 deg did not improve the sensitivity of the analysis at late erosion stages. The applicability of the method for monitoring the remineralization of eroded enamel remained unclear in a demineralization/remineralization cycling model of early dental erosion in vitro. PMID:23085926

  19. Clinical evaluation of Er:YAG laser caries treatment

    NASA Astrophysics Data System (ADS)

    Dostalova, Tatjana; Jelinkova, Helena; Kucerova, Hana; Krejsa, Otakar; Hamal, Karel; Kubelka, Jiri; Prochazka, Stanislav

    1997-05-01

    To prepare the enamel, the energy used was mainly 345 mJ and repetition rate 2 Hz, for dentine the optimal energy of Er:YAG drilling machine was 200 mJ and repetition rate from 1 to 2 Hz, depending on cavity depth. Subject of treatment were caries of enamel and dentine and it was possible to remove the old insufficient fillings. The average number of pulses was 111.22, ranging from 16 to 489. During preparation, vibrations of microexplosions were felt by 8 patients, however, neither pain or unpleasant sensations were experienced. The filling materials used were composite resins and glassionomer cements. Their clinical evaluation 6 months post insertion was similar to that of the classical drilling system.

  20. Effect of Fluoride Concentration on Reduction of Enamel Demineralization According to the Cariogenic Challenge.

    PubMed

    Noronha, Mayara Dos Santos; Romão, Dayse Andrade; Cury, Jaime Aparecido; Tabchoury, Cínthia Pereira Machado

    2016-01-01

    Fluoride present in toothpaste at 1,100 µg/g is considered effective on caries control. However, under high cariogenic challenge due to increasing sugar exposure, higher fluoride concentration (5,000 µg/g) could be necessary to compensate the unbalance on caries process. This was tested in a pH-cycling regimen, which evaluated the effect of fluoride concentration relative to toothpaste on reduction of enamel demineralization under conditions of two levels of cariogenic challenge. Enamel slabs (n=20) were subjected to two pH-cycling regimens, simulating 8x and 16x/day sugar exposure and were treated with solutions containing: 0 (no fluoride), 275 or 1,250 µg F/mL, resulting in 6 treatment groups: 4-h/0-F; 8-h/0-F; 4-h/275-F; 8-h/275-F; 4-h/1,250-F and 8-h/1,250-F. The 275 and 1,250 µg F/mL concentrations simulate mouth salivary dilution when 1,100 and 5,000 µg/g toothpastes are used. Enamel demineralization was assessed by surface (%SHL) and cross-sectional hardness. Fluoride taken up by enamel was also evaluated. Data were analyzed by ANOVA one-way and Tukey's test. The treatment with 1,250 µg F/mL significantly reduced %SHL compared with 275 µg F/mL (p<0.05), irrespective the level of cariogenic challenge (4-h/1,250-F vs. 4-h/275-F and 8-h/1,250-F vs 8-h/275-F comparisons, respectively). These data were supported by fluoride concentration found in enamel. These findings suggest that higher fluoride concentrations could partly compensate the greater caries risk under higher cariogenic challenge due to increasing sugar exposure. PMID:27652699

  1. Dental Enamel Development: Proteinases and Their Enamel Matrix Substrates

    PubMed Central

    Bartlett, John D.

    2013-01-01

    This review focuses on recent discoveries and delves in detail about what is known about each of the proteins (amelogenin, ameloblastin, and enamelin) and proteinases (matrix metalloproteinase-20 and kallikrein-related peptidase-4) that are secreted into the enamel matrix. After an overview of enamel development, this review focuses on these enamel proteins by describing their nomenclature, tissue expression, functions, proteinase activation, and proteinase substrate specificity. These proteins and their respective null mice and human mutations are also evaluated to shed light on the mechanisms that cause nonsyndromic enamel malformations termed amelogenesis imperfecta. Pertinent controversies are addressed. For example, do any of these proteins have a critical function in addition to their role in enamel development? Does amelogenin initiate crystallite growth, does it inhibit crystallite growth in width and thickness, or does it do neither? Detailed examination of the null mouse literature provides unmistakable clues and/or answers to these questions, and this data is thoroughly analyzed. Striking conclusions from this analysis reveal that widely held paradigms of enamel formation are inadequate. The final section of this review weaves the recent data into a plausible new mechanism by which these enamel matrix proteins support and promote enamel development. PMID:24159389

