Assessment of the developmental defects of the enamel in children and adolescents with sickle cell disease: A comparative study.

BACKGROUND: Sickle cell disease (SCD) is the most important hemoglobinopathy in terms of frequency and social impact and can affect the stomatognathic system. AIM: To assess and compare the developmental defects of the enamel (DDE) in children and adolescents with and without SCD. DESIGN: This was a cross-sectional, analytical, and comparative study of 210 children and adolescents aged 5-18 years, who visited the Hematology and Hemotherapy Hospital of Pernambuco. RESULTS: Developmental defects of the enamel were observed in 55.2% of the SCD patients and 35.2% of the non-SCD patients (healthy group; p < .05). In the SCD group, DDE were more common in females than in males (69.1% vs. 40.0%; p < .05). The incidence of DDE in the permanent teeth was higher in the upper arch than in the lower arch (SCD group, 13.1% vs. 4.6%; healthy group, 8.9% vs. 3.6%; p < .05). CONCLUSION: Compared with the healthy group, the SCD patients were almost twice as likely to develop DDE, mostly affecting females and the permanent teeth. These findings suggest that individuals with SCD need early dental care to avoid future oral problems.

Assessment of demineralized tooth lesions using optical coherence tomography and other state-of-the-art technologies: a review.

Tooth demineralization is one of the most common intraoral diseases, encompassing (1) caries caused by acid-producing bacteria and (2) erosion induced by acid of non-bacterial origin from intrinsic sources (e.g. stomach acid reflux) and extrinsic sources (e.g. carbonated drinks). Current clinical assessment based on visual-tactile examination and standardized scoring systems is insufficient for early detection. A combination of clinical examination and technology is therefore increasingly adapted. This paper reviews various procedures and technologies that have been invented to diagnose and assess the severity of tooth demineralization, with focus on optical coherence tomography (OCT). As a micron-resolution non-invasive 3D imaging modality, variants of OCT are now available, offering many advantages under different working principles for detailed analytical assessment of tooth demineralization. The roles, capabilities and impact of OCT against other state-of-the-art technologies in both clinical and research settings are described. (139 words).

Diet drinks and dental caries among U.S. adults: cluster analysis.

BACKGROUND: In recent years, the consumption of sugar sweetened beverages has been declining, while low calorie sweetener and diet beverage consumption is increasing. Evidence about the effect of diet drinks on dental caries is insufficient, and has not accounted for the complexity of beverage consumption patterns. Therefore, the aim of this study is to examine the association between consuming diet drinks and dental caries among US adults. METHODS: We analyzed 2011-2014 NHANES dietary data of adults using cluster analysis, with individuals grouped based on their beverage consumption. Clusters were identified based on the R-square statistic and the local peak of the pseudo F statistic. Survey procedure and sample weights were used to account for the complex NHANES sampling design. RESULTS: Four beverage consumption patterns were identified: "high soda", "high diet drinks", "high coffee/tea" and "high water". The "High soda" cluster was the only one associated with higher DMFT after controlling for confounders (ß=1.02, 95% CI=0.42 - 1.63), whereas DT was associated with "high soda" (ß=0.45, 95% CI=0.25 - 0.64) and "high coffee/tea" (ß=0.24, 95% CI=0.01 - 0.47). On the other hand, the "high diet drinks" cluster was neither associated with DMFT (ß=0.69, 95% CI=0.51 - -0.35) nor DT (ß=0.07, 95% CI=-0.21 - 0.35). CONCLUSION: Diet drinks consumption may not be associated with increased risk of dental caries. However, more studies should be conducted in order to confirm this finding.

Evaluation of bleaching efficacy, microhardness, and trans-amelodentinal diffusion of a novel bleaching agent for an in-office technique containing hexametaphosphate and fluoride.

OBJECTIVE: This study evaluated in vitro the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium hexametaphosphate (HMP), and NaF/TMP added to a 35% hydrogen peroxide (H2O2) bleaching gel on the color change, enamel hardness, and trans-amelodentinal diffusion. MATERIALS AND METHODS: Enamel discs/bovine dentin (n = 150) were divided according to the bleaching gel: 35% H2O2 (H2O2); 35% H2O2 + 0.1% NaF (H2O2/NaF); 35% H2O2 + 1% HMP (H2O2/HMP); 35% H2O2 + 0.1% NaF + 1% HMP (H2O2/NaF/HMP), and 35% H2O2 + 2% CaGlu (H2O2/Caglu). The bleaching gels were applied three times (40 min/session) at 7-day intervals between each application. Then, color alteration (ΔE), whitening index (ΔWID), percentage of surface hardness loss (% SH), cross-sectional hardness (ΔKHN), and trans-amelodentinal diffusion were determined. Data were submitted for analysis of variance (ANOVA), followed by the Student-Newman-Keuls test (p < 0.05). RESULTS: All bleaching gels showed significant color changes after treatment (p < 0.001). ΔE and ΔWID were similar among the evaluated gels. Mineral loss (% SH and ΔKHN) and trans-amelodentinal diffusion of hydrogen peroxide were lower for H2O2/NaF/HMP; the H2O2/CaGlu group presented the highest values about the other groups (p < 0.001). CONCLUSION: It is possible to conclude that the addition of NaF/HMP to the in-office bleaching agent did not interfere with the bleaching efficacy and reduced enamel demineralization and H2O2 diffusion. CLINICAL SIGNIFICANCE: The association of NaF/HMP to the bleaching gel can be used as a novel approach for minimizing the adverse effects of H2O2 by-products and with similar clinical efficacy.

