Morphological study of remineralization of the eroded enamel lesions by tyrosine-rich amelogenin peptide.

BACKGROUND: Tyrosine-rich amelogenin peptide (TRAP) is the main amelogenin digestion product in the developmental enamel matrix. It has been shown to promote remineralization of demineralized enamel in our previous study. However, direct evidence of the effect of TRAP on the morphology and nanostructure of crystal growth on an enamel surface has not been reported. This study aimed to examine the effect of TRAP on the morphology of calcium phosphate crystals grown on early enamel erosion using a pH-cycling model. METHODS: Eroded lesions were produced in human premolars by 30-second immersion in 37% phosphoric acid. Forty-five samples of eroded human premolar enamel blocks were selected and randomly divided into 3 groups: deionized water (DDW, negative control); 100 µg/mL TRAP, and 2 ppm sodium fluoride (NaF, positive control group). For 14 days, the specimens were exposed to a pH-cycling model. Using scanning electron microscopy (SEM) and atomic force microscopy (AFM) methods, the surface morphology, calcium-phosphorus ratio, and enamel surface roughness were examined. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR) were used to assess crystal characteristics. RESULTS: After pH-cycling, compared to the two control groups, the surface of the eroded enamel of the peptide TRAP group shows a large number of new, densely arranged rod-like crystals, parallel to each other, regularly arranged, forming an ordered structure, with crystal morphology similar to that of natural enamel. The crystals are mostly hydroxyapatite (HA). CONCLUSION: This study demonstrates that the peptide TRAP modulates the formation of hydroxyapatite in eroded enamel and that the newly formed crystals resemble natural enamel crystals and promote the remineralization of enamel, providing a promising biomaterial for remineralization treatment of enamel lesions.

Evaluation of the Effect of NovaMin and Er,Cr:YSGG Laser on Remineralization of Erosive Lesions of Primary Enamel Teeth: An In Vitro Study.

Introduction: The purpose of this in vitro study is to ascertain how NovaMin and Er,Cr:YSGG laser radiation affect the remineralization of primary tooth enamel lesions. Methods: 40 main teeth served as the study's sample size. These teeth were allocated into five groups at random. The first group served as a negative control (artificial saliva); the second group served as a positive control (APF gel 1.23%); the third group NovaMin, the fourth group Er,Cr:YSGG laser, the fifth group Er,Cr:YSGG laser and finally, the application of NovaMin. For the purpose of measuring microhardness, all samples were submitted to the dental materials laboratory three times. Results: The collected data were compared using the SPSS 28 program between the baseline measurement, after demineralization, and after remineralization. The data were analyzed using ANCOVA and Bonferroni tests. All groups demonstrated a considerable increase in microhardness as compared to the negative control group (P<0.05). With the exception of the third and fourth groups, there was no discernible difference in the rise in microhardness between the other groups. The third and fourth groups were compared, and the results revealed that NovaMin had a greater impact than laser therapy alone (P=0.023). Scanning electron microscopy (SEM) analysis backed up the findings. Conclusion: In comparison to using the Er,Cr:YSGG laser alone, using NovaMin alone can speed up the remineralization of erosion lesions on the surface of primary teeth.

Influence of Different Mouthwashes on the Efficacy of Fluoridated Dentifrices in Prevention of Enamel Erosion: An In Vitro Study.