  2. Genes expressed in dental enamel development are associated with molar-incisor hypomineralization.

    PubMed

    Jeremias, Fabiano; Koruyucu, Mine; Küchler, Erika C; Bayram, Merve; Tuna, Elif B; Deeley, Kathleen; Pierri, Ricardo A; Souza, Juliana F; Fragelli, Camila M B; Paschoal, Marco A B; Gencay, Koray; Seymen, Figen; Caminaga, Raquel M S; dos Santos-Pinto, Lourdes; Vieira, Alexandre R

    2013-10-01

    Genetic disturbances during dental development influence variation of number and shape of the dentition. In this study, we tested if genetic variation in enamel formation genes is associated with molar-incisor hypomineralization (MIH), also taking into consideration caries experience. DNA samples from 163 cases with MIH and 82 unaffected controls from Turkey, and 71 cases with MIH and 89 unaffected controls from Brazil were studied. Eleven markers in five genes [ameloblastin (AMBN), amelogenin (AMELX), enamelin (ENAM), tuftelin (TUFT1), and tuftelin-interacting protein 11 (TFIP11)] were genotyped by the TaqMan method. Chi-square was used to compare allele and genotype frequencies between cases with MIH and controls. In the Brazilian data, distinct caries experience within the MIH group was also tested for association with genetic variation in enamel formation genes. The ENAM rs3796704 marker was associated with MIH in both populations (Brazil: p=0.03; OR=0.28; 95% C.I.=0.06-1.0; Turkey: p=1.22e-012; OR=17.36; 95% C.I.=5.98-56.78). Associations between TFIP11 (p=0.02), ENAM (p=0.00001), and AMELX (p=0.01) could be seen with caries independent of having MIH or genomic DNA copies of Streptococcus mutans detected by real time PCR in the Brazilian sample. Several genes involved in enamel formation appear to contribute to MIH.

  3. Near-IR polarization imaging of sound and carious dental enamel

    NASA Astrophysics Data System (ADS)

    Darling, Cynthia L.; Jiao, Jane J.; Lee, Chulsung; Kang, Hobin; Fried, Daniel

    2010-02-01

    A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. In this investigation, an automated system was developed to collect images for the full 16-element Mueller Matrix. The polarized light was controlled by linear polarizers and liquid crystal retarders and the 36 images were acquired as the polarized near-IR light propagates through the enamel of extracted human thin tooth sections. In previous work, we reported that polarized light is rapidly depolarized by demineralized enamel, and sound and demineralized dentin.1 The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection. In this initial study, major differences in the Mueller matrix elements were observed in both sound and demineralized enamel which supports this approach and warrants further investigation.

  4. Near-IR Polarization Imaging of Sound and Carious Dental Enamel.

    PubMed

    Darling, Cynthia L; Jiao, Jane J; Lee, Chulsung; Kang, Hobin; Fried, Daniel

    2010-01-01

    A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. In this investigation, an automated system was developed to collect images for the full 16-element Mueller Matrix. The polarized light was controlled by linear polarizers and liquid crystal retarders and the 36 images were acquired as the polarized near-IR light propagates through the enamel of extracted human thin tooth sections. In previous work, we reported that polarized light is rapidly depolarized by demineralized enamel, and sound and demineralized dentin.(1) The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection. In this initial study, major differences in the Mueller matrix elements were observed in both sound and demineralized enamel which supports this approach and warrants further investigation.

  5. Genes Expressed in Dental Enamel Development Are Associated with Molar-Incisor Hypomineralization

    PubMed Central

    Jeremias, Fabiano; Koruyucu, Mine; Küchler, Erika C.; Bayram, Merve; Tuna, Elif B.; Deeley, Kathleen; Pierri, Ricardo A.; Souza, Juliana F.; Fragelli, Camila M.B.; Paschoal, Marco A.B.; Gencay, Koray; Seymen, Figen; Caminaga, Raquel M.S.; dos Santos-Pinto, Lourdes; Vieira, Alexandre R.