Prevention of demineralization during multi-bracketed fixed orthodontic treatment: An overview of systematic reviews.

BACKGROUND: Demineralization during multi-bracketed fixed orthodontic treatment is a well-known problem. AIM: To systematically evaluate the evidence for the prevention of enamel demineralization during multi-bracketed fixed orthodontic treatment. DESIGN: Systematic reviews (with or without meta-analysis) that have appraised the primary studies on the prevention of demineralization during multi-bracketed fixed orthodontic treatment were searched systematically and included as per pre-defined eligibility criteria. The risk of bias of the included reviews was assessed by two authors using the ROBIS tool and AMSTAR-2 tool. RESULTS: Twenty-nine reviews conducted on 128 exclusive primary studies were included for the present overview; 23 of these reviews were assessed to be of a high risk of overall bias, 5 were of low risk, and 1 review was of unclear risk of bias. CONCLUSIONS: Predominantly, the published reviews have focused on fluorides, whereas some reviews have also studied the role of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), reminder therapy, lasers, and sealants. Professional fluorides, sealants, reminder therapy, and lasers might be valuable interventions to prevent demineralization during orthodontic treatment based on the conclusions of reviews with high quality; however, further studies are required to elucidate the role of CPP-ACP, chlorhexidine varnish, and powered toothbrushes.

Comparison of Dentin Caries Remineralization with Four Bioactive Cements.

The treatment of deep carious lesions involves the use of ion-releasing agents to seal the lesions. These agents release minerals, leading to the remineralization of the remaining demineralized dentin. This study aimed to compare the dentin caries remineralization with bioactive cements. 60 Dentin blocks were prepared from the dentin of human third molars. Artificial carious lesions were induced on the blocks with pH cycling. The samples were divided into five groups (n=12). Dycal, Oxford ActiveCal PC, Biodentine, and ACTIVA BioACTIVE were applied using a mold. One group did not receive any cement. The samples were stored in remineralization solution for 30 days. The cement was removed using a #15 blade, and the dentin surface was evaluated using Energydispersive X-ray Spectroscopy and X-ray Diffraction. One-way ANOVA did not show a significant difference in the weight percentages of calcium and phosphorus and the calcium-to-phosphorus ratios between the groups. The highest and the lowest weight percentages of calcium and phosphorus were observed in Biodentine and control groups, respectively. There were no significant differences in the remineralization properties of bioactive cements. Hydroxyapatite crystals were not formed in any of the adjacent dentin using these cements.

The dual anti-caries effect of carboxymethyl chitosan nanogel loaded with chimeric lysin ClyR and amorphous calcium phosphate.

In this study, we evaluated the anti-biofilm and anti-demineralization abilities of a novel material, CMC-ClyR-ACP nanogel, designed by loading the chimeric lysin ClyR and amorphous calcium phosphate (ACP) into a nanocarrier material carboxymethyl chitosan (CMC), in a demineralization model. Dynamic light scattering, transmission electron microscopy, and Fourier transmission infrared spectroscopy showed that CMC-ClyR-ACP nanogel was synthesized successfully. Enamel samples prepared from premolars were divided into five groups according to their treatments with: (i) double distilled water ddH2 O, (ii) CMC-ACP, (iii) CMC-ClyR-ACP, (iv) ClyR, or (v) 0.12% chlorhexidine. Streptococcus mutans was allowed to form biofilms on the teeth for two days before treatment procedures were carried out from day 3 to day 6. The relative biofilm viability analyzed by Cell Counting Kit-8 showed that it was significantly lower (at 55.7%) for CMC-ClyR-ACP than seen for ddH2 O (89.9%), which was consistent with result of confocal laser scanning microscopy. The percentage surface hardness loss of CMC-ClyR-ACP (29.2%) was significantly lower than that of CMC-ACP (51.0%) and ClyR (58.7%) alone, and there was no significant difference between CMC-ClyR-ACP and chlorhexidine (26.9%), which was confirmed by scanning electron microscopy. Therefore, CMC-ClyR-ACP nanogel may be an effective strategy for the control of enamel demineralization.

Effect of daily use of fluoridated dentifrice and bleaching gels containing calcium, fluoride, or trimetaphosphate on enamel hardness: an in vitro study.

OBJECTIVE: This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice. DESIGN: Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100 ppm) dentifrice. The bleaching gels were applied thrice (40 min/session) at the intervals of 7 days between each application. After 21 days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined. RESULTS: Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels. CONCLUSION: The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice. CLINICAL RELEVANCE: The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.

Evaluation of new compositions of 10% hydrogen peroxide-based bleaching agents containing trimetaphosphate and fluoride on enamel demineralization.

