Cell-Free Biomimetic Mineralization Strategies to Regenerate the Enamel Microstructure

The distinct architecture of native enamel gives it its exquisite appearance and excellent intrinsic-extrinsic fracture toughening properties. However, damage to the enamel is irreversible. At present, the clinical treatment for enamel lesion is an invasive method; besides, its limitations, caused by the chemical and physical difference between restorative materials and dental hard tissue, makes the restorative effects far from ideal. With more investigations on the mechanism of amelogenesis, biomimetic mineralization techniques for enamel regeneration have been well developed, which hold great promise as a non-invasive strategy for enamel restoration. This review disclosed the chemical and physical mechanism of amelogenesis; meanwhile, it overviewed and summarized studies involving the regeneration of enamel microstructure in cell-free biomineralization approaches, which could bring new prospects for resolving the challenges in enamel regeneration.

A Comparative Evaluation of Nanohydroxyapatite-Enriched Hydrogen Peroxide Home Bleaching System on Color, Hardness and Microstructure of Dental Enamel

This study aimed to evaluate two hydrogen peroxide (HP)-based at-home bleaching systems in order to analyze whether nano-hydroxyapatite (nHA) addition may represent a reliable and safe solution for tooth whitening without altering dental microstructure and hardness. Human third molars (N = 15) were treated with two bleaching agents, one containing 6%HP (6HP) and the other 6% HP nHA-enriched (6HP-nHA) with average particle diameter ranging from 5–20 nm. Their effects on enamel were assessed using a spectrophotometer, Vickers microhardness (VMH) test and Scanning Electron Microscopy (SEM), comparing the treated groups with the non-treated control group (CTR). Color analysis revealed improvement in whiteness in both groups compared to CTR. VMH test results showed no differences among the groups. SEM analysis highlighted no evident changes in the enamel microstructure of tested groups compared to CTR. At high magnification, in 6HP group, a slight increase in irregularities of enamel surface morphology was observed, while 6HP-nHA group displayed removal of the aprismatic layer but preservation of the intact prismatic structure. These results suggest that the 6HP-nHA agent may be recommended to provide reliable whitening treatment, without damaging the enamel micromorphology and hardness.

Mechanical characterization of the enamel microstructure treated with non alcoholic drinks

In previous studies, it has been shown that the microstructure of prismatic dental enamel presents differences between the external and internal zone. Radial enamel is found in the outer third of enamel and has higher microhardness values than enamel with Hunter- Schreger Bands (HSB) that occupies the inner 2/3. Our aim was to evaluate the mechanical behavior of radial enamel and HSB due the action of a non-alcoholic beverage in vitro. Longitudinal sections of dental crowns were embedded in polymer, worn and polished with sandpapers of decreasing granulation. The samples were immersed in a flavoured natural water for 12 minutes. Nanohardness tests (Triboindenter Hysitron) were performed on the radial and HSB enamel before and after the exposure to the drink. Hardness determinations "H", reduced modulus "Er" and contact depth "hc" were obtained. The percentage of reduction of hardness was determined. The values found in healthy radial enamel were H: 5.48±0.23 GPa; Er: 86.97±8.11 GPa; hc: 149.73±4.25 nm and in HSB H: 4.24±0.43 GPa; Er: 75.24±7.09 GPa; hc: 176.36±11.29 nm. After exposure to beverage, it was found in the radial enamel H: 2.22±0.31 GPa; Er: 58.73±10.79 GPa; hc: 270.29±21.22 nm, and in HSB H: 1.54±0.42 GPa; Er: 48.11±6.54 GPa; hc: 350.10±63.33 nm. After the drink action, the values of hardness of the radial enamel and HSB decreased and the trend observed in healthy enamel remained, where the highest values corresponded to the radial enamel. The percentage reduction of H in the radial enamel was 59.48% and in the HSB enamel it was 63.67%. The contact depth increased by about 50%.The decrease in hardness is related to the mineral loss produced by the acids contained in the drink. We conclude that the action of the non-alcoholic beverage produces a decrease in the mechanical properties in both the radial enamel and the HSB. The lower values in the reduced module Er indicate the formation of a superficial softened layer, the enamel with HSB being more vulnerable.

