EFFECT OF LASER IRRADIATION ASSOCIATED WITH FLUORIDE IN DECREASING EROSIVE TOOTH WEAR: A SYSTEMATIC REVIEW WITH A NETWORK META-ANALYSIS  .

OBJECTIVE: The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW). METHODS: The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in µm). RESULTS: A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss. CONCLUSIONS: Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful.

Influence of bottled salad dressings on the development of enamel erosion in the presence or absence of salivary pellicle - An in vitro study.

Background: Acidic beverages are believed to elevate the risk of enamel surface erosion. In addition to the intake of soft drinks, the increased consumption of salad dressings has been linked to a higher prevalence of dental erosion. Therefore, the current study aimed to investigate the influence of bottled salad dressings on the development of enamel erosion in the presence or absence of pellicle through in vitro experiment. Methods: Preliminary pH and calcium analyses of solutions were performed. Highest pH and calcium content was found for sandwich spread i.e., 4.69 and 55.4 mg/100 g grams, respectively. Eighty tooth specimens (measuring 4 × 4 × 3 mm) were prepared from extracted human premolars and randomly assigned to four groups (group 1: orange juice; group 2: eggless plain mayonnaise; group 3: sandwich spread; and group 4: thousand island dressing) with 20 samples in each group. Ten tooth specimens from each group were immersed in 20 ml of the respective solutions for 5 min (control group). The remaining ten tooth specimens from each group were submerged in 5 mL saliva vials for 3 min to facilitate salivary pellicle formation before being immersed in their respective solutions for 5 min (saliva-covered group). Pre and post-experimental assessments of enamel roughness and hardness were conducted using a surface roughness tester and Knoop Hardness indenter, respectively. Results: Overall, enamel roughness was notably elevated in the control group, with the eggless plain mayonnaise (0.52 ± 0.38) and thousand island dressing groups (0.57 ± 0.29) showing a significant increase in surface roughness post-test (p = 0.05). Nevertheless, there was no significant difference in the enamel roughness between the groups. On the other hand, regardless of the presence/absence of the salivary pellicle, a marked decrease in enamel hardness was observed among all groups except for group 3 (sandwich spread) with a mean score of 311.5 ± 82.6 (p < 0.05). Conclusion: A significant increase in surface roughness and reduction in enamel hardness was observed with salad dressings. However, in vitro formed salivary pellicle showed a protective effect against tooth erosion.

Experimental toothpastes containing ß-TCP nanoparticles functionalized with fluoride and tin to prevent Erosive Tooth Wear.

OBJECTIVES: The present study aimed to synthesize toothpastes containing Beta- TriCalcium Phosphate (ß-TCP) nanoparticles, functionalized with fluoride and tin, and test their ability to reduce erosive tooth wear (ETW). METHODS: Toothpastes were synthesized with the following active ingredients: 1100 ppm of fluoride (as sodium fluoride, F-), 3500 ppm of tin (as stannous chloride, Sn2+), and 800 ppm of ß-TCP (Sizes a - 20 nm; and b - 100 nm). Enamel specimens were randomly assigned into the following groups (n = 10): 1. Commercial toothpaste; 2. Placebo; 3 F-; 4. F- + ß-TCPa; 5. F- + ß-TCPb; 6. F- + Sn2+; 7. F- + Sn2+ + ß-TCPa and 8. F- + Sn2+ + ß-TCPb. Specimens were subjected to erosion-abrasion cycling. Surface loss (in µm) was measured by optical profilometry. Toothpastes pH and available F- were also assessed. RESULTS: Brushing with placebo toothpaste resulted in higher surface loss than brushing with F- (p = 0.005) and F- + ß-TCPb (p = 0.007); however, there was no difference between F- and F- + ß-TCPb (p = 1.00). Commercial toothpaste showed no difference from Placebo (p = 0.279). The groups F-, F- + ß-TCPa, F- + ß-TCPb, F- + Sn2+, F- + Sn2+ + ß-TCPa and F- + Sn2+ + ß-TCPb were not different from the commercial toothpaste (p > 0.05). Overall, the addition of ß-TCP reduced the amount of available fluoride in the experimental toothpastes. The pH of toothpastes ranged from 4.97 to 6.49. CONCLUSIONS: Although toothpaste containing ß-TCP nanoparticles protected enamel against dental erosion-abrasion, this effect was not superior to the standard fluoride toothpaste (commercial). In addition, the functionalization of ß-TCP nanoparticles with fluoride and tin did not enhance their protective effect. CLINICAL SIGNIFICANCE: Although ß-TCP nanoparticles have some potential to control Erosive Tooth Wear, their incorporation into an experimental toothpaste appears to have a protective effect that is similar to a commercial fluoride toothpaste.

