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Ivette Guanipa Ortiz M, Gomes de Oliveira S, de Melo Alencar C, Baggio Aguiar FH, Alves Nunes Leite Lima D. Remineralizing effect of the association of nano-hydroxyapatite and fluoride in the treatment of initial lesions of the enamel: A systematic review. J Dent 2024; 145:104973. [PMID: 38556192 DOI: 10.1016/j.jdent.2024.104973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Assessed the effect of dental products containing nano-hydroxyapatite (nano-HA) + fluoride on the remineralization of white spot lesions (WSL) in vivo or in situ. METHODS Seven databases were explored using a two-pronged approach (intervention/treatment). After screening, full-text assessment, and further exclusion, the qualitative synthesis of five studies (four clinical and one in situ) was performed. Based on the Cochrane collaboration guidelines relevant data of the studies were collected and summarized. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to appraise the studies' methodological quality and the GRADE guidelines to assess their level of evidence. The RoB 2.0 domains were rated on their risk of bias (RoB) as low, high, or with some concerns, and an adaptation of the tool was used to the in situ study. RESULTS The included studies assessed 151 WSL in anterior permanent teeth, on patients with varying ages. The protocol application, treatment length (7d-12 w), and control groups varied greatly between the studies making the performance of a quantitative analysis unfeasible. The general RoB of the clinical studies was classified as being of low risk (n = 2) or some concerns (n = 2). The in situ study was considered as being of low risk. The level of the evidence was moderate. Most of the studies found moderate evidence regarding the superiority of this association in clinical settings. CONCLUSION Even with the nano-HA + fluoride promising results for the remineralization treatment of WSL, due to the restricted number of studies and types of products, its extended use cannot be recommended based on the current systematic review, especially when considering the moderate level of the evidence found. CLINICAL SIGNIFICANCE Due to the biocompatibility and higher surface coverage of nano-HA and the remineralization capacity of fluoride formulations, the association of these elements to remineralize WSL has been positively reported. After the collection and qualitative appraise of the data, the clinical evidence of the use of these dental products is promising but limited.
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Affiliation(s)
| | - Simone Gomes de Oliveira
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas -UNICAMP, Brazil
| | - Cristiane de Melo Alencar
- Department of Dental Materials of the Graduate Program in Dentistry, Federal University of Pará, Belém, PA, Brazil
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Shankarappa S, Burk JT, Subbaiah P, Rao RN, Doddawad VG. White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives. J Orthod Sci 2024; 13:21. [PMID: 38784071 PMCID: PMC11114457 DOI: 10.4103/jos.jos_205_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 05/25/2024] Open
Abstract
White spot lesions (WSLs) refer to localized areas of hypo-mineralization limited to the enamel of the teeth surface, which is noticeable clinically to the naked eye on drying of the teeth. During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus. This review aims to elaborate and focus on etiology, pathophysiology, diagnosis, treatment aspect, and future scope for research about the WSLs occurring due to fixed orthodontic treatment.
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Affiliation(s)
- Suma Shankarappa
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Jerusha Titus Burk
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Pradeep Subbaiah
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Raghunath Nagasundara Rao
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, A Constituent College of JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Vidya Gowdappa Doddawad
- Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
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Rahmath Meeral P, Doraikannan S, Indiran MA. Efficiency of casein phosphopeptide amorphous calcium phosphate versus topical fluorides on remineralizing early enamel carious lesions - A systematic review and meta analysis. Saudi Dent J 2024; 36:521-527. [PMID: 38690375 PMCID: PMC11056415 DOI: 10.1016/j.sdentj.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 05/02/2024] Open
Abstract
Objective To assess the remineralizing efficiency of caesin phosphopepdide amorphous calcium phosphate (CPP-ACP) versus topical fluorides on early enamel lesions in vivo. Data sources PubMed, Web of Science, Scopus, EBSCO were searched based on the PICOS criteria up to December 2022 with English language restriction. All relevant studies were subjected to two separate reviews before being included at the title, abstract, and full text levels. Study selection 41 studies were reviewed and 11 selected for inclusion in the final sample for the review. All were randomized clinical trials with the follow-up period of the studies ranging from 3 to 12 months. Out of the 11 studies, only two are with low risk of bias on assessment with Cochrane risk of bias assessment tool, while the other nine articles were with the moderate and high risk of bias. Conclusions Conflicting evidence exists on the clinical efficacy of CPP-ACP compared to the various fluoride forms tested, and no adverse effect associated with CPP-ACP use was discovered in comparison to fluorides that had certain detrimental health impacts. Although, the review results in favor of both fluorides and CPP-ACP with similar clinical efficiency, when ill effects are considered the CPP-ACP can be a choice of remineralizing early enamel lesions. However, before concrete suggestions can be given, high-quality, well-designed clinical research in this area are still necessary. Clinical significance A considerable remineralizing impact has been shown in both in vitro and in vivo experiments, making CPP-ACP/CPP-ACPF a more promising remineralizing agent than fluorides. Therefore, this can be applied clinically to early enamel carious lesion.
