Pit and fissure sealants — A review

Caries on the occlusal surface of dentition is a significant dental health problem. Among all of the teeth particularly molars and premolars have greater susceptibility to caries. Their susceptibility to caries is probably related to its occlusal morphology. Use of fissure sealant and fluoride have been shown to play an important role in reducing caries. This can be possible through converting the caries susceptible areas like pits and fissures into glazed surface which prevent bacterial colonization and makes the tooth easy to clean. Pit and fissure areas of enamel do not receive sufficient protection from topical or systemic fluorides, the reason for ineffectiveness of fluorides in the pit and fissure caries may be due to inaccessibility to these areas and due to the differences in enamel thickness. The most efficient way to prevent pit and fissure caries is by effectively sealing the fissures using resins called pit and fissure sealants.

Pit and fissure depth in the enamel of mandibular third molars: An open gate for microleakage?

The aim of this descriptive ex vivo study was to evaluate qualitatively the depth of pit and fissures (P&F) of the enamel in human mandibular third molars. Fifty (n=50) extracted human mandibular third molars were cleaned and disinfected. All tooth surfaces were coated with nail varnish except for a 1-mm margin around the periphery of the occlusal surface. The teeth were immersed for 48 hours at 37 °C in 1% methylene blue dye solution prepared in artificial saliva. After cleaning, the crowns were separated from the root at the cementoenamel junction and subsequently sectioned longitudinally in buccolingual direction at the location of the central fossa. All sections were examined using a stereoscopic microscope and photographed. The images were downloaded on a computer. The length of penetration of the P&F was recorded using the following scoring system: C1: P&F extended to half of the enamel thickness; C2: P&F extended beyond half of the enamel thickness without reaching the dentine-enamel junction; C3: P&F extended to the dentine-enamel junction. For pits, C1, C2 and C3 were observed in 35, 9 and 6 teeth, respectively, while for fissures, C1, C2 and C3 were observed in 15, 18 and 17 teeth, respectively. The P&F detected in the samples extended to the deepest portions of enamel, quite frequently reaching the enamel-dentine junction. Clinicians should recognize that even if pits and fissures are not clinically obvious, they penetrate deep into the enamel and frequently reach the dentine-enamel junction. Effective treatment is recommended to block access to P&F, thus preventing ingress of bacteria.

Color Change in Tooth Induced by Various Calcium Silicate-Based Pulp-Capping Materials

Color stability of pulp-capping material is considered vital to the final aesthetic result since the material is placed in the coronal area. The purpose of this study was to compare the color stability of various pulp-capping materials by analyzing color change of tooth over time. A cavity was formed in the crown of the extracted premolar, and 4 types of pulp-capping materials were filled. Color assessment was performed with a spectrophotometer at different intervals: before placement; immediately after material placement; 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after placement. Proroot white MTA® and TheraCal LC® showed a significant decrease in the L* value and an increase in the ΔE* value over time. In contrast, Biodentine® and Well-Root™ PT showed no significant change in the L* value and maintained a steady ΔE* value. The application of pulp-capping materials containing bismuth oxide as a radiopacifier may result in a color change of teeth. Long-term color stability of pulp-capping materials should be considered when treating teeth with thin enamel thickness or in aesthetically important area.

Detection of Dental Caries’ and Dermatoglyphics’ Association with Relative Enamel Thickness Using CBCT Images in Saudi Subpopulation: A Novel Approach