Oro-dental manifestations of eating disorders: a systematic review.

BACKGROUND: Eating disorders (EDs) pose a significant risk to health, especially when not diagnosed early. For several years EDs and oral health has been extensively studied, and now it is quite clear the existence of a correlation between specific oral manifestations and these disorders. While these oral signs could potentially aid early diagnosis of EDs, their identification and the eventual establishment of a correlation is currently heavily limited to the clinician's experience. The present systematic review critically examines existing literature, offering an updated overview of oro-dental manifestations associated with EDs. METHOD: MEDLINE (via PubMed), Web of Science, Scopus, and grey literature were searched, and relevant epidemiological comparative studies were screened using the Rayyan software. No limitations have been imposed on the research regarding oro-dental outcomes, encompassing all medically diagnosed EDs. The quality of the studies was valuated using AXIS appraisal tool for cross-sectional studies. RESULT: Out of 3990 studies, 32 fulfilled the eligibility criteria and were included in the synthesis. The identified eating disorders include Anorexia Nervosa, Bulimia Nervosa and/or Eating Disorders Not Otherwise Specified, predominantly among female subjects, primarily originating from Europe. The evaluated oro-dental outcomes include dental erosion, caries, saliva assessment, hygiene-periodontal parameters, and mucosal tissue appearance. The association with erosion is confirmed while gingival recession, dentinal hypersensitivity, salivary flow thresholds and aspects relating to oral pathology are receiving increasing support from emerging evidence. DISCUSSION: This trend emphasizes the critical role of the complete intraoral examination to detect significant oro-dental signs that may indicate the onset of an ED.

The article is a review of existing studies that explores the link between eating disorders and oral health issues. It found that people with eating disorders, including anorexia nervosa and bulimia nervosa, may experience dental problems such as tooth erosion, cavities, and altered saliva production. The review findings emphasize the importance of dental care providers recognizing these signs early and suggests better training for dental professionals. By doing so, they can help diagnose eating disorders sooner and recommend appropriate treatment. This approach aims to improve patients' overall wellbeing by addressing both the oral health issues and the underlying eating disorders, making it essential for patients and medical teams to be aware of the interconnectedness between oral health and eating disorders.

Hard drugs use and tooth wear: a scoping review.

OBJECTIVES: This study aims to map evidence on the relationship between hard drug use and dental wear. The scoping review is guided by the question: What is the relationship between hard drug consumption and dental wear? MATERIALS AND METHODS: Adhering to PRISMA-ScR guidelines, searches were conducted across PubMed, Embase, and four databases in March 2024. Inclusion criteria included studies investigating the association between hard drug use and dental wear, regardless of publication date or language. Data were presented through narrative exposition, tables, and a conceptual framework. RESULTS: Twenty-eight studies (four case-control, three cross-sectional, five case reports, and sixteen literature reviews) were included. Among case-control studies, 75% observed an association between drug use and dental erosion; however, no cross-sectional studies demonstrated this association. Despite questionable quality, reviews established connections between drug use and dental erosion. Studies aimed to elucidate potential causes for dental erosion. CONCLUSIONS: Analysis suggests a potential link between hard drug use and dental wear, though indirect. Factors like bruxism and reduced salivary pH may contribute to dental wear among drug users. Further investigation through primary studies exploring this relationship is necessary. CLINICAL RELEVANCE: Dentists should focus not only on clinical characteristics of dental wear but also on mediating factors such as bruxism and decreased salivary pH associated with drug use. This holistic approach allows for a deeper understanding of dental wear mechanisms, enabling targeted preventive and therapeutic interventions.

In Vitro Evaluation of Remineralization Potential of Five Toothpastes on Soft Drink-Eroded Human Enamel and Dentine.

