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Park H, Hong S, Chrzan B, Al-Talib T, Abubakr NH. Resin infiltration for white spot lesions: An in vitro experimental trial. J Orthod 2024:14653125241244806. [PMID: 38587302 DOI: 10.1177/14653125241244806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To evaluate the aesthetic outcome by varying the duration allowed for infiltrant penetration when treating white spot lesions with resin infiltration. DESIGN An in vitro, experimental randomised study. METHODS Artificially created white spot lesions (WSLs) were induced on 100 extracted anterior teeth (T1). Teeth were divided into enamel and dentine groups depending on the extent of the lesion and then randomly assigned into different treatment protocol groups: penetration times of 3, 6 and 9 min. Resin infiltration treatment was applied according to the treatment protocol assigned (T2). Samples were thermocycled for 10,000 cycles (1 clinical year) (T3). The samples from the 3-min enamel and dentine groups were then randomly assigned into either a repeat treatment or no additional treatment group (T4). Samples were then thermocycled for an additional 10,000 cycles (T5). Spectrophotometric analysis was measured colour change (ΔE) for all groups. RESULTS Mean ΔE values equal to or greater than the critical value (3.7) indicate a detectable clinical difference in colour of the treated WSL when compared to before WSL formation. Mean ΔE values, for the enamel groups, were slightly above or significantly below the critical value, and for the dentine groups, were significantly above the critical value. Mean ΔE values within the enamel and dentine groups both demonstrated a downward trend with increasing time allowed for resin infiltrant penetration (P < 0.05). No significant mean ΔE difference (P = 0.53) was found between groups that received a single or repeat treatment. After the first thermocycling event, no significant difference in colour change was observed in all groups except for the deep dentine lesion treated for 3 min. There was a significant difference in colour change for all groups except the enamel group that received a single treatment following thermocycling after a single or repeat treatment. CONCLUSION Increasing the resin infiltrant penetration time to at least 9 min is advised as the most optimised treatment protocol. Resin infiltration treatment should be done only once to treat a particular white spot lesion as subsequent treatment for the same lesion results in marginal colour improvement. The colour improvement of WSLs resulting from the resin infiltration treatment can be expected to last for at least 1 year. Resin infiltration treatment of shallow lesions with a single and optimised infiltration technique can be expected to last an additional year.
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Affiliation(s)
- Hahnnah Park
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Sandy Hong
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Brian Chrzan
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - Tanya Al-Talib
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
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Salerno C, Grazia Cagetti M, Cirio S, Esteves-Oliveira M, Wierichs RJ, Kloukos D, Campus G. Distribution of initial caries lesions in relation to fixed orthodontic therapy. A systematic review and meta-analysis. Eur J Orthod 2024; 46:cjae008. [PMID: 38387465 PMCID: PMC10883713 DOI: 10.1093/ejo/cjae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND Initial caries lesion (ICLs) adjacent to orthodontic brackets are the most common side effect of orthodontic treatment with fixed appliances. The reported prevalence is uncertain and varies considerably across studies, from 27% to 97%. OBJECTIVES This paper was designed to evaluate and synthesize the available evidence on the prevalence and incidence rates of ICLs in relation to orthodontic treatment. Selection criteria: The review (Prospero protocol CRD42023412952) included randomized and non-randomized clinical trials of interventions, cohort studies, and cross-sectional studies, published after 1990 on the prevalence or incidence of ICLs during or after orthodontic treatment with fixed appliances. Search methods: Pubmed, Scopus, and Embase databases were searched from 1990 until 01 May 2023. The risk of bias assessment was performed with RoB 2 and ROBINS-I tool and the Joanna Briggs Institute Critical Appraisal Checklist. Data collection and analysis: The proportion of individuals with ICLs, reported as the number/percentage of individuals/teeth with ICLs or mean number of ICLs per subject, were used to synthesize results. RESULTS The search yielded a total of 468 papers; 21 studies were included in the systematic review, 2 of which were not included in the meta-analysis. The prevalence rate [95%CI] of ICLs was 0.57% [0.48; 0.65] in 1448 patients, 0.22% [0.14; 0.33] in 11583 teeth, with a mean number of lesions equal to 2.24 [1.79; 2.70] in 484 patients evaluated. The incidence rate of new carious lesions developed during orthodontic treatment was 0.48% [0.33; 0.63] in 533 patients, 0.15% [0.08; 0.26] in 1890 teeth with a mean number of ICLs equal to 2.29 [1.12; 3.46] in 208 patients evaluated. LIMITATIONS Although the high number of included studies and the overall good quality, there was a significant heterogeneity in the collected data. CONCLUSION The prevalence and incidence rates of ICLs in subjects undergoing orthodontic treatment are quite high and raise some concerns in terms of risk assessment of orthodontic treatment. ICLs represent an alarming challenge for both patients and professionals. Effective caries prevention strategies during treatment need to be considered and implemented where appropriate.
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Affiliation(s)
- Claudia Salerno
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Silvia Cirio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142 Milan, Italy
| | - Marcella Esteves-Oliveira
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Endodontology, Justus-Liebig-University Giessen, Giessen, Germany
- Department of Conservative Dentistry, Periodontology and Endodontology, University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery (UZMK), University of Tübingen, Tübingen, Germany
| | - Richard J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital, Athens, Greece
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai 600077, India
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Huang X, Qin D, Ngan P, Cao L, Hua F, He H. White spot lesion-related perception of aesthetics and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists. Orthod Craniofac Res 2024. [PMID: 38466047 DOI: 10.1111/ocr.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. METHODS A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one-way analysis of variance and multivariable generalized estimating equations. RESULTS A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p < .05) towards excessive white spot formation without colouration and were more tolerant than OR (p < .05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p < .05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p < .05). CONCLUSIONS Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs.
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Affiliation(s)
- Xinliang Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Danchen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Lingyun Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Fathy Abo-Elmahasen MM, Shaaban AM, Elsaharty M, Mohamed AAS, Assadawy MI, El Sayed IS. Evaluation of the remineralizing effect of the chicken eggshell paste after removal of the fixed orthodontic appliance: An in vitro study. J Orthod Sci 2024; 13:7. [PMID: 38516108 PMCID: PMC10953725 DOI: 10.4103/jos.jos_194_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Demineralization of the enamel surface, which appears as white spot lesions during and after removal of the fixed orthodontic appliance, is the most common disadvantage of the orthodontic treatment course. Using the remineralizing agents during and after orthodontic treatment helps to avoid those enamel defects. OBJECTIVE The present study aims to assess the remineralizing effect of the chicken eggshell powder on the demineralized enamel surfaces after debonding the orthodontic bracket system. MATERIALS AND METHODS The current study was performed on 80 prepared premolar crowns embedded into acrylic molds. The samples were prepared to receive routine steps of the bonding process for the bracket system. The paste of the chicken eggshell powder was added to the samples after the debonding process. Scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) were used to evaluate the remineralization effect of the chicken eggshell powder. Also, the Vickers microhardness tester was used to assess the enamel surface microhardness. RESULTS It was found that the mean value of the Ca/P ratio for the samples before bonding of the orthodontic bracket system was (4.17 ± 2.2). This value significantly decreased to (2 ± 1.3) after debonding of the orthodontic bracket system and then showed a significant increase to (4.79 ± 2.65) after remineralization. These results were assured by the values of the Vickers microhardness tester. CONCLUSION The chicken eggshell powder has an excellent remineralization effect for the demineralized enamel surface after debonding the orthodontic enamel surface.
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Affiliation(s)
| | - Adel M. Shaaban
- Department of Dental Biomaterials, Faculty of Dental Medicine, (Cairo, Boys), Al-Azhar University, Cairo, Egypt
| | - Mohamed Elsaharty
- Department of Orthodontics, Faculty of Dentistry, Tanta University, Tanta, Gharbia Governorate, Egypt
| | - Ahmed A. S. Mohamed
- Department of Orthodontics, Faculty of Dentistry, Menofia University, Shibin el Kom, Menofia Governorate, Egypt
| | - Mohamed I. Assadawy
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dental Medicine, (Cairo, Boys), Al-Azhar University, Cairo, Egypt
| | - Ibrahim Sabry El Sayed
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dental Medicine, (Cairo, Boys), Al-Azhar University, Cairo, Egypt
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Chaiwat A, Thirasupa N, Ajcharanukul O. Use of micro-computed tomography and scanning electron microscopy with energy-dispersive spectroscopy to distinguish natural white spot enamel lesions from sound enamel in human premolars. J Oral Sci 2024; 66:50-54. [PMID: 38233154 DOI: 10.2334/josnusd.23-0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The aim of the present study was to develop a novel method for distinguishing white spot lesions (WSLs) from sound enamel in human premolars using micro-computed tomography (micro-CT) and scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS), and to examine differences in surface morphology, chemical composition, and mineral density (MD) between these two areas. METHODS Fourteen premolars with natural WSLs on the enamel surface of the crowns were examined. After sectioning the teeth, each specimen containing WSLs adjacent to intact enamel was examined for MD, surface morphology, and atomic percentages (At%) of chemical components using micro-CT and SEM/EDS, respectively. Differences between these areas of the same specimen were analyzed statistically using paired t-test. RESULTS SEM images highlighted increased roughness and irregularity in the lesion area. EDS analysis revealed significant reductions in calcium (Ca), phosphorus (P), fluorine (F), chlorine (Cl), and sodium (Na) levels at the lesion surface in comparison to intact enamel (P < 0.05). The decreases in the MD of the lesions were statistically significant in comparison to sound enamel (P < 0.05). CONCLUSION These findings provide standard measurements for evaluating the essential characteristics of WSLs and intact enamel, being vital for assessment of treatment outcomes and development of innovative biomaterials for management of hypo-mineralized enamel lesions.
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Affiliation(s)
| | - Neeranart Thirasupa
- Orthodontic Section, Department of Pedodontics and Preventive Dentistry, Faculty of Dentistry, Srinakharinwirot University
| | - Orapin Ajcharanukul
- Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University
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Solanki D, Fulzele P, Thosar N, Shirbhate U. Management of Turner's Hypoplasia Using Resin Infiltration: A Case Report. Cureus 2023; 15:e48870. [PMID: 38106735 PMCID: PMC10724612 DOI: 10.7759/cureus.48870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
The causes of enamel discoloration can vary, leading to aesthetic concerns for patients. Injuries to primary teeth can lead to developmental issues in permanent successors, with enamel hypoplasia, commonly referred to as Turner's tooth. Diverse methods are available for addressing tooth discoloration. A case of an 11-year-old pediatric patient with a brown patch on the upper left central incisor was reported to the Pediatric Dentistry Department. A well-demarcated, yellowish-brown lesion was present on the labial surface of 21 and was diagnosed as Turner's hypoplasia. Resin infiltration was done using the Icon Smooth Surface (DMG America Company, Englewood, NJ) resin infiltration kit. The resin infiltration technique provides an approach to meet aesthetic requirements. In this case, the resin infiltration technique was successfully utilized to address the discoloration of the left maxillary central incisor, which was affected by Turner's hypoplasia.
