demineralization

The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide‑amorphous calcium phosphate (CPP‑ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups.

In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP‑ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated‑measures ANOVA (α = 0.05).

All samples’ microhardness reduced considerably after immersion in liquid pharmaceuticals(amoxicillin [84.9 kgf/mm2 ] and ibuprofen [75.1 kgf/mm2 ]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin‑cheese and amoxicillin‑CPP‑ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen‑CPP‑ACP subgroup (P = 0.499).

As a result, cheese and CPP‑ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.

The aim of the study was to evaluate the effect of disinfection and storage solutions, and time periods on the fracture strength of whole teeth and tooth sections. One hundred and sixty extracted teeth were divided into 16 groups based on disinfection methods, storage times and tooth types. Teeth samples were measured, and areas calculated. Specimens groups were 1. 10% buffered formalin, 2. 0.2% thymol-in-saline, 3. 5.25% sodium hypochlorite (NaOCl), 4. OHCWA disinfection protocol, 5. Distilled-water. Each group had storage subgroups of 14, 90 and 180 days. Group 6 (control) were frozen in distilled water for 14 days. Specimens were tested using an Instron Universal tester and load at fracture was analyzed for statistical significance. The NaOCl group showed significantly lower loads at fracture compared to all other storage solutions at corresponding storage times. Distilled-water storage for 90 and 180 days had significantly lower fracture loads, except specimens stored in NaOCl for 14 and 90 days. The area of the specimen, was significantly associated with the magnitude of load at fracture. NaOCl storage significantly affected the fracture strength of teeth. Fracture resistance of teeth was inversely proportional to the storage time and directly proportional to the area of the specimen.

Remineralizing agents such as fluoride and casein phosphopeptide‑amorphous calcium phosphate (CPP‑ACP) are popular treatment choices for incipient enamel lesions. Recently introduced resin infiltration enhances the esthetics of teeth affected by these enamel lesions. Furthermore, few studies reported the utilization of colloidal silica infiltration for the white spot lesions. However, the potency of these materials for treatment in primary teeth necessitates investigation. Thus, this study evaluated and compared the effectiveness of CPP‑ACP fluoride (CPP‑ACPF), resin infiltration, and colloidal silica infiltration on surface microhardness in artificial white spot lesions in primary incisors using the Vickers microhardness testing machine.

In this in vitro study, on the labial surface of 45 primary incisors, artificial white spot lesions were created by immersing them in a demineralizing solution. According to the evaluation method, random distribution of specimens into three groups: Group 1: CPP‑ACPF, Group 2: resin infiltration, and Group 3: colloidal silica infiltration. Specimens after treatment were stored in artificial saliva, followed by microhardness evaluation using Vickers microhardness. Microhardness readings at baseline, post demineralization, and after treating them with different materials were taken. The level of significance was 0.01.

Enamel specimens treated with resin infiltration showed a high microhardness mean value compared to CPP‑ACPF and colloidal silica infiltration.

Resin infiltration is a promising and effective treatment option for incipient enamel lesions followed by CPP‑ACPF compared to colloidal silica infiltration in primary teeth.

The use of sports and energy drinks has drastically increased in the adolescent population. This population often is in orthodontic treatment, and the use of such drinks with poor oral hygiene promotes the development of white spot lesions (WSLs). Quantifying the degree of the lesion has been limited in the past. The hypothesis was that the Canary Caries Detection System could be used to quantify the degree of WSLs caused by different commercial beverages.

A total of 105 extracted human premolars were divided into seven groups (n=15). Each group was tested in one of six beverages or a phosphate-buffered solution (control). The teeth were exposed to its beverage three times a day for 15 minutes for 28 days. Canary numbers and ambient light and fluorescent photographs were collected at baseline (T0 ) and on days 14 (T1 ) and 28 (T2 ).

The paired t test and one-way ANOVA found that T0 to T1 measurements were statistically significant (P<0.0015) and that T0 to T2 measurements were statistically significant (P<0.0001). Visually, the ambient light photographs and fluorescent photographs from T0 to T1 and T1 to T2 correlated with the increase in Canary numbers.