AIM: The purpose of the current study was to evaluate the impact of three various mouthwashes on the effectiveness of fluoride dentifrices in preventing enamel erosion. MATERIALS AND METHODS: A total of 120 sound intact human premolar teeth which were extracted for orthodontic treatment were selected for the study. A 3 × 3 mm window section was positioned in the middle of the coronal surface of the tooth in order to define the study area. Each sample was placed in a solution of 1% citric acid (pH 3.5) for 10 minutes in order to produce an eroded surface. All samples were divided into two main groups (60 samples each) as follows: Group A for sodium fluoride dentifrices and group B for stannous fluoride dentifrices, again it is subdivided into: CHX: Chlohex ADS®, EO: Listerine®, CPC: Colgate® Plax (20 samples in each subgroup). After that, samples underwent the pH cycling model for 5 days. Samples were examined for surface loss using a scanning electron microscope. RESULTS: In sodium fluoride dentifrices group, before intervention, the surface loss was 3.12 ± 1.03 in CHX group, 3.08 ± 1.20 in EO group, and 3.09 ± 0.96 in CPC group. After intervention, the less surface loss found with CHX group (2.18 ± 0.84), followed by CPC (2.34 ± 0.74) and EO group (2.46 ± 0.97). In stannous fluoride dentifrices group, before intervention, the surface loss in CHX group was 3.26 ± 1.19, in EO group, it was 3.18 ± 1.31, and in CPC group, it was 3.22 ± 1.06. After intervention, the less surface loss found with CHX: group (1.90 ± 0.54), followed by CPC (2.24 ± 0.28) and EO group (2.38 ± 0.20). CONCLUSION: The present study concluded that the fluoride dentifrices' preventive effects against tooth surface loss were unaffected by a different mouthwashes with varying compositions and major constituents. In terms of erosion, fluoridated toothpaste containing stannous fluoride was found to provide better surface loss protection than sodium fluoride. CLINICAL SIGNIFICANCE: Primary prevention and the eradication of contributing causes are the greatest strategies for preventing erosion. Simultaneously, antibacterial agent in the mouthwashes may help in enhancing the effect of fluoride in the enamel, owing to their high affinity for teeth structures. Therefore, in addition to cause-related treatment, further efforts to reduce tooth tissue loss are also necessary.

The Impact of Prenatal Vitamin D on Enamel Defects and Tooth Erosion: A Systematic Review.

Prenatal Vitamin D has been suggested to be critical for dental health in children, affecting outcomes including the prevalence of enamel defects and tooth erosion. This systematic review aimed to evaluate the potential impact of prenatal Vitamin D levels on these dental health outcomes. A total of seven studies, involving 6978 participants, were included after a comprehensive search of PubMed, Web of Science, and Scopus from 2013 to June 2023. The average age of mothers varied across studies, with Vitamin D levels or supplementation practices displaying significant variation among the study populations. The age of children at examination ranged from 3.6 to 6.6 years. The analysis demonstrated a diverse association between Vitamin D levels and dental outcomes, with enamel defects reported in 21.1% to 64% of the children and opacities ranging from 36% to 79.5% across studies. Maternal Vitamin D insufficiency was identified as a significant risk factor for enamel defects in one study (OR: 3.55), whereas high prenatal Vitamin D levels indicated a protective effect against Hypomineralized Second Primary Molars (OR: 0.84) and Molar Incisor Hypomineralization (OR: 0.95) in another. Conversely, low Vitamin D levels increased the risk of enamel hypoplasia (OR: 1.29) and dental decay. The maternal and child demographics varied greatly across the studies, and the assessment and prevalence of Vitamin D deficiency or insufficiency were heterogenous. This review illuminates the potential influence of prenatal Vitamin D on dental health in children, underscoring the importance of adequate Vitamin D levels during pregnancy. However, more robust research is required to establish the optimal Vitamin D intake during pregnancy to ensure healthy dental outcomes in children.

Effect of an In-Office Bleaching Agent with Surface Pre-Reacted Glass-Ionomer Filler on the Enamel Surface: A In-Vitro Study.

In-office bleaching with high concentrations of hydrogen peroxide (H2O2) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H2O2-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H2O2) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion.

Damage from Carbonated Soft Drinks on Enamel: A Systematic Review.

The present study was conducted to analyze the erosive potential of the ever-increasing consumption of carbonated drinks on the dental surface. To identify relevant studies, a comprehensive search was conducted on PubMed, Scopus, and Web of Science covering the last 5 years (2018-2023) using the following Boolean keywords: "soft drinks AND tooth". Finally, a total of 19 studies were included. The initial search provided a total of 407 items. Nineteen records were finally involved in the inclusion phase, seven of which were in vivo and twelve in vitro. An abuse of carbonated acid substances leads to an increase in the possibility of dental erosion with consequent structural disintegration and reduction of the physical and mechanical properties of the enamel. There is thus greater bacterial adhesion on rougher surfaces, determined by the erosive process, and therefore a greater risk of caries. The pH of most commercialized carbonated drinks is lower than the critical pH for the demineralization of the enamel. Carbonated drinks' pH and duration of exposure have different deleterious effects on enamel.

Effect of air-abrasion pretreatment with three bioactive materials on enamel susceptibility to erosion by artificial gastric juice.