ATR-FTIR, EDS and SEM evaluations of enamel structure after treatment with hydrogen peroxide bleaching agents loaded with nano-hydroxyapatite particles

Background Tooth whitening is one of the most requested dental treatments, but it still presents some side effects. Indeed, the bleaching agent can generate patients’ discomfort and dental hard tissue damages, not achieving an efficient and long-lasting treatment with optimum whitening effect. To overcome these limitations, the bleaching agents containing nano-hydroxyapatite can represent a reliable solution to avoid these detrimental effects. Methods In this study, human third molars were treated with commercial bleaching agents, containing nano-hydroxyapatite (nHA) and 6% (at-home treatment), 12% and 18% (in-office treatments) of hydrogen peroxide (HP), named respectively G1, G2 and G3. The results were evaluated descriptively and analytically using Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray spectroscopy (EDS), comparing the treated groups with a commercial gel containing 10% carbamide peroxide (CONV) and with a non-treated control group (CTRL). Results ATR-FTIR analysis revealed a similar composition in carbonates and phosphates for CTRL, G1 and G2 groups, which showed no significant differences in their spectral profiles; an increased amount of organic matter was found in G3, while CONV displayed an intermediate behavior. SEM analysis did not highlight significant changes in the enamel microstructure of G1 and CONV when compared to CTRL; the pattern observed in G2 presented a slight increase of enamel irregularities, while G3 displayed a partial removal of the aprismatic layer and microporosities. No evident effects due to nHA were observed in the structure of the hydroxyapatite component of G1, G2 and CONV, if compared to CTRL, while G3 showed a slight loss of crystallinity. In all groups, EDS identified slight changes in the concentration of chemical elements O and Ca, while the Ca/P ratio was similar when compared to CTRL. Conclusion The obtained results suggest that the application of the tested commercial bleaching agents, with a concentration of HP up to 12%, does not alter the morphological and chemical composition of the enamel surface and maintains its crystallinity.

Developmental hypomineralization of the enamel of the first permanent and the second deciduous molars - report of two cases

Introduction. Molar-incisor hypomineralisation (MIH) is a developmental defect of dental enamel that affects one to all four first permanent molars (FPM) and frequently permanent incisors. Enamel aberrations are observed as demarcated opacities of different colours (from white to brown) and as posteruptive enamel breakdown (PEB). Clinically similar pathological signs can also be present in deciduous molars. Case outline. Histology of an FPM and a second deciduous molar (SDM) was performed after extraction from two unrelated patients with MIH due to inflammatory complications. Tooth samples were analysed using a stereomicroscope (SM), light microscope (LM) and scanning electron microscope (SEM). Enamel thickness of both affected teeth was normal. An obvious distinction in enamel microstructure was observed between the normally developed and the MIH-hypomineralised enamel with SM, LM, and SEM. Conclusion. In MIH patients, regular dental visits enable early diagnosis of the disease and appropriate treatment of the patient as soon as possible, with included preventive measures.

Dental enamel structure in long-nosed armadillos (Xenarthra: Dasypus) and its evolutionary implications

Most xenarthrans have a reduced and simplified dentition that lacks enamel. However, the presence of prismatic enamel has been recorded in the Eocene armadillos Utaetus buccatus (Euphractinae) and Astegotherium dichotomus (Astegotheriini). Among extant xenarthrans, the occurrence of enamel has been recognized only in the long-nosed armadillo, Dasypus novemcinctus (Dasypodinae), but its microstructure has never been described. In this contribution, we analyse the enamel microstructure in deciduous and permanent teeth of four Dasypus species. In deciduous molariform teeth of some species, we identify an apical cap of vestigial enamel (without crystalline structure), interpreted as an amorphous ameloblastic secretion. In permanent teeth, a thin layer of true enamel is found in the apical portion of unworn molariforms. The enamel is prismatic in D. novemcinctus, but in Dasypus hybridus, Dasypus sabanicola and Dasypus punctatus it is prismless. Taking into account the Eocene species of armadillos, the ancestral condition of enamel in cingulates could have been more complex (as in other placentals) and undergone progressive reduction, as shown in the Dasypus lineage. In light of previous genetic and developmental studies, we review and briefly discuss the processes that can account for the reduction/loss of enamel in extant and extinct armadillos. The retention of enamel and the fact that this genus is the only living xenarthran with two functional generations of teeth support the early divergence of the Dasypus lineage among living cingulates. This is in agreement with morphological and molecular analyses.