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Affiliation(s)
- P. Rahmath Meeral
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
| | - Srisakthi Doraikannan
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai 600077, India
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Shu J, Huang Y, Ma X, Duan Z, Wu P, Chu S, Wu Y, Wang Y. Aesthetic impact of resin infiltration and its mechanical effect on ceramic bonding for white spot lesions. BMC Oral Health 2024; 24:365. [PMID: 38515110 PMCID: PMC10958835 DOI: 10.1186/s12903-024-04011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/11/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Treating white spot lesions (WSLs) with resin infiltration alone may not be sufficient, raising questions about its compatibility with other treatments amid controversial or incomplete data. Therefore, this study aimed to assess the aesthetic feasibility of resin infiltration combined with bleaching, as well as its potential mechanical effect on ceramic bonding to WSLs. METHODS One hundred and fifty flat enamel surfaces of bovine incisors were prepared. Ninety specimens were deminerailized and randomly assigned to three groups(n = 30): post-bleaching resin infiltration (Bl-R), pre-bleaching resin infiltration (R-Bl), and only resin infiltration (R). Color, surface roughness and microhardness were assessed in immediate, thermocycling and pigmentation tests. The remaining sixty samples were randomly assigned to three groups (n = 20): control (Ctrl), bonding (Bo), pre-bonding resin infiltration (R-Bo). Shear bonding strength, failure mode, micro-leakage depth and interface morphology were evaluated after ceramic bonding. The Tukey test and analysis of variance (ANOVA) were used for statistical analysis. RESULTS For the effect of resin infiltration and bleaching on WSLs, the R-Bl group showed the worst chromic masking ability, with the highest |ΔL|, |Δa|, |Δb|, and ΔE values after treatment. Compared with those in the Bl-R group, the R-Bl and R groups showed significant time-dependent staining, which is possibly attributed to their surface roughness. For the effect of resin infiltration on the adhesive properties of WSLs, resin infiltration reduced the staining penetration depth of WSLs from 2393.54 ± 1118.86 μm to 188.46 ± 89.96 μm (P < 0.05) while reducing WSLs porosity in SEM observation. CONCLUSIONS Post-bleaching resin infiltration proved to be advantageous in the aesthetic treatment of WSLs. Resin infiltration did not compromise bonding strength but it did reduce microleakage and enhance marginal sealing. Overall, resin infiltration can effectively enhance the chromatic results of treated WSLs and prevent long-term bonding failure between ceramics and enamel. Based on these findings, the use of post-bleaching resin infiltration is recommended, and resin infiltration before ceramic bonding is deemed viable in clinical practice.
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Affiliation(s)
- Jiaen Shu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yijia Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xueying Ma
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhonghua Duan
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Pei Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Sijing Chu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yuqiong Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
- National Center for Stomatology, Shanghai, China.
- National Clinical Research Center for Oral Diseases, Shanghai, China.
- Shanghai Key Laboratory of Stomatology, Shanghai, China.
- Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Yuhua Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.