OBJECTIVE: The purpose of the study was to investigate the protective effect of three in-office preventive treatments with bioactive materials against enamel erosion induced by artificial gastric juice similar to that found in gastroesophageal reflux disease (GERD) patients. The treatments included air-abrasion of enamel with a fluoride-containing bioactive glass (BioMinF®), Bioglass 45S5 (ProSylc) and nano-hydroxyapatite (MI Pearls) to test enamel susceptibility following an erosive challenge. METHODS: Enamel surface loss was evaluated using confocal microscopy, while changes in enamel surface roughness and morphology were also investigated after the treatments. SEM and EDS were used to observe formation of apatite crystals on enamel and to detect alterations in mineral composition. In Group 1 (negative control) the specimens did not receive any treatment; Group 2 specimens (positive control) treated with 0.4 % SnF2, while in Groups 3-5 enamel was air-abraded with BioMinF®, ProSylc and MI Pearls, respectively. RESULTS: All the experimental groups reduced significantly enamel surface loss compared to the negative control group (p < 0.05), except for the MI Pearls treatment (p > 0.05). The most protective behavior against erosion presented the treatment with SnF2. BioMinF induced the larger amount of apatite crystals on the enamel surface, followed by ProSylc. SIGNIFICANCE: BioMinF and ProSylc treatments may be beneficial against dental erosion induced by gastric juice in GERD patients, while MI Pearls treatment may not suitable for this indication. Both materials promote formation of apatite crystals on enamel in acidic conditions protecting the surface from the erosion. The tested treatments may be useful in GERD patients who cannot comply with at-home therapies with SnF2.

Influence of Enamel Exposure to Acidic Drink on Shear Bond Strength of Different Fissure Sealants.

In the present study, we evaluated the influence of bovine enamel exposure to acidic drinks (Coca-Cola, Coca-Cola Company, Milano, Italy, pH = 2.37) on shear bond strength of three sealants (Fissurit; Grandio Seal and Admira Fusion-Voco Gmbh, Cuxhaven, Germany). For each sealant, two adhesive techniques were tested to investigate the impact of the adhesive application on shear bond strength of sealants after immersion in acidic drink and in the control: Group 1-Control: enamel surface was not in contact with acid drinks, acid etching application and self-adhesive technique for fissure sealant; Group 2-enamel surface was not in contact with acid drinks, acid etching, and adhesive applications, an etch-and-rinse technique for fissure sealant; Group 3-enamel surface was immersed in acid drink, acid etching application and self-adhesive technique for fissure sealant; Group 4-enamel surface was immersed in acid drink, acid etching, and adhesive applications, an etch-and-rinse technique for fissure sealant. For each specimen, the sealant composite resin was applied to the enamel surface and tested with a universal testing machine. Shear bond strength was measured in MPa and with an optical microscope to determine failure modes, quantified with adhesive remnant index (ARI). Enamel acidification variably influenced bond strength values of the different sealants. When no enamel pretreatment was applied, no significant differences were found among the sealants (p > 0.05). However, the mere application of acid etching without adhesive procedures resulted in lower bond strength (p < 0.001). The acid pretreatment affected significantly the bond strength of all sealants tested (p < 0.001), but no significant differences were recorded between the subgroups.

Enamel erosion control by strontium-containing TiO2- and/or MgO-doped phosphate bioactive glass.

OBJECTIVES: To evaluate the effect of strontium-containing titanium- and/or magnesium-doped phosphate bioactive glass on the control of dental erosion. MATERIALS AND METHODS: Fifty fragments of human enamel were divided into five groups: negative control, 45S5 bioglass, strontium-containing Ti-doped phosphate bioactive glass (PBG-Ti), strontium-containing Mg-doped phosphate bioactive glass (PBG-Mg), and strontium-containing Ti- and Mg-doped phosphate bioactive glass (PBG-TiMg). The specimens underwent cycles of erosive challenge twice daily for 5 days with 1 mL of citric acid for 2 min followed by 1 mL of the suspension with bioactive substances for 3 min. After the cycles, profilometry, roughness and microhardness testing, and scanning electron microscopy (SEM) were performed. The following statistical tests were used: one-way ANOVA (profile, roughness, and surface microhardness (%VMS) data variation), Tukey's HSD (%VMS), Games-Howell test (profilometry), Student's t test (roughness), and Pearson's correlation between the variables. RESULTS: The lower loss of enamel surface and lower %VMS was observed in the PBG-Mg and PBG-TiMg groups, and only the PBG-Mg group showed similar roughness between baseline and eroded areas (p > 0.05). On SEM micrographs, PBG-Ti and PBG-Mg groups showed lower apparent demineralization. CONCLUSION: All bioactive materials protected the enamel against erosion. However, strontium-containing phosphate bioactive glasses showed lower enamel loss, and the presence of Mg in these bioactive glasses provided a greater protective effect. CLINICAL RELEVANCE: Experimental strontium-containing phosphate bioactive glasses are effective in controlling enamel erosion. The results obtained in this study will guide the development of new dental products.

