Using an Optical Reflectometer to Measure Caries Lesion Activity on Enamel

Abstract Background: Specular reflection can be used to quantify dental erosion, and might also provide similar results for caries. This study assessed the possibility of using specular reflection intensity (SRI; quantitative lesion activity assessment) to measure the progression of initial enamel caries lesions. Methods: Two hundred native enamel specimens and flat ground enamel specimens (n=100 each) were subjected to a 4-species biofilm caries model during 2, 4, 6, 8, and 10 weeks (n=20 each), to induce ‘active’ enamel caries lesions. Afterwards, to induce ‘inactive’ lesions, all specimens were continuously remineralized and brushed twice daily for 2, 4, 6, 8, and 10 weeks. Change in specular reflection intensity (%SRI), visual caries detection (ICDAS) and visual caries severity assessment were performed for all active lesions and during the remineralization phase. Scanning electron microscopy (SEM) images were taken for qualitative analysis. Results: For active lesions, %SRI dropped from 100% to about 80% in native enamel, and to about 15% in polished enamel. Remineralization/brushing increased %SRI in native enamel, but not in polished enamel. The comparison with visual caries scores yielded a better linear relationship of %SRI with early enamel lesion where caries was induced for up to 6 weeks. Conclusion: The use of the optical reflectometer for the assessment of caries lesion activity seemed to work better for early caries lesions and for polished specimens.

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Artificial Caries Lesion Characteristics after Secondary Demineralization with Theobromine-Containing Protocol

Molecules ◽

10.3390/molecules26020300 ◽

2021 ◽

Vol 26 (2) ◽

pp. 300

Author(s):

Hani M. Nassar ◽

Frank Lippert

Keyword(s):

Mineral Content ◽

Significance Level ◽

Lesion Depth ◽

Caries Lesion ◽

Mineral Profile ◽

Bonferroni Test ◽

Bovine Enamel ◽

Caries Lesions ◽

Nail Varnish

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.

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How combining different caries lesions characteristics may be helpful in short-term caries progression prediction: model development on occlusal surfaces of primary teeth

BMC Oral Health ◽

10.1186/s12903-021-01568-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Isabela Floriano ◽

Elizabeth Souza Rocha ◽

Ronilza Matos ◽

Juliana Mattos-Silveira ◽

Kim Rud Ekstrand ◽

...

Keyword(s):

Goodness Of Fit ◽

Primary Teeth ◽

Clinical Parameters ◽

Short Term ◽

Caries Lesion ◽

Occlusal Surfaces ◽

Caries Progression ◽

One Year ◽

Caries Lesions ◽

Cavitated Lesions

Abstract Background Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status. Methods The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions. Results 205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91). Conclusions Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions.

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Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro

Journal of Dentistry ◽

10.1016/j.jdent.2014.08.009 ◽

2014 ◽

Vol 42 (11) ◽

pp. 1495-1501 ◽

Cited By ~ 16

Author(s):

C.A.B. Cardoso ◽

A.R.F. de Castilho ◽

P.M.A. Salomão ◽

E.N. Costa ◽

A.C. Magalhães ◽

...

Keyword(s):

Enamel Caries ◽

Caries Lesions

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Performance of Laser Fluorescence for Residual Caries Detection in Primary Teeth

European Journal of Dentistry ◽

10.1055/s-0039-1697375 ◽

2008 ◽

Vol 02 (03) ◽

pp. 176-184 ◽

Cited By ~ 4

Author(s):

Taskin Gurbuz ◽

Yucel Yilmaz ◽

Fatih Sengul

Keyword(s):

Light Microscopy ◽

Gold Standard ◽

Primary Teeth ◽

Polarized Light ◽

Laser Fluorescence ◽

Caries Detection ◽

Sem Images ◽

Significant Difference ◽

Residual Caries ◽

Cavity Floor

ABSTRACTObjectives: The aim of this study was to evaluate the performance of a visual-tactile examination and a laser fluorescence device for detecting residual dentinal caries after carious dentin removal with bur excavation, hand excavation and chemomechanical excavation (Carisolv™].Methods: Thirty extracted coronal caries primary second molars were used. The caries infected dentin has been removed. A blinded examiner checked all cavities for residual caries using a visualtactile examination and laser fluorescence. Then the teeth were sectioned through the prepared cavities andthe two halves of each tooth were processed for light microscopy and Scanning Electron Microscopy (SEM). The presence or absence of residual caries was verified using polarized light microscopy as the gold standard. The cavity floor dentin after removing carious dentin was examined using SEM.Results: In among all groups a significant difference is determined between visual-tactile examination and laser fluorescence (P<.05). There was an agreement between laser fluorescence or visual-tactile examination and histological gold standard (P>.05). In addition, SEM images of the surfaces with the caries removed have shown that a vast majority of the tubule openings is observed to be open in the samples of the Carisolv group in opposition to the other groups.Conclusions: The laser fluorescence system could be effective in checking the removal by other methods, such as bur or Carisolv and avoid excessive removal of the sound dentin. (Eur J Dent 2008;2:176-184)