    2013-01-01

    Genetic disturbances during dental development influence variation of number and shape of the dentition. In this study, we tested if genetic variation in enamel formation genes is associated with molar-incisor hypomineralization (MIH), also taking into consideration caries experience. DNA samples from 163 cases with MIH and 82 unaffected controls from Turkey, and 71 cases with MIH and 89 unaffected controls from Brazil were studied. Eleven markers in five genes [ameloblastin (AMBN), amelogenin (AMELX), enamelin (ENAM), tuftelin (TUFT1), and tuftelin-interacting protein 11 (TFIP11)] were genotyped by the TaqMan method. Chi-square was used to compare allele and genotype frequencies between cases with MIH and controls. In the Brazilian data, distinct caries experience within the MIH group was also tested for association with genetic variation in enamel formation genes. The ENAM rs3796704 marker was associated with MIH in both populations (Brazil: p=0.03; OR=0.28; 95% C.I.=0.06–1.0; Turkey: p=1.22e–012; OR=17.36; 95% C.I.=5.98–56.78). Associations between TFIP11 (p=0.02), ENAM (p=0.00001), and AMELX (p=0.01) could be seen with caries independent of having MIH or genomic DNA copies of Streptococcus mutans detected by real time PCR in the Brazilian sample. Several genes involved in enamel formation appear to contribute to MIH. PMID:23790503

  6. Sucrose substitutes and their role in caries prevention.

    PubMed

    Matsukubo, Takashi; Takazoe, Ichiro

    2006-06-01

    Many non- or low-cariogenic sucrose substitutes are currently available and are found as ingredients of a variety of candy, chewing gum, and drinks. Recently the role of sugar alcohols in promoting remineralisation of enamel has attracted much attention. Thus, the dental profession needs to understand the general characteristics and features of sugar substitutes to provide advice on oral health to patients as well as the general public. There are two critical requirements for sucrose substitutes, namely, being nutritionally appropriate and not being detrimental to the overall general health of the individual. The use of a greater variety of confectionary containing sucrose substitutes and the development of new substitutes with high nutritional value are essential in the battle against caries. In this paper we review in detail the characteristics of sucrose substitutes currently in use, their role in caries prevention and promotion of oral health.

  7. [Helicobacter pylori in the development of dental caries].

    PubMed

    Moseeva, M V; Belova, E V; Vakhrushev, Ia M

    2010-01-01

    It is shown, that in patients with erosive and ulcer defects of gastroduodenal zone at settling Helicobacter pylori (Hp) in an oral cavity in 100% of cases caries develops at intensity 13.6 +/- 1.4 teeth. Produced Hp protease and ammonia cause disintegration connected to protein silica acids and reduce activity lysocim, worsening, thus, fluid and protective properties of a saliva. In the subsequent infringement of autopurification of a teeth results in accumulation of a dental strike where protease activity conditionally pathogenic microflora conducts to depolymerization and demineralization enamels of a teeth.

  8. Optical-fiber-based laser-induced breakdown spectroscopy for detection of early caries

    NASA Astrophysics Data System (ADS)

    Sasazawa, Shuhei; Kakino, Satoko; Matsuura, Yuji

    2015-06-01

    A laser-induced breakdown spectroscopy (LIBS) system targeting for the in vivo analysis of tooth enamel is described. The system is planned to enable real-time analysis of teeth during laser dental treatment by utilizing a hollow optical fiber that transmits both Q-switched Nd:YAG laser light for LIBS and infrared Er:YAG laser light for tooth ablation. The sensitivity of caries detection was substantially improved by expanding the spectral region under analysis to ultraviolet (UV) light and by focusing on emission peaks of Zn in the UV region. Subsequently, early caries were distinguished from healthy teeth with accuracy rates above 80% in vitro.

  9. The dental management of troublesome twos: renal tubular acidosis and rampant caries

    PubMed Central

    B, Sandhyarani; Huddar, Dayanand; Patil, Anil; Sankeshwari, Banashree

    2013-01-01

    Renal tubular acidosis is a group of disorders in which there is metabolic acidosis due to defect in renal tubular acidification mechanism to maintain normal plasma bicarbonate and blood pH. Irrespective of organ system involved, oral cavity often reflects the disease occurring anywhere in the body. Thus congenital chronic renal diseases, causing acid–base disturbances affects development and structure of the teeth. Chronic renal tubular acidosis causes enamel defects, dental caries, oral candidiasis, angular cheilitis, etc. We hereby present an unusual case report of a 4-year-old boy suffering from renal tubular acidosis associated with rampant caries, whose full mouth rehabilitation has been done. PMID:23667245

