Mineral Density and Fluoride Content of in vitro Remineralized Lesions

1988 ◽  
Vol 67 (3) ◽  
pp. 577-581 ◽  
Author(s):  
Y. Jima ◽  
T. Koulourides

This in vitro investigation studied the remineralization of experimental caries lesions in bovine enamel by use of three methods: (1) surface microhardness, (2) microradiography, and (3) abrasion biopsy for mineral density and fluoride content. The lesions were produced by a two-day exposure to 0.01 mol/L lactic acidlsodium hydroxide buffer partially saturated with 3.0 mmol/L Ca, 1.8 mmol/L P, in 1% CMC, at pH 4.0 and 37°C. The lesions were exposed to a remineralizing solution containing 3.0 mmol/L Ca, 1.8 mmol/L P, and 3 ppm F in 1% CMC at pH 7.0 and 37°C for two, six, and ten days, with solution changes every two days. The data derived from the three methods are presented in sequence from the baseline and at days two, six, and ten of the remineralizing treatment. Microhardness measurements showed hardness recoveries of 35.9, 78.9, and 87.5%, respectively. Microradiography suggested complete recovery with the ten-day remineralization. Abrasion biopsy of successive 10-μm layers to a depth of 100 μm indicated 15.2, 39.8, and 68.8% mineral density recoveries, with fluoride content of the surface layer increasing from a baseline of 300 ppm to 4600, 9000, and 9800 ppm F for the 2, 6, 10 days of remineralization, respectively. Subsequent acid-etching of thin sections from the ten-day-remineralized specimens showed that the fluoride-enriched remineralized area was more resistant to acid dissolution than was the underlying nonnal enamel.

2019 ◽  
Vol 44 (5) ◽  
pp. E234-E243 ◽  
Author(s):  
L Al Dehailan ◽  
EA Martinez-Mier ◽  
GJ Eckert ◽  
F Lippert

SUMMARY Most currently marketed fluoride varnishes (FVs) have not been evaluated for their effectiveness in preventing dental caries. The objective of this study was to investigate the anticaries efficacy, measured as fluoride release into artificial saliva (AS); change in surface microhardness of early enamel caries lesions; and enamel fluoride uptake (EFU) of 14 commercially available FVs and two control groups. Bovine enamel specimens (5×5 mm) were prepared and assigned to 18 groups (n=12). Early caries lesions were created in the specimens and characterized using Vickers microhardness (VHNlesion). FV was applied to each group of specimens. Immediately afterward, specimens were incubated in 4 mL of AS for 18 hours, which were collected and renewed every hour for the first six hours. AS samples were analyzed for fluoride using an ion-specific electrode. Specimens were then brushed for 20 seconds with toothpaste slurry and subjected to pH cycling consisting of a four-hour/day acid challenge and one-minute treatments with 1100 ppm F dentifrice for five days. Microhardness was measured following pH cycling (VHNpost). EFU was determined using microbiopsy. Acid resistance (eight-hour demin challenge) was performed after pH cycling, and microhardness was measured (VHNart) and compared with baseline values to test the FV impact after pH cycling. One-way analysis of variance was used for data analysis (α=0.05). FVs differed in their release characteristics (mean ± SD ranged from 14.97 ± 2.38 μg/mL to 0.50 ± 0.15 μg/mL), rehardening capability (mean ± SD ranged from 24.3 ± 15.1 to 11.7 ± 12.7), and ability to deliver fluoride to demineralized lesions (mean ± SD ranged from 3303 ± 789 μg/cm3 to 707 ± 238 μg/cm3). Statistically significant but weak linear associations were found between ΔVHN(post – lesion), EFU, and fluoride release (correlations 0.21-0.36). The results of this study demonstrated that differences in FV composition can affect their efficacy in in vitro conditions.