OBJECTIVE: The purpose of this in vitro study was to evaluate the potential remineralization of enamel and dentine erosion lesions after the application of five different toothpastes. METHODOLOGY: A total of 104 enamel and dentine samples were prepared from maxillary third molars. Each group was divided according to the toothpaste application mode (topical = 56; brushing = 48) and the toothpaste used seven topical groups and six brushing groups (n = 8). The groups included negative control (NC), positive control (PC), Sensodyne Pronamel (SP), Regenerate (R), Regenerate with boosting serum (R+), Colgate Duraphat 5000 (CD), and tooth mousse (TM). RESULTS: The statistical analysis showed significant surface microhardness (SMH) change. All enamel groups showed a significant decrease in SMH compared to NC for both application modes. However, no significance was recorded between test groups. Similar results were observed between dentine groups and their relevant controls for both application modes, except brushed R and R+ groups, which were insignificant to their NC. For topical groups, TM showed a significant increase in SMH. While R and R+ showed lower loss than SP and CD. CONCLUSIONS: All tested agents offered a degree of remineralization in both enamel and dentine with no significant difference between agents in enamel groups while R, R+, and TM offered better results in dentine groups. CLINICAL SIGNIFICANCE:  For dentine groups, similar findings were observed with superior tooth surface protection with the application of TM over other agents. Tooth surface remineralization was achieved when agents were either applied topically or brushed over the surface.

Effect of a Nano-hydroxyapatite Toothpaste on Enamel Erosive Lesions of Third Molars Induced by Exposure to Orange Juice.

Objectives: This study aimed to assess the effect of a nano-hydroxyapatite (nano-HA) toothpaste on erosive enamel lesions of third molars induced by exposure to orange juice. Materials and Methods: In this in vitro, experimental study, the microhardness of 24 sound-extracted third molars was measured by a Vickers tester. The teeth were then randomly assigned to three groups (n = 8) of nano-HA toothpaste (Pharmed), 1.23% sodium fluoride gel, and artificial saliva. The teeth were exposed to orange juice for 5 min daily for 7 days and were then exposed to nano-HA toothpaste, fluoride gel, or artificial saliva (depending on their group allocation) for 10 min a day. The microhardness of the teeth was measured again after 7 days. Data were analyzed using paired t-test, analysis of variance, and Bonferroni test (alpha = 0.05). Results: Within-group comparisons showed a significant reduction in microhardness of the teeth after the intervention in artificial saliva (P = 0.000), and fluoride gel (P = 0.002) groups. However, no significant reduction occurred in the microhardness of the nano-HA group, compared with the baseline (P = 0.132). Between-group comparisons revealed no significant difference in the microhardness of the three groups at baseline (P > 0.05). However, after the intervention, the microhardness of the nano-HA group was significantly higher than that of other groups (P < 0.05). However, the difference in secondary microhardness between fluoride gel and artificial saliva groups was not significant (P = 1.00). Conclusion: Pharmed toothpaste containing nano-HA has optimal efficacy for remineralization of enamel erosive lesions induced by exposure to orange juice.

Effect of adding fluoride to camellia sinensis against dentin erosion generated by non-bacterial acids / Efecto de la adición de flúor a la camellia sinensis frente a la erosión de dentina generada por ácidos no bacterianos

Introduction: Natural products are an option to be used in different conditions in the oral cavity, such as Camellia sinensis, which due to its different properties would be beneficial in the erosion of the dental surface. Objetive: Determinar el efecto del extracto de Camellia sinensis (C. sinensis) adicionado con flúor frente a la acción erosiva de ácidos no bacterianos en la superficie de la dentina humana. Materials and Methods: Quasi-experimental, prospective, longitudinal, and in vitro study, consisting of 50 samples of human dentin, which were classified into 5 study groups: distilled water, hydrochloric acid, 2% C. sinensis extract, sodium fluoride. 2% and 2% C. sinensis extract added with 2% sodium fluoride. The surface roughness of each sample was evaluated with the SRT6200 digital roughness meter, obtaining a total average roughness and the measurements were carried out in two moments. Results: It was observed that the 2% C. sinensis extract, the 2% sodium fluoride, and the C. sinensis extract added with 2% sodium fluoride, showed a variation in surface roughness between before and after, which was not significant (p<0.05) in all cases. It should be noted that the C. sinensis plus sodium fluoride group is the one that obtained the best variation in the mean surface roughness than the other groups studied. Conclusions: The 2% C. sinensis extract, 2% sodium fluoride, and the combination of both compounds demonstrated an inhibitory effect against the erosive action of hydrochloric acid (0.01 M) on the dentin surface, not presenting a statistically significant difference in the results.