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Affiliation(s)
- Dhruvi Solanki
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Punit Fulzele
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nilima Thosar
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Ramsundar K, Jain RK, Pitchaipillai SG. Inhibition of Quorum Sensing Controlled Virulence Factors and Biofilm Formation of Streptococcus mutans Isolated From Orthodontic Subjects by 4-Hydroxycinnamic Acid. Cureus 2023; 15:e47490. [PMID: 38021948 PMCID: PMC10663405 DOI: 10.7759/cureus.47490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Dental plaque biofilms are a collection of microorganisms that are adhered to the tooth enamel surface. Inhibition of plaque biofilms is required to prevent dental caries and periodontitis and currently, there are many chemical and herbal products in use for inhibition of biofilms but with limited success. Materials and methods Dental plaque collection was done from subjects undergoing orthodontic therapy followed by isolation of Streptococcus mutans. Isolated S. mutans were subjected to disk diffusion assay with 4-HCA (baseline 10mg/mL) for the zone of inhibition and broth micro-dilution to evaluate the minimum inhibitory concentration (MIC) and sub-MIC. Crystal violet staining was done for biofilm inhibition assay. Results Growth of S. mutans was inhibited by 4-HCA at concentrations as low as 0.31 mg/mL. 4-HCA (40μL) inhibited the bacterial growth and a clear zone (15 mm) was observed. 4-Hydroxycinnamic acids treated culture showed progressive reduction in the biofilm production at the concentration of 0.01 mg/mL. The 4-HCA concentration as low as 4 mg and 2 mg has remarkably inhibited biofilm formation of 49.3% and 34.3%, respectively. Conclusion The anti-quorum sensing and anti-biofilm activity of 4-Hydroxycinnamic acid against S. mutans isolated from subjects undergoing orthodontic treatment showed a remarkable result.
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Affiliation(s)
- Kavitha Ramsundar
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Ravindra Kumar Jain
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sankar G Pitchaipillai
- Microbiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Enerbäck H, Lövgren ML, Strömberg N, Westerlund A. Effect of high-fluoride toothpaste and mouth rinse on the prevention of demineralized lesions during orthodontic treatment: a randomized controlled trial. Eur J Orthod 2023; 45:477-484. [PMID: 37524332 PMCID: PMC10566543 DOI: 10.1093/ejo/cjad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. TRIAL DESIGN Three-armed parallel-group randomized controlled trial. METHODS The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. RECRUITMENT October 2010 to December 2012. RESULTS In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01. CONCLUSIONS To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended. LIMITATIONS The protocol was not registered, and the present study did not use a double-blinded design.
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Affiliation(s)
- Hanna Enerbäck
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mai Lin Lövgren
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicklas Strömberg
- Department of Cariology, Institute of Odontology, University of Umeå, Umeå, Sweden
| | - Anna Westerlund
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Specialist Clinic for Orthodontics, Public Dental Service, Mölndal, Sweden
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Qibi LH, Hasan LA, Dewachi Z. Influence of resin infiltration pretreatment on the microleakage under orthodontic bracket (an in vitro study). J Orthod Sci 2023; 12:43. [PMID: 37881679 PMCID: PMC10597359 DOI: 10.4103/jos.jos_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/23/2022] [Accepted: 01/09/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVES In order to assess the changes in tooth orthodontic adhesive interface microleakage after applying a caries resin penetrated to the sound enamel tooth surface in different storage media. MATERIALS AND METHODS A total of 60 human maxillary first premolars (orthodontic extraction) were collected by random separation of the teeth into two equal groups. The control group was classified into three subgroups (n = 10) (control in deionized water, control in milk, and control in energy drink), while the experimental one (treated with ICON) was categorized into three subgroups (n = 10) (ICON in deionized water, ICON in milk, and ICON in energy drink) incubation phase lasted three weeks in total. RESULTS A one-way analysis of variance (ANOVA) yielded a significant difference between all experimental subgroups (ICON in deionized water, ICON in milk, and ICON in energy drink) and control subgroups (control in deionized water, control in milk, and control in energy drink). The control group in the energy drink subgroup had the highest mean microleakage value when compared to the other subgroups, whereas the resin-infiltrated group in deionized water had the lowest mean value. According to the results of the T-test, ICON pre-treatment tooth samples had significantly lower mean values of microleakage than non-ICON tooth samples. CONCLUSIONS The adhesive system (control group) revealed that a resin infiltrate on a sound enamel surface prior to orthodontic bracket bonding reduced bracket tooth interface microleakage in all examined samples. The ICON-infiltrated surface was discovered to provide a secondary preventive strategy against white spot lesion development by reducing microleakage under brackets.
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Affiliation(s)
- Leqaa H. Qibi
- Department of Pedodontics, Orthodontics, and Preventive Dentistry, College of Dentistry, Mosul University, Mosul, Iraq
| | - Lamiaa A. Hasan
- Department of Pedodontics, Orthodontics, and Preventive Dentistry, College of Dentistry, Mosul University, Mosul, Iraq
| | - Zaid Dewachi
- Department of Pedodontics, Orthodontics, and Preventive Dentistry, College of Dentistry, Mosul University, Mosul, Iraq
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Hennig CL, Löhnert S, Nitzsche A, Nietzsche S, Steiniger F, Marquetand J, Tolksdorf K, Guellmar A, Sigusch B, Jacobs C. Influence of Different Bracket Adhesive Systems on Enamel Demineralization-An In Vitro Study. J Clin Med 2023; 12:4494. [PMID: 37445529 DOI: 10.3390/jcm12134494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND enamel demineralization is a common side effect of orthodontic therapy with fixed braces. The aim of the present in vitro study was to compare a conventional adhesive system and a modern adhesive system (APC Flash-Free [FF] technology) with regard to the demineralization of enamel by Streptococcus sobrinus (S. sobrinus). METHODS this in vitro study included premolar teeth and compared APC FF adhesive brackets (Group A, n = 15) with conventional adhesive brackets (Group B, n = 15) from the same company. Specimens were incubated with a positive control group (PCG, n = 5) and a negative control group (NCG, n = 5) in an S. sobrinus suspension for three weeks. To evaluate the grade of enamel demineralization, the samples were analyzed using a polarizing microscope. RESULTS the test specimens of group B with conventionally bonded bracket adhesive showed significantly greater (+10.8 μm) demineralization with regard to the penetration depth of the demineralization than the PCG (p = 0.012). Thus, there was a difference from group A with the new bracket adhesive of the FF brackets (+7.29 μm). Significantly, demineralization was more pronounced cervically than coronally in both groups, and it occurred cervically more frequently than grade 3 demineralization (p = 0.001). CONCLUSIONS it seems plausible that new orthodontic bracket adhesives and the modern FF adhesive system positively contribute to the reduction in enamel demineralization during orthodontic treatment.
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Affiliation(s)
- Christoph-Ludwig Hennig
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
| | - Simon Löhnert
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
| | - Ann Nitzsche
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
| | - Sandor Nietzsche
- Electron Microscopy Center, University Hospital Jena, Ziegelmühlenweg 1, 07743 Jena, Germany
| | - Frank Steiniger
- Electron Microscopy Center, University Hospital Jena, Ziegelmühlenweg 1, 07743 Jena, Germany
| | - Justus Marquetand
- Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany
- Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72074 Tübingen, Germany
- MEG-Center, University of Tübingen, 72074 Tübingen, Germany
| | - Konrad Tolksdorf
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - André Guellmar
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
| | - Bernd Sigusch
- Department of Conservative Dentistry and Periodontology, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
| | - Collin Jacobs
- Department of Orthodontics, Center of Dental Medicine, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany
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11
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Malcangi G, Patano A, Morolla R, De Santis M, Piras F, Settanni V, Mancini A, Di Venere D, Inchingolo F, Inchingolo AD, Dipalma G, Inchingolo AM. Analysis of Dental Enamel Remineralization: A Systematic Review of Technique Comparisons. Bioengineering (Basel) 2023; 10:bioengineering10040472. [PMID: 37106659 PMCID: PMC10135549 DOI: 10.3390/bioengineering10040472] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/01/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The demineralization process conditions the structure of the enamel and begins with a superficial decalcification procedure that makes the enamel surface porous and gives it a chalky appearance. White spot lesions (WSLs) are the first clinical sign that can be appreciated before caries evolves into cavitated lesions. The years of research have led to the testing of several remineralization techniques. This study's objective is to investigate and assess the various methods for remineralizing enamel. The dental enamel remineralization techniques have been evaluated. A literature search on PubMed, Scopus, and Web of Science was performed. After screening, identification, and eligibility processes 17 papers were selected for the qualitative analysis. This systematic review identified several materials that, whether used singly or in combination, can be effective in the process of remineralizing enamel. All methods have a potential for remineralization when they come into contact with tooth enamel surfaces that have early-stage caries (white spot lesions). From the studies conducted in the test, all of the substances used to which fluoride has been added contribute to remineralization. It is believed that by developing and researching new remineralization techniques, this process might develop even more successfully.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Matteo De Santis
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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12
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Lazar L, Vlasa A, Beresescu L, Bud A, Lazar AP, Matei L, Bud E. White Spot Lesions (WSLs)-Post-Orthodontic Occurrence, Management and Treatment Alternatives: A Narrative Review. J Clin Med 2023; 12. [PMID: 36902696 DOI: 10.3390/jcm12051908] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Although treatment with fixed or mobile appliances has become an important part of modern orthodontics, side effects such as white spot lesions (WSLs) have a negative impact on the aesthetic outcome of orthodontic treatment. The purpose of this article was to review current evidence on the diagnosis, risk assessment, prevention, management and post-orthodontic treatment of these lesions. Data collection was performed electronically, and the initial search using the keywords "white spot lesions", "orthodontics", "WSL", "enamel" and "demineralization" in different combinations resulted in 1032 articles for the two electronic databases used. Ultimately, a total of 47 manuscripts were considered relevant to the aim of this research and included in this review. The results of the review indicate that WSLs remain a significant problem during orthodontic treatment. According to studies in the literature, the severity of WSLs correlates to the duration of treatment. Using toothpaste with more than 1000 ppm fluoride at home reduces the frequency of WSL separation and regular application of varnishes in the office reduces the frequency of the occurrence of WSLs only in the context of maintaining a strict hygiene regime. The old hypothesis that elastomeric ligatures retain more dental plaque than metal ones has been refuted. There are no differences in the appearance of WSLs between conventional brackets and self-ligating brackets. Clear aligner mobile devices develop fewer WSLs but are more extensive as opposed to conventional fixed devices, while lingual orthodontic appliances have a lower incidence of WSLs, and the most effective device for preventing these lesions is WIN, followed by Incognito.