Molecules ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 300
Author(s):  
Hani M. Nassar ◽  
Frank Lippert

Developing artificial caries lesions with varying characteristics is needed to adequately study caries process in vitro. The objective of this study was to investigate artificial caries lesion characteristics after secondary demineralization protocol containing theobromine and fluoride. Sixty bovine enamel slabs (4 × 3 mm) were demineralized using a Carbopol-containing protocol for 6 days. A baseline area (2 × 3 mm) was protected with acid-resistant nail varnish, after which specimens were exposed for 24 h to a secondary demineralization protocol containing acetic acid plus one of four fluoride/theobromine combinations (n = 15): theobromine (50 or 200 ppm) and fluoride (0 or 1 ppm). Specimens were sectioned and analyzed using transverse microradiography for changes in mineral content, lesion depth, and surface layer mineralization. Data was analyzed using paired t-test and analysis of variance followed by Bonferroni test at 0.05 significance level. After secondary demineralization, fluoride-containing groups had significantly deeper lesions (p = 0.002 and 0.014) compared to the group with 0 ppm fluoride and 50 ppm theobromine. Mineral content and lesion depth were significantly different compared to baseline for all groups. Theobromine did not show an added effect on mineral uptake. Theobromine-containing groups exhibited particularly deep lesions with a more uniform mineral profile in the presence of fluoride.


2015 ◽  
Vol 20 (7) ◽  
pp. 1655-1662 ◽  
Author(s):  
Laila Al Dehailan ◽  
Esperanza Angeles Martinez-Mier ◽  
Frank Lippert

2009 ◽  
Vol 11 (1) ◽  
pp. 23-27 ◽  
Author(s):  
Thomas R. Blattert ◽  
Stefan Glasmacher ◽  
Hans-Joachim Riesner ◽  
Christoph Josten

In generalized osteoporosis, instrumentation with cement-augmented pedicle screws is an amplification of the therapeutic spectrum. Early clinical results are promising for both solid and cannulated screws; however, there are concerns regarding the revision characteristics of these screws, especially for the cannulated-fenestrated type with its continuous cement interconnection from the core of the screw to surrounding bone tissue. In a human cadaver model, bone mineral density (BMD) was assessed radiographically. Spinal levels T9–L4 were instrumented left unilaterally, transpedicularly by using cannulated-fenestrated pedicle screws with the dimensions 6.5 × 45 mm. Polymethylmethacrylate cement (1.5 ml) was injected through the screws into each vertebra. After polymerization of the cement, the extraction torque was recorded. For both implantation and explantation of the screws, a fluoroscope was used to guarantee correct screw and cement positioning and to observe possible co-movements—that is, any movement of the cement mass within the vertebral body upon removal of the screw. For comparison, the extraction torque of same-dimension pedicle screws was recorded in a nonosteoporotic, non–cement-augmented instrumentation. The BMD was 0.60 g/cm2, a level that corresponds to a severe grade of osteoporosis. For removal of the screws, the median and mean extraction torques were 34 and 49 ± 44 Ncm, respectively. No co-movements of the cement mass occurred within the vertebral body. In the nonosteoporotic control, BMD was 1.38 g/cm2. The median and mean extraction torques were 123 and 124 ± 12 Ncm, respectively. Thus, the revision characteristics of cement-augmented, cannulated-fenestrated pedicle screws are not problematic, even in cases of severe osteoporosis. The winglike cement interconnection between the screw core and surrounding bone tissue is fragile enough to break off in the event of an extraction torque and to release the screw. There is no proof to support the theoretical fear that while trying to remove a screw, the composite of screw and cement would not break but instead would rotate as a whole in the osteoporotic vertebral body.


1988 ◽  
Vol 67 (2) ◽  
pp. 508-514 ◽  
Author(s):  
T. Ikemi ◽  
T. Koulourides

The profile of mineral density of experimental enamel lesions was determined by means of sampling with a new abrasion biopsy technique. Three types of lesions were produced on bovine enamel slabs: (1) pre-softened in lactic acid buffer for 16 hr; (2) pre-softened and exposed to a test for acid resistance for seven days; and (3) pre-softened, exposed to the seven-day Intra-oral Cariogenicity Test with extra-oral immersions in 1000 ppm F solutions for one min twice daily (ICT/F), plus the seven-day test for acid resistance. Lesions were assessed with measurements of surface microhardness, microradiography of thin sections, and abrasion biopsy. For abrasion biopsy of the experzmental lesions, 15 parallel layers of approximately 10 μm each were abraded simultaneously with reference slabs of sound enamel on strips of lapping film. The depth of abrasion for each sample was calculated from the phosphorus content of the reference sample. Exposure to the ICT/F formed an acid-resistant zone within the lesion which diminished the microhardness change, although it did not have an appreciable effect on the total lesion depth as assessed with microradiography; abrasion biopsy indicated the formation of a mineral-dense zone within the lesion. This recently-developed technique of abrasion biopsy of experimental lesions offers the opportunity to link the composition of the lesion to controlled experimental conditions which will improve our understanding of demineralizing and remineralizing reactions on a standard tooth substrate.