  10. Effect of a new carbon dioxide laser treatment on dissolution profiles of dental enamel

    NASA Astrophysics Data System (ADS)

    Featherstone, John D. B.; Le, Charles Q.; Fried, Daniel

    2003-06-01

    Previous studies have shown that pretreatment of dental enamel by specific carbon dioxide laser conditions inhibited subsequent acid dissolution of the enamel surface. The aim of the present study was to examine the dissolution profiles following irradiation by a new short pulse carbon dioxide laser treatment. Bovine enamel blocks were irradiated at 9.6 μm with a 5-8 μs or a 20-30 μs pulse duration laser using overlapping spots, and a range of fluences. Dissolution profiles were measured in an acetate buffer. Higher fluences produced rapid initial dissolution followed by a plateau with a low dissolution rate. For caries inhibition purposes the high solubility decomposition phases need to be avoided or removed.

  11. Epidemiology of dental caries.

    PubMed

    Winter, G B

    1990-01-01

    The most recent epidemiological data on the prevalence of dental caries in children indicate a halting of the increasing levels in many developing countries and a continuing decrease in many highly industrialized countries of the world. However, a further fall in caries levels predicted for 5-yr-old children in the U.K. has not occurred and the decline in caries may have begun to level out. 'Polarization' of caries to a minority of high-risk individuals is occurring in the developed world, with 20-25% of children accounting for more than 50% of the disease. Socio-economic factors are important in determining the proportion of high-risk children in these countries. The multifactorial aetiology of caries allows a number of different interpretations to account for changes in the prevalence of the disease with time, in both the developing and developed countries. These changes are variously ascribed to alterations in dietary habits, especially the consumption of sugar; variations in the patterns of oral hygiene; increased contact with trace elements, especially fluoride, in the environment; changes in the ecology and/or virulence of oral and dental plaque microflora and alterations in the oral protective mechanisms including the immune status. The epidemiological evidence available on the relationship of all these social, environmental and other factors to changes in the prevalence levels of caries does not, however, fully explain all the changes that have been observed. The claim that caries is no longer a public health problem is premature, as it ignores the still high proportion of individuals with tooth decay throughout the world.

  12. Effects of peptide concentration on remineralization of eroded enamel.

    PubMed

    Chung, Hsiu-Ying; Huang, Kuo-Chen

    2013-12-01

    Promoting remineralization to repair eroded enamel is a promising therapy in clinics. In this study, biocompatible asparagine-serine-serine (NSS) peptide chelates free ions from artificial saliva through charged functional groups, and subsequently form nano-hydroxyapatite crystals to partially repair erosive lesions. The nanomechanical properties, cross-sectional microstructure, types of deposited minerals, and subsurface microstructure of enamel at various treatment stages were characterized by nanoindentation, scanning electron microscopy (SEM), X-ray diffraction (XRD), and transmission electron microscopy (TEM), respectively. The results revealed that the nanohardness and elastic modulus of eroded enamel increase with peptide concentration, particularly for the 3NSS peptide system. In contrast, the structure of the 5NSS peptide is larger and longer, leading to increasing difficulty in penetrating to the deep acid-eroded regions; therefore, the remineralization effect was restricted to the top enamel surface. The 3NSS peptide with high concentration promoted the formation of smaller, finer, and staggered nanohydroxyapatite crystals. The enamel remineralized with a 100μM 3NSS exhibited the highest degree of nanohardness recovery (34%), resulting from subsurface crystalline regrowth.

  13. Attenuation of 1310- and 1550-nm laser light through sound dental enamel

    NASA Astrophysics Data System (ADS)

    Jones, Robert S.; Fried, Daniel

    2002-06-01

    Inexpensive laser diodes and fiber-optic technology have revived optical transillumination as a promising diagnostic method for the early detection of dental caries. The principal factor limiting transillumination through dental hard tissue is light scattering in the normal enamel and dentin. Previous studies have shown that the scattering coefficient decreases with increasing wavelength. Therefore, the near-IR region is likely to be well suited for fiber optic transillumination. The objective of this study was to measure the optical attenuation of near-IR light through dental enamel at 1310-nm and 1550-nm. These laser wavelengths are readily available due to their suitability for application to fiber optic communication. In this study the collimated transmission of laser light through polished thin sections of dental enamel for various thickness from 0.1 to 2.5 mm was measured in cuvettes of index matching fluid with n= 1.63. Beer-Lambert plots show that the attenuation coefficients are 3.1+/- 0.17cm-1 and 3.8+/- 0.17cm-1 for 1310-nm and 1550-nm, respectively. This study indicates that near-IR laser wavelengths are well-suited for the transillumination of dental enamel for caries detection since the attenuation through normal tissue is an order of magnitude less than in the visible.

