scholarly journals Self-assembling Peptide P11-4 and Fluoride for Regenerating Enamel

2017 ◽  
Vol 97 (2) ◽  
pp. 148-154 ◽  
Author(s):  
M. Alkilzy ◽  
A. Tarabaih ◽  
R.M. Santamaria ◽  
C.H. Splieth

Regenerative medicine-based approaches for caries treatment focus on biomimetic remineralization of initial carious lesions as a minimal invasive therapy. In vitro, self-assembling peptide P11-4 enhances remineralization of early carious lesions. To investigate the safety and clinical efficacy of P11-4 for treatment of initial caries, a randomized controlled single-blind study was conducted on children aged >5 y with visible active early caries on erupting permanent molars. Subjects were randomized to either the test group (P11-4 + fluoride varnish) or control group (fluoride varnish alone). Caries were assessed at baseline and at 3 and 6 mo posttreatment per laser fluorescence, a visual analog scale, the International Caries Detection and Assessment System, and Nyvad caries activity criteria. Intention-to-treat analyses were performed, and safety and clinical feasibility of the treatment approaches were assessed. Compared with the control group, the test group showed clinically and statistically significant improvement in all outcomes at 3 and 6 mo. The laser fluorescence readings (odds ratio = 3.5, P = 0.015) and visual analog scale scores (odds ratio = 7.9, P < .0001) were significantly lower for the test group, and they showed regression in the International Caries Detection and Assessment System caries index (odds ratio = 5.1, P = 0.018) and conversion from active to inactive lesions according to Nyvad criteria (odds ratio = 12.2, P < 0.0001). No adverse events occurred. The biomimetic mineralization facilitated by P11-4 in combination with fluoride application is a simple, safe, and effective noninvasive treatment for early carious lesions that is superior to the presently used gold standard of fluoride alone. By regenerating enamel tissue and preventing lesion progression, this novel approach could change clinical dental practice from a restorative to a therapeutic approach. This could avoid additional loss of healthy hard tissue during invasive restorative treatments, potentially enabling longer tooth life and thereby lowering long-term health costs ( ClinicalTrials.gov NCT02724592).

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elzbieta Paszynska ◽  
Malgorzata Pawinska ◽  
Maria Gawriolek ◽  
Inga Kaminska ◽  
Justyna Otulakowska-Skrzynska ◽  
...  

AbstractThe aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demonstrating non-inferiority of hydroxyapatite compared to the fluoride control toothpaste. This RCT showed for the first time, that in children, the impact of the daily use of a toothpaste with microcrystalline hydroxyapatite on enamel caries progression in the primary dentition is not inferior to a fluoride control toothpaste (Clinical Trials NCT03553966).


2013 ◽  
Vol 38 (1) ◽  
pp. 7-12 ◽  
Author(s):  
V Pitchika ◽  
C Kokel ◽  
J Andreeva ◽  
A Crispin ◽  
R Hickel ◽  
...  

Objective: To investigate the effectiveness of a new fluoride varnish (Clinpro White Varnish, 3M Espe, Seefeld, Germany) with regard to the caries incidence within a 2-year period. Study design: A non-randomized sample of 400 children from the Kyffhäuser district (Thuringia, Germany) was divided into a fluoride group (FG, biannual application of fluoride varnish) and control group (CG, no intervention). (Non-)cavitated caries lesions were recorded using World Health Organization (WHO) and Universal Visual Scoring System (UniViSS) criteria. Parents were given questionnaires to gather information about their socio-economic status (SES). Non-parametric methods and binomial logistic regression were used for data analysis. Results: There was a significant increase in caries incidence in both groups. The number of non-cavitated carious lesions was significantly lower in the FG (mean 2.2; sd 2.3) compared with the CG (mean 2.9; sd 1.9). Initial statistical analysis revealed that fluoride varnish might prevent non-cavitated carious lesions. When including SES as a confounder into regression model, potential preventive effect was lost. Conclusions: This study underlines the importance of the multi-factorial etiology of caries and illustrates that the effectiveness of biannual fluoride varnish application was evident in non-cavitated carious lesions only.