Prevention of acidic attack on tooth enamel surfaces using polishing paste containing ion-releasing filler.

The purpose of this study was to investigate the ability of polishing paste containing surface pre-reacted glass-ionomer (S-PRG) filler to prevent acidic attack on tooth enamel surfaces. Resin composites were filled in the standardized cavities and finished with silicon carbide paper. These specimens were divided into three groups: the unpolished "control" group, the "PRG" group polished with S-PRG paste, and the "DDP" group polished with diamond-containing polishing paste. Following polishing, the specimens were immersed in a lactic acid buffer solution for 28 days. Optical coherence tomography (OCT) signals were measured to obtain the signal intensity and width at 1/e2 at selected locations on the enamel surface adjacent to the restoration. Although signal intensity significantly increased in all groups, widths at 1/e2 did not change significantly in the PRG group. For both the control and DDP groups, signal intensity and width at 1/e2 increased and decreased over time, respectively.

Impact of early biofilm on the assessment of initial enamel erosion with swept-source optical coherence tomography.

Objective: This study examined the impact of early biofilm on the tooth surface, during the assessment of initial enamel erosion using swept-source optical coherence tomography (SS-OCT). Method and materials: Forty-five enamel windows of 2 × 4 mm2 were prepared on 23 extracted human teeth. The specimens were exposed to citric acid (pH 3.2) for 30 minutes and randomly divided into three groups (n = 15): Group 1, no biofilm; Group 2, 1-day-old biofilm; and Group 3, 3-day-old biofilm. Specimens in Groups 2 and 3 were inoculated with oral bacteria (Streptococcus sanguinis, Streptococcus mitis, and Actinomyces naeslundii) to produce early laboratory-cultivated biofilms for 1 and 3 days respectively. Surface microhardness (SMH) measurements were taken at pre- (t1) and post-erosion (t2); and SS-OCT scans were done at t1, t2, and post-biofilm cultivation (t3). Integrated reflectivity (IR) of the tooth-air interface (IRsurface) and enamel (IRenamel) were computed from the mean A-scans. Statistical analysis was performed using paired t tests and one-way ANOVA (α = .05). Results: A significant increase in IRenamel was observed at t2 (P < .05). At t3, IRsurface between Group 1 (control) and Group 2 (P = .012) as well as Group 3 (P = .001) were significantly different. Significant variances in IRenamel were perceived between t2 and t3 for Groups 2 and 3 but not for Group 1. Conclusion: As early biofilm affected SS-OCT assessment of initial enamel erosion, they should be removed from the tooth surface prior to OCT procedures..

Stannous Fluoride Preventive Effect on Enamel Erosion: An In Vitro Study.

The aim of this in vitro study was to evaluate the effects of a single dose application of two daily toothpastes on enamel exposed to acid attack. The research was conducted on human molars enamel fragments (n = 72). The two different toothpastes active ingredients were sodium fluoride (NaF) and stannous fluoride (SnF2). They were compared in protecting the surface of the enamel exposed to three acids: citric acid, lactic acid and hydrochloric acid. A spectrophotometer was used to measure the calcium ions and phosphate released in the solutions by the enamel specimens. Afterward, ionic concentrations were analyzed through the t-Student test, in order to estimate the significance level (p < 0.05) of the solubility differences obtained between the treatment and control groups. Finally, sample surfaces were analyzed with scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX). The two analyzed toothpastes did not reveal any statistically significant variation in the release of calcium and phosphate (p > 0.05). Nevertheless, acid-resistant deposits were detected in samples treated with stannous fluoride and exposed to lactic acid, though the presence of tin ion deposits on samples treated with stannous fluoride was not shown. A single dose of a fluoride-based toothpaste before different acids attack, in simulated oral cavity conditions, did not show a significant preventive effect.