This in vitro study revealed a statistically significant increase in the T0 to T1 Canary numbers and a statistically significant increase from T0 to T2 Canary numbers for all the test beverages. Changes in Canary numbers indicated significant changes in mineral density (i.e., demineralization) and development of WSLs on enamel after exposure to sports and energy beverages.

Different factors play a role in causing tooth decay. Modern dentistry is looking for a way to prevent tooth decay and suggests different ways to increase remineralization. The aim of this study was to evaluate the effect of nanohydroxyapatite toothpaste and mouthwash on remineralization of primary enamel lesions and obstruction of tubules.

In this study, 90 human extracted central teeth were used. Artificial decay was induced by placing the specimens for 72 hrs in a demineralization solution in an incubator at 37 °C. Hardness of the specimens was determined by a microhardness test before any surface treatment. The specimens were then divided randomly into 6 groups of 15. For 1-6 groups, the specimens were subjected to a pH cycling for 14 days, which included 3 hrs of demineralization and 21 hrs of remineralization. At the same time, 1-3 groups were in contact with diluted toothpaste in a ratio of 1:3 with deionized water at a rate of 5 ml twice a day for two min. Eac specimen of 4-6 groups was exposed to 5 ml of three types of mouthwashes for one min. Then, the specimens were cut in the buccolingual direction in order to simultaneously evaluate the dentinal tubules and Vickers microhardness test was performed again and the before and after microhardness values were compared. Then, the percentage of deposition on the surface and tubule obstruction were analyzed using SEM (Scanning electron microscope) (P=0.006). Data were analyzed using SPSS24 software bu the descriptive statistics, ANOVA analysis of variance, and multiple Tukey comparisons.

The results of analysis of variance test showed that there was a statistically significant difference in the microhardness changes between study groups (P=0.006). Also, in-group analysis of microhardness changes, there was a significant difference (P<0.0001). Besides, only in the group containing 0.5% nanohydroxyapatite toothpaste, more than 50% tubule deposition and obstraction was observed (P<0.05).

According to the present study, nanohydroxyapatite can be one of the treatment strategies to repair incipient lesions of teeth and the addition of nanohydroxyapatite, preferably to toothpaste, increases the dental microhardness.

Evidence shows that people from different regions have different teeth characteristics based on their daily water consumption. This exploratory study aimed to measure the mineralization potential of mineral water and fresh milk on the demineralized enamel surface. The enamel surface was softened for 10 min in 100 ml of 1% citric acid under 150 rpm agitation in all specimens. Afterward, the specimens were mineralized with 100 ml of mineral water and milk under 150 rpm agitation. The mineral content of the enamel surface before and after the treatment in nanoscale was measured using an energy-dispersive X-ray spectrometer (EDXS). Before and after treatment, the results of EDXS were analyzed using a one-way ANOVA test. The results showed that initial treatment with citric acid significantly increased the surface roughness of the enamel surface. Moreover, in treatment with fresh milk, the potassium and sodium content of the enamel surface increased. It was also reported that mineral water treatment increased the sodium content of the enamel surface. The findings suggested that milk and mineral water might slightly recover the damage induced by citric acid on the enamel surface.

Since bone defects can result in different disabilities, many efforts have been made to bone tissue engineering. In this case, scaffolds play an important role as a key element of tissue engineering in providing three-dimensional structure for cell growth in vitro The aim of the present study was to provide the three-dimensional biological bioscaffold from the bovine femur dense bone and investigate the possibility of its potential for application in tissue engineering as biological 3D ECM bioscaffold via mesenchymal stem cells seeding and differentiation toward bone tissue. For the preparation of bioscaffolds, after cutting bovine femur bone into small pieces, demineralization and decellularization were done. Bioscaffolds biocompatibility was evaluated using an MTT assay. The morphological and cell adhesion characteristics of Bone marrow mesenchymal stem cells (BMSCs) on the bioscaffolds were evaluated using Scanning Electron Microscopy (SEM) technique. Finally, the cells were treated with an osteogenic differentiation medium and then evaluated for differentiation. Histological studies showed that the use of sodium dodecyl sulfate (2.5%) for 8 h eliminated the cells. Radiography and calcium oxalate test confirmed demineralization. MTT assay and SEM studies showed that the obtained bioscaffolds are biocompatible and could provide an optimum three-dimensional environment for cell adhesion and movement. Moreover, the Alizarin red staining showed a higher differentiation rate for BMSCs. In the present study, bone-derived 3D bioscaffold showed an important role in the growth and differentiation of BMSCs, due to the natural characteristics, cell adhesion properties, and potential to enhance differentiation toward bone tissue. It may have the potential for use as bioscaffold as supporting metrics for maintenance, growth in bone tissue engineering.