  14. Dental caries - not just holes in teeth! A perspective.

    PubMed

    Bowen, W H

    2016-06-01

    Cavitation in teeth results from a pathogenic process termed dental caries that has occurred on the tooth surface for weeks or even years. Accumulation of dental plaque (biofilm) on the tooth is usually the first manifestation of the disease. Although acid production is the immediate and proximal cause of dissolution of teeth; it is the milieu within which the acid is formed that should be of primary concern. Focusing on the 'critical pH' has detracted attention from the more biological aspects (biofilm formation) of dental caries. Dental caries is unique; it is a biological process occurring on essentially an inert surface. Investigation of the multitude of interactions occurring in plaque ranging from enamel interfaces to surfaces of bacteria and matrices poses challenges worthy of the best scientific minds. The mouth clearly offers unique opportunities to investigate the multi facets of biofilm formation in vivo, generating data that have relevance way beyond the mouth. Prevention of this ubiquitous disease, dental caries, continues to present serious challenges. The public health benefits of fluoride delivered in its various formats are well recognized. Nevertheless, additional preventive approaches are required. Overcoming the rapid clearance of agents from the mouth is particularly challenging. Building on the polymerizing capacity of glucosyltransferases it may be possible to incorporate a therapeutic agent into the matrix plaque, thereby delivering therapeutic agents precisely to where they are needed. PMID:26343264

  15. Lead Poisoning in Jewellery Enamellers

    PubMed Central

    Fothergill, R.; Kipling, M. D.; Weber, A. B.

    1967-01-01

    Lead poisoning in jewellery enamellers in Birmingham has been described both at the beginning of this century and again in recent years. The condition arises from the habit of some workers of placing the enamel applicator in the mouth. The history of the hazard is reviewed and an investigation described. PMID:6073093

  16. Role of sugar and sugar substitutes in dental caries: a review.

    PubMed

    Gupta, Prahlad; Gupta, Nidhi; Pawar, Atish Prakash; Birajdar, Smita Shrishail; Natt, Amanpreet Singh; Singh, Harkanwal Preet

    2013-01-01

    Dental caries is a chronic disease which can affect us at any age. The term "caries" denotes both the disease process and its consequences, that is, the damage caused by the disease process. Dental caries has a multifactorial aetiology in which there is interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. The role of sugar (and other fermentable carbohydrates such as highly refined flour) as a risk factor in the initiation and progression of dental caries is overwhelming. Whether this initial demineralization proceeds to clinically detectable caries or whether the lesion is remineralized by plaque minerals depends on a number of factors, of which the amount and frequency of further sugars consumption are of utmost importance. This paper reviews the role of sugar and sugar substitutes in dental caries.

  17. Ultrastructural evaluation of enamel surface morphology after tooth bleaching followed by the application of protective pastes.

    PubMed

    Poggio, Claudio; Grasso, Nicolò; Ceci, Matteo; Beltrami, Riccardo; Colombo, Marco; Chiesa, Marco