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Metabolic Profile of Supragingival Plaque Exposed to Arginine and Fluoride

Journal of Dental Research ◽

10.1177/0022034519869906 ◽

2019 ◽

Vol 98 (11) ◽

pp. 1245-1252 ◽

Cited By ~ 5

Author(s):

M.M. Nascimento ◽

A.J. Alvarez ◽

X. Huang ◽

C. Browngardt ◽

R. Jenkins ◽

...

Keyword(s):

Acid Production ◽

Metabolic Profile ◽

Assessment System ◽

Caries Detection ◽

Metabolic Profiles ◽

Ph Homeostasis ◽

Supragingival Plaque ◽

Plaque Ph ◽

Oral Biofilms ◽

Caries Lesions

Caries lesions develop when acid production from bacterial metabolism of dietary carbohydrates outweighs the various mechanisms that promote pH homeostasis, including bacterial alkali production. Therapies that provide arginine as a substrate for alkali production in supragingival oral biofilms have strong anticaries potential. The objective of this study was to investigate the metabolic profile of site-specific supragingival plaque in response to the use of arginine (Arg: 1.5% arginine, fluoride-free) or fluoride (F: 1,100 ppm F/NaF) toothpastes. Eighty-three adults of different caries status were recruited and assigned to treatment with Arg or F for 12 wk. Caries lesions were diagnosed using International Caries Detection and Assessment System II, and plaque samples were collected from caries-free and carious tooth surfaces. Taxonomic profiles were obtained by HOMINGS (Human Oral Microbe Identification using Next Generation Sequencing), and plaque metabolism was assessed by the levels of arginine catabolism via the arginine deiminase pathway (ADS), acidogenicity, and global metabolomics. Principal component analysis (PCA), partial least squares–discriminant analysis, analysis of variance, and random forest tests were used to distinguish metabolic profiles. Of the 509 active lesions diagnosed at baseline, 70 (14%) were inactive after 12 wk. Generalized linear model showed that enamel lesions were significantly more likely to become inactive compared to dentin lesions ( P < 0.0001), but no difference was found when treatment with Arg was compared to F ( P = 0.46). Arg significantly increased plaque ADS activity ( P = 0.031) and plaque pH values after incubation with glucose ( P = 0.001). F reduced plaque lactate production from endogenous sources ( P = 0.02). PCA revealed differences between the metabolic profiles of plaque treated with Arg or F. Arg significantly affected the concentrations of 16 metabolites, including phenethylamine, agmatine, and glucosamine-6-phosphate ( P < 0.05), while F affected the concentrations of 9 metabolites, including phenethylamine, N-methyl-glutamate, and agmatine ( P < 0.05). The anticaries mechanisms of action of arginine and fluoride are distinct. Arginine metabolism promotes biofilm pH homeostasis, whereas fluoride is thought to enhance resistance of tooth minerals to low pH and reduce acid production by supragingival oral biofilms.

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Synthesis of plate-like β-tricalcium phosphate nanoparticles and their efficiency in remineralization of incipient enamel caries

Progress in Biomaterials ◽

10.1007/s40204-019-00126-y ◽

2019 ◽

Vol 8 (4) ◽

pp. 261-276

Author(s):

Roghayyeh Marefat Seyedlar ◽

Mohammadbagher Rezvani ◽

Samira Barari ◽

Mohammad Imani ◽

Azizollah Nodehi ◽

...

Keyword(s):

Tricalcium Phosphate ◽

Calcium Nitrate ◽

Negative Control ◽

Second Phase ◽

Calcium Nitrate Tetrahydrate ◽

Enamel Caries ◽

Nitrate Tetrahydrate ◽

Addition Rate ◽

Post Hoc ◽

Caries Lesions

AbstractThe purpose of this study was to synthesize nano-sized β-tricalcium phosphate (nano-TCP) particles and determine its concentration-dependent properties on incipient enamel caries lesions. Nano-TCP was synthesized as a wet chemical through a method using low concentration of precursors and low addition rate of calcium nitrate tetrahydrate as a second phase. Morphology and phase composition of the particles were analyzed by SEM, XRD, and EDXA techniques. Incipient enamel lesions were created in human premolars with an acidic buffer. The teeth were then incubated in aqueous dispersions of nano-TCP as remineralization solutions. Sodium fluoride solution and deionized water were used as positive and negative control groups, respectively. The quality and thickness of the remineralized layer on enamel were investigated using SEM. The data were statistically analyzed by analysis of variance (ANOVA) and post hoc Tukey’s test. The synthesized nano-TCP mostly consisted of porous platelet-like crystals of 50–100 nm thickness and pore diameters of 100–300 nm. SEM observation showed that a homogenous layer was formed on the surface of the enamels remineralized in nano-TCP solutions. The thickness of the mineralized layer was dependent on the incubation time and nano-TCP concentration.