2016 ◽  
Vol 17 (9) ◽  
pp. 774-779 ◽  
Author(s):  
Sophie Doméjean ◽  
Julie Rongier ◽  
Michèle Muller-Bolla

ABSTRACT Aim The aim of this systematic review was to assess the in vivo scientific evidence regarding the ability of a recently developed light fluorescence device, SoproLife® (Sopro-Acteon group, La Ciotat, France) in detecting occlusal carious lesions. The PubMed database was searched for in vivo trials that evaluated the validity of the SoproLife® camera for the detection of occlusal carious lesions. Among the 11 articles originally identified with the keyword “Soprolife,” only three articles were included. The three included surveys used the International Caries Detection and Assessment System (ICDAS)-II criteria as gold standard for the assessment of SoproLife® compared or not to other detection devices (DIAGNOdent® and Spectra Caries Detection Aid®). Two of the included studies reported only on permanent teeth or both primary and permanent teeth. The SoproLife® validity values varied markedly among studies with a sensitivity ranging between 0.43 and 0.95 and a specificity between 0.55 and 1. Interobserver reproducibility with the SoproLife® was reported in two of the three studies (0.98 and 0.72) and none of the studies reported about intraobserver reproducibility. No clear-cut conclusion can be made based on the three included clinical studies; further in vivo investigations are needed to confirm the validity of the SoproLife® camera in terms of detection of occlusal carious lesions. How to cite this article Doméjean S, Rongier J, Muller-Bolla M. Detection of Occlusal Carious Lesion using the SoproLife® Camera: A Systematic Review. J Contemp Dent Pract 2016;17(9):774-779.


2016 ◽  
Vol 124 (2) ◽  
pp. 188-194 ◽  
Author(s):  
Lia S. Castilho ◽  
Fernanda V. M. D. Cotta ◽  
Audrey C. Bueno ◽  
Allyson N. Moreira ◽  
Efigênia F. Ferreira ◽  
...  

Author(s):  
Urszula Kozak ◽  
Anna Sękowska ◽  
Renata Chałas

The present study aimed to evaluate the effect of the oral-hygiene regime on the incidence of enamel demineralization in young patients treated with fixed appliances. Research was conducted in a group of 144 patients aged 12–18 years, divided into 2 groups: orthodontically treated and control. The study was divided into three stages: before treatment (I), at 1 month (II), and at 6 months (III) for their follow-up. The International Caries Detection and Assessment System (ICDAS) was used for the visual assessment of white spot lesions (WSL). After 1 month, no new white spot lesions were observed. After 6 months of the treatment, new lesions were observed in 5% of the orthodontically treated patients and in 6% of the patients in the control group. New decalcifications were located on the proximal surfaces of the central incisors, first premolars, and first molars in the orthodontically treated group; and on the lateral incisors, first premolars, and first molars in the control group. We also observed new enamel demineralization on the vestibular surfaces of the canine and first premolar in the study group. The placement of a fixed appliance did not significantly affect teeth with the presence of new white spot lesions compared to the control group during 6 months of observation.


2021 ◽  
pp. 1-11
Author(s):  
Phoebe Pui Ying Lam ◽  
Divesh Sardana ◽  
Weijia Luo ◽  
Manikandan Ekambaram ◽  
Gillian Hiu Man Lee ◽  
...  

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (<i>p</i> = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.


2004 ◽  
Vol 18 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Fausto Medeiros Mendes ◽  
Sérgio Luiz Pinheiro ◽  
Antonio Lucindo Bengtson

DIAGNOdent is a laser fluorescence device used for dental caries diagnosis in occlusal and smooth surfaces. Despite the promising preliminary results, the molecules involved in the increase of fluorescence in carious lesions remain unclear. The aim of this study was to compare the laser fluorescence readings before and after changes in the organic material of occlusal carious lesions in primary teeth. Twenty-four primary molars stored in saline solution with at least one site with occlusal caries were divided into two groups. The control group had 17 sites with caries and the experimental one had 16 sites. The carious lesions were measured with laser fluorescence. The experimental samples were then removed from the storage solution and immersed in a 2% sodium hypochlorite solution for 24 hours. After washing with water, the teeth were measured again with the laser fluorescence device. The teeth of the control group were submitted to the same procedures, but saline solution was used instead of the sodium hypochlorite solution. A statistically significant reduction in the mean of the readings after immersion in the two tested solutions compared with the initial readings was observed in both groups, but the decrease was statistically higher in the experimental group (p < 0.0001). In this study, the data indicate that changes in the fluorescence of carious lesions measured by the laser fluorescence are mainly due to the organic content alterations rather than to the mineral loss.