- National Center for Stomatology, Shanghai, China.
- National Clinical Research Center for Oral Diseases, Shanghai, China.
- Shanghai Key Laboratory of Stomatology, Shanghai, China.
- Shanghai Research Institute of Stomatology, Shanghai, China.
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Chabuk MMG, Al-Shamma AMW. Surface roughness and microhardness of enamel white spot lesions treated with different treatment methods. Heliyon 2023; 9:e18283. [PMID: 37539286 PMCID: PMC10395522 DOI: 10.1016/j.heliyon.2023.e18283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/17/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Objective To analyse the surface roughness and microhardness of artificial enamel white spot lesions before and after WSL formation, after treatment (Opalsutre™ microabrasion, Sylc® bioactive glass, and ICON® resin infiltration), and after pH cycling with the help of the profilometer surface roughness tester and the digital Vickers microhardness tester. Materials and methods Seventy-five extracted molars were used to acquire one hundred specimens. 50 specimens were randomly assigned to five groups (n = 10) for the surface roughness study: 1) Sound group, 2) WSL group, 3) micro abrasion (MA; Opalustre, Ultradent, South Jordan, UT, USA), 4) bioactive glass 45S5 Sylc powder (Sylc; Denfotex Research Ltd, Inverkeithing, UK), and 5) ICON resin infiltration (ICON; DMG, Hamburg, Germany). An additional 25 specimens were used to obtain 50 enamel slabs for the surface microhardness study, which were also assigned to the same groups. All groups underwent a final stage of pH cycling. Surface roughness and surface microhardness measurements were performed at different stages for all groups. Results Regarding surface roughness, ICON significantly reduced the surface roughness compared to Opalustre and Sylc, with no significant difference between Opalustre and Sylc. In terms of surface microhardness, ICON showed the highest improvement, followed by Sylc and then Opalustre. Both surface roughness and microhardness were significantly affected by demineralization, partially improved after treatment, and then regressed significantly after pH cycling. Conclusion ICON resin infiltrant can be considered as a superior treatment option for improving surface roughness and microhardness, while Opalustre demonstrated relatively the poorest performance compared to the other treatment options. It is noteworthy that the pH cycling procedure had an adverse impact irrespective of the treatment option used.
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Affiliation(s)
- Mina MG. Chabuk
- Corresponding author. Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad. Al-Mansour, Baghdad, 10011, Iraq.
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Salah R, Afifi RR, Kehela HA, Aly NM, Rashwan M, Hill RG. EFFICACY OF NOVEL BIOACTIVE GLASS IN THE TREATMENT OF ENAMEL WHITE SPOT LESIONS: A RANDOMIZED CONTROLLED TRIAL✰. J Evid Based Dent Pract 2022; 22:101725. [PMID: 36494113 DOI: 10.1016/j.jebdp.2022.101725] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES to evaluate the efficacy of 2 types of bioactive glass (45S5) compared to casein-phosphopeptide stabilized-amorphous calcium phosphate (CPP-ACP) in the treatment of orthodontically-induced white spot lesions (WSLs). METHODS Sixty post-orthodontic WSLs (ICDAS II score 2) were randomly allocated to a double blind randomized controlled trial with 3 parallel arms (n = 20). Test group I (Bio-BAG) received BiominF slurry and toothpaste, and test group II (N-BAG) received Novamin slurry and toothpaste. While the positive control group (CPP-ACP) received Recaldent paste. Products were applied daily in-office during week 1, and boosted by self-administered home application for 4 weeks (week 1-4). Standard oral hygiene care was performed by all participants twice daily during months 2-6. All patients were assessed for change in WSL dimensions using computer assisted analysis based on standardized digital intraoral photographs in addition to laser fluorescence DIAGNOdent assessment before treatment (T0) and at 1 week (T1), 1 month (T2), 3 months (T3,) and 6 months (T4) follow up periods. RESULTS Kruskal Wallis test was used (P < .05 for all). At T4, a statistically significant (P < .001) regression of WSL was disclosed in all 3 groups compared to baseline, and a highly significant lesion size percent reduction in Bio-BAG group compared to the control group (P < .001). The mean area of the lesions decreased by 64.8%, 32.2%, and 31.6% for groups I, II and III respectively (P = .001). DIAGNOdent findings largely reflected the clinical scores (Mean scores at baseline/T4 for groups I, II, and III respectively; 16.57/3.62, 16.93/7.90, 21.95/19.27). No adverse effects were reported. CONCLUSIONS The combined in-office and home-application of BiominF paste for 4 weeks resulted in greater esthetic improvements of post-orthodontic WSLs compared to Novamin and CPP-ACP. In addition, BiominF showed a significant reduction in fluorescence intensity which indicates potential lesion remineralization. CLINICAL RELEVANCE Post-orthodontic WSLs can be diminished using bioactive glass remineralization therapy.