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13
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Yang H, Ma Y, Xie X, Wang H, Li X, Fang D, Bai Y. Candida albicans enriched in orthodontic derived white spot lesions and shaped focal supragingival bacteriome. Front Microbiol 2023; 14:1084850. [PMID: 36760510 PMCID: PMC9902512 DOI: 10.3389/fmicb.2023.1084850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
White spot lesions (WSLs) are common enamel infectious diseases in fixed orthodontic treatment, which might attribute to the dysbiosis of oral microbiome. However, the correlation of Candida albicans with oral bacteriome in WSLs still remains unrevealed. This study investigated the carriage of C. albicans and how it shaped the bacterial community in disease or healthy supragingival plaque, to explore the potential role of interkingdom interaction in orthodontic WSLs. In this study, 31 patients with WSLs (WSLs) and 23 healthy patients (Health) undergoing fixed orthodontic treatment were enrolled. The supragingival microbiota in both groups were determined using 16S rRNA gene sequencing. Colonization and abundance of C. albicans in the plaque were determined via culture-dependent and -independent methods. Among WSLs patients, the correlation of C. albicans and bacteriome was analyzed under QIIME2-based bioinformatics and Spearman's correlation coefficient. The raw reads were deposited into the NCBI Sequence Read Archive (SRA) database (Accession Number: SRP404186). Significant differences in microbial diversity as well as composition were observed between WSLs and Health groups. Leptotrichia remarkably enriched in the WSLs group, while Neisseria and Cardiobacterium significantly enriched in the Health group. In addition, 45% of WSLs patients were C. albicans carriers but none in patients without WSLs. Among all WSLs patients, beta diversity and microbial composition were distinguished between C. albicans carriers and non-carriers. In C. albicans carriers, Corynebacterium matruchotii and Streptococcus mutans significantly enriched whereas Saccharibacteria_TM7_G-1 significantly depleted. The abundance of C. albicans was positively associated with bacteria such as Streptococcus mutans, while the negative correlation was detected between C. albicans and several bacteria such as Cardiobacterium hominis and Streptococcus sanguinis. Our study elucidated the distinguished supragingival plaque microbiome between orthodontic patients with and without WSLs. C. albicans frequently existed and enriched in orthodontic derived WSLs. The carriage of C. albicans shape plaque bacterial community in demineralized lesions and might play roles in WSLs pathogenesis.
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14
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Khachatryan G, Markaryan M, Vardanyan I, Manrikyan M, Manrikyan G. Morphological Characteristics and Prevention of Tooth Enamel Demineralization during Orthodontic Treatment with Non-Removable Appliances. Int J Environ Res Public Health 2022; 20:540. [PMID: 36612862 PMCID: PMC9819192 DOI: 10.3390/ijerph20010540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Despite the large number of studies on the effect of braces on teeth, there is no information on the dynamics of the state of the ultrastructure of the hard tissues of teeth during orthodontic treatment. The purpose of this study is to examine the state of the hard tissues of the teeth and carry out preventive measures to reduce the risk of complications in the process of orthodontic treatment using a non-removable device. Methods: For the in vitro study, 68 teeth were randomly divided into group A-no prophylactic treatment, and group B-treated with the fluorine varnish Tiefenfluorid. After 35 days, all the teeth were prepared for microscopic examination. The clinical study included 59 patients aged 12-17 years with orthodontic brackets. The split-mouth technique was used. The areas around the bracket of one-half of the oral cavity were treated with Tiefenfluorid every 6 months during the entire treatment period. The teeth of the second half of the oral cavity served as the control group. The data were processed in the SPSS19 package. Results: In vitro and clinical study results showed a statistically significant difference between the prophylactic and control groups of teeth in favor of the prophylactic group, where the statistical significance was p ≤ 0.01.
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Affiliation(s)
- Gagik Khachatryan
- Department of Dental and Pharmacological Professional Education, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Marina Markaryan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Izabella Vardanyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Mikayel Manrikyan
- Department of Pediatric Dentistry and Orthodontics, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
| | - Gayane Manrikyan
- Department of Therapeutic Dentistry, Yerevan State Medical University (YSMU), Koryun Str. 2, Yerevan 0002, Armenia
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15
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Huang X, Liang J, Zhou W, Ma T, Weir MD, Hack GD, Fay GG, Oates TW, Cheng L, Xu HHK. Novel dental resin infiltrant containing smart monomer dodecylmethylaminoethyl methacrylate. Front Cell Infect Microbiol 2022; 12:1063143. [PMID: 36519132 PMCID: PMC9743298 DOI: 10.3389/fcimb.2022.1063143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives White spot lesions (WSLs) are prevalent and often lead to aesthetic problems and progressive caries. The objectives of this study were to: (1) develop a novel resin infiltrant containing smart monomer dodecylmethylaminoethyl methacrylate (DMAEM) to inhibit WSLs, and (2) investigate the effects of DMAEM incorporation on cytotoxicity, mechanical properties, biofilm-inhibition and protection of enamel hardness for the first time. Methods DMAEM was synthesized using 1-bromododecane, 2-methylamino ethanol and methylmethacrylate. DMAEM with mass fractions of 0%, 1.25%, 2.5% and 5% were incorporated into a resin infiltant containing BisGMA and TEGDMA. Cytotoxicity, mechanical properties and antibacterial effects were tested. After resin infiltration, bovine enamel was demineralized with saliva biofilm acids, and enamel hardness was measured. Result DMAEM infiltration did not increase the cytotoxicity or compromise the physical properties when DMAEM mass fraction was below 5% (p > 0.05). Biofilm metabolic activity was reduced by 90%, and biofilm lactic acid production was reduced by 92%, via DMAEM (p < 0.05). Mutans streptococci biofilm CFU was reduced by 3 logs (p < 0.05). When demineralized in acid and then under biofilms, the infiltrant + 5% DMAEM group produced an enamel hardness (mean ± sd; n = 6) of 2.90 ± 0.06 GPa, much higher than 0.85 ± 0.12 GPa of the infiltrant + 0% DMAEM group (p < 0.05). Significance A novel resin infiltrant with excellent mechanical properties, biocompability, strong antibacterial activity and anti-demineralization effect was developed using DMAEM for the first time. The DMAEM resin infiltrant is promising for inhibiting WSLs, arresting early caries, and protecting enamel hardness.
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Affiliation(s)
- Xiaoyu Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States,Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jingou Liang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China,Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States,Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Wen Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States,Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Tao Ma
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Michael D. Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States
| | - Gary D. Hack
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States
| | - Guadalupe Garcia Fay
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States
| | - Thomas W. Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China,Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,*Correspondence: Hockin H. K. Xu, ; Lei Cheng,
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland Dental School, Baltimore, MD, United States,Center for Stem Cell Biology & Regenerative Medicine, University of Maryland School of Medicine, Baltimore, MD, United States,Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States,*Correspondence: Hockin H. K. Xu, ; Lei Cheng,
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16
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Nair MJ, Rao A, Jayaprakash K, Natarajan S, Kumblekar V, Suprabha BS. Effectiveness of laser fluorescence-based device in detecting the extent of re-mineralisation in primary teeth compared to the conventional method: An In vitro study. Indian J Dent Res 2022; 33:292-296. [PMID: 36656191 DOI: 10.4103/ijdr.ijdr_546_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Laser fluorescence (LF)-based clinical device DIAGNOdent™ is at present being used to detect caries. Can the same be used to detect therapeutic remineralisation of early white spot lesions? Aims To explore the feasibility of using LF-based device in monitoring the changes following remineralisation of demineralised primary teeth. Materials and Method The sample number for the present experimental in vitro study was 10. The LF based device readings were correlated with surface microhardness (SMH) test values to evaluate its efficiency. SMH analysis was performed using a microhardness tester (Tescol-HT1000AD). All the samples were demineralised, followed by remineralisation using fluoride varnish and pH cycling. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 17.0 (IBM SPSS®) software. Paired t-test was performed to compare laser fluorescence readings and SMH test result values at baseline, after demineralisation, and after remineralisation. Pearson's correlation was used to compare the relation between the laser fluorescence and SMH test. Results A good negative correlation was seen between the two methods at the baseline readings even though it was not statistically significant (P = 0.069). A positive correlation between the methods existed following demineralisation which was not significant (P = 0.074). The correlation between the parameters following remineralisation showed a moderate negative correlation but was not significant (P = 0.55). Conclusion DIAGNOdent™ values at baseline, after demineralisation, and after remineralisation was consistent with SMH values. Thus, DIAGNOdent™ can be explored to provide chairside assistance in identifying remineralisation of white spot lesions.
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Affiliation(s)
- Megha J Nair
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - Arathi Rao
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - K Jayaprakash
- Department of Dental Materials, Biomaterials and Research Center, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - Vasavi Kumblekar
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - B S Suprabha
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
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Tomaževič T, Drevenšek M, Kosem R. Evaluation of fluoride varnish treatment of postorthodontic white spot lesions by visual inspection and laser fluorescence-A randomized controlled study. Clin Exp Dent Res 2022; 8:931-938. [PMID: 35510617 PMCID: PMC9382033 DOI: 10.1002/cre2.579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES White spot lesions (WSLs), as a side effect of orthodontic therapy, can be treated with fluoride varnish, with the difference in efficiency reported. MATERIAL AND METHODS Patients with buccal WSLs were consecutively included in a randomized controlled double-blind study. At first inspection and at three follow-ups over 6 months, 0.1% fluoride varnish and placebo (water) were applied in the test group (N = 21) and control group (N = 21), respectively. The maximum laser fluorescence value (LFV) of WSLs was recorded using DIAGNOdent. Between the groups, differences in the mean numbers of WSLs and the mean LFV of WSLs per patient at different time points were analyzed with mixed-design analysis of variance. Orthodontic therapy duration (OTD) was included in the model as a covariate. RESULTS A decrease in the mean WSLs number and LFV was observed; however, there were no significant differences between study groups at any time point. OTD was in interaction only with LFV. Analysis showed a different pattern of mean LFV changes for patients with OTD of >48 months compared to patients with OTD of ≤24. CONCLUSION The changes in numbers of WSLs and LFV over the study period indicated regression of WSLs, but an additional effect of FV was not confirmed.
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Affiliation(s)
- Tanja Tomaževič
- Department of Paediatric and Preventive Dentistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Martina Drevenšek
- Department of Orthodontics, Faculty of Medicine, University of Ljubljana, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Rok Kosem
- Department of Paediatric and Preventive Dentistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
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18
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Almulhim K, Khan AS, Alabdulghani H, Albasarah S, Al-Dulaijan Y, Al-Qarni FD. Effect of Ageing Process and Brushing on Color Stability and Surface Roughness of Treated White Spot Lesions: An in vitro Analysis. Clin Cosmet Investig Dent 2021; 13:413-419. [PMID: 34629906 PMCID: PMC8493663 DOI: 10.2147/ccide.s334633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the effect of ageing process and brushing on the color stability and surface roughness of white spot lesions treated with resin infiltration or remineralization. Patients and Methods Artificial white spot lesions were created on the facial surface of extracted bovine teeth. Specimens were divided into three main groups based on treatment received: resin infiltration (Icon), MI Paste Plus (MI) or no treatment (control). Specimens underwent pH cycling for 7 days, followed by brushing with toothbrush simulator. Specimens were then immersed in three different solutions (water, cranberry juice, or coffee) for 7 days. Surface roughness (SR) and color stability (CS) assessments were performed at baseline and after each test. One-way and two-way ANOVA were used to calculate the statistical comparisons between the groups and significance considered at P <0.05. Results Icon group had the least color change after pH cycling, while MI showed the least color change after brushing test. Immersion in coffee produced the highest color change in all groups, followed by cranberry juice. Icon group had the best color stability when immersed in cranberry juice or coffee. Control and the MI treated specimens showed gradual increase of SR after pH cycling and brushing test, while Icon group had improved surface properties. Brushing test alone produced less color change in comparison with immersion in cranberry juice and coffee; however, brushing increased SR. Conclusion Icon treatment showed superior color stability and surface roughness, compared to the control and the MI treated teeth. Brushing had less influence on color change compared to the immersion in cranberry juice or coffee.