Quantitative and Qualitative Evaluation of Enamel Erosion Following Air Abrasion with Bioactive Glass 45S5.

PURPOSE: To evaluate the effect of pre-treatment air abrasion of surfaces using bioactive glass 45S5 on the progression of erosion in bovine enamel induced by a common soft drink. MATERIALS AND METHODS: Twelve intact bovine incisors were selected and 24 enamel samples were prepared and randomly assigned to two groups (n = 12): 1. control group, no anti-erosive treatment; 2. experimental group: samples were air abraded with bioglass 45S5 before the erosive challenge. The enamel samples were submitted to erosive cycling using a common soft drink. Enamel surface loss was evaluated using optical profilometry; surface microhardness and roughness changes were determined using Vickers method and Vertical Scanning Interferometry, respectively. In addition, SEM observations and EDS analysis were performed to detect any alterations in surface morphology and mineral content. The data were statistically analysed using one-way ANOVA and Tukey's post-hoc test at a significance level of α = 0.05. RESULTS: The experimental group exhibited less (18.7%) surface loss than did the control group (p < 0.05), while also presenting a statistically significantly smaller decrease in surface microhardness compared to the control group after erosive cycling (p < 0.05). However, neither group showed a statistically significant change in surface roughness (p > 0.05). After the treatments, changes in surface morphology and mineral content of enamel were observed. CONCLUSIONS: Surface pre-treatment using air abrasion bioglass 45S5 may help prevent enamel erosion induced by excessive consumption of soft drinks. Further clinical trials are needed to confirm the effectiveness of this method and its clinical significance.

Enamel Erosion: A Possible Preventive Approach by Casein Phosphopeptide Amorphous Calcium Phosphate-An In Vitro Study.

CONTEXT: Several efforts were made in order to alter the compositions of acidic food items concerning their properties to be able to reduce their erosivity potential. The addition of combinations of calcium and phosphate salts to these food products has grabbed great interest. AIM: In vitro evaluation of the effect of the addition of 0.2% w/v casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to four commonly available beverages (of which two were carbonated) on enamel erosion. MATERIALS AND METHODS: Sound-extracted human third molar teeth were taken, and enamel sections (n = 270) were made and polished. Acid-resistant nail varnish was painted to create an exposed enamel window of 1 mm2, followed by testing of the four soft drinks and distilled deionized water (DDW). Every drink was evaluated with and without the addition of 0.2% w/v CPP-ACP. The enamel specimens were kept in 50 mL solution at 37°C for 30 minutes, rinsed, and then varnish was removed. All samples were then profiled using white-light profilometer, and erosive depths were recorded. STATISTICAL ANALYSIS: One-way analysis of variance test and post hoc Tukey test. RESULTS: Enamel erosion was created by all the soft drinks tested, but the addition of 0.2% w/v CPP-ACP has remarkably reduced (p value < 0.05) erosive depths in all test solutions compared to solutions without CPP-ACP. The erosive depths for solutions with DDW did not vary much from those with 0.2% CPP-ACP. CONCLUSION: Addition of 0.2% w/v CPP-ACP to the soft drinks has remarkably reduced their erosivity potential. HOW TO CITE THIS ARTICLE: Velagala D, Reddy VN, Achanta A, et al. Enamel Erosion: A Possible Preventive Approach by Casein Phosphopeptide Amorphous Calcium Phosphate-An In Vitro Study. Int J Clin Pediatr Dent 2020;13(5):486-492.

An Experimental Review of Optical Coherence Tomography Systems for Noninvasive Assessment of Hard Dental Tissues.

