The Potential of Hydroxyapatite Toothpaste towards the Hypersensitive Tooth

Dental hypersensitivity is a communal problem that we may often encounter in the daily life of both men and women, especially in the elderly who can unconsciously affect every daily activity. Dentin hypersensitivity is defined as sharp pain caused by stimulation of exposed dentin and unprotected dentin by enamel which can be caused by attrition, abrasion, crown fracture, gingival recession, and orthodontic trauma. Aim: The aim of this study was to analyse the potential of hydroxyapatite toothpaste towards the hypersensitive tooth through literature review. Method: This study analyzed 35 journals from each database PubMed, Ebsco, Google Scholar, ResearchGate, Wiley Online Library, and other international journal websites with keywords hydroxyapatite, hypersensitive dentin, remineralization. Conclusion: Toothpaste containing hydroxyapatite was more effective than toothpaste without hydroxyapatite in inducing tooth remineralization process. The use of toothpaste containing hydroxyapatite in the long term and routine for 15 days is more effective in reducing dental hypersensitivity.

Rehardening of Eroded Enamel with CPP-ACFP Paste and CO2 Laser Treatment

Background. Diet and lifestyle can destroy tooth structure due to the dissolution of enamel by acidic beverages. The present study evaluated the effect of CO2 laser irradiation and CPP-ACFP (casein phosphopeptide and amorphous calcium phosphate with fluoride) paste on the remineralization of enamel eroded by carbonated soft drinks. Methods. In the present in vitro study, 46 human sound premolar teeth were sectioned mesiodistally to achieve 84 samples. Fourteen samples were assigned to the positive control group (G1), and the remaining samples were immersed in 500 mL of cola drink for 2 minutes, followed by rinsing with distilled water for 10 seconds. This procedure was carried out three times to create erosive lesions. Then, the 60 eroded samples were randomly assigned to five groups of G2 to G6 in terms of the treatment as follows: negative control (G2), CO2 laser irradiation (G3), CPP-ACFP paste (G4), CO2 laser irradiation followed by CPP-ACFP paste application (G5), and CPP-ACFP paste application followed by CO2 laser irradiation (G6). The mean surface microhardness of the enamel surface was evaluated and determined at three points for each sample. Data were analyzed with one-way ANOVA and Tukey HSD tests ( α = 0.05 ). Results. The highest and the lowest hardness values were recorded in the G1 ( 314 ± 12 kg/mm2) and G2 ( 213.7 ± 12 kg/mm2) groups, respectively. ANOVA revealed significant differences between the study groups ( P < 0.001 ). Two-by-two comparisons showed significant differences between the G2 group and the other groups, indicating the efficacy of all the treatment modalities in tooth remineralization and rehardening procedures ( P < 0.05 ). Only in group G6, the enamel microhardness was not significantly different from the G1 positive control group ( P > 0.05 ). Conclusion. Considering the parameters used in the present study, CO2 laser irradiation or CPP-ACFP paste application alone increased eroded enamel’s surface hardness; however, their sequential application was more effective in rehardening the eroded enamel’s surface to near-normal levels.

Phosphate Ion Release and Alkalizing Potential of Three Bioactive Dental Materials in Comparison with Composite Resin

Aim. Several new bioactive compounds were recently introduced to the market with favorable ion release, tooth remineralization, and alkalizing potential. This study sought to compare the phosphate ion release and alkalizing potential of three bioactive materials in comparison with composite resin. Methods. Thirty-six discs (2 × 6 mm) were fabricated from Fuji II LC resin modified glass ionomer (RMGI), Activa BioActive, Cention N, and Z250 composite in plastic molds. The specimens were stored in distilled water for 24 and 48 h and 6 months. Half of the specimens were used to assess the phosphate ion release while the other half were used to assess the alkalizing potential 1 h after pH drop from 6.8 to 4. Phosphate ion release was quantified by a spectrophotometer while the pH value was measured by a pH meter. Data were analyzed using two-way ANOVA, one-way ANOVA, and Tukey’s HSD test (for pairwise comparisons) at 0.05 level of significance. Results. At 24 h, the maximum phosphate ion release in distilled water occurred in the Fuji II LC group followed by Cention N, Activa BioActive, and Z250. At 6 months, Cention N followed by Activa BioActive showed higher phosphate ion release than Fuji II LC and Z250. No significant difference was noted between Activa BioActive and Cention N at any time point. All materials, except for Z250, increased the pH of the environment. Fuji II LC had maximum alkalizing effect at all time points followed by Cention N and Activa BioActive. Conclusion. Use of bioactive compounds is a promising method to ensure phosphate ion release, and can have a positive effect on tooth remineralization over time. Also, bioactive compounds can alkalize an acidic environment.