Introducción: Los productos naturales son una opción para ser usados en diferentes afecciones en la cavidad bucal, como lo podría ser la Camellia sinensis, que por sus diferentes propiedades sería de beneficio en la erosión de la superficie dental. Objetivo: Determinar el efecto del extracto de Camellia sinensis (C. sinensis) adicionado con flúor frente a la acción erosiva de ácidos no bacterianos en la superficie de la dentina humana. Materiales y Métodos: Estudio cuasi experimental, prospectivo, longitudinal ein vitro, constituido por 50 muestras de dentina de dientes permanentes, que se clasificaron en 5 grupos de estudio: Agua destilada, ácido clorhídrico, extracto de C. sinensis a 2%, fluoruro de sodio al 2% y extracto de C. sinensisa 2% adicionado con fluoruro de sodio al 2%. Se evaluó la rugosidad superficial de cada muestra con el rugosímetro digital SRT6200, obteniéndose una rugosidad media total y se realizaron las mediciones en dos momentos. Resultado: Se observó que el extracto de C. sinensisal 2%, el fluoruro de sodio al 2% y el extracto de C. sinensis adicionado con fluoruro de sodio al 2%, presentaron una variación de la rugosidad superficial entre el antes y el después, no siendo esta significativa (p<0.05) en todos los casos. Cabe resaltar que el grupo C. sinensis más fluoruro de sodio, es el que obtuvo una mejor variación de la media de rugosidad superficial, que los otros grupos estudiados. Conclusión: El extracto de C. sinensisal 2%, el fluoruro de sodio al 2% y la combinación de ambos compuestos demostraron un efecto inhibitorio frente a la acción erosiva del ácido clorhídrico (0,01 M) en la superficie de dentina, no presentando una diferencia estadísticamente significativa en los resultados.

The Effect of Oral Care Foams and a Spray on Salivary pH Changes after Exposure to Acidic Beverages in Young Adults.

Soft drinks may have a deleterious effect on dental health due to a high titratable acidity and a low pH that could be sufficient to induce tooth demineralization. The use of oral care products immediately after acidic challenge may diminish the erosive potential of soft drinks. We assessed the effect of oral care foams and a spray on salivary pH changes after exposure to Coca-Cola® in young adults. Thirty-three consenting eligible patients were recruited in this double-blind, randomized, crossover study performed in six visits. Baseline examination included unstimulated salivary flow rate, stimulated salivary buffer capacity, and the simplified oral hygiene index (OHI-S) assessment. Salivary pH and time for pH recovery were registered after exposure to Coca-Cola® alone or that followed by the application of each of the studied products (an oral foam containing hydroxyapatite and probiotics, an oral foam containing amino fluoride, an alkaline oral spray, and tap water). Thirty-two patients completed the entire study protocol and were included in the final analysis. The mean minimum salivary pH and the mean oral clearance rate after rinsing with Coca-Cola® were 6.3 and 27 min, respectively. Further rinsing with any one of the tested solutions, including tap water, resulted in a significant improvement in these parameters. When the pH curves were plotted, the oral care products demonstrated a lower area under the curve that differed significantly from the area under the curve for Coca-Cola®; tap water did not differ significantly from Coca-Cola® and oral care products. Minimum salivary pH correlated positively with salivary buffer capacity and salivation rate, while salivary clearance correlated with OHI-S plaque scores. In conclusion, the effect of oral care foams and a spray on minimum salivary pH and salivary clearance after exposure to Coca-Cola® did not differ significantly among the tested products and tap water. Trial registration NCT06148662. Funding: none.

Low-fluoride gels supplemented with nano-sized sodium trimetaphosphate reduce dentin erosive wear in vitro.