    2016-05-01

    The aim of the present in vitro study was to evaluate the morphology of bleached enamel surface followed by the application of different protective pastes. Specimens were prepared from 50 human incisors free of caries and defects. The bleaching procedure was performed with 35% hydrogen peroxide (Perfect Bleach Office+). For the remineralization treatment, different protective pastes (Tooth Mousse, MI Paste Plus, Remin Pro, and Profluorid Varnish) were evaluated. Specimens were randomly assigned to 10 groups of 5 specimens each. The specimens were analyzed under scanning electron microscopy. The superficial morphology of enamel was examined and scored as follows: 0, enamel with smooth surface morphology; 1, enamel with slight irregularities; 2, enamel with moderate irregularities; 3, enamel with accentuated irregularities. The photomicrographs were evaluated in a double-blind manner by three examiners, previously calibrated. Results were analyzed by a Kruskal-Wallis nonparametric test, at the significance level of 0.05. Dunn method posttest was applied for multiple comparisons. A different superficial morphology was observed among control group specimens and specimens treated with bleaching agent and protective pastes (p < 0.05). Enamel bleached showed pronounced surface changes and irregularities, significantly different from other groups except for groups 8 (enamel + Perfect Bleach Office+ + Remin Pro) and 10 (enamel + Perfect Bleach Office+ + Profluorid Varnish) (p > 0.05). The application of the tested pastes after bleaching is effective on repairing enamel surface morphology, demonstrating a higher efficacy for the CPP-ACP products compared to fluoridated ones. SCANNING 38:221-226, 2016. © 2015 Wiley Periodicals, Inc.

  18. Sugars and dental caries.

    PubMed

    Touger-Decker, Riva; van Loveren, Cor

    2003-10-01

    A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.

  19. Dental caries: A complete changeover (Part II)-Changeover in the diagnosis and prognosis

    PubMed Central

    Carounanidy, Usha; Sathyanarayanan, R

    2009-01-01

    Realization that dental caries is a reversible, dynamic biochemical event at a micron level has changed the way the profession recognizes the caries disease and the caries lesion. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. The most appropriate diagnostic aid for this purpose is the risk model of caries risk assessment. The analyses of the biological determinants provide clues to the dominant causal factor. The detection of a carious lesion has undergone a rigorous revision and revolution in order to identify the earliest mineral change so that it can be controlled without resorting to invasive management options. Apart from detection, it became mandatory to assess the extent of the lesion (noncavitated/cavitated), assess the activity status of the lesion (active/arrested), monitor the lesion progress (progression/regression over a period of time), and finally to predict the prognosis of the lesion as well as the disease. The prognosis of the disease can be best assessed by analyzing the predictor factors in caries risk assessment. The ultimate objective of such a meticulous and methodical approach aids in devising a tailor-made treatment plan, using preventing measures precisely and restorative measures minimally. This ensures the best oral health outcome of the patient. PMID:20543914

  20. Altered inorganic composition of dental enamel and dentin in primary teeth from girls with Turner syndrome.

    PubMed

    Rizell, Sara; Kjellberg, Heidrun; Dietz, Wolfram; Norén, Jörgen G; Lundgren, Ted

    2010-04-01

    In Turner syndrome (TS) one X-chromosome is missing or defective. The amelogenin gene, located on the X-chromosome, plays a key role during the formation of dental enamel. The aim of this study was to find support for the hypothesis that impaired expression of the X-chromosome influences mineral incorporation during amelogenesis and, indirectly, during dentinogenesis. Primary tooth enamel and dentin from girls with TS were analysed and compared with the enamel and dentin of primary teeth from healthy girls. Qualitative and quantitative changes in the composition of TS enamel were found, in addition to morphological differences. Higher frequencies of subsurface lesions and rod-free zones were seen in TS enamel using polarized light microscopy. Similarly, scanning electron microscopy showed that the enamel rods from TS teeth were of atypical sizes and directions. Using X-ray microanalysis, high levels of calcium and phosphorus, and low levels of carbon, were found in both TS enamel and dentin. Using microradiography, a lower degree of mineralization was found in TS enamel. Rule induction analysis was performed to identify characteristic element patterns for TS. Low values of carbon were the most critical attributes for the outcome TS. The conclusion was that impaired expression of the X-chromosome has an impact on dental hard tissue formation.

  1. Design of a randomized controlled double-blind crossover clinical trial to assess the effects of saliva substitutes on bovine enamel and dentin in situ