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Affiliation(s)
- Khalid Almulhim
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdul Samad Khan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hanan Alabdulghani
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sara Albasarah
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yousif Al-Dulaijan
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal D Al-Qarni
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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19
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Nguyen YTH, Nonaka N, Maruyama H, Yoshida A. Application of a real-time PCR assay for the detection of Ascaris suum DNA in the liver of experimentally infected chickens. J Vet Med Sci 2021; 83:671-674. [PMID: 33658451 PMCID: PMC8111357 DOI: 10.1292/jvms.20-0404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the sampling method for the detection of Ascaris
suum larval DNA in chicken livers using real-time PCR. Chickens were inoculated
with A. suum eggs of a single dose (Group A) or repeatedly low doses
(Group B). White spots (WSs) were continuously observed on liver from day 3 after the last
infection in Group B and day 14 in Group A. In Group A, larval DNA was detected in WS
lesions (78.6%) at a significantly higher rate than in the remaining tissue samples
(31.3%). In conclusion, applying WS lesions to the assay improved the detection rate of
A. suum DNA in chicken livers, especially in the case of a single
infection.
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Affiliation(s)
- Yen Thi Hoang Nguyen
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan.,Department of Parasitology, Faculty of Veterinary Medicine, Vietnam National University of Agriculture, Trau Quy, Gia Lam, Ha Noi 100000, Vietnam
| | - Nariaki Nonaka
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan.,Laboratory of Parasitology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-ku, Sapporo, Hokkaido 060-0818, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan
| | - Ayako Yoshida
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1 Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan.,Centre for Animal Disease Control (CADIC), University of Miyazaki, 1-1 Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan
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20
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Abstract
Objective The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. Materials and Methods Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). Result In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. Conclusions Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.
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Affiliation(s)
- J Lee
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - L O Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - P P Lima
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - P T Gakunga
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - B T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
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Youssef A, Farid M, Zayed M, Lynch E, Alam MK, Kielbassa AM. Improving oral health: a short-term split-mouth randomized clinical trial revealing the superiority of resin infiltration over remineralization of white spot lesions. Quintessence Int 2020; 51:696-709. [PMID: 32901234 DOI: 10.3290/j.qi.a45104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate masking effects of resin infiltration on labial white spot lesions (WSL), by comparing the latter with a remineralization approach (using hydroxyapatite and fluorides) and conventional oral care (using fluoride-free toothpaste). METHOD AND MATERIALS Fifteen patients with at least three WSL were enrolled for a within-person randomized controlled trial, thus allowing for intrapersonal comparisons. Each WSL per tooth in every patient was randomly assigned to one of the following groups. Group 1: lesions were resin-infiltrated with Icon (RI; DMG); Group 2: Remin Pro (RP; VOCO) was used as remineralizing agent; and Group 3 (control): affected teeth were brushed with Complete Care toothpaste (CC; Himalaya). RP and CC were applied by means of a polishing brush, using a low-speed handpiece (5 min), and these procedures were repeated chairside thrice daily for 7 consecutive days. Digital photographs were captured before and after lesion treatment under standardized conditions. The CIE L*a*b* color system was used to analyze the optical outcome, and intrapersonal color differences were statistically evaluated. RESULTS Compared to RP and CC, RI showed prompt and subjectively satisfactory color improvements, and this was primarily driven by L* and b* shifts. Statistical analysis of the objective color differences (ΔE*) between the three groups revealed significant differences for RI vs RP (P = .029), RI vs CC (P < .001), and RP vs CC (P = .001). CONCLUSION Resin infiltration is considered a time-effective treatment option for esthetically camouflaging WSL, while RP and CC failed to improve lesion appearance and oral health in the current short-term trial.
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Badiee M, Jafari N, Fatemi S, Ameli N, Kasraei S, Ebadifar A. Comparison of the effects of toothpastes containing nanohydroxyapatite and fluoride on white spot lesions in orthodontic patients: A randomized clinical trial. Dent Res J (Isfahan) 2020; 17:354-359. [PMID: 33343843 PMCID: PMC7737819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Studies show that fluoride (F) and nano-hydroxyapatite (nano-HA) would result in remineralization of white spot lesions (WSLs), which are among the most prevalent consequences of fixed orthodontic treatment. The present study evaluates and compares the clinical effects of an Iranian toothpaste containing nano-HA with F-containing one on early enamel lesions. MATERIALS AND METHODS In this randomized clinical trial study, 50 patients who had received fixed orthodontic treatment were recruited immediately after debonding. Three photographs, including frontal, lateral right and left views of occlusion, were obtained. Moreover, surfaces with WSLs were recorded using DIAGNOdent. Plaque index of each patient determined using disclosing agents. At first visit, each patient was asked to select one type of toothpaste (nano-HA containing vs. F containing named A or B), randomly and were instructed how to brush their teeth (25 patients in each group). Examination was done at 1, 3, and 6 months' intervals. Finally, photographs were analyzed by Digimizer (V5) software, and the lesion extent was recorded in pixels. SAS 9.4 was used to analyze data and was set at 0.05. RESULTS According to data, lesion extent showed a significant decrease (P < 0.001). At baseline, the difference between the two groups regarding the lesion extent was 268 pixels while it dropped to 89 pixels after 6 months. DIAGNOdent results showed that at baseline, fluorescence difference was 0.3 while it reached the number of 0.8 after 6 months, indicating the outperformance of nano-HA containing toothpaste. CONCLUSION The Iranian nano-HA containing toothpaste performed better than F-containing one in terms of the amount of remineralization and diminishing the lesion extent.
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Affiliation(s)
- Mohammadreza Badiee
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Dental School Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sayedali Fatemi
- Department of Pharmacology and Toxicology, Pharmacy Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Ameli
- Associate Professor of Orthodontics, Department of Orthodontic, Dental School, Semnan University of Medical Sciences, Semnan, Iran
| | - Shahin Kasraei
- Department of Restorative Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asghar Ebadifar
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, Dental School Shahid Beheshti University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Asghar Ebadifar, Shahid Beheshti Dental School, Evin St., Chamran High Way, Tehran, Iran. E-mail:
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Alamri A, Salloot Z, Alshaia A, Ibrahim MS. The Effect of Bioactive Glass-Enhanced Orthodontic Bonding Resins on Prevention of Demineralization: A Systematic Review. Molecules 2020; 25:E2495. [PMID: 32471284 DOI: 10.3390/molecules25112495] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022] Open
Abstract
At present, bioactive glasses (BAGs) are demonstrating promising results in the remineralization of hard tissues. Their bioactive properties can potentially overcome the demineralization effect accompanying orthodontic treatment. This review aimed to evaluate the effectiveness of bioactive glass enhanced orthodontic bonding resins on enamel remineralization, in addition to their antibacterial, ion release and acid neutralization effect. Four databases (PubMed, MEDLINE, Web of Science and Scopus) were searched. Two hundred and fifty-one full-text articles were screened independently, out of which seven studies satisfied the inclusion criteria. Quality appraisal was performed by two independent reviewers. Methodologies used to assess the anti-demineralization effect included Micro-Computed Tomography, Polarized Light Microscopy and Hardness Testing (Knoop and Berkovich). All seven articles confirmed the superior remineralization effect of BAG orthodontic bonding resins compared to their non-BAG counterparts. A proportional relationship was proved between BAG concentrations and increased anti-demineralization effect. The addition of antibacterial agents to BAG does not necessarily improve its anti-demineralization effect. Although studies have confirmed the effectiveness of BAG orthodontic bonding resins on enamel remineralization, there was a degree of heterogeneity across studies due to the lack of an in vitro studies standardized protocol.
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Lo Giudice R, Lipari F, Puleio F, Alibrandi A, Lo Giudice F, Tamà C, Sazonova E, Lo Giudice G. Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up. Dent J (Basel) 2020; 8:E35. [PMID: 32290119 PMCID: PMC7344573 DOI: 10.3390/dj8020035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.
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Affiliation(s)
- Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Frank Lipari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Angela Alibrandi
- Department of Economics, Section of Statistical and Mathematical Sciences, Messina University, 98100 Messina, Italy;
| | - Fabrizio Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Cristina Tamà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Evgenia Sazonova
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
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Salamara O, Papadimitriou A, Mortensen D, Twetman S, Koletsi D, Gizani S. Effect of fluoride varnish with functionalized tri-calcium phosphate on post-orthodontic white spot lesions: an investigator-blinded controlled trial. Quintessence Int 2020; 51:854-862. [PMID: 32577707 DOI: 10.3290/j.qi.a44810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate the effect of a 5% sodium fluoride varnish with functionalized tri-calcium phosphate (fTCP) on post-orthodontic white spot lesions. A secondary aim was to study if the patients and their clinicians perceived clinical improvements. METHOD AND MATERIALS Fifty-nine patients with at least two visible WSLs on their maxillary incisors, canines, or first premolars present at the debonding of fixed appliances (baseline) were enrolled and assigned to a Varnish group (Clinpro White Varnish, 3M Espe) receiving topical applications at baseline and after 8 weeks, or a Control group treated with a fluoride-free mock product. The primary endpoint was white spot lesion appearance after 16 weeks, assessed from photographs using the modified ICDAS white spot lesion score (0 to 3). The patients and the dental examiners rated the white spot lesions subjectively with aid of a visual analog scale. RESULTS Fifty-seven patients completed the study. After 16 weeks, 62% of the white spot lesions in the Varnish group were completely reversed (score 0) compared to 39% in the Control group. The treatment effect was statistically significant (OR 0.22; 95% CI 0.08 to 0.59, P = .003) after adjusting for baseline oral hygiene index and type of tooth. A significant correlation (P < .05) was observed between patients' and orthodontists' perception of the lesions. CONCLUSION The 5% sodium fluoride varnish with fTCP appeared clinically effective in reversing post-orthodontic white spot lesions 16 weeks after debonding. The patients and the clinicians agreed on the obtained esthetic improvements.
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Perdigão J. Resin infiltration of enamel white spot lesions: An ultramorphological analysis. J ESTHET RESTOR DENT 2019; 32:317-324. [PMID: 31742888 DOI: 10.1111/jerd.12550] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is not a clear understanding of the ultramorphology of enamel white spot lesions (WSLs). The purpose of this study is to characterize resin infiltration of enamel WSLs using electron microscopy. MATERIALS AND METHODS Enamel sections with sound enamel and WSLs were sectioned from extracted teeth and assigned to three groups: (a) left untreated; (b) etched with 15% hydrochloric acid (Icon-Etch); (c) restored with the resin infiltration sequence (Icon-Etch, Icon-Dry, and Icon-Infiltrant). Restored specimens were demineralized to obtain replicas. Observations were carried out under a field-emission scanning electron microscope. RESULTS Icon-Etch resulted in an array of pits and funneled holes on the WSL. Replicas of WSLs depicted 0.5-6.0-μm-thick shaggy resin tags up to a depth of 465 μm. Enamel crystallites were enveloped with resin at the bottom of the WSL forming a hybrid layer. CONCLUSIONS The resin infiltrant filled the spaces between the crystallites and resulted in an enamel hybrid layer. CLINICAL SIGNIFICANCE In addition to masking enamel WSLs, resin infiltration is able envelop residual enamel crystallites forming an enamel hybrid layer. This hybridization makes resin-embedded enamel more resistant to acid attack than sound enamel.