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Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

Journal of Dental Research ◽

10.1177/0022034514551753 ◽

2014 ◽

Vol 93 (11) ◽

pp. 1070-1075 ◽

Cited By ~ 42

Author(s):

M. Fontana ◽

J.A. Platt ◽

G.J. Eckert ◽

C. González-Cabezas ◽

K. Yoder ◽

...

Keyword(s):

Assessment System ◽

Retention Rates ◽

Caries Detection ◽

Major Barrier ◽

Occlusal Surfaces ◽

Before And After ◽

Permanent Molars ◽

Caries Lesions ◽

Sealant Retention ◽

Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

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Galla chinensis Compounds Remineralize Enamel Caries Lesions in a Rat Model

Caries Research ◽

10.1159/000445036 ◽

2016 ◽

Vol 50 (2) ◽

pp. 159-165 ◽

Cited By ~ 9

Author(s):

Tie-Ting Zhang ◽

Hui-Jing Guo ◽

Xue-Jun Liu ◽

Jin-Pu Chu ◽

Xue-Dong Zhou

Keyword(s):

Rat Model ◽

Experimental Period ◽

Positive Control ◽

Negative Control ◽

Preliminary Evaluation ◽

Streptococcus Sobrinus ◽

Mineral Density ◽

Treatment Groups ◽

Enamel Caries ◽

Caries Lesions

Objectives: To investigate the effect of Galla chinensis chemical compounds on enamel caries remineralization in rats. Methods: A total of 40 rats were inoculated with Streptococcus sobrinus 6715 and fed a cariogenic diet (Keyes 2000). The rats were randomly divided into 4 groups and treated topically twice a day with each of the following extracts (or control) for 5 weeks: distilled and deionized water (DDW, negative control); 1,000 ppm NaF (positive control); 4,000 ppm G. chinensis crude aqueous extract (GCE), or 4,000 ppm gallic acid (GA). After the experimental period, Keyes' caries diagnosis and scoring technique was applied as a preliminary evaluation on the molar teeth. For more accurate remineralization data, the residual enamel volume of the first molar and the mineral density (MD) of the enamel were further analyzed by micro-CT. Results: The severity of molar enamel caries decreased in the following order of treatment groups: DDW > GA > GCE > NaF (p < 0.05). In addition, the residual first molar enamel volume and MD values increased in the order of DDW, GA, GCE and NaF treatment groups (p < 0.05). In most molars, remineralization layers were observed on the surface of lesions. Conclusion:G. chinensis compounds remineralize enamel caries lesions in a rat model.

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Caries-Preventive Effects of Fluoride-Releasing Materials

Advances in Dental Research ◽

10.1177/08959374950090040601 ◽

1995 ◽

Vol 9 (4) ◽

pp. 377-383 ◽

Cited By ~ 19

Author(s):

T. Büyükyilmaz ◽

B. Øgaard

Keyword(s):

Clinical Studies ◽

Antimicrobial Agents ◽

Orthodontic Appliances ◽

Clinical Effects ◽

Bonding Agents ◽

Model Studies ◽

Fixed Orthodontic Appliances ◽

Caries Model ◽

Orthodontic Patients ◽

Caries Lesions

The plaque-retentive properties of fixed orthodontic appliances result in a severe challenge on surfaces generally not susceptible to caries. Lesions may develop within a month in the absence of fluoride, and clinical studies have shown that from 50 to 75% of orthodontic patients develop decalcifications on labial surfaces during treatment. Fluoride mouthrinses reduce the occurrence, although compliance is often poor. Orthodontic bonding agents and cements releasing fluoride, which reduce the need for cooperation, have been introduced. Few clinical studies have been done to prove the cariostatic properties of fluoride-releasing materials in orthodontics. In short-term caries model studies, glass ionomers and a glass filler containing light-cured adhesive that releases relatively large amounts of fluoride have shown cariostatic properties. However, during severe challenges such as occur with orthodontic appliances, fluoride alone has limited cariostatic properties. The combination of fluoride with antimicrobial agents, and the use of acidic fluoride solutions depositing acid-resistant coatings of calcium fluoride and titanium have shown to give better clinical effects than fluoride alone during extreme conditions. Fluoride-releasing materials may therefore be considered as useful supplements to these procedures.

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