Structural Biology of Calcium Phosphate Nanoclusters Sequestered by Phosphoproteins

Biofluids that contain stable calcium phosphate nanoclusters sequestered by phosphopeptides make it possible for soft and hard tissues to co-exist in the same organism with relative ease. The stability diagram of a solution of nanocluster complexes shows how the minimum concentration of phosphopeptide needed for stability increases with pH. In the stable region, amorphous calcium phosphate cannot precipitate. Nevertheless, if the solution is brought into contact with hydroxyapatite, the crystalline phase will grow at the expense of the nanocluster complexes. The physico-chemical principles governing the formation, composition, size, structure, and stability of the complexes are described. Examples are given of complexes formed by casein, osteopontin, and recombinant phosphopeptides. Application of these principles and properties to blood serum, milk, urine, and resting saliva is described to show that under physiological conditions they are in the stable region of their stability diagram and so cannot cause soft tissue calcification. Stimulated saliva, however, is in the metastable region, consistent with its role in tooth remineralization. Destabilization of biofluids, with consequential ill-effects, can occur when there is a failure of homeostasis, such as an increase in pH without a balancing increase in the concentration of sequestering phosphopeptides.

The Use of Resinous Infiltrants for the Management of Incipient Carious Lesions: a Literature Review

The objective of this work was to analyze scientific evidence from a literature review pertaining to the effectiveness of resinous infiltrants for minimally invasive treatment of incipient carious lesions. Studies published between 2002 and 2019 were queried from the following databases: Capes, PubMed, Medline, BBO, Lilacs and SciELO. The search keywords included "Dental Caries", "Tooth Remineralization", "Dental Leakage". Most of the studies found resin-infiltrating treatment to be a viable option for the minimally invasive treatment of incipient carious lesions; this treatment was able to fulfill the primary expected effects: inhibition of carious progression and the lesions esthetic improvement. However, some issues need to be clarified to improve the safety of this treatment because it can be recommended in clinical practice. In conclusion, the use of resinous infiltrants has been reported as promising for the treatment of incipient carious lesions. However, there is a need for long-term studies to confirm the effectiveness of this treatment to determine its applicability for clinical use. Keywords: Dental Caries. Dental Leakage. Tooth Remineralization. ResumoO objetivo desse trabalho foi analisar evidências científicas, por meio de uma revisão de literatura, sobre a eficácia do uso de infiltrantes resinosos para o tratamento minimamente invasivo de lesões cariosas incipientes. A seleção do material literário utilizado foi realizada por pesquisa sobre o tema nas bases de dados: portal de periódicos Capes, PubMed, Medline, BBO, Lilacs e SciELO, abrangendo prioritariamente, o período de 2002 a 2019. Para busca nas bases de dados foram utilizadas palavras-chave como “Cárie Dentária”, “Remineralização Dentária”, “Infiltração Dentária”, assim como suas correspondentes na língua inglesa. A maioria dos estudos encontrados aponta o tratamento infiltrante resinoso como uma opção viável para o tratamento minimamente invasivo de lesões cariosas incipientes sendo capaz de cumprir os principais efeitos esperados: inibição da progressão cariosa e melhoria estética das lesões. Entretanto, alguns impasses necessitam ser esclarecidos para que o tratamento seja recomendado com mais segurança na prática clínica. Conclui-se que o uso de infiltrantes resinosos tem sido relatado como promissor para o tratamento de lesões cariosas incipientes, contudo há necessidade de novas pesquisas e estudos a longo prazo para confirmar sua eficácia em todos aspectos desejáveis para seu uso clínico. Palavras-chave: Cárie Dentária. Infiltração Dentária. Remineralização Dentária.

The effect of pasteurized milk and pure soy milk on enamel remineralization

Introduction: Tooth remineralization agent can be found in pasteurized milk and soy milk. Ca2+ and PO43- ions concentration in both products inhibited hydroxyapatite dissolution and enhanced remineralization. This study was aimed to investigate the effect of pasteurized milk and pure soy milk on tooth enamel remineralization. Methods: This study was an experimental laboratory with pre-test post-test control group design. Twenty-seven maxillary premolars were divided into 3 groups; 37% phosphoric acid used to demineralized the samples followed by initial enamel hardness measurement. All samples were immersed in aquadest, pasteurized milk, and pure soy milk for 14 days, 102 minutes per day. Final enamel hardness was measured with the Vickers hardness test. Results: Increasing enamel hardness was found in all groups. Two-way ANOVA test was used to compare the increase of enamel hardness in all group, which showed the p-value = 0.002. Post-hoc LSD test was then used to compare the increase of the enamel hardness in pasteurized milk and pure soy milk groups, which resulted in the p-value = 0.147. Conclusion: There was an effect of pasteurized milk and pure soy milk group on enamel remineralization. However, there was no difference in the increase of enamel hardness value between pasteurized milk and pure soy milk groups.Keywords: Pasteurized milk, pure soy milk, tooth enamel, remineralization.