Dental decay is caused by the fermentation of carbohydrates and the production of acids which demineralize teeth. The fermented food debris lowers the pH under 5.5, resulting in the mineral loss of teeth. Anti-decay factors are used to reduce decay rates and increase dental protection.

Fifteen sectioned teeth samples were immersed in Ag NPs solution and then irradiated with laser pulses. Structures, morphologies, chemical compositions and microhardness were studied using the Vickers micro-hardness tester, energy dispersive x-ray machine, atomic force microscope and scanning electron microscopes.

Nine mature extracted human third molars, cleaned and placed in plastic molds then filled with a warm epoxy resin, were sectioned longitudinally and polished. The samples were then cleaned ultrasonically and stored in distilled water and taken immediately one by one for laser treatment. Sharper, overlapping, interconnected rods and higher resistance against enamel decay were demonstrated with little alterations of the mineral percentages of the teeth samples.

The combination of laser light and silver annoparticles improved the decay resistance; where regular inter-connected chain-like merged grains were formed. These laser-induced modifications in enamel components have reduced the lattice stress and enamel solubility and improved resistance against decay. The computer model indicated a possible prediction of the laser- treated profile prior to laser treatment.

The aim of this study is to quantitatively evaluate the remineralization potential of three remineralizing systems as follows: fluoride, casein phosphopeptide‑amorphous calcium phosphate (CPP‑ACP), and CPP‑ACP with fluoride, under scanning electron microscope with energy‑dispersive X‑ray analysis.

In this in vitro study A total of 40 enamel specimens were prepared from the buccal or lingual surfaces of human premolars extracted for orthodontic reason. Specimens were then placed in demineralizing solution for 96 h, to produce artificial caries‑like lesion. Calcium and phosphate weight percentage of demineralized specimens was measured. Specimens were divided into four groups as follows: (a) control, (b) CPP‑ACP, (c) CPP‑ACP with fluoride, and (d) fluoride varnish. Except for the control group, the entire specimens were subjected to remineralization using respective remineralizing agents of their groups. The prepared specimens were assessed for calcium and phosphate weight percentage using scanning electron microscopy‑energy dispersive X‑ray spectroscopy. One way analysis of variance (ANOVA), followed by Tukey’s test, was performed with the help of critical difference (CD) or least significant difference at 5% and 1% level of significance. P ≤ 0.05 was taken to be statistically significant and P < 0.001 as statistically highly significant.

The mean weight percentage of calcium and phosphorus of specimens treated with CPP‑amorphous calcium phosphate nanocomplexes plus fluoride (ACPF) was significantly higher than other groups.

All the groups showed statistically significant remineralization. However, because of added benefit of fluoride, CPP‑ACPF showed statistically significant amount of remineralization than CPP‑ACP

Investigations have demonstrated that fluoride is an essential element in preventive dentistry. However, there are still controversies about the preventive effects of various kinds of laser. The aim of this study was to examine the effect of diode laser irradiation (810 nm) with or without fluoride therapy in the prevention of deciduous enamel demineralization.
Sixty deciduous molar crowns were randomly assigned to 6 groups: C: received no treatment; F: fluoride varnish application; 2L: 2 times diode laser irradiation; 4L: 4 times diode laser irradiation; F2L: 2 times laser irradiation over fluoride varnish; F4L: 4 times laser irradiation over fluoride varnish. Teeth in all groups were subjected to a pH-cycling process to produce artificial caries-like lesions.
The analysis of variance (ANOVA) of microhardness values indicated a significant great effect for laser, fluoride, and the interaction of laser- fluoride on reducing the final microhardness value (P Our results suggest that fluoride varnish, diode laser, and their combination decrease the loss of the enamel microhardness value and potentially prevent deciduous enamel demineralization. However, the combination of laser and fluoride was not more effective than fluoride.