OBJECTIVE: The study assessed the effect of low-fluoride gels supplemented with micrometric or nano-sized sodium trimetaphosphate (TMP) on dentin erosive wear in vitro. DESIGN: Bovine dentin blocks (n = 154) were selected by surface microhardness and randomly allocated into seven groups (n = 22/group), according to the gels: Placebo; 4500 ppm F (4500F); 9000 ppm F (9000F); 5% TMP microparticulate plus 4500F (5TMPm+4500F); 2.5% TMP nanoparticulate plus 4500 F (2.5TMPn+4500F); 5% TMP nanoparticulate plus 4500F (5TMPn+4500F); and 12,300 ppm F acid gel (APF). All blocks were treated only once for 60 s and cyclically eroded (ERO, citric acid, 4 × 90 s/day) or eroded and brushed (4 × 15 s/day, five strokes/s, ERO+ABR) over five days (each subgroup n = 11). Dentin wear and integrated hardness loss in depth (ΔKHN) were determined, and the data were submitted to two-way ANOVA, followed by Tukey's test, and Spearman's correlation (p < 0.05). RESULTS: For ERO, all gels containing 4500F supplemented with TMP significantly reduced dentin wear compared with their counterpart without TMP, reaching values similar to 9000F. For ERO+ABR, 5TMPn+ 4500F gel led to significantly lower wear than all its counterparts, reaching values similar to 9000F and APF. As for ΔKHN, all gels containing TMP promoted superior protective effects compared with 4500F, reaching values similar to 9000F and APF under both challenges. A positive correlation between dentin wear and mineral content in depth was verified. CONCLUSIONS: Gels containing 4500F supplemented with TMP significantly reduced dentin erosive wear compared with pure 4500F, with additional benefit from the use of nanoparticles.

Addition of substances to reduce the erosive potential of acidic beverages to tooth enamel: A scoping review.

OBJECTIVE: This scoping review aimed (1) to map, analyse, interpret and synthesize data from in situ studies on which substances were added to acidic beverages to reduce the erosive potential on tooth enamel and (2) to establish the level of evidence of the effectiveness of adding substances to acidic beverages to reduce the erosive potential on tooth enamel. DESIGN: This is a scoping review, according to the methods from the Joanna Briggs Institute and PRISMA-ScR, with high-sensitivity searches in the databases PubMed (MEDLINE), Virtual Health Library, Embase (Elsevier), Scopus (Elsevier), Web of Science and ScienceDirect (Elsevier). In situ studies published in English until December 2022 were included. Studies that did not report a control group were excluded. To map and summarize the results, tables and figures were used. RESULTS: From 895 potentially eligible articles, nine were included. Blackcurrant juices (n = 5) with the addition of calcium (n = 3) or xanthan gum (n = 2) formulations were the most tested in terms of reducing the erosive potential of the beverages on tooth enamel. The profilometer was the equipment of choice (n = 8) for evaluating the loss of enamel structure after the experimental tests. CONCLUSIONS: Calcium and xanthan gum are among the most tested by in situ studies, offering promising results in reducing the erosive potential of fruit juices and carbonated and energy drinks.

Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets.

OBJECTIVE: This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations. METHODS: Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC). RESULTS: Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min. CONCLUSIONS: The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.

Are S-PRG composites able to resist against erosive and abrasive challenges and protect surrounding enamel in situ?

OBJECTIVES: This study evaluated the resistance of S-PRG (Surface Pre-Reacted Glass-ionomer) composites and other restorative materials against erosive and abrasive challenges and their protective effect on enamel adjacent to the restorations. MATERIALS AND METHODS: Bovine enamel blocks were prepared and randomized into 12 groups, including 6 types of material, each of them subjected to erosion_e or erosion+abrasion_ea: Beautifil II (S-PRG); Beautifil Bulk Restorative (S-PRG); Filtek Z250 XT; Filtek Bulk Fill; EQUIA Forte; Riva Light Cure. Cavities were prepared in the middle of enamel blocks and restored with the materials. Initial profiling measurement was performed on the material and on adjacent enamel (100, 200, 300, 600 and 700 µm from the restoration margin). Palatal intraoral appliances with the restored enamel blocks were used by the volunteers (n = 10). During 5 days appliances were immersed in 2.5 % citric acid for 2 min; 6 × /day (erosion_e). For ea condition, blocks were brushed for 1 min after each acid immersion. Final profile assessment was performed. Data were analysed by two and three way ANOVA followed by Tukey's test (p < 0.05). RESULTS: Material wear: Riva Light Cure showed the highest wear followed by EQUIA Forte and then all resin composites, including the ones with S-PRG (p = 0.000). Enamel wear: there was significant interaction among type of restorative material, wear condition and distance (p = 0.014), enamel around materials showed similar wear (p = 0.983) and the enamel subjected to ea exhibited highest wear (p = 0.000). CONCLUSION: SPRG based composites showed resistance against erosive and abrasive challenges but were not able to protect enamel adjacent to the restorations. CLINICAL SIGNIFICANCE: S-PRG composites exhibit resistance to material wear comparable to resin composites. However, they have shown an inability to effectively protect the adjacent enamel under in situ erosive-abrasive conditions, despite the presence of mineral-loss-preventing ions surrounding materials.