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Affiliation(s)
- Jorge Perdigão
- Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota
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Yassaei S, Aghili H, Shahraki N, Safari I. Efficacy of erbium-doped yttrium aluminum garnet laser with casein phosphopeptide amorphous calcium phosphate with and without fluoride for remineralization of white spot lesions around orthodontic brackets. Eur J Dent 2019; 12:210-216. [PMID: 29988235 PMCID: PMC6004814 DOI: 10.4103/ejd.ejd_265_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to assess the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, pastes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) with and without fluoride and their combination for prevention of white spot lesions in the enamel. Materials and Methods This in vitro experimental study was conducted on 90 extracted sound premolars. The teeth were then randomly divided into six groups of 15: (1) Control, (2) laser, (3) CPP-ACP with fluoride (GC MI Paste, Recaldent™ 900 ppm as NaF), (4) CPP-ACP without fluoride (GC Tooth Mousse Recaldent™), (5) laser + CPP-ACP with fluoride, and (6) laser + CPP-ACP without fluoride. In each group, enamel surface was exposed to the remineralizing agent. The teeth were then subjected to pH cycling for 14 days. The teeth were then sectioned, polished, and underwent cross-sectional microhardness testing at 20-160 μ depth quantitatively. Using the Simpson's rule, the amount of mineral loss was calculated in each group. Statistical Analysis Used: ANOVA was used for the comparisons, and Tukey's test was applied for pairwise comparisons. Results The highest mean volume percentage of microhardness at 20-60 μ depth belonged to the group laser + CPP-ACP with fluoride and the lowest belonged to the control group (P = 0.001). The differences were not significant at 80-120 μ depth (P > 0.05). These finding are confirmed according to △Z (mineral loss). Conclusion Based on these results, Er: YAG laser was able to decrease demineralization and was a potential alternative to preventive dentistry and was more effective when combined with CPP-ACP products.
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Affiliation(s)
- Sogra Yassaei
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Aghili
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Neda Shahraki
- Department of Orthodontics, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Isa Safari
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Gözetici B, Öztürk-Bozkurt F, Toz-Akalın T. Comparative Evaluation of Resin Infiltration and Remineralisation of Noncavitated Smooth Surface Caries Lesions: 6-month Results. Oral Health Prev Dent 2019; 17:99-106. [PMID: 30874252 DOI: 10.3290/j.ohpd.a42203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To compare the therapeutic effects of the resin infiltration technique, self-assembling peptide (P11-4), and fluoride varnish application on white spot lesions (WSLs) on buccal surfaces based on LF pen measurements and LAA-ICDAS scores. MATERIALS AND METHODS The lesions of 113 patients from a total of 319 patients with at least four visible WSL on buccal surfaces were assessed by LAA-ICDAS and laser fluoresence (LF pen). To be included in the study, participants were required to have at least 4 buccal WLSs, each in different quadrants, with an LF pen score ≥ 8. Twenty-one patients were included in the study based on the laser fluoresence values. The lesions were randomly assigned into 4 groups (n = 21): IG (Icon), CRG (Curodont Repair), DG (Duraphat), and CG (control) groups. The treatment protocols were applied, but the control group received no treatment except regular brushing. Lesions were scored by LAA-ICDAS after 3 and 6 months and LF pen after 1 week, 3 and 6 months. RESULTS There was a statistically significant decrease in LF pen measurements of the control and the intervention groups after 6 months when compared to baseline. The greatest lesion regression was observed with IG (-23.25 ± 18.21), which differed statistically significantly from CRG (-8.15 ± 13.89), DG (-10.1 ± 10.31) and CG (-4.15 ± 9.72), followed by DG which differed statistically significantly from CG. Statistically significant differences were observed in the activity status of the lesions between baseline and 6 months, except for the control group. CONCLUSION In this study, the lesion regression rates shown by mean LF pen values in all groups after six months encourages the management of non-cavitated smooth surface caries lesions with non-operative treatment approaches. Regular brushing and professional tooth cleaning seem to be effective for the management of WSLs on buccal surfaces, and resin infiltration or fluoride varnish might enhance the improvement of these lesions in moderate- to high-caries-risk individuals.
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Mahmoudzadeh M, Alijani S, Soufi LR, Farhadian M, Namdar F, Karami S. Effect of CO2 Laser on the Prevention of White Spot Lesions During Fixed Orthodontic Treatment: A Randomized Clinical Trial. Turk J Orthod 2019; 32:165-171. [PMID: 31565692 DOI: 10.5152/turkjorthod.2019.18052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/20/2019] [Indexed: 11/22/2022]
Abstract
Objective This study aimed to assess the effect of carbon dioxide (CO2) laser on prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. Methods In this parallel controlled trial, 554 maxillary anterior teeth in 95 patients with age range of 12-30 years were included. The samples were randomly divided in two groups: 1) CO2 laser (n=278) and 2) control (n=276) groups. Following bracket attachment, the teeth in the laser group were exposed to CO2 laser (0.4 mw, 10.6 μm, 5 Hz) for 20 s, and the control group received placebo light. Incidence, severity, and extent of the lesions were assessed in four surface regions (gingival, incisal, mesial, and distal) at baseline and 6 months post-irradiation. The inter-group comparison was performed by the Mann-Whitney U test and McNemar analysis. Results A significant difference regarding WSLs incidence in all teeth was observed between the two study groups (p<0.001). The two study groups illustrated a significant difference in lesion extent and incidence in incisal, mesial, and distal regions (p<0.05). The WSLs were significantly different in terms of severity in the incisal and mesial sites (p<0.05). Conclusion The CO2 laser irradiation seemed to effectively prevent incidence of WSLs. In addition, its effectiveness varied depending on the surface region.
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Affiliation(s)
- Majid Mahmoudzadeh
- Department of Orthodontics, Hamadan University of Medical Sciences School of Dentistry, Hamadan, Iran
| | - Sara Alijani
- Department of Orthodontics, Hamadan University of Medical Sciences School of Dentistry, Hamadan, Iran
| | - Loghman Rezaei Soufi
- Department of Operative, Dental Research Center, Hamadan University of Medical Sciences School of Dentistry, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, Hamadan University of Medical Sciences School of Public Health and Research Center for Health Sciences, Hamadan, Iran
| | - Fatemeh Namdar
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Karami
- Post Graduate Orthodontic Student of Hamadan School of Dentistry, Department of Orthodontics, Hamadan University of Medical Sciences School of Dentistry, Hamadan, Iran
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Abstract
The present study compared two pH-cycling models designed to induce subsurface lesions (SLs) with a less demineralized surface layer on teeth, with the aim of developing new technologies for assessment of such lesions by examining the performance of confocal Raman microscopy for detection of white spot lesions (WSLs). Twelve sound premolars were exposed to two sets of model conditions (A, B) designed to induce SLs. Teeth on which white lesions had formed in vivo were used as positive controls. All specimens were inspected using an intraoral camera and Raman microscopy to detect small changes in the appearance and structure of the enamel. Changes in the natural color of the teeth during the treatment were recorded via the camera. Phosphate maps with their spectra were constructed from the phosphate peak at 960 cm-1. The depth of lesions was measured on the basis of variations in phosphate peak intensity. Protocol B was reliable for reproducing SLs in a relatively short period. Both protocols had intrinsic limitations in not completely simulating the complex intraoral conditions leading to WSL formation with respect to lesion depth and preservation of an intact surface layer. Raman microscopy can be considered the gold standard for analysis of hard tissue mineralization.
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Affiliation(s)
- Rand Al-Obaidi
- Laboratory of Bioengineering and Nano-science, Montpellier University
| | - Hamideh Salehi
- Laboratory of Bioengineering and Nano-science, Montpellier University
| | - Alban Desoutter
- Laboratory of Bioengineering and Nano-science, Montpellier University
| | - Hervé Tassery
- Laboratory of Bioengineering and Nano-science, Montpellier University.,Laboratory of Bioengineering and Nano-science, Aix Marseille University
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Nam HJ, Kim YM, Kwon YH, Yoo KH, Yoon SY, Kim IR, Park BS, Son WS, Lee SM, Kim YI. Fluorinated Bioactive Glass Nanoparticles: Enamel Demineralization Prevention and Antibacterial Effect of Orthodontic Bonding Resin. Materials (Basel) 2019; 12:ma12111813. [PMID: 31167432 PMCID: PMC6600697 DOI: 10.3390/ma12111813] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 12/27/2022]
Abstract
Orthodontic treatment involving the bonding of fixed appliances to tooth surfaces can cause white spot lesions (WSLs). WSLs increase the likelihood of cavity formation and hence require preservation and prosthetic restoration. Therefore, the prevention of WSLs is of greater importance than treatment. Application of fluoride or the use of fluoride-containing mouthwash can prevent WSLs, but this requires patient cooperation and additional time and cost. Bioactive glass containing 2.5% fluoride was synthesized and mixed with the orthodontic bonding adhesive Transbond XT Low Flow (LV) at ratios of 1, 3, and 5% to prepare orthodontic adhesive samples. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) were used to characterize the samples. The Vickers hardness test, bracket retention test, and adhesive remnant index (ARI) of the samples were analysed to determine their mechanical properties. To determine the biological cytotoxicity, the cell activity of the samples was evaluated using cell viability tests and the antibacterial activity was analysed using Streptococcus mutans. To evaluate the anti-demineralization effect, the sample was bonded to extracted teeth and a pH cycle test was performed. Micro computed tomography data were obtained from the bonded teeth and sample, and the anti-demineralization effect was evaluated using the ImageJ software program. The Vickers hardness of the sample was higher than that of LV and was dependent on the concentration of fluoride-containing bioactive glass (FBAG). The bracket retention test and ARI of the sample showed no significant differences from those of LV. The cell viability test showed no significant changes at 24 and 48 h after application of the sample. The fluoride ion release test indicated an ion release rate of 9.5–17.4 μg/cm2. The antibacterial activity of the experimental group containing FBAG was significantly higher than that of the LV group. The anti-demineralization test showed a concentration-dependent increase. However, the resin containing 5 mass% FBAG (FBAG5) showed a statistically-significant increase compared with LV. The orthodontic adhesive containing FBAG showed antibacterial and anti-demineralization effects, thus indicating possible WSL prevention activity.
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Affiliation(s)
- Hyung-Jin Nam
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - You-Min Kim
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - Yong Hoon Kwon
- Department of Dental Materials, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Kyung-Hyeon Yoo
- School of Materials Science and Engineering, Pusan National University, Busan 46241, Korea.
| | - Seog-Young Yoon
- School of Materials Science and Engineering, Pusan National University, Busan 46241, Korea.
| | - In-Ryoung Kim
- Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Bong-Soo Park
- Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Woo-Sung Son
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - Seung-Min Lee
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - Yong-Il Kim
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
- Institute of Translational Dental Sciences, Pusan National University, Busan 46241, Korea.
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Nam HJ, Kim YM, Kwon YH, Kim IR, Park BS, Son WS, Lee SM, Kim YI. Enamel Surface Remineralization Effect by Fluorinated Graphite and Bioactive Glass-Containing Orthodontic Bonding Resin. Materials (Basel) 2019; 12:E1308. [PMID: 31013602 DOI: 10.3390/ma12081308] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 12/24/2022]
Abstract
All orthodontic appliances are potentially cariogenic. The plaque around the orthodontic appliance can make demineralization on tooth surface causing white spot lesion (WSL). The most effective method to prevent WSL is Fluoride appliance and gargling, but this requires patient cooperation, which consumes additional treatment time and cost. As suggested in this study, biomaterials like bioactive glass and fluorinated graphite (FGt) having antibacterial and anti-demineralization ability effective and easy to use in the clinic. To clinically use orthodontic bonding resins containing Graphite Fluoride BAG (FGtBAG), its properties, biological stability, antimicrobial activity, and remineralization effect must be verified. BAG was mixed with 2.5% FGt containing 51 to 61% fluorine. This mixture was mixed with the CharmFill Flow (CF) in the ratios of 1, 3, and 5 wt%. Microhardness and shear bond strength tests were performed to evaluate its mechanical properties. MTT (3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl tetra) assay was performed for evaluating its safety. Streptococcus mutans, which is major cariogen by producing lactic acid, was evaluated for antibacterial ability of reducing WSL. In addition, x-ray images were obtained by CBCT (Cone beam computed tomography) after a pH cycle. The remineralization effect was verified in vivo and by Image J. FGtBAG did not differ significantly from CF in mechanical tests. The MTT assay found no significant differences between the groups. The antibacterial activity of FGtBAG at 24 h and 48 h was significantly higher than that of CF. The fluoride release rate tended to increase with the FGtBAG content. The pH cycle results showed that FGtBAG had higher concentration-dependent remineralization effect than CF. The results of this study suggests that orthodontic resins containing FGtBAG can prevent WSL owing to their antibacterial activity and remineralization effect.