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Affiliation(s)
- Rania Salah
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Rania R Afifi
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hany A Kehela
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Nourhan M Aly
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maher Rashwan
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt; Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Robert G Hill
- Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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da Freiria ACB, Ortiz MIG, de Sobral DFS, Aguiar FHB, Lima DANL. Nano-hydroxyapatite-induced remineralization of artificial white spot lesions after bleaching treatment with 10% carbamide peroxide. J ESTHET RESTOR DENT 2022; 34:1290-1299. [PMID: 36205242 DOI: 10.1111/jerd.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/08/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assessed in vitro the effect of nanohydroxyapatite (n-HA) to improve the aesthetic appearance and microhardness of white spot lesions (WSL) when associated with a low-concentration bleaching agent (carbamide peroxide-CP10%). MATERIAL AND METHODS Enamel/dentin specimens (n = 60) of 5 × 5 × 2.2 mm were prepared, of these, 48 were submitted to pH-cycling to create artificial WSL. Subsequently, these were allocated into five groups (n = 12): n-HA; n-HA + CP10%; CP10%; WSL control (WSLC ); sound control (Sound). The color was assessed at baseline, pre-treatment, and post-treatment using a spectrophotometer, and the color (ΔE/ΔE00 ) and whiteness index (ΔWID) alterations were determined. The enamel cross-sectional microhardness (CSMH) was evaluated (post-treatment) with a Knoop indenter, 25gf/5 s, 20-200 μm. The data was analyzed through generalized linear models (α = 5%). RESULTS ΔE and ΔE00 were significantly higher for the bleached groups (n-HA + CP10% and CP10%), and the n-HA was higher than the WSLC group (p < 0.05). ΔWID was significantly higher for the bleached groups (p < 0.05). The CSMH values were significantly higher in the sound group than in the n-HA, CP10%, and WSLC groups (p < 0.05). The WSLC had lower microhardness than the n-HA + CP10% and sound groups (p < 0.05). CONCLUSION n-HA is suitable to remineralize and recover the color of the WSL. However, its association with CP10% maintains the esthetical outcome while increasing its in-depth remineralizing effect. CLINICAL SIGNIFICANCE Considering the aesthetic and functional repercussions of the WSL persistence, treatments that tend to improve its physical appearance and reinforce its weakened substructure in a non-invasive way are ideal. For this associating low-concentration, bleaching agents to the remineralizing treatments is promising to treat this type of lesions.