In vitro assessment of dental erosion caused by clear aligners.

The primary objective of this in vitro study was to investigate the erosive potential of enamel under the use of clear aligners (CA), by simulating in vivo conditions experienced by patients who do not remove their CA during the consumption of acidic beverages. In addition, the difference in erosion protection conferred by artificial and human saliva was also evaluated. Sound-extracted human premolars (n = 20) had half of their surfaces protected with acid-resistant nail polish and were randomly distributed into two experimental groups (n = 10): teeth immersed in human saliva or artificial saliva. All teeth had half of their lingual surfaces enclosed by a CA device. The erosive challenges consisted of individual immersion of each sample in citrus acid three times a day, intermediated by immersion in human saliva or artificial saliva for 2 h, during ten days of the erosive protocol. The enamel mineral content was analyzed by high-resolution microtomography. The differential mineral concentration profiles were obtained by subtracting the profile of the mineral concentration of the exposed area and enamel under the CA area from the respective sound area (control). In addition, enamel wear and enamel volume loss were measured. Scanning electron microscopy (SEM) was also performed to analyze the enamel surface. Data were analyzed by two-way ANOVA, followed by the Student-Newman-Keuls test. The enamel wear was higher in teeth immersed in artificial saliva, when compared to human saliva (p < 0.001). The volume loss of the exposed enamel area was lower for tooth immersed in human saliva than in artificial saliva (p < 0.001), during the acid challenge protocol. The use of CA during acid challenges promoted wear and mineral loss of dental enamel, being these changes more pronounced on the enamel surface under the CA. These results open a new path for the development of further studies adopting clinical protocols that promote more accurate responses in the clinical practice during orthodontic treatment.

Erosive tooth wear among non-institutionalised older adults in Hong Kong: a cross-sectional study.

BACKGROUND: Non-institutionalised older adults is the majority of older adults in Hong Kong. The study aimed to examine erosive tooth wear (ETW) and its association with dental conditions and oral hygiene habits among non-institutionalised older adults in Hong Kong. METHODS: This cross-sectional study recruited dentate adults aged 60 or above from nine elderly daycare centres in the five main districts of Hong Kong. The study consists of a questionnaire survey and a clinical examination. A researcher used a questionnaire to collected the participants' demographic information, oral hygiene habits such as toothbrushing habits and dental visit behaviour. A calibrated examiner performed an oral examination in the daycare elderly centre to assess the ETW using basic erosive wear (BEWE) criteria. Oral hygiene was recorded using visible plaque index. Prosthetic status was recorded using the World Health Organization criteria. Logistic regression was used to examine the correlation between ETW and the dental conditions and oral hygiene habits. RESULTS: This study recruited 433 dentate adults and 333 adults were female (77%). Their age ranged from 60 to 99 years and their mean age was 74 years (SD = 7). They all had ETW (BEWE > 0). Over half of them (57%) had BEWE score of 3, indicating severe ETW. Analysis showed increasing age (OR = 1.030, p = 0.029) and older adults with untreated dental caries had higher odds (OR = 1.822, p = 0.002) of presenting severe ETW. No other associations were found between the ETW and the factors studied. CONCLUSION: Hong Kong non-institutionalised older adults aged 60 or above had ETW and more than half of them had severe ETW. Increasing age and having untreated dental caries were associated with severe ETW.