Optical coherence tomography (OCT) is a noninvasive, high-resolution, cross-sectional imaging technique. To date, OCT has been demonstrated in several areas of dentistry, primarily using wavelengths around 1,300 nm, low numerical aperture (NA) imaging lenses, and detectors insensitive to the polarization of light. The objective of this study is to compare the performance of three commercially available OCT systems operating with alternative wavelengths, imaging lenses, and detectors for OCT imaging of dental enamel. Spectral-domain (SD) OCT systems with (i) 840 nm (Lumedica, OQ LabScope 1.0), (ii) 1,300 nm (Thorlabs, Tel320) center wavelengths, and (iii) a swept-source (SS) OCT system (Thorlabs OCS1300SS) centered at 1,325 nm with optional polarization-sensitive detection were used. Low NA (0.04) and high NA (0.15) imaging lenses were used with system (iii). Healthy in vivo and in vitrohuman enamel and eroded in vitro bovine enamel specimens were imaged. The Tel320 system achieved greater imaging depth than the OQ LabScope 1.0, on average imaging 2.6 times deeper into the tooth (n = 10). The low NA lens provided a larger field of view and depth of focus, while the high NA lens provided higher lateral resolution and greater contrast. Polarization-sensitive imaging eliminated birefringent banding artifacts that can appear in conventional OCT scans. In summary, this study illustrates the performance of three commercially available OCT systems, objective lenses, and imaging modes and how these can affect imaging depth, resolution, field of view, and contrast in enamel. Users investigating OCT for dental applications should consider these factors when selecting an OCT system for clinical or basic science studies.

Effect of CPP-ACPF and Nano-hydroxyapatite Preventive Treatments on the Susceptibility of Enamel to Erosive Challenge.

PURPOSE: The purpose of this in vitro study was to evaluate the effect of two preventive clinical treatments on bovine enamel susceptibility after erosive challenge induced by a soft drink. MATERIALS AND METHODS: Eighteen sound bovine incisors were used for this study. Three experimental groups were assigned as follows: Group 1 was the control group; Group 2 specimens received a CPP-ACPF paste treatment; and Group 3 specimens received a treatment with a product containing 1% nano-hydroxyapatite and 455 ppmF-. The specimens were submitted to erosive challenge using a common soft drink (Coca Cola). The erosive activity on the enamel was evaluated by measuring surface microhardness change (Vickers method), surface roughness alterations and surface loss (vertical scanning interferometry (VSI) method). The data were statistically analysed using one-way analysis of variance (ANOVA) and Tukey's post-hoc test at a level of statistical significance a = 0.05. RESULTS: The tested treatments exhibited significantly lower decreases in surface microhardness compared to the control group after the erosive challenge (p < 0.05). The tested treatment groups did not show statistically significant lower increases in surface roughness compared to the control group (p > 0.05). In addition, the treatment groups exhibited statistically significant lower surface loss than the control group (p < 0.05). CONCLUSION: Although the tested treatments reduced erosive activity, none of them provided complete protection against the development of enamel erosion, which means that they should be only used as a part of an individually tailored preventive programme.

Evaluation of a clinical preventive treatment using Er,Cr:YSGG (2780 nm) laser on the susceptibility of enamel to erosive challenge.

The purpose of this in vitro study was to evaluate the effect of a clinical preventive treatment using Er,Cr:YSGG laser irradiation on bovine enamel susceptibility after erosive challenge. Twelve sound bovine incisors were used and twenty-four enamel specimens were prepared in total. Two experimental groups (n = 12) were assigned as follows: Group 1 was the control group and in Group 2, the enamel specimens were irradiated with an Er,Cr:YSGG (2780 nm) laser system for 20 s, with average output power of 0.25 W, pulse repetition rate at 20 Hz without water or air flow and the pulse duration was fixed at 140 µsec. The tip diameter was 600 µm, the tip to tissue distance was 1 mm, the speed of handpiece movement was 2 mm/s, the power density was 88.34 W/cm2, and the fluence was 31.25 J/cm2. The specimens were submitted to erosive challenge using a common soft drink. Surface microhardness changes, surface roughness changes, and surface loss were evaluated after erosive challenge. The data were statistically analyzed using one-way ANOVA and Tukey's post-hoc test at a level of significance a = 0.05. Er,Cr:YSGG laser-treated enamel exhibited significantly less decrease in surface microhardness and significant less surface loss compared to control enamel after the erosive challenge (p < 0.05). The experimental groups did not show significant differences in surface roughness increase after the erosive challenge (p > 0.05). Er,Cr:YSGG laser treatment may be promising for the limitation of enamel erosive tooth wear induced by excessive consumption of soft drinks. Clinical studies are needed to clarify whether this protective effect is clinically significant.

Comparative evaluation of grape seed and cranberry extracts in preventing enamel erosion: An optical emission spectrometric analysis.

