Hydroxyapatite Film Coating by Er:YAG Pulsed Laser Deposition Method for the Repair of Enamel Defects

There are treatments available for enamel demineralization or acid erosion, but they have limitations. We aimed to manufacture a device that could directly form a hydroxyapatite (HAp) film coating on the enamel with a chairside erbium-doped yttrium aluminum garnet (Er:YAG) laser using the pulsed laser deposition (PLD) method for repairing enamel defects. We used decalcified bovine enamel specimens and compacted α-tricalcium phosphate (α-TCP) as targets of Er:YAG-PLD. With irradiation, an α-TCP coating layer was immediately deposited on the specimen surface. The morphological, mechanical, and chemical characteristics of the coatings were evaluated using scanning electron microscopy (SEM), scanning probe microscopy (SPM), X-ray diffractometry (XRD), and a micro-Vickers hardness tester. Wear resistance, cell attachment of the HAp coatings, and temperature changes during the Er:YAG-PLD procedure were also observed. SEM demonstrated that the α-TCP powder turned into microparticles by irradiation. XRD peaks revealed that the coatings were almost hydrolyzed into HAp within 2 days. Micro-Vickers hardness indicated that the hardness lost by decalcification was almost recovered by the coatings. The results suggest that the Er:YAG-PLD technique is useful for repairing enamel defects and has great potential for future clinical applications.

Combination effect of diurnal exposure to sucrose and nocturnal exposure to lactose on enamel demineralization

We have hypothesized that the association between human milk and caries in breastfeeding children could be explained by the combination of a diurnal cariogenic diet with the nocturnal lactose fermentation, conditions simulated in this experimental study. Cariogenic biofilm was formed on bovine enamel slabs, which were exposed 8x/day for 3 min to a 10% sucrose solution, simulating a highly cariogenic diurnal diet, or 50 mM NaCl solution (control). Simulating the nocturnal retention of milk in mouth, biofilms were transferred to culture medium containing 0.7% lactose for 2 h, or only to culture medium (control). Four groups were designed (n=12): Ctrl, no exposure to diurnal sucrose or nocturnal lactose; Lac, only nocturnal exposure to lactose (2 h); Suc, only diurnal exposure to sucrose (8x/day); and Suc→Lac, diurnal exposure to sucrose (8x/day) followed by nocturnal exposure to lactose (2 h). The medium was changed 3x/day, at the beginning of the day, and after diurnal and nocturnal exposures. Calcium in the medium was determined as chemical indicator of partial demineralizations occurred during the diurnal and the nocturnal treatments; the medium pH was also determined. After 96 h of growth, biofilms were harvested to evaluate CFU, biomass, and extracellular polysaccharides, soluble and insoluble. The percentage of enamel surface hardness loss (%SHL) was evaluated as cumulative demineralization. Data were analyzed by one-way ANOVA, Tukey’s test (α=5%). Highest %SHL (p<0.05) was found for Suc→Lac (40.6%) group when compared to Suc (32.1%), Lac (7.7%), and Ctrl (3.8%). Calcium released during the diurnal and nocturnal treatments were respectively: Suc→Lac=Suc>Lac=Ctrl and Suc→Lac=Lac>Suc=Ctrl (p<0.05). Regarding Ctr group, calcium released from nocturnal lactose fermentation by Suc→Lac group was 4-fold greater than that provoked by Lac group. The findings were supported by the pH of the media. The data suggest that the biofilm formed under diurnal exposure to sucrose enhances the cariogenicity of nocturnal exposure to lactose.