This study evaluated the effect on enamel demineralization of 10% hydrogen peroxide (H2 O2 ) gels containing different concentrations of sodium trimetaphosphate (TMP) and sodium fluoride (NaF) combined with the daily use of fluoridated or placebo dentifrice. Bovine enamel blocks were selected by surface hardness (n = 72) and randomly assigned to one of the following experimental treatments: 10% H2 O2 ; 10% H2 O2  + 3% TMP + 0.1% NaF; and 10% H2 O2  + 0.3% TMP + 0.05% NaF, each with or without fluoridated dentifrice. H2 O2 -based gels were applied for 30 min d-1 followed by treatment with dentifrice (1 min). Enamels blocks were stored in artificial saliva at 37°C between sessions during the 14 days of experiment. Percentage of surface hardness loss (%SH) was calculated, and the blocks were cut into halves to analyze cross-sectional hardness (ΔKHN). Polarized light microscopy images were obtained of the longitudinal sections of the samples. Enamel treated with fluoridated dentifrice presented lower hardness loss than those treated with placebo dentifrice (%SH and ΔKHN). Use of TMP- and NaF-based gels, regardless of concentration, led to the lowest %SH values. Specimens treated with 10% H2 O2 gel had the highest %SH and ΔKHN values. Gels with 10% H2 O2  + 3% TMP + 0.1% NaF showed the lowest ΔKHN values. Microscopy images clearly showed that the addition of TMP and NaF to the H2 O2 -based gels was effective in reducing the loss of hardness, and the fluoridated dentifrice helped minimize it in all treatments.

Establishment of microcosm biofilm models that reproduce a cariogenic diet intake.

Biofilms were developed from human saliva on bovine enamel discs in four experimental conditions to investigate dental caries development: feast and famine (M1), abundance and scarcity (M2), three meals daily (M3), and three meals plus two snacks daily (M4). The main difference between these models was the diet for microbial growth. The evaluations included verifying the pH of the spent culture media and analyzing the enamel discs for demineralization (microhardness and roughness) and biofilms (biomass, viable populations of mutans streptococci, and total microbiota). Two major behaviors were observed: M1 and M2 promoted an acidic environment, while M3 and M4 maintained pH values closer to neutral. The demineralization process was slower in the neutral groups but more pronounced in M3, while a greater increase in microbiota and biomass was observed over time for both neutral groups. Thus, the M3 model was better at mimicking the oral environment that leads to demineralization.

The effect of Er,Cr:YSGG laser, fluoride, and CPP-ACP on caries resistance of primary enamel.

The aim of this in vitro study was to determine the effect of different remineralization agents and laser on caries resistance of primary enamel. In the study, 150 sound primary molars were used. The initial microhardness values were measured and the teeth were randomly assigned to ten treatment groups (n = 15): no treatment/negative control (C), NaF, APF, fluoride varnish (FV), CPP-ACP, laser (L), L + NaF, L + APF, L + FV, L + CPP-ACP. The microhardness values were measured after the treatments and the pH cycle. The obtained data were analyzed statistically. One sample from each group was examined before treatment, after treatment, and after the pH cycle with a scanning electron microscope. While microhardness values after treatment compared to baseline increased, microhardness after the pH cycle decreased compared to after treatment values in all experimental groups (p < 0.05). In regard to the difference in microhardness after the pH cycle and baseline, there were no statistically significant differences between groups C and NaF and between C and CPP-ACP (p > 0.05). There was a significant difference between groups L and L + FV (p < 0.05), while no significant difference was noted between groups L and L + NaF, L + APF, L + CPP-ACP (p > 0.05). As a conclusion, FV is more effective when used in combination with laser than laser alone. NaF, CPP-ACP, and laser may be insufficient in protecting the primary teeth against acid attacks compared to FV used with laser.

Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: A hierarchical approach.

BACKGROUND: Molar incisor hypomineralization (MIH) is associated with unfavourable dental conditions such as dental caries and may consequently impact oral health-related quality of life (OHRQoL). OBJECTIVE: To assess the impact of MIH on OHRQoL in children with early mixed dentition. METHOD: A population-based cross-sectional study of 728 8-year-old children from the public school system in Curitiba, Brazil, was conducted. The Child Perception Questionnaire for 8- to 10-year-olds (CPQ8-10 ) was used to evaluate OHRQoL. MIH was diagnosed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The assessments of MIH, dental caries, and malocclusion were performed by four calibrated examiners (κ ≥ 0.80). Demographic and socioeconomic data (DSE) were obtained from the children's parents/caregivers using a structured questionnaire. The analysis of OHRQoL determinants was performed through a three-level hierarchical approach: mesial (DSE), intermediate (clinical conditions), and distal (child's oral self-perception), using Poisson regression with robust variance (α = 0.05). RESULTS: The prevalence of MIH was 12.1% (95% CI: 10-15). An association was found between MIH and OHRQoL in the "oral symptoms" domain of the CPQ8-10 (PR: 1.07, 95% CI: 1.03-1.11, P