INTRODUCTION: Dental erosion is defined as the loss of tooth structure due to chemical process that does not involve bacteria. The management of such a condition calls for a comprehensive approach to identifying the cause and treating it. AIM: The aim of this study is to comparatively evaluate the role of grape seed extract (GSE) and cranberry extract (CE) in preventing dental erosion using optical emission spectrometry. MATERIALS AND METHODS: Prepared enamel specimens were subjected to the erosive challenge using HCl for 10 s, followed by immersion in experimental natural groups and control fluoride group for 30 s and artificial saliva for 60 min. This cycle was repeated three times. The amounts of calcium and phosphorous present in the acid solution after 1st, 2nd, and 3rd erosive challenges were determined for each group using induced coupled plasma-optical emission spectrometry. RESULTS: The cumulative calcium and phosphorous release after the 1st, 2nd, and 3rd erosive challenges were found to be the least in SnF2 group, followed by GSE group and then in CE group. CONCLUSION: The protective of GSE and CE was inferior to the gold standard control group of stannous fluoride role, against enamel erosion. GSE showed better remineralizing effect; however, there was no statistically significant difference between the two groups.

Er,Cr:YSGG Laser Energy Delivery: Pulse and Power Effects on Enamel Surface and Erosive Resistance.

BACKGROUND: High power lasers have been suggested as a useful tool for dental caries and erosion prevention due to the increase of enamel acid resistance. OBJECTIVE: to evaluate the effect of Er,Cr:YSGG (erbium,chromium:yttrium, scandium, gallium, garnet) laser irradiation pulse frequency and power on enamel surface and acid erosion resistance. METHODS: By combining pulse frequency (5-75 Hz) and power settings (0.10-1.00 W), 20 irradiated groups and one nonirradiated control group were tested. A total of 63 bovine enamel blocks (n = 3/group) were prepared for surface hardness and roughness evaluation, performed in three phases: baseline, after irradiation, and after erosive challenge. Enamel blocks were irradiated with Er,Cr:YSGG laser with MZ8 tip (iPlus; Waterlase, Biolase, CA) for 30 sec according to experimental group and submitted. Erosive challenge consisted of four cycles alternating immersion in 0.01 M HCl (5 mL/mm2; 2 min; at 37°C) and immersion in artificial saliva for 3 h. Analysis of variance (three-way ANOVA), Tukey's test, and Pearson correlation were performed for the statistical analysis (p < 0.05). RESULTS: After irradiation, groups irradiated with pulse frequency of 10 and 15 Hz showed a decrease in surface hardness. After erosive challenge, 5 and 75 W groups showed increase in surface hardness; 0.25, 0.5, 0.75, and 1 W groups showed minor alterations in surface roughness. CONCLUSIONS: the irradiation of Er,Cr:YSGG laser with different parameters of power and pulse frequency settings may alter enamel surface and erosive resistance differently. Pulse frequency of 30 Hz and power of 0.50 W was considered the best parameter to prevent enamel acid erosion.

Effects of tannin-fluoride and milk-fluoride mixture on human enamel erosion from inappropriately chlorinated pool water.

This in vitro study aimed to investigate the efficacy of tannin-fluoride and milk-fluoride mixtures on human enamel erosion after exposure to inappropriately chlorinated pool water. Enamel specimens were immersed in swimming pool water (pH 2.7) for 30 min and in each test reagent for 4 min once a day for 60 consecutive days (group I: control, group II: tannin-fluoride, group III: milk-fluoride, group IV: tannin-fluoride before and milk-fluoride after erosive challenge, and group V: milk containing tannin-fluoride before and after erosive exposure). Surface microhardness was assessed on days 0, 30, and 60. Scanning electron microscopy (SEM) and electron probe microanalysis (EPMA) were performed after treatment of samples for 60 days. Surface microhardness of experimental groups was ranked as follows: group III > group IV-group V > group II > group I (P < 0.05). Moreover, SEM images revealed deposition of substances on erosive enamel surface after treatment with tannin-fluoride and milk-fluoride mixtures. Furthermore, EPMA profiles showed decrease of phosphorus and increase of fluoride content in groups II and IV. In conclusion, we demonstrated that treatment with fluoridated milk with or without tannin-fluoride has protective effects against enamel erosion caused by low-pH swimming pool water.