Solutions and gels containing a sugarcane-derived cystatin (CaneCPI-5) reduce enamel and dentin erosion in vitro

The effect of solutions and gels containing a sugarcane-derived cystatin (CaneCPI-5) on the protection against enamel and dentin erosion in vitro was evaluated. Bovine enamel and dentin specimens were divided into two groups (n=135 and 153/group for enamel and dentin, respectively) that were treated with solutions or chitosan gels containing 0.1 or 0.25 mg/ml CaneCPI-5. The positive controls for solutions and gels were Elmex Erosion Protection™ solution and NaF gel (12,300 ppm F), respectively. Deionized water and chitosan gel served as controls, respectively. The solutions were first applied on the specimens for 1 min and the gels for 4 min. Stimulated saliva was collected from 3 donors and used to form a 2 h acquired pellicle on the specimens. Then, the specimens were submitted to an erosive pH cycling protocol 4 times/day for 7 days (0.1% citric acid pH 2.5/90s, artificial saliva/2h, artificial saliva overnight). The solutions and gels were applied again during pH cycling, 2 times/day for 1 min and 4 min, respectively, after the first and last erosive challenges. Enamel and dentin losses (µm) were assessed by contact profilometry. Data were analyzed by 2-way ANOVA and Tukey´s test (p <0.05). All the treatments significantly reduced enamel and dentin loss in comparison with controls. Both CaneCPI-5 concentrations had a similar protective effect against enamel erosion, but only the higher concentration was as effective against dentin erosion as the positive control. Regarding the vehicles, only the 0.1 mg/ml gel performed worse than the positive control for dentin. CaneCPI-5 reduced enamel and dentin erosion to a similar extent as the fluoride-containing vehicles. However, dentin requires higher CaneCPI-5 concentrations, in the case of gels. Solutions or gels containing CaneCPI-5 might be a new approach to protect against dental erosion.

Surface Morphological Changes and Predisposition to Staining in Dental Enamel Bleached with Different Hydrogen Peroxide Concentrations

Background: The tooth bleaching treatment can cause structural changes in the surfaces of the teeth; these changes can increase the absorption of staining agents. Purpose: This study assessed surface morphological changes and predisposition to staining in dental enamel bleached with different hydrogen peroxide (HP) concentrations, with or without the use of a light source (LS). Methods: 25 bovine incisor specimens were divided into five groups (n = 5): Control- no treatment; HP35 - hydrogen peroxide 35%; HP35+LED - hydrogen peroxide 35% + light emission; HP20 - hydrogen peroxide 20%; and HP7 - hydrogen peroxide 7,5%. Twenty days after bleaching, the specimens were immersed in staining solutions four hours a day for 28 days. The morphological alterations of the bovine enamel surface were evaluated by means of scanning electron microscopy, X-ray dispersive energy spectroscopy and predisposition to the staining of the brightened enamel by means of colorimetry. Results: ANOVA with Tukey's test (p<0.05) showed that HP7 had the highest ΔL values (p=0.176) (brightest), with a better lightening effect. The bleached groups exhibited morphological changes in the enamel. The groups did not exhibit significant changes in oxygen, calcium, and phosphorus values (p=0.020). The presence or absence of light was not significant (p=0.007) for the predisposition to staining in bleached teeth. Conclusion: The time of exposure to the staining solution was significant for staining bovine dental enamel. High concentrations of HP were not necessary for achieving effective bleaching. HP caused an increase in enamel porosity and depressions. The light source did not influence bleaching.

Influence of Pre-Etched Area and Functional Monomers on the Enamel Bond Strength of Orthodontic Adhesive Pastes

This study was performed to investigate the influence of pre-etching area and functional monomers in orthodontic adhesive pastes on enamel bond strength. Bovine enamel was partially pre-etched with phosphoric acid for 30 s over areas with a diameter of 1.0, 2.0 or 3.0 mm, and metal brackets were then bonded with or without functional monomers in the orthodontic adhesive paste. For the baseline groups, the whole adherent area was pre-etched. The shear bond strength (SBS) and adhesive remnant index (ARI) were determined. The adhesive paste/enamel interfaces were observed by scanning electron microscopy (SEM). Although the adhesive paste with functional monomers showed higher SBS than the functional monomer-free adhesive paste in all groups, there were no significant differences in SBS between them regardless of the pre-etched area. The SBS increased with increasing pre-etched area in both orthodontic adhesive pastes. In SEM images of adhesive paste/enamel interfaces, although adhesive with functional monomers showed excellent adaptation, the functional monomer-free adhesive paste showed gap formation at the interface. These findings suggested that the pre-etching area greatly influenced bond strength, regardless of the presence or absence of the functional monomer in the orthodontic adhesive paste.