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Cosma LL, Şuhani RD, Mesaroş A, Badea ME. Current treatment modalities of orthodontically induced white spot lesions and their outcome - a literature review. Med Pharm Rep 2019; 92:25-30. [PMID: 30957083 PMCID: PMC6448498 DOI: 10.15386/cjmed-1090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction White spot lesion is a demineralization of the enamel that appears as a white spot on the surfaces of the tooth. The cause of this spot is determined by the activity of the bacterial plaque and it represents the initial stage of a carious lesion. This lesion is a common side effect for patients with fixed orthodontic appliances mainly because of the brackets' position that favors the accumulation of plaque that ultimately leads to the formation of the white spot. Methods We conducted a search on a single database, PubMed. "Orthodontic", "white spot lesions", "enamel demineralization treatment" and "remineralization" were the search terms used. We found 324 articles, but we took in consideration only the ones from the last 10 years, which resulted in 223 articles. Results The first step after research was article selection: first by scrutinizing the title and secondly by reviewing the abstracts or full texts. The exclusion criteria were: meta-analysis, reviews, original articles regarding prevention of white spot lesions and their prevalence or incidence. We included the articles that seemed relevant for the treatment of white spot lesions, made either on extracted teeth either on orthodontic patients. We found 75 articles to be eligible for this research and we eliminated 5 because of the lack of an abstract or full text and a further 22 were rejected because they did not fit the aforementioned criteria. Conclusion Although some traditional methods for the treatment of white spot lesions seem to have undesirable results, nowadays with new technologies and thorough investigations in nanotechnology, the eradication of the lesion appears to be short term.
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Affiliation(s)
- Lavinia Luminiţa Cosma
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Diana Şuhani
- Department of Pediatric Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Mesaroş
- Department of Dental Propedeutics and Esthetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mîndra Eugenia Badea
- Department of Prevention in Dentistry, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Arora TC, Arora D, Tripathi AM, Yadav G, Saha S, Dhinsa K, Gopalakrishnan N. An In-Vitro evaluation of resin infiltration system and conventional pit and fissure sealant on enamel properties in white spot lesions. J Indian Soc Pedod Prev Dent 2019; 30:686-693. [PMID: 31249175 DOI: 10.4103/1319-2442.261345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Clinically appearing early caries are referred to as white spot lesions (WSLs). These lesions compromise esthetics and precede cavitation; therefore, they must be halted by effective materials. AIM To evaluate and compare the depth of penetration and effect of resin infiltration system (Icon) and other conventional pit and fissure sealants (Clinpro and Embrace) on enamel surface properties of WSLs. METHODOLOGY Freshly extracted premolars were obtained. Enamel surfaces were treated with resin infiltrant and fissure sealant. Depth of penetration and surface roughness of specimens were measured with an optical profilometer. Microhardness was determined by a Vickers' hardness tester. STATISTICAL ANALYSIS Normality of the data was checked by Shapiro-Wilk test. Inferential statistics were performed using one-way analysis of variance. Post hoc pairwise comparison was done using post hoc Tukey's test. RESULTS Icon resin infiltrant showed the highest depth of penetration and microhardness followed in descending order by Embrace and Clinpro whereas Clinpro was found to cause maximum surface roughness followed in descending order by Embrace and Icon. CONCLUSION The resin infiltration technique for treating WSLs seems adjusted to the philosophy of minimally invasive dentistry in a single appointment, making it beneficial for the patients, especially children.
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Affiliation(s)
- Tarang Chadha Arora
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Deval Arora
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhay Mani Tripathi
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gunjan Yadav
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sonali Saha
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kavita Dhinsa
- Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Jing D, Hao J, Shen Y, Tang G, Lei L, Zhao Z. Effect of fixed orthodontic treatment on oral microbiota and salivary proteins. Exp Ther Med 2019; 17:4237-4243. [PMID: 30988796 DOI: 10.3892/etm.2019.7401] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/11/2019] [Indexed: 02/05/2023] Open
Abstract
The aim of the present prospective comparative cohort study was to analyze changes in Streptococcus (S.) mutans and Lactobacillus in the saliva of patients with fixed orthodontics. Salivary parameters, including secretory immunoglobulin A (sIgA), myeloperoxidase (MPO) and lactate dehydrogenase (LDH), were investigated during orthodontic treatment, as well as immune response and inflammatory processes. A total of 15 patients were included and treated with fixed appliances. Whole saliva was obtained at four time-points: Prior to bonding (T1), 3 months after bonding (T2), 6 months after bonding (T3) and 18 months after bonding (T4). Quantitative polymerase chain reaction was performed to evaluate changes in total bacteria, S. mutans and Lactobacillus DNA in saliva. ELISA was applied to measure sIgA, MPO and LDH levels. The level of total bacteria remained stable during the 18-month treatment period, and the quantity of Lactobacillus exhibited a slight but non-significant increase. S. mutans remained stable over the first 6 months and significantly increased at T4 (P<0.05), and there was a significant difference in S. mutans levels between two types of braces. A higher level of S. mutans was found in patients with conventional braces, as compared to those with self-ligating braces (P<0.05) who exhibited an unchanged level of S. mutans during this period. The amount of sIgA, MPO and LDH remained constant during the orthodontic treatment period. No correlation was detected between sIgA and bacterial quantity. In conclusion, S. mutans in patients with conventional braces increased significantly in the late period of treatment, which indicated that white spot lesions may occur after long-term orthodontic treatment. As the type of braces may be considered a latent influencing factor, self-ligating braces should be preferred. However, the effect of fixed orthodontic treatment on Lactobacillus and sIgA, MPO and LDH in the oral microenvironment was insignificant (Chinese Clinical Trial Registry no. ChiCTR-RCH-13003295).
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Affiliation(s)
- Dian Jing
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jin Hao
- Department of Stem Cell and Regenerative Biology Harvard School of Dental Medicine, Harvard University, Cambridge, MA 02138, USA
| | - Yu Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ge Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lei Lei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Indrapriyadharshini K, Madan Kumar PD, Sharma K, Iyer K. Remineralizing potential of CPP-ACP in white spot lesions - A systematic review. Indian J Dent Res 2019; 29:487-496. [PMID: 30127201 DOI: 10.4103/ijdr.ijdr_364_17] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective The aim of this systematic review was to assess the long term remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) only in paste form compared with fluoride varnish, and or placebo in both naturally occurring and post-orthodontic white spot lesions in vivo. Data Sources The literature search covered the electronic databases: PubMed and Google scholar from 2005-2016. Only articles published in English were included. Randomized control trials in which CPP-ACP delivered by paste form were included. All studies which met inclusion criteria underwent two independent reviews. Study Selection Two ninety five articles were identified from the search after excluding duplications. Abstracts of forty one articles were reviewed independently. Twenty nine articles were excluded after reading abstract. Full text articles were retrieved for fifteen relevant studies. After reviewing articles independently, three articles were excluded after full text reading. Finally twelve studies were selected based on the eligibility criteria. The remineralizing effect of CPP-ACP were compared with placebo and fluoridated toothpaste and fluoride varnish in randomized control trial. Conclusion A high level evidence of remineralizing potential of CPP-ACP on naturally occurring white spot lesion and WSL post orthodontic treatment was found in comparison with placebo/fluoridated toothpaste and fluoride varnish without any statistically significant difference. Well-designed RCTs are, therefore, required to improve the level of evidence in this area.
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Affiliation(s)
- K Indrapriyadharshini
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P D Madan Kumar
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Khushbu Sharma
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Kiran Iyer
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
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Lee SM, Yoo KH, Yoon SY, Kim IR, Park BS, Son WS, Ko CC, Son SA, Kim YI. Enamel Anti-Demineralization Effect of Orthodontic Adhesive Containing Bioactive Glass and Graphene Oxide: An In-Vitro Study. Materials (Basel) 2018; 11:ma11091728. [PMID: 30223468 PMCID: PMC6163975 DOI: 10.3390/ma11091728] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023]
Abstract
White spot lesions (WSLs), a side effect of orthodontic treatment, can result in reversible and unaesthetic results. Graphene oxide (GO) with a bioactive glass (BAG) mixture (BAG@GO) was added to Low-Viscosity Transbond XT (LV) in a ratio of 1, 3, and 5%. The composite’s characterization and its physical and biological properties were verified with scanning electron microscopy (SEM) and X-ray diffraction (XRD); its microhardness, shear bond strength (SBS), cell viability, and adhesive remnant index (ARI) were also assessed. Efficiency in reducing WSL was evaluated using antibacterial activity of S. mutans. Anti-demineralization was analyzed using a cycle of the acid-base solution. Adhesives with 3 wt.% or 5 wt.% of BAG@GO showed significant increase in microhardness compared with LV. The sample and LV groups showed no significant differences in SBS or ARI. The cell viability test confirmed that none of the sample groups showed higher toxicity compared to the LV group. Antibacterial activity was higher in the 48-h group than in the 24 h group; the 48 h test showed that BAG@GO had a high antibacterial effect, which was more pronounced in 5 wt.% of BAG@GO. Anti-demineralization effect was higher in the BAG@GO-group than in the LV-group; the higher the BAG@GO concentration, the higher the anti-demineralization effect.
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Affiliation(s)
- Seung-Min Lee
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - Kyung-Hyeon Yoo
- School of Materials Science and Engineering, Pusan National University, Busan 46241, Korea.
| | - Seog-Young Yoon
- School of Materials Science and Engineering, Pusan National University, Busan 46241, Korea.
| | - In-Ryoung Kim
- Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Bong-Soo Park
- Department of Oral Anatomy, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Woo-Sung Son
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
| | - Ching-Chang Ko
- Department of Orthodontics, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | - Sung-Ae Son
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea.
| | - Yong-Il Kim
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Korea.
- Institute of Translational Dental Sciences, Pusan National University, Busan 46241, Korea.