Background. Dental caries is the localized destruction of dental hard tissues (enamel and dentine). Decayed, Missing, and Filled Teeth (DMFT) index is the most commonly used dental caries index. Thickness of the outermost part of the tooth called the enamel is determined by the rate of deposition of enamel proteins. Relative enamel thickness (RET) gives a measure of enamel thickness with respect to dentine. Dental caries is influenced by a genetically determined factor called dermatoglyphics (DG). As the genes responsible for RET and DG lie on the same chromosome and develop during the same time of intrauterine life, it is biologically plausible to correlate RET and DG. Aims. This study consists of two primary aims: (1) to assess RET using cone beam computed tomography images and correlate it with caries and (2) to correlate RET with DG. Materials and Methods. 148 dental subjects were assessed for DMFT caries score and were categorized as Group 1 with DMFT = 0 and Group 2 with DMFT ≥ 1 . Following this, their DG pattern was recorded digitally. The CBCT images of these subjects were assessed for RET, and the data were analyzed statistically. Results. Mean RET in our sample population is 18.45 (SD 3.79) while mean DMFT is 5.34 (SD 5.13). Mean RET in Group 1 subjects was 19.82 (SD 4.05) while that in the Group 2 was 17.68 (SD 3.43). RET and DMFT showed a statistically significant negative correlation ( p = 0.007 ). The “Single Loop” DG characteristic showed a statistically significant difference between males and females ( p = 0.031 ). The “Simple Arch” type of DG was positively correlated with RET. Conclusion. This is the first in vivo study to assess RET using CBCT images and correlate with DMFT and DG. RET is inversely related to DMFT while directly proportional to the “Simple arch” DG pattern. Males and females differed in their “Single Loop” DG characteristic.

Recessive Mutations in ACP4 Cause Amelogenesis Imperfecta

Amelogenesis imperfecta (AI) is an innate disorder that affects the formation and mineralization of the tooth enamel. When diagnosed with AI, one’s teeth can be hypoplastic (thin enamel), hypomature (normal enamel thickness but discolored and softer than normal enamel), hypocalcified (normal enamel thickness but extremely weak), or mixed conditions of the above. Numerous studies have revealed the genes that are involved in causing AI. Recently, ACP4 (acid phosphatase 4) was newly found as a gene causing hypoplastic AI, and it was suggested that mutant forms of ACP4 might affect access to the catalytic core or the ability to form a homodimer. In this study, a Korean and a Turkish family with hypoplastic AI were recruited, and their exome sequences were analyzed. Biallelic mutations were revealed in ACP4: paternal (NM_033068: c.419C>T, p.(Pro140Leu)) and maternal (c.262C>A, p.(Arg88Ser)) mutations in family 1 and a paternal (c.713C>T, p.(Ser238Leu)) mutation and de novo (c.350A>G, p.(Gln117Arg)) mutation in the maternal allele in family 2. Mutations were analyzed by cloning, mutagenesis, immunofluorescence, immunoprecipitation, and acid phosphatase activity test. Comparison between the wild-type and mutant ACP4s showed a decreased amount of protein expression from the mutant forms, a decreased ability to form a homodimer, and a decreased acid phosphatase activity level. We believe that these findings will not only expand the mutational spectrum of ACP4 but also increase our understanding of the mechanism of ACP4 function during normal and pathologic amelogenesis.

ENAMEL THICKNESS MEASUREMENTS ON 3D RECONSTRUCTIONS OF TEETH FOR PALEONTOLOGICAL APPLICATIONS

Findings of teeth play a significant role in palaeoanthropology. And excavations in Vietnamese LangTrank cave serve as a vivid example and evidence of this statement. Teeth constitute the majority of the paleontological material dated to Middle and Late Pleistocene periods. This is to some extent the result of dietary preferences of porcupines as these rodents include in their diets bones of animals however avoiding extremely hard coronal parts of teeth. Under such circumstances teeth serve a key to taxonomic differentiation of findings as genetic analysis is often hindered by a lack of preserved DNA at such dating of material. However morphological analysis is difficult in some cases either, as teeth can be worn out or broken. In that case enamel thickness measurements become an effective study instrument as this feature varies between species. In the current study two teeth with clear signs of expressed dental wear, presumably upper fourth premolars of wild boar required more detailed analysis. Thus they were reconstructed after micro-computed tomography scanning similarly to other upper teeth picked for comparison: orang-utan tooth from the same location and two teeth from the Upper Palaeolithic Sunghir (they have been scanned earlier). This study required new approaches to image processing and measurement methodology due to marked attrition of the samples. The workflow and results of enamel thickness assessments which facilitated taxonomical differentiation of the findings are presented in the article.