    PubMed Central

    2011-01-01

    Background Hyposalivation is caused by various syndromes, diabetes, drugs, inflammation, infection, or radiotherapy of the salivary glands. Patients with hyposalivation often show an increased caries incidence. Moreover, hyposalivation is frequently accompanied by oral discomfort and impaired oral functions, and saliva substitutes are widely used to alleviate oral symptoms. However, preference of saliva substitutes due to taste, handling, and relief of oral symptoms has been discussed controversially. Some of the marketed products have shown demineralizing effects on dental hard tissues in vitro. This demineralizing potential is attributed to the undersaturation with respect to calcium phosphates. Therefore, it is important to modify the mineralizing potential of saliva substitutes to prevent carious lesions. Thus, the aim of the present study was to evaluate the effects of a possible remineralizing saliva substitute (SN; modified Saliva natura) compared to a demineralizing one (G; Glandosane) on mineral parameters of sound bovine dentin and enamel as well as on artificially demineralized enamel specimens in situ. Moreover, oral well-being after use of each saliva substitute was recorded. Methods/Design Using a randomized, double-blind, crossover, phase II/III in situ trial, volunteers with hyposalivation utilize removable dentures containing bovine specimens during the experimental period. The volunteers are divided into two groups, and are required to apply both saliva substitutes for seven weeks each. After both test periods, differences in mineral loss and lesion depth between values before and after exposure are evaluated based on microradiographs. The oral well-being of the volunteers before and after therapy is determined using questionnaires. With respect to the microradiographic analysis, equal mineral losses and lesion depths of enamel and dentin specimens during treatment with SN and G, and no differences in patients' experienced oral comfort after SN

  2. Oral Lactobacilli and Dental Caries: A Model for Niche Adaptation in Humans.

    PubMed

    Caufield, P W; Schön, C N; Saraithong, P; Li, Y; Argimón, S

    2015-09-01

    Lactobacilli have been associated with dental caries for over a century. Here, we review the pertinent literature along with findings from our own study to formulate a working hypothesis about the natural history and role of lactobacilli. Unlike most indigenous microbes that stably colonize a host, lactobacilli appear to be planktonic, opportunistic settlers that can gather and multiply only in certain restrictive niches of the host, at least within the oral cavity. We postulate that the following essential requirements are necessary for sustained colonization of lactobacilli in humans: 1) a stagnant, retentive niche that is mostly anaerobic; 2) a low pH milieu; and 3) ready access to carbohydrates. Three sites on the human body meet these specifications: caries lesions, the stomach, and the vagina. Only a handful of Lactobacillus species is found in caries lesions, but they are largely absent in caries-free children. Lactobacilli present in caries lesions represent both a major contributor to caries progression and a major reservoir to the gastrointestinal (GI) tract. We extend the assertion from other investigators that lactobacilli found in the GI tract originate in the oral cavity by proposing that lactobacilli in the oral cavity arise from caries lesions. This, in turn, leads us to reflect on the health implications of the lactobacilli in the mouth and downstream GI and to ponder whether these or any of the Lactobacillus species are truly indigenous to the human GI tract or the oral cavity.

  3. Validation of an early childhood caries risk assessment tool in a low-income Hispanic population

    PubMed Central

    Custodio-Lumsden, Christie L.; Wolf, Randi L.; Contento, Isobel R.; Basch, Charles E.; Zybert, Patricia A.; Koch, Pamela A.; Edelstein, Burton L.

    2016-01-01

    Objectives There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of “MySmileBuddy” (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC). Methods One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression. Results MSB diet risk scores were significantly positively associated with salivary mutans (P < 0.05), and approached significance with visible plaque levels (P < 0.1). MSB comprehensive risk scores were significantly associated with both oral mutans and visible plaque (P < 0.05). Neither was associated with visually evident decalcifications or cavitations. Conclusions Findings suggest that MSB may have clinical utility as a valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions. PMID:26440728

  4. Er:YAG laser irradiation to control the progression of enamel erosion: an in situ study.

    PubMed

    Scatolin, R S; Colucci, V; Lepri, T P; Alexandria, A K; Maia, L C; Galo, R; Borsatto, M C; Corona, S A M

    2015-07-01

    This in situ study evaluated the effect of Er:YAG laser irradiation in controlling the progression of enamel erosion-like lesions. Fifty-six enamel slabs (330 KHN ± 10 %) with one fourth of the surface covered with resin composite (control area) were submitted to initial erosion-like lesion formation with citric acid. The slabs were divided into two groups: irradiated with Er:YAG laser and non-irradiated. Fourteen volunteers used an intraoral palatal appliance containing two slabs, in two phases of 5 days each. During the intraoral phase, in a crossed-over design, half of the volunteers immersed the appliance in citric acid while the other half used deionized water, both for 5 min, three times per day. Enamel wear was determined by an optical 3D profilometer. ANOVA revealed that when deionized water was used as immersion solution during the intraoral phase, lower values of wear were showed when compared with the groups that were eroded with citric acid, whether irradiated or non-irradiated with Er:YAG laser. When erosion with citric acid was performed, Er:YAG laser was not able to reduce enamel wear. Small changes on enamel surface were observed when it was irradiated with Er:YAG laser. It may be concluded that Er:YAG laser irradiation did not reduce the progression of erosive lesions on enamel submitted to in situ erosion with citric acid.