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Dogan S, Fong H, Yucesoy DT, Cousin T, Gresswell C, Dag S, Huang G, Sarikaya M. Biomimetic Tooth Repair: Amelogenin-Derived Peptide Enables in Vitro Remineralization of Human Enamel. ACS Biomater Sci Eng 2018; 4:1788-1796. [PMID: 33445335 DOI: 10.1021/acsbiomaterials.7b00959] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
White spot lesions (WSL) and incipient caries on enamel surfaces are the earliest clinical outcomes for demineralization and caries. If left untreated, the caries can progress and may cause complex restorative procedures or even tooth extraction which destroys soft and hard tissue architecture as a consequence of connective tissue and bone loss. Current clinical practices are insufficient in treating dental caries. A long-standing practical challenge associated with demineralization related to dental diseases is incorporating a functional mineral microlayer which is fully integrated into the molecular structure of the tooth in repairing damaged enamel. This study demonstrates that small peptide domains derived from native protein amelogenin can be utilized to construct a mineral layer on damaged human enamel in vitro. Six groups were prepared to carry out remineralization on artificially created lesions on enamel: (1) no treatment, (2) Ca2+ and PO43- only, (3) 1100 ppm fluoride (F), (4) 20 000 ppm F, (5) 1100 ppm F and peptide, and (6) peptide alone. While the 1100 ppm F sample (indicative of common F content of toothpaste for homecare) did not deliver F to the thinly deposited mineral layer, high F test sample (indicative of clinical varnish treatment) formed mainly CaF2 nanoparticles on the surface. Fluoride, however, was deposited in the presence of the peptide, which also formed a thin mineral layer which was partially crystallized as fluorapatite. Among the test groups, only the peptide-alone sample resulted in remineralization of fairly thick (10 μm) dense mineralized layer containing HAp mineral, resembling the structure of the healthy enamel. The newly formed mineralized layer exhibited integration with the underlying enamel as evident by cross-sectional imaging. The peptide-guided remineralization approach sets the foundation for future development of biomimetic products and treatments for dental health care.
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Wiewiora C, Armbruster P, Lallier T, Ballard R. Effectiveness of Vanish XT in Reducing the Development of White Spot Lesions: An In Vitro Study. Oral Health Prev Dent 2018; 16:345-350. [PMID: 30175332 DOI: 10.3290/j.ohpd.a40938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To evaluate the effectiveness of Vanish XT in preventing white spot lesions (WSLs) when placed around orthodontic brackets. The efficacy of Vanish XT was compared with that of Pro Seal, a commercially available product already proven in preventing demineralization. MATERIALS AND METHODS Sixty extracted human canine teeth were divided into three groups (n = 20). The two experimental groups were treated with either Vanish XT or Pro Seal. A third group received no treatment (control). Ethidium bromide with DNA was added to and mixed with the products to produce fluorescence to verify retention of the experimental products. The teeth were submersed in a lactic acid solution for 32 days to create WSLs. All sample teeth were brushed twice daily with a non-fluoride toothpaste to evaluate retention of the experimental products. Photos were taken under fluorescence microscopy and white light at three time intervals. Demineralization was quantified utilizing computer software, and photos were analyzed to obtain values for percent surface area of demineralization and surface color change. RESULTS Percent surface area of WSL data, both under white light conditions and fluorometric analysis, revealed a significant difference between Pro Seal and Vanish XT when compared with the control group. No significant differences were found between Pro Seal and Vanish XT treated teeth. Fluorescence evaluation revealed that both experimental products were largely removed by 32 days of brushing and acid exposure. CONCLUSION Vanish XT is effective in preventing demineralization around orthodontic brackets. Its preventive efficacy is equivalent to that of Pro Seal.
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Muthuvel P, Ganapathy A, Subramaniam MK, Revankar VD. Erosion Infiltration Technique': A Novel Alternative for Masking Enamel White Spot Lesion. J Pharm Bioallied Sci 2017; 9:S289-S291. [PMID: 29284982 PMCID: PMC5731033 DOI: 10.4103/jpbs.jpbs_150_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Enamel White spot lesions are early signs of demineralization under the intact enamel, which may or may not lead to the development of caries. An inactive white spot lesion might act as an arrested dental caries and impair the esthetic appearance by displaying a milky white color from its interior opacity. The first choice of treatment is remineralization with various remineralizing agents such as fluoride and ACP-CCP. Caries infiltration is a less invasive and effective method for arresting the white spot lesions. It also improves the esthetics by masking the chalky white appearance by the process of optical adaptation to the adjacent healthy enamel. This is achieved by the hydrophobic resin, which has a similar refractive index to that of the healthy enamel.
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Affiliation(s)
- Praveen Muthuvel
- Department of Conservative Dentistry and Endodontics, RVS Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Aarthi Ganapathy
- Department of Conservative Dentistry and Endodontics, Vinayaka Missions Sankarachariyar Dental College, Salem, Tamil Nadu, India
| | - Mohan Kumar Subramaniam
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Vanita D Revankar
- Department of Conservative Dentistry and Endodontics, Vinayaka Missions Sankarachariyar Dental College, Salem, Tamil Nadu, India
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Xiaotong W, Nanquan R, Jing X, Yuming Z, Lihong G. [Remineralization effect of casein phosphopeptide-amorphous calcium phosphate for enamel demineralization: a system review]. Hua Xi Kou Qiang Yi Xue Za Zhi 2017; 35:629-635. [PMID: 29333778 PMCID: PMC7041152 DOI: 10.7518/hxkq.2017.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 09/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aims to assess the remineralization effect of casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP) on enamel demineralization by performing system review of randomized controlled trials (RCT) involving the treatment of enamel demineralization with CPP-ACP. METHODS The study was developed based on the
Cochrane handbook for systematic reviews of interventions (Version 5.1.0) and included the following: search strategy, selection criteria, data extraction, and risk of bias assessment. We searched electronic databases such as PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP up to September 2016. RCT of treating enamel demineralization with CPP-ACP were included. Data extraction and domain-based risk of bias assessment were independently performed by two reviewers. RESULTS Twelve RCTs were included. Because of the difference of experimental design and evaluation standards, the quantitative analysis can not be carried out. CONCLUSIONS There is no strong evidence that CPP-ACP is superior to conventional fluoride formulations in enamel remineralization. However, due to the limitations of sample size, follow-up time and study design, more high quality and large-sample RCT are needed to further verify the evidence.
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Affiliation(s)
- Wang Xiaotong
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Rao Nanquan
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xie Jing
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhao Yuming
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Ge Lihong
- Dept. of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Lee SM, Kim IR, Park BS, Lee DJ, Ko CC, Son WS, Kim YI. Remineralization Property of an Orthodontic Primer Containing a Bioactive Glass with Silver and Zinc. Materials (Basel) 2017; 10:E1253. [PMID: 29088092 DOI: 10.3390/ma10111253] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/15/2017] [Accepted: 10/28/2017] [Indexed: 12/02/2022]
Abstract
White spot lesions (WSLs) are irreversible damages in orthodontic treatment due to excessive etching or demineralization by microorganisms. In this study, we conducted a mechanical and cell viability test to examine the antibacterial properties of 0.2% and 1% bioactive glass (BAG) and silver-doped and zinc-doped BAGs in a primer and evaluated their clinical applicability to prevent WSLs. The microhardness statistically significantly increased in the adhesive-containing BAG, while the other samples showed no statistically significant difference compared with the control group. The shear bond strength of all samples increased compared with that of the control group. The cell viability of the control and sample groups was similar within 24 h, but decreased slightly over 48 h. All samples showed antibacterial properties. Regarding remineralization property, the group containing 0.2% of the samples showed remineralization properties compared with the control group, but was not statistically significant; further, the group containing 1% of the samples showed a significant difference compared with the control group. Among them, the orthodontic bonding primer containing 1% silver-doped BAG showed the highest remineralization property. The new orthodontic bonding primer used in this study showed an antimicrobial effect, chemical remineralization effect, and WSL prevention as well as clinically applicable properties, both physically and biologically.
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Abufarwa M, Noureldin A, Campbell PM, Buschang PH. Comparative study of two chemical protocols for creating white spot lesions: An in vitro FluoreCam evaluation. ACTA ACUST UNITED AC 2017; 9. [PMID: 28544729 DOI: 10.1111/jicd.12274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/25/2017] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to compare the effectiveness and practicality of two commonly-used protocols for white spot lesion creation. METHODS Sound posterior human teeth were sectioned into halves and randomly allocated into two groups (n=20). Using the FluoreCam system, the enamel surfaces were imaged under standardized conditions, and baseline data (area, intensity, and impact) were recorded. Specimens were covered with an acid-resistant polish, leaving a 2×6-mm enamel window. Group 1 was immersed in Queiroz solution (64 hours/37°C/pH5 with agitation); Group 2 was immersed in Buskes solution (14 days/37°C/pH5 with agitation). The specimens then were imaged again. Within-group changes that occurred over time were evaluated using the Wilcoxon signed-rank test. Between-group differences were analyzed using the Mann-Whitney U-test. Polarized light microscopy (PLM) was used to calculate the mean lesion depth of representative specimens. RESULTS Each protocol showed significant changes in the surface area, intensity and impact of demineralization over time (P<.05). There were no statistically-significant differences (P=.53, P=.2, P=.74) between the two groups. PLM showed that the mean lesion depths of representative specimens were 51.4 and 73.0 μm for groups 1 and 2, respectively. CONCLUSIONS While both protocols produce similar amounts of demineralization, the Queiroz solution is more practical, as it requires less time.
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Affiliation(s)
- Moufida Abufarwa
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Amal Noureldin
- Department of Public Health Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Phillip M Campbell
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Peter H Buschang
- Department of Orthodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
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Paulos RS, Seino PY, Fukushima KA, Marques MM, de Almeida FCS, Ramalho KM, de Freitas PM, Brugnera A, Moreira MS. Effect of Nd:YAG and CO 2 Laser Irradiation on Prevention of Enamel Demineralization in Orthodontics: In Vitro Study. Photomed Laser Surg 2017; 35:282-286. [PMID: 28157423 DOI: 10.1089/pho.2016.4235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate Nd:YAG and CO2 laser effects in the prevention of demineralization in deeper layers of enamel via successive acid challenge cycles. BACKGROUND DATA Lasers are promising in the prevention of enamel demineralization around the orthodontic brackets; however, there are very few studies that evaluate if the effects of treatment could be extended after successive acid challenge cycles due to permanent enamel structural alterations. MATERIALS AND METHODS Human enamel samples were divided into five groups (n = 12): G1-application of 1.23% acidulated fluoride phosphate gel (AFP, control); G2-Nd:YAG laser irradiation (0.6 W, 84.9 J/cm2, 10 Hz, 110 μs, contact mode); G3-Nd:YAG laser irradiation associated with AFP; G4-CO2 laser irradiation (0.5 W, 28.6 J/cm2, 50 Hz, 5 μs, and 10 mm focal distance); and G5-CO2 laser irradiation associated with AFP. The samples were submitted to successive acid challenge cycles. Quantitative light-induced fluorescence and scanning electron microscopy were used to assess enamel demineralization. The data were statistically compared (α = 5%). RESULTS G1: 50.87 ± 4.57; G2: 47.72 ± 2.87; G3: 50.96 ± 4.01; G4: 28.21 ± 2.19; and G5: 30.13 ± 6.38. The CO2 laser groups had significantly lower mineral losses than those observed in all other groups after successive acid challenge cycles. CONCLUSIONS Only the CO2 laser (10.6 μm) irradiation prevents enamel demineralization around the orthodontic brackets even after exposure to successive acid challenges. The CO2 laser at 10.6 μm showed a deeper effect in enamel regarding caries prevention.