Novel resin-based material containing ß-tricalcium phosphate nanoparticles for the reduction of dentin permeability.

OBJECTIVES: To synthesize and characterize a novel dentin adhesive containing Beta-Tricalcium Phosphate (ß-TCP) nanoparticles and test its ability to reduce dentin permeability (dP). METHODS: Experimental adhesives were prepared by mixing Bis-GMA, TEGDMA, HEMA (50/25/25 wt.%), photo-initiators, and inhibitors. The following groups were tested: Experimental adhesives without ß-TCP (Exp.); with 10 wt.% ß-TCP (Exp.10 wt.% ß-TCP); with 15 wt.% ß-TCP (Exp.15 wt.% ß-TCP), Scotchbond Multi-Purpose (SBMP) and Clearfil SE Protect Bond (CFPB). Degree of conversion (DC%, 10 and 20 s); Flexural Strength (FS), Knoop Hardness (KHN), and Cell Viability (OD%) tests were performed. dP was evaluated by hydraulic conductance, using human dentin disks (n=12), at three-time intervals: post-EDTA (T0); post-treatment (T1); and post-erosion/abrasion cycling (T2). Data were statistically analyzed (α=0.05). RESULTS: For all groups, exposure time for 20 s presented a higher DC% than for 10 s. For FS, filled adhesives did not differ from unfilled and from CFPB. Experimental adhesives did not differ among them and showed lower KHN than the commercial products. Cell viability did not differ among adhesives, except Exp. 15 wt.%, which showed lower OD% than Exp., Exp. 10% and, CFPB. For dP, only Exp.10 and 15 wt.% ß-TCP did not present difference between the times T1 and T2. After cycling, Exp.10 wt.% ß-TCP presented lower permeability than Exp. and CFPB. CONCLUSIONS: The incorporation of 10 wt.% ß-TCP nanoparticles into the resin-based dental material did not affect its mechanical properties and biocompatibility, and promoted the greatest reduction in dentin permeability, sustaining this effect under erosive/abrasive challenges. CLINICAL SIGNIFICANCE: A novel resin-based dental material containing ß-TCP nanoparticles was able to reduce dentin permeability, maintaining its efficacy after erosive/abrasive challenges. The synthesized material did not affect dental pulp cell viability and might be promising for other conditions that require dental remineralization, such as tooth wear and dental caries.

Prevalence of erosive tooth wear and associated risk factors in Colombian adolescents

Abstract Accurate determination of the prevalence of erosive tooth wear (ETW) and associated risk factors in adolescents can inform clinical management guidelines. The aim of this analytical cross-sectional study was to estimate the prevalence, severity, and risk factors of ETW in adolescents aged 12-15 years in the municipality of Usaquén in Bogotá, Colombia. Two calibrated examiners clinically assessed ETW using Basic Erosive Wear Examination (BEWE) Index (range: 0-3). All tooth surfaces (excluding proximal) were scored to allow estimation of the Highest (0-3) and Total BEWE (sum of Highest BEWE score per sextant: 0-18) scores per patient. Sociodemographic characteristics, ETW risk factors, and caries severity (ICDAS-epi-merged) were evaluated, and their association with the presence of ETW (indicated by a Highest BEWE score of 2-3) was examined using preliminary analyses and logistic regression models. The study sample included 454 adolescents (mean age: 13.5±1.1 years; female: 61.7%), and the prevalence of ETW was 71.6%. The majority of participants exhibited a Highest BEWE score of 3 (58.0%) and a Total BEWE score ≤8 (84.3%). The preliminary analysis showed an association between the presence of ETW and age, caries, and brushing teeth before eating (p-value < 0.05). Risk factors for ETW included always brushing teeth before eating [adjusted Prevalence Ratio (PRa) 1.31, p-value=0.014], presence of extensive carious lesions (PRa 1.23, p-value = 0.024), male gender (PRa 1.14, p-value = 0.028), and age > 14 years (PRa 1.17, p-value = 0.009). Although ETW was highly prevalent, most Colombian adolescents exhibited low Total BEWE scores. ETW was associated with frequent fruit intake, age, toothbrushing habits, caries lesions, and sex.