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Affiliation(s)
| | | | | | - Flavio Henrique Baggio Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Débora Alves Nunes Leite Lima
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Hamdi K, Hamama HH, Motawea A, Fawzy A, Mahmoud SH. Long-term evaluation of early-enamel lesions treated with novel experimental tricalcium silicate paste: A 2-year randomized clinical trial. J ESTHET RESTOR DENT 2022; 34:1113-1121. [PMID: 35815478 DOI: 10.1111/jerd.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/07/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the current study is to evaluate the remineralization potential of experimental tricalcium silicate (TCS) paste in comparison with more popular remineralizing agents like silver diamine fluoride potassium iodide (SDF-KI) and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on early enamel lesions. MATERIALS AND METHODS Forty-five patients in the age range of 15-50 years had early enamel lesions on the buccal surface of molar teeth. The patients were randomly divided into three treatment groups (SDF-KI, CPP-ACP, and TCS group) with 15 patients per group. Lesions were evaluated clinically by DIAGNOdent pen immediately and after 3,6,12, and 24 months of treatment. RESULTS The study was completed with 45 patients and 92 teeth. Twice-daily application of CPP-ACP and TCS paste showed a significant remineralization effect on early enamel lesions after 24 months (p < 0.001). Also, annual application of SDF-KI showed a significant remineralization effect after 24 months (p < 0.001). There was a significant difference between (SDF-KI and CPP-ACP) and (SDF-KI and TCS) at the different follow-up periods 3,6,12, and 24 months (p < 0.001). Meanwhile, there was no significant difference between CPP-ACP and TCS at the mentioned follow-up periods (p > 0.05). CONCLUSION TCS showed potential remineralization for early enamel lesions. CLINICAL RELEVANCE Experimental TCS is a promising remineralizing agent for management of early enamel lesions.
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Affiliation(s)
- Kareem Hamdi
- Operative Dentistry Department, Faculty of Dentistry, Zagazig University, Zagazig, Egypt
| | - Hamdi H Hamama
- Operative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Amira Motawea
- Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Amr Fawzy
- UWA Dental School, University of Western Australia, Perth, Western Australia, Australia
| | - Salah Hasab Mahmoud
- Operative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Memarpour M, Razmjouei F, Rafiee A, Vossoughi M. Remineralization effects of self-assembling peptide P 11 -4 associated with three materials on early enamel carious lesions: An in vitro study. Microsc Res Tech 2022; 85:630-640. [PMID: 34549853 DOI: 10.1002/jemt.23937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/28/2021] [Accepted: 09/01/2021] [Indexed: 11/09/2022]
Abstract
The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P11 -4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P11 -4, (3) fluoridate toothpaste (FT), (4) P11 -4 + FT, (5) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), (6) P11 -4 + CPP-ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P11 -4 + BT. The surface enamel microhardness (EMH) and energy-dispersive X-ray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05). EMH after demineralization was significantly lower than the baseline value (p < .001). The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P11 -4 was significantly lower than the others (p < .001). The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.
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Affiliation(s)
- Mahtab Memarpour
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Faranak Razmjouei
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azade Rafiee
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Vossoughi
- Oral and Dental Disease Research Center, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Nadar B, Yavagal P, Velangi C, Yavagal C, Basavaraj S. Efficacy of casein phosphopeptide-amorphous calcium phosphate varnish in remineralizing white spot lesions: A systematic review and meta-analysis. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.346406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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López-García S, Guerrero-Gironés J, Pecci-Lloret MP, Pecci-Lloret MR, Rodríguez-Lozano FJ, García-Bernal D. In Vitro Biocompatibility of CPP-ACP and Fluoride-containing Desensitizers on Human Gingival Cells. Oper Dent 2021; 46:E264-E275. [PMID: 34919730 DOI: 10.2341/20-245-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To analyze the biocompatibility of different desensitizers containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride in their composition: MI Varnish (MV), Clinpro White Varnish (3M Oral Care), Profluorid Varnish (VOCO), Duraphat (Colgate) and Embrace Varnish (Pulpdent) on human gingival fibroblast cells (hGF). METHODS AND MATERIALS Human gingival fibroblast (hGF) cells were exposed to several desensitizer extracts at different concentrations (0.1%, 1%, and 4% eluates). Then, in vitro biocompatibility was studied by analyzing the IC50 value, cell proliferation (MTT assay and cell cycle), cell migration (wound healing assay), cell morphology and F-actin content (immunocytofluorescence), and induction of apoptosis/necrosis (flow cytometry). Data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey test. RESULTS The lowest cell viability and IC50 were observed in all concentrations of Embrace Varnish-treated hGFs (p<0.001), whereas the highest were exhibited by those treated with Clinpro White Varnish. Similar effects were evidenced when induction of apoptosis/necrosis and cell migration assays were assessed. Finally, MI Varnish, Profluorid Varnish, Duraphat, and Embrace Varnish extracts showed lower numbers of attached cells, some of them with an unusual fibroblastic morphology when cultured with 4% concentration of the varnishes, while Clinpro White Varnish exhibited a similar number of cells with an evident actin cytoskeleton compared to the control group. CONCLUSIONS The results obtained in this study indicate that hGFs show better in vitro biocompatibility after exposure to Clinpro White Varnish, even at the highest concentration employed, making it the most eligible for topical applications. In contrast, Embrace Varnish exhibited a high cytotoxicity towards hGFs that could potentially delay the healing process and regeneration of the oral mucosa, although more studies are needed to confirm this hypothesis.