An In Vitro Assessment of the Acid Resistance Characteristics of Nanohydroxyapatite/Silica Biocomposite Synthesized Using Mechanochemistry

This paper reports on the in vitro assessment of the acid resistance characteristics of mesoporous silica/nanohydroxyapatite (MSN@nHAp) biocomposite synthesized through the mechanochemical method. Bovine enamel models were used to study the acid resistance characteristics of the composite ( n = 5 ). X-ray diffraction and Fourier transform infrared spectroscopy were used to characterize the surface morphology of the MSN@nHAp. The XRD and FTIR results confirmed the successful syntheses and surface modification of nanohydroxyapatite with silica. The MSN@nHAp exhibits superior acid resistance characteristics. The salient aspect of this study suggests that mechanochemistry is a useful technique in the synthesis and surface modification of valuable biomaterials. The study concludes that the MSN@nHAp composite could be utilised in toothpaste formulation for oral healthcare management due to its acid resistance properties.

Impact of Bioactive Glass-Based Toothpaste on Color Properties and Surface Microhardness of Bleached Enamel

Objectives The role of toothpaste used during aesthetic treatments is rarely investigated. The objective was to evaluate the effects of a bioactive glass-based toothpaste (BGT) used before or after the dental bleaching with 35% hydrogen peroxide (HP). Materials and Methods Bovine enamel blocks (4 × 4 mm; n = 12) were submitted to tooth bleaching and different treatments/storage, before or after HP, based on: (1) no toothpaste and immersion in artificial saliva (AS) after HP for 24 hours, 7 days, or 14 days (control); (2) daily BGT use and AS storage for 7 or 14 days (after HP); and (3) daily BGT use and AS storage for 7 or 14 days (prior to HP). Surface and in-depth color were determined using the CIE L*a*b* system (ΔL*, Δa*, Δb*, and ΔE) on enamel surface and underlying dentin. The surface microhardness (SMH) was evaluated using a Knoop microhardness tester. Statistical Analysis Data were submitted to analysis of variance (ANOVA) (color variables), repeated measures ANOVA (SMH), and Tukey’s test (α = 0.05). Results The color changes on the enamel or underlying dentin were not statistically different among the groups (p > 0.05). Twenty-four hours after HP presented a decrease in SMH differing from baseline (p < 0.01). This decrease did not occur in the groups previously exposed to BGT (p > 0.05). BGT use after HP for 7 days differed from group with exclusive AS storage (p < 0.05). Conclusion In-office tooth bleaching can decrease the microhardness of enamel surface; however, the use of BGT promotes the protection or enables the mineral recovery of tooth without the influence the bleaching efficacy.

Análise da eficácia de dentifrícios clareadores e seus efeitos na superfície dental: um estudo in vitro

Tooth whitening can be performed at the dental office, at-home or upon the use of OTC (Over-the-Counter) products. Among the latter, there are whitening toothpastes that promise to bleach and to prevent tooth staining. Objectives: (1) to investigate the bleaching and abrasive potential of different whitening dentifrices to enamel; and (2) to evaluate the effect of Oral-B 3D White Perfection® (Oral-B) toothpaste in preventing staining. Materials and Methods: Bovine enamel samples were stained and brushed for 14 days with water (negative control) or with different products: Colgate Total 12® (control), Oral-B, Sensodyne Branqueador Extra Fresh® (Sensodyne), and Colgate Luminous White Advanced® (Colgate). Oral-B was also tested before and after staining. The samples were tested by their color (spectrophotometer) and surface roughness (profilometer). Color change (ΔDE00) was calculated using the CIEDE2000 color system. The data were analyzed using Kruskal-Wallis, SNK, and Mann-Whitney tests (ɑ=5%). Results: The negative control showed the lowest ΔE00 (p