Orthodontic treatment has many advantages such as esthetic improvement and self-esteem enhancement; yet it has some disadvantages such as increasing the risk of formation of white spot lesions, because it makes oral hygiene more difficult. It is rational to implement procedures to prevent these lesions. The present study was aimed to assess the effect of CO2 laser and fluoride varnish on the surface of the enamel surface microhardness around the orthodontic braces.
Eighty extracted premolar teeth were selected, scaled, polished with nonfluoridated pumic and metal brackets were bonded to them. Then, they were randomly allocated to 5 groups: control (neither fluoride nor laser is used on enamel surfaces), fluoride (4 minutes fluoride varnish treatment of the enamel surfaces), CO2 laser (10.6 μm CO2 laser irradiation of the teeth), laser-fluoride (fluoride application after laser irradiation) and fluoride-laser (fluoride was applied and then teeth were irradiated with laser). After surface treatment around brackets on enamel, the samples were stored in 0.1% thymol for less than 5 days and then they were exposed to a 10-day microbiological caries model. Microhardness values of enamel were evaluated with Vickers test. One sample of each group (5 teeth from 80 samples) was prepared for SEM (scanning electron microscopy) and the data from 75 remaining teeth were analyzed with analysis of variance (ANOVA) and chi-square tests (α = 0.05).
Microhardness mean values from high to low were as follow: fluoride-laser, laser-fluoride, laser, fluoride and control. Microhardness in fluoride-laser group was significantly higher compared with that of the control group. Distribution adhesive remnant index (ARI) scores were significantly different between groups and most of bond failures occurred at the enamel-adhesive interface in groups 2 to 5 and at the adhesive-bracket interface in the control group.
Combination of fluoride varnish and CO2 laser irradiation can reduce enamel demineralization around orthodontic brackets.

The aim of this study was to assess the caries-preventive potential of carbon dioxide (CO2) laser application in conjunction with the use of titanium tetra fluoride solution on the enamel adjacent to bracket.
Seventy-five freshly extracted bovine incisors were used. In order to attach the brackets, the area of examination was covered with adhesive tape to limit acid etching of the entire enamel surface. Metal orthodontic brackets for upper central were bonded to all the teeth following the manufacturer’s instruction. Then all the teeth were painted with 2 layers of acid-resistant nail varnish on all surfaces except the boxes area cervical to the brackets. The teeth were then randomly divided into five groups (n = 15): control group (C); laser group (L); titanium group (T); laser-titanium group (LT) and titanium-laser group (TL). The laser-titanium group was first irradiated with CO2 laser (same as the L group) then TiF4 solution was applied on the enamel (same as the T group). Samples in the TL group were first treated with TiF4 solution (same as the T group) and then irradiated with CO2 laser on the surface (same as the L group). Then, the teeth were immersed in pH-cycling solutions. After that, the amount of calcium released into the two solutions (de- and re-mineralization) was measured with an atomic absorption spectroscopy. The data were analyzed by one-way Analysis of var-iance (ANOVA) and Tukey test.
Calcium loss in LT, TL and T groups were significantly lower than those in the L and C groups (P The application of Titanium tetra fluoride 4% solution on enamel can inhibit as much as 87% of subsequent caries like lesion progression.

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. 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. 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). 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.

One complication of fixed orthodontic treatment in patients with poor oral hygiene is development of demineralized enamel lesions compromising esthetics. This study aimed to review preventive measures and treatment of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Review of Literature: In this review study, PubMed and Google Scholar databases were searched for articles published during 1964-2013 using the keywords “white spot lesions”, “demineralization”, “mastic gum”, “casein phosphopeptide amorphous calcium phosphate or CPP-ACP”, “chitosan” and “orthodontics”; 96 articles were evaluated. White spot lesions can be prevented by conventional plaque control and adjunct measures such as the use of fluoride-containing compounds, chlorhexidine (CHX), xylitol gums, chitosan compounds and laser. Low-concentration fluoride, CPP-ACP compounds and laser help remineralize these lesions. If not treated, bleaching, microabrasion and tooth restoration are the final solutions.