  5. Administration of Bifidobacterium animalis subsp. lactis BB-12 in early childhood: a post-trial effect on caries occurrence at four years of age.

    PubMed

    Taipale, T; Pienihäkkinen, K; Alanen, P; Jokela, J; Söderling, E

    2013-01-01

    Probiotic bifidobacteria are widely used in the prevention of childhood diseases. These bacteria are also associated with caries occurrence. The present secondary analysis in a low-caries population evaluated the effect of early administration of Bifidobacterium animalis subsp. lactis BB-12 (BB-12) on caries occurrence and identified markers of dental decay in early childhood. In the original randomized, double-blind, placebo-controlled study (NCT00638677, http://www.clinicaltrials.gov), infants (n = 106) received BB-12, xylitol or sorbitol tablets from the age of 1-2 months to 2 years with a slow-release pacifier or a spoon (daily dose of BB-12 10(10) colony-forming units, polyol 200-600 mg). The present data were collected using clinical examinations and questionnaires at the age of 4 years. The occurrence of dental caries was assessed using the International Caries Detection and Assessment System. Oral hygiene status and mutans streptococci (MS) levels were also determined. No differences were detected between the study groups in the occurrence of enamel caries (p = 0.268) or obvious dentinal caries (p = 0.201). The occurrence of caries was associated with daily consumption of sweet drinks (p = 0.028), visible plaque observed (p = 0.002) and MS detected in the dental plaque (p = 0.002). Administration of BB-12 in infancy does not seem to increase or decrease the occurrence of caries by 4 years of age in a low-caries population. PMID:23571819

  6. RISK INDICATORS AND RISK PREDICTORS OF DENTAL CARIES IN SCHOOLCHILDREN

    PubMed Central

    Tagliaferro, Elaine Pereira da Silva; Ambrosano, Gláucia Maria Bovi; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos

    2008-01-01

    The purpose of this study was to identify risk indicators of high caries level at baseline (HCLB) based on cross-sectional data and predictors of high caries increment (HCI) based on a 7-year-follow-up examination in 6-8-year-old schoolchildren. Two hundred and six schoolchildren were examined in 1997 and in 2004 by the same two calibrated dentists, in Piracicaba, Brazil. At baseline, dental caries, presence of sealants, fluorosis, and oral hygiene status were recorded. The children's parents completed a questionnaire concerning socioeconomic level, fluoride use, dental service utilization, dietary and oral hygiene habits. HCLB and HCI were defined considering the upper quartile of the total caries experience distribution (dmfs+DMFS) and caries increment distribution, respectively. Logistic regression models were adjusted estimating the Odds Ratio (OR), 95% confidence intervals and p-values. Having white spot lesions (OR=5.25) was found to be a risk indicator of HCLB. Schoolchildren with dental fluorosis (OR=0.17) or those who brushed the teeth more than two times a day (OR=0.37) presented less probability of HCLB. The predictors of HCI were: dmfs>0 (OR=2.68) and mothers' educational level up to 8 years of schooling (OR=2.87). Clinical and socioeconomic variables were found to be risk indicators and/or predictors of dental caries in schoolchildren. PMID:19082400

  7. Porcelain enamel neutron absorbing material

    SciTech Connect

    Iverson, Daniel C.

    1990-01-01

    A porcelain enamel composition as a neutron absorbing material can be prepared of a major proportion by weight of a cadmium compound and a minor proportion of compounds of boron, lithium and silicon. These compounds in the form of a porcelain enamel coating or layer on several alloys has been found to be particularly effective in enhancing the nuclear safety of equipment for use in the processing and storage of fissile material. The composition of the porcelain enamel coating can be tailored to match the coefficient of thermal expansion of the equipment to be coated and excellent coating adhesion can be achieved.