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Affiliation(s)
- Renato Siva Paulos
- 1 Master Program in Biodentistry, Ibirapuera University , São Paulo, Brazil
| | | | | | - Marcia Martins Marques
- 2 Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil
| | | | | | | | - Aldo Brugnera
- 4 Department of Biomedicine Engineering, Camilo Castelo Branco University , São Paulo, Brazil
| | - Maria Stella Moreira
- 1 Master Program in Biodentistry, Ibirapuera University , São Paulo, Brazil .,2 Department of Restorative Dentistry, School of Dentistry, University of São Paulo , São Paulo, Brazil .,5 Universidade Nove de Julho , São Paulo, Brazil
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Ahrari F, Akbari M, Mohammadpour S, Forghani M. The efficacy of laser-assisted in-office bleaching and home bleaching on sound and demineralized enamel. Laser Ther 2016; 24:257-64. [PMID: 26877590 DOI: 10.5978/islsm.15-or-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AIMS This study investigated the effectiveness of laser-assisted in-office bleaching and home-bleaching in sound and demineralized enamel. MATERIALS AND METHODS The sample consisted of 120 freshly-extracted bovine incisors. Half of the specimens were stored in a demineralizing solution to induce white spot lesions. Following exposure to a tea solution for 7.5 days, the specimens were randomly assigned to 4 groups of 30 according to the type of enamel and the bleaching procedure employed. Groups 1 and 2 consisted of demineralized teeth subjected to in-office bleaching and home bleaching, whereas in groups 3 and 4, sound teeth were subjected to in-office and home bleaching, respectively. A diode laser (810 nm, 2 W, continuous wave, four times for 15 seconds each) was employed for assisting the in-office process. The color of the specimens was measured before (T1) and after (T2) staining and during (T3) and after (T4) the bleaching procedures using a spectrophotometer. The color change (ΔE) between different treatments stages was compared among the groups. RESULTS There were significant differences in the color change between T2 and T3 (ΔE T2-T3) and T2 and T4 (ΔE T2-T4) stages among the study groups (p<0.05). Pairwise comparison by Duncan test revealed that both ΔET2-T3 and ΔET2-T4 were significantly greater in demineralized teeth submitted to laser-assisted in-office bleaching (group 1) as compared to the other groups (P< 0.05). CONCLUSION Laser-assisted in-office bleaching could provide faster and greater whitening effect than home bleaching on stained demineralized enamel, but both procedures produced comparable results on sound teeth.
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Affiliation(s)
- Farzaneh Ahrari
- Dental Research Center, Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Akbari
- Dental Research Center, Department of Operative dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sakineh Mohammadpour
- Postgraduate Dental Student, Department of Periodontics, School of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Forghani
- Dental Materials Research Center, Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Yetkiner E, Wegehaupt FJ, Attin R, Wiegand A, Attin T. Stability of two resin combinations used as sealants against toothbrush abrasion and acid challenge in vitro. Acta Odontol Scand 2014; 72:825-30. [PMID: 24850503 DOI: 10.3109/00016357.2014.913197] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To test the stability of two conventional adhesives when combined with a low-viscosity caries infiltrant used for sealing sound enamel against toothbrush abrasion and acid challenge in vitro. MATERIALS AND METHODS Bovine enamel discs (Ø = 3 mm) randomly assigned to three groups (n = 10/group) were etched with 37% phosphoric acid for 30 s and treated with resins of different monomer contents forming three test groups: (1) Untreated specimens (Control); (2) Infiltrant (Icon, DMG) + conventional enamel bonding adhesive (Heliobond, Ivoclar Vivadent); and (3) Infiltrant + conventional orthodontic adhesive (Transbond XT Primer, 3M Unitek). All specimens were immersed in hydrochloric acid (pH 2.6) for up to 9 days, during which they were exposed to 1825 toothbrush-strokes per day. Calcium dissolution was assessed using Arsenazo III method at 24-h intervals. Data were analyzed by Kruskal-Wallis and Wilcoxon signed ranks tests. RESULTS Cumulative calcium dissolution for the untreated specimens (39.75 ± 7.32 μmol/ml) exceeded the sealed groups (Icon + Heliobond: 23.44 ± 7.03 μmol/ml; Icon + Transbond XT Primer: 22.17 ± 5.34 μmol/ml). Untreated specimens presented a relatively constant calcium dissolution rate throughout the experimental period, whereas the sealed groups presented a gradual increase indicating weakening of the seal by toothbrush abrasion. Both sealed groups presented significantly lower daily calcium dissolution at all time points compared to the control, except for Group 2 on the last measurement day. CONCLUSIONS Low-viscosity caries infiltrant application on sound enamel prior to conventional resin application provided a protective effect against enamel demineralization, but this effect was not stable when challenged mechanically by toothbrush abrasion.
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Affiliation(s)
- Enver Yetkiner
- Department of Orthodontics, University of Ege , Izmir , Turkey
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Abstract
Objective: The objective of this study is to test the antimicrobial effect of zinc oxide when incorporated into an orthodontic bonding material and to check the effect of addition of zinc oxide on the shear bond strength of the bonding material. Materials and Methods: Zinc oxide was added to a resin modified light cure glass ionomer cement (GIC) (Fuji Ortho LC GC America, Alsip, Ill) to make modified bonding agent containing 13% and 23.1% ZnO and the antimicrobial assay was done using agar disc diffusion method. Discs of the modified bonding agent were prepared and a culture of Streptococcus mutans mixed with soft agar was poured over it and incubated at 38°C for 48 h and zones of inhibition were measured. The test was repeated after a month to check the antimicrobial effect. In addition shear bond strength of the brackets bonded with the modified bonding agent was tested. Results: The agar disc showed zones of inhibition around the modified bonding agent and the antimicrobial activity was more when the concentration of ZnO was increased. The antimicrobial effect was present even after a month. The shear bond strength decreased as the concentration of ZnO increased. Conclusion: The incorporation of ZnO into a resin modified light cure GIC (Fuji Ortho LC GC America, Alsip, Ill) added antimicrobial property to the original compound.
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Affiliation(s)
- Archana Jatania
- Department of Orthodontics, Saraswati Dhanwantri Dental College, Parbhani, Maharashtra, India
| | - B M Shivalinga
- Department of Orthodontics, JSS Dental College and Hospital, Mysore, Karnataka, India
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Zhao X, Gao X. [Effect of resin infiltration treatment on the colour of white spot lesions]. Hua Xi Kou Qiang Yi Xue Za Zhi 2014; 32:306-9. [PMID: 25033652 PMCID: PMC7041215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 03/01/2014] [Indexed: 11/14/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effect of resin infiltration and fluoride solution on masking different demineralized white spot lesions by assessing color change. METHODS Artificial white spot lesions were produced on 60 human molars. Each sample had at least two enamel surfaces opened (named A and B). The samples were randomly divided into groups 1, 2, and 3 according to their time of demineralization (24, 48, and 72 h). After demineralization, the A spot of each sample was treated by resin infiltration. The B spot was treated with 0.1% fluoride solution daily for 30 days. After the remineralization of the B spot, resin infiltration was used again on the B spot of each sample. Color assessment was performed by a spectrophotometer in five distinct stages: baseline, after the production of artificial caries, after resin infiltration of A spots, after 30 days of fluoride solution treatment of B spots, and after resin infiltration of remineralized B spots. RESULTS Before demineralization, the L* values of spots A and B in all groups were not significantly different (P > 0.05), whereas the L* values of spots A and B were significantly increased after demineralization. The L* values of A spots recovered significantly after treatment by resin infiltration (P<0.05), but only groups 1 and 2 reached the baseline. The L* values of B spots had no significant differences (P > 0.05) after fluoride treatment compared with that after demineralization. After resin infiltration on B spots, the L* values recovered but could not reach the baseline nor the level of A spots treated by resin infiltration only. CONCLUSION Resin infiltration is a more effective treatment for masking white spot lesions than traditional fluoride treatment. The effect of masking white spot lesions has certain relationships with the degree of demineralization and activity of the lesion.
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Zhao X, Gao X. [Effect of resin infiltration treatment on the colour of white spot lesions]. Hua Xi Kou Qiang Yi Xue Za Zhi 2014; 32:306-309. [PMID: 25033652 PMCID: PMC7041215 DOI: 10.7518/hxkq.2014.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 03/01/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effect of resin infiltration and fluoride solution on masking different demineralized white spot lesions by assessing color change. METHODS Artificial white spot lesions were produced on 60 human molars. Each sample had at least two enamel surfaces opened (named A and B). The samples were randomly divided into groups 1, 2, and 3 according to their time of demineralization (24, 48, and 72 h). After demineralization, the A spot of each sample was treated by resin infiltration. The B spot was treated with 0.1% fluoride solution daily for 30 days. After the remineralization of the B spot, resin infiltration was used again on the B spot of each sample. Color assessment was performed by a spectrophotometer in five distinct stages: baseline, after the production of artificial caries, after resin infiltration of A spots, after 30 days of fluoride solution treatment of B spots, and after resin infiltration of remineralized B spots. RESULTS Before demineralization, the L* values of spots A and B in all groups were not significantly different (P > 0.05), whereas the L* values of spots A and B were significantly increased after demineralization. The L* values of A spots recovered significantly after treatment by resin infiltration (P<0.05), but only groups 1 and 2 reached the baseline. The L* values of B spots had no significant differences (P > 0.05) after fluoride treatment compared with that after demineralization. After resin infiltration on B spots, the L* values recovered but could not reach the baseline nor the level of A spots treated by resin infiltration only. CONCLUSION Resin infiltration is a more effective treatment for masking white spot lesions than traditional fluoride treatment. The effect of masking white spot lesions has certain relationships with the degree of demineralization and activity of the lesion.
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Yassaei S, Shahraki N, Aghili H, Davari A. Combined effects of Er: YAG laser and casein phosphopeptide-amorphous calcium phosphate on the inhibition of enamel demineralization: An in vitro study. Dent Res J (Isfahan) 2014; 11:193-8. [PMID: 24932189 PMCID: PMC4052644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Development of white spot lesions on enamel is a significant and common problem during the fixed orthodontic treatment. Various preventive methods have been suggested. The purpose of this study was to evaluate the preventive potential of MI Paste Plus, Er: YAG Laser and combined under similar in vitro conditions against demineralization. MATERIALS AND METHODS In this experimental in vitro study, 60 extracted premolars were randomly allocated to four groups (n = 15) of control, MI Paste Plus, Laser and MI + Laser (MIL). Enamel surface of each group was treated with one of above materials before and during the pH cycling for 12 days through a daily procedure of demineralization and remineralization for 3 h and 20 h, respectively. Teeth were sectioned and evaluated quantitatively by cross-sectional microhardness testing at 20 μm intervals from the outer enamel surface toward dentinoenamel junction up to 160 μm and data were analyzed using the one-way analysis of variance and Tukey test. P < 0.05 was considered as significant. RESULTS MIL group had the least amount of demineralization (P < 0.001). Control group (C group) had the greatest relative mineral loss and the laser group (L group) had 45% less mineral loss than the C group and there was no significant difference between the MI Paste Plus and L group (P = 0.154). CONCLUSION BASED ON THESE RESULTS, ER: YAG laser was able to decrease demineralization and was a potential alternative to preventive dentistry and was more effective when combined with casein phosphopeptide-amorphous calcium phosphate products.
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Affiliation(s)
- Sogra Yassaei
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Neda Shahraki
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Address for correspondence: Dr. Neda Shahraki, Department of Orthodontics, Faculty of Dentistry, Daheye Fajr BLV, Imam Ave, P.O. Box: 89195/165, Yazd, Iran. E-mail:
| | - Hossein Aghili
- Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdolrahim Davari
- Department of Operative, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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