Author(s):  
Ellen Elisabeth Jansen ◽  
Hendrik Meyer-Lueckel ◽  
Marcella Esteves-Oliveira ◽  
Richard Johannes Wierichs

Abstract Objectives The aim of this study was to evaluate the influence of different bleaching gels on the masking and caries-arresting effects of infiltrated and non-infiltrated stained artificial enamel caries lesions. Materials and methods Bovine enamel specimens (n = 240) with each two sound areas (SI and SC) and each two lesions (DI and DC) were infiltrated (DI and SI), stained (1:1 red wine-coffee mixture,70 days), and randomly distributed in six groups to be bleached with the following materials: 6%HP (HP-6), 16%CP (CP-16), 35%HP (HP-35), 40%HP (HP-40), and no bleaching (NBl,NBl-NBr). Subsequently, specimens were pH-cycled (28 days, 6 × 60 min demineralization/day) and all groups except NBl-NBr were brushed with toothpaste slurry (1.100 ppm, 2×/day, 10 s). Differences in colorimetric values (ΔL, ΔE) and integrated mineral loss (ΔΔZ) between baseline, infiltration, staining, bleaching, and pH cycling were calculated using photographic and transversal microradiographic images. Results At baseline, significant visible color differences between DI and SC were observed (ΔEbaseline = 12.2; p < 0.001; ANCOVA). After infiltration, these differences decreased significantly (ΔEinfiltration = 3.8; p < 0.001). Staining decreased and bleaching increased ΔL values significantly (p ≤ 0.001). No significant difference in ΔΔE was observed between before staining and after bleaching (ΔEbleaching = 4.3; p = 0.308) and between the bleaching agents (p = 1.000; ANCOVA). pH-cycling did not affect colorimetric values (ΔEpH-cycling = 4.0; p = 1.000). For DI, no significant change in ΔZ during in vitro period was observed (p ≥ 0.063; paired t test). Conclusions Under the conditions chosen, the tested materials could satisfactorily bleach infiltrated and non-infiltrated stained enamel. Furthermore, bleaching did not affect the caries-arresting effect of the infiltration. Clinical relevance The present study indicates that bleaching is a viable way to satisfactorily recover the appearance of discolored sound enamel and infiltrated lesions.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hidenori Hamba ◽  
Keiki Nakamura ◽  
Toru Nikaido ◽  
Junji Tagami ◽  
Takashi Muramatsu

Abstract Background This study aimed to compare the efficacies of experimental toothpastes containing functionalized tricalcium phosphate (fTCP) with and without fluoride for in vitro enamel remineralization under pH-cycling conditions. Methods To create artificial white spot lesions, 36 bovine enamel specimens were immersed in a demineralization solution for 10 days. During pH-cycling for 12 days, the specimens were divided into four groups based on the experimental toothpaste type used: (a) fTCP-free, fluoride-free (fTCP − F −); (b) fTCP-containing, fluoride-free (fTCP + F −); (c) fTCP-free, fluoride-containing (fTCP − F +); and (d) fTCP-containing, fluoride-containing (fTCP + F +). Micro-focus X-ray computed tomography (μCT) scans of all specimens were obtained before demineralization, after demineralization, and after pH-cycling. The mineral density and mineral loss (ΔZ) in the enamel subsurface lesions were measured and the percentage of remineralization (%R) was calculated from ΔZ after demineralization and pH-cycling. One-way ANOVA with Tukey’s test was used for statistical analysis of the %R values. The treated enamel surface was investigated via scanning electron microscopy (SEM). Results The fTCP − F − group presented with the lowest amount of mineral gain after pH-cycling. In contrast, the fTCP + F + group showed the highest degree of remineralization within all lesion parts. The %R was highest in the fTCP + F + group (38.2 ± 7.8, all P < 0.01). SEM revealed the presence of small crystals on the enamel rods in the fTCP + F − and fTCP + F + groups. Conclusions The experimental toothpaste containing fTCP and fluoride increased remineralization of the artificial enamel subsurface lesions during pH-cycling. Furthermore, fTCP and fluoride appear to act independently on the remineralization of enamel subsurface lesions, although they coexisted in one toothpaste type. Trial registration: This is not a human subject research.