Dentin erosive wear is reduced by fluoride varnishes containing nanosized sodium trimetaphosphate in vitro

Abstract This study evaluated the effect of fluoride varnishes containing micrometric or nanosized sodium trimetaphosphate (TMP) on dentin erosive wear in vitro. Bovine root dentin blocks were selected by surface hardness and randomly divided into five experimental groups/varnishes (n = 20/group): placebo, 5% sodium fluoride (NaF); 5% NaF+5% micrometric TMP; 5% NaF+2.5% nanosized TMP; and 5% NaF+5% nanosized TMP. Half of the surface of all blocks received a single application of the assigned varnish, with subsequent immersion in artificial saliva for 6 h. Varnishes were then removed and the blocks were immersed in citric acid (90 s, 4×/day, 5 days). After each erosive cycle, ten blocks of each group were immersed in a placebo dentifrice for 15 s (ERO), while the other ten blocks were subjected to abrasion by brushing (ERO+ABR). Dentin erosive wear was assessed by profilometry. Data were submitted to 2-way ANOVA and to the Holm-Sidak test (p<0.05). Dentin erosive wear was significantly higher for ERO+ABR than for ERO for all varnishes. TMP-containing varnishes promoted superior effects against dentin erosive wear compared with 5% NaF alone; and 5% nanosized TMP led to the lowest wear among all varnishes. In conclusion, the addition of TMP to conventional fluoride varnish (i.e., varnish containing only NaF) enhanced its protective effects against bovine root dentin erosion and erosion+abrasion. Additionally, the use of 5% nanosized TMP led to superior effects in comparison to 5% micrometric TMP, both for erosion and erosion+abrasion in vitro.

Can the combination of proanthocyanidin and vitamin E or palm oil effectively protect enamel against in vitro erosive and abrasive challenges?

Abstract Objectives This study aimed to assess the effect of proanthocyanidin, palm oil and vitamin E against erosive and erosive+abrasive challenges in vitro after enamel pellicle formation in situ. Methodology Bovine enamel blocks (n=84) were obtained and divided into the following treatment groups: negative control (NC) - deionized water; positive control (PC) - SnCl2/NaF/AmF-containing solution; palm oil (PO); 2% proanthocyanidin (P2); vitamin E (VitE); 2% proanthocyanidin+palm oil (P2PO); and 2% proanthocyanidin+vitamin E (P2VitE). For 5 days, one half of the sample from each group was subjected to erosion and the other half was subjected to erosion+abrasion. The acquired enamel pellicle (AEP) was pre-formed in situ for 30 minutes. The specimens were then treated in vitro with solutions (500 µl, 30s for each group). Subsequently, the blocks were left in the oral cavity for another hour to obtain the modified AEP. The blocks were immersed in 0.5% citric acid (pH=2.5) for 90s, 4×/day. AEP formation and treatment were carried out before the first and third erosive challenges, and after these challenges, abrasive cycles (15s) were performed on half of the samples. Enamel wear was quantified by profilometry and data were analyzed by two-way ANOVA and Tukey's test (p<0.05). Results All groups showed higher wear when exposed to erosion+abrasion than when exposed to erosion alone (p=0.0001). PO, P2VitE, P2, and P2PO showed enamel wear similar to the PC group, but only PC, PO and P2VitE differed from the NC group. The other groups behaved similarly to NC. Conclusion It was concluded that the combination of proanthocyanidin and vitamin E was effective in reducing wear in the face of in vitro erosive and erosive+abrasive challenges.

Prevalence and Associated Factors to Non-Carious Cervical Lesions in Brazilian University Students: A Cross-Sectional Survey

Abstract Objective: To identify the prevalence, severity, hypersensitivity, and distribution of Non-carious cervical lesions (NCCL) among university students in Brazil. Material and Methods: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Results: 179 participants answered an anamnesis with twenty questions about the presence or absence of habits associated with NCCL. The participants' teeth were evaluated to identify the presence or absence of the lesion, its classification, involved surfaces, severity, hypersensitivity, and tooth wear index. A hypersensitivity test was performed with ice water. Data were analyzed using the chi-square test and simple logistic regression (p<0.01). Conclusion: The prevalence of NCCL was 15.1% and abfraction was the most frequent lesion. Premolars were the teeth most affected by non-carious cervical lesions.