2019 ◽  
Vol 9 (3) ◽  
pp. 138-144
Author(s):  
Emine Tatar ◽  
İsmet Rezani Toptancı

Aim:  The goal of preventive dentistry is to intervene prior to the formation of dental caries. This study evaluated the remineralization effects of fluoride varnish, casein phosphopeptide amorphous calcium phosphates (CPP-ACP) and casein phosphopeptide amorphous calcium fluoride phosphates (CPP-ACFP) cream, and tricalcium phosphate (TCP) varnish. Materials and Methodology: Samples with early artificial caries lesions were randomly divided into the following 5 groups with 20 samples in each group: (I) control, (II) fluoride varnish, (III) CPP-ACP cream, (IV) CPP-ACFP cream and (V) TCP varnish. The effectiveness of these remineralization agents was evaluated using a laser fluorescence device (DIAGNOdent), a scanning electron microscope (SEM) and energy dispersive X-ray analysis (EDX). Results: In the pre- and post-treatment evaluations, the DIAGNOdent remineralization measurements were statistically significant in all the groups, except the control group (p < 0.05). In comparison with the DIAGNOdent measurements, the CPP-ACFP group was found to have significantly higher remineralization than the fluoride group (p < 0.05), while no significant differences were found between the other groups (p > 0.05). The EDX analysis evaluated the Ca/P ratio between the groups. These results indicated that the CPP-ACFP group was significantly higher than the control group, the CPP-ACP group and the TCP group (p < 0.05); no significant differences were found between the CPP-ACFP group and the fluoride group (p > 0.05). In SEM imaging, the most extensive mineral accumulation was observed in the CPP-ACFP group. Conclusion: Three analytical methods demonstrated that CPP-ACFP was the most effective remineralization material tested in this study.   How to cite this article: Tatar E, Toptancı İR. Evaluation of the effectiveness of remineralization preparations used in paediatric dentistry practices. Int Dent Res 2019;9(3):138-44.   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.


2018 ◽  
Vol 6 (3) ◽  
pp. 47 ◽  
Author(s):  
Tamara Abrams ◽  
Stephen Abrams ◽  
Koneswaran Sivagurunathan ◽  
Veronika Moravan ◽  
Warren Hellen ◽  
...  

The aim of this study was to evaluate the ability of visual examination (International Caries Detection and Assessment System—ICDAS II), light-emitting diodes (LED) fluorescence (SPECTRA), laser fluorescence (DIAGNODent, DD), photothermal radiometry and modulated luminescence (PTR-LUM, The Canary System, CS) to detect natural decay beneath resin-modified glass ionomer (RMGIC) and compomer restorations in vitro. Twenty-seven extracted human molars and premolars, consisting of 2 control teeth, 10 visually healthy/sound and 15 teeth with natural cavitated lesions, were selected. For the carious teeth, caries was removed leaving some carious tissue on one wall of the preparation. For the sound teeth, 3 mm deep cavity preparations were made. All cavities were restored with RMGIC or compomer restorative materials. Sixty-eight sites (4 sites on sound unrestored teeth, 21 sound sites and 43 carious sites with restorations) were selected. CS and DD triplicate measurements were done at 2, 1.5, 0.5, and 0 mm away from the margin of the restoration (MOR). SPECTRA images were taken, and two dentists provided ICDAS II scoring for the restored surfaces. The SPECTRA data and images were inconclusive due to signal interference from the restorations. Visual examinations of the restored tooth surfaces were able to identify 5 of the 15 teeth with caries. In these situations, the teeth were ranked as having ICDAS II 1 or 2 rankings, but they could not identify the location of the caries or depth of the lesion. CS and DD were able to differentiate between sound and carious tissue at the MOR, but larger variation in measurement, and poorer accuracy, was observed for DD. It was concluded that the CS has the potential to detect secondary caries around RMGIC and compomer restorations more accurately than the other modalities used in this study.


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