2018 ◽  
Vol 52 (1-2) ◽  
pp. 129-138 ◽  
Author(s):  
Jonathan E. Creeth ◽  
Ritu Karwal ◽  
Anderson T. Hara ◽  
Domenick T. Zero

This study aimed to determine the effect of zinc ions and F concentration in a dentifrice on remineralization of early caries lesions in situ and on resistance to subsequent demineralization. This was a single-center, 6-period, 6-product, blinded (examiner, subject, analyst), randomized (n = 62), crossover study. Products (all NaF) were: 0, 250, 1,150 and 1,426 ppm F (dose-response controls), “Zn-A” (0.3% ZnCl2, 1,426 ppm F), and “Zn-B” (as Zn-A, with high-foaming surfactants) in a conventional silica base. Subjects wore palatal appliances holding partially demineralized bovine enamel specimens. They brushed their teeth with 1.5 g test dentifrice (25 s), then swished the slurry ensuring even exposure of specimens (95 s), expectorated, and rinsed (15 mL water, 10 s). After 4 h intraoral remineralization, specimens were removed and acid-challenged in vitro. Surface microhardness (SMH), measured pre-experimental, post-initial acid exposure, post-remineralization, and post-second acid exposure, was used to calculate recovery (SMHR), net acid resistance (NAR), and a new, specifically demineralization-focused calculation, “comparative acid resistance” (CAR). Enamel fluoride uptake (EFU) was also measured. For the F dose-response controls, all measures showed significant relationships with dentifrice F concentration (p < 0.0001). The presence of zinc counteracted the ability of F to promote remineralization in this model. Compared to the 1,426 ppm F control, the zinc formulations gave reduced SMHR, EFU, and NAR (all p < 0.0001); however, they showed evidence of increased CAR (Zn-A: p = 0.0040; Zn-B: p = 0.0846). Products were generally well tolerated. In this study, increasing dentifrice F concentration progressively increased in situ remineralization and demineralization resistance of early caries enamel lesions. Zinc ions reduced remineralization but could increase demineralization resistance.


2017 ◽  
Vol 51 (5) ◽  
pp. 451-459 ◽  
Author(s):  
Richard J. Wierichs ◽  
Julian Kogel ◽  
Julian Lausch ◽  
Marcella Esteves-Oliveira ◽  
Hendrik Meyer-Lueckel

The application of a self-assembling peptide on noncavitated caries lesions is supposed to be a feasible approach to facilitate remineralization and mask their unfavorable appearance. However, demineralizing conditions are common in the oral environment, so the aim of this pH-cycling study was to compare recommended and novel treatment methods regarding their ability to hamper demineralization and as a consequence mask artificial enamel caries lesions. Artificial caries lesions were prepared in bovine enamel and randomly allocated to 11 groups (n = 22). Treatments before pH-cycling were as follows: the application of a self-assembling peptide (Curodont™ Repair [C]), a low-viscosity resin (Icon® [I]), 2 fluoride solutions (10,000 ppm F-: Elmex fluid [E] and 43,350 ppm F-: Tiefenfluorid® [T]), and no intervention (N). During pH-cycling (28 days, 6 × 60 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 ×/day) with either fluoride-free (named e.g., C0) or NaF (1,100 ppm F-; e.g., C1) dentifrice slurry. In another subgroup specimens were pH-cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between values after pre-demineralization, surface treatment, and pH-cycling. Specimens of C0, C1, NNB, N0, N1, T0, and E0 showed significantly increased ΔZ and LD values after pH-cycling (p ≤ 0.003; paired t test). C0, C1, NNB, and N0 showed significantly higher changes in ΔΔZ than E1, I0, I1, and T1 (p < 0.001; ANOVA). Significantly reduced colorimetric values could only be observed for I1, I0, E1, and E0 after treatment and after pH-cycling (p ≤ 0.027; paired t test). In conclusion, under the conditions chosen only the application of a low-viscosity resin could mask caries lesions significantly, whereas self-assembling peptides could neither inhibit lesion progression nor mask the lesions considerably.


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