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Affiliation(s)
- S López-García
- Sergio López-García BS, PhD, School of Dentistry/Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - J Guerrero-Gironés
- Julia Guerrero-Gironés DDS, PhD, School of Dentistry/Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - M P Pecci-Lloret
- María Pilar Pecci-Lloret DDS, PhD, School of Dentistry/Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - M R Pecci-Lloret
- Miguel Ramón Pecci-Lloret DDS, PhD, School of Dentistry/Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - F J Rodríguez-Lozano
- *Francisco Javier Rodríguez-Lozano, DDS, PhD, School of Dentistry/Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - D García-Bernal
- David García-Bernal BS, PhD, Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
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Gutiérrez-Prieto SJ, Sequeda-Castañeda LG, Penedo-Jaramillo GM, Chacín-Nieto AV, Contreras-Cáceres DR, Moreno-Abello GC, Galvis-Rincón MP, Gamboa-Jaimes FO, Luengas-Caicedo PE. In vitro mineral apposition analysis of two Colombian plant extracts on Amelogenesis imperfecta teeth. Clin Exp Dent Res 2021; 8:336-349. [PMID: 34498426 PMCID: PMC8874054 DOI: 10.1002/cre2.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/30/2021] [Accepted: 08/08/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To determine if native Colombian Piper marginatum Jacq. and Ilex guayusa Loes plant extracts have a remineralizing effect on teeth with Amelogenesis imperfecta in comparison with the commercial products Clinpro-3M and Recaldent™. MATERIAL AND METHODS An in vitro study was carried out with 128 human teeth slices (64 healthy and 64 with Amelogenesis imperfecta) on which an initial Raman spectroscopy was performed followed by Raman spectroscopies at 0, 24, 48, and 72 h to determine possible remineralization by observing mineral increase or decrease as a result of P. marginatum Jacq. and I. guayusa Loes extract application in comparison to control substance (Clinpro and Recaldent™) application. Obtained data were analyzed using a bivariate method with a t unidirectional test. Significant differences among groups were determined by an ANOVA with Dunnett post hoc tests. RESULTS Native I. guayusa Loes and P. marginatum Jacq. Colombian plants extracts exhibited phosphate and orthophosphate mineral apposition, where P. marginatum Jacq. presented better results. CONCLUSIONS Native Colombian I. guayusa Loes and P. marginatum Jacq plant extract might in the future be useful for dental tissue remineralization, as they induced phosphate and orthophosphate mineral apposition, main components of tooth enamel. These types of natural compounds can become an alternative to fluorine, whose ingestion is harmful to the human body.
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Affiliation(s)
- Sandra J Gutiérrez-Prieto
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis G Sequeda-Castañeda
- Department of Chemistry, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia.,Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Gabriela M Penedo-Jaramillo
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Andrea V Chacín-Nieto
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Daniel R Contreras-Cáceres
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Gloria C Moreno-Abello
- Department of Dental Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María P Galvis-Rincón
- Department of Periodontal Systems, Dentistry Research Centre, School of Dentistry, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Fredy O Gamboa-Jaimes
- Department of Microbiology, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pilar E Luengas-Caicedo
- Department of Pharmacy, Faculty of Sciences, Universidad Nacional de Colombia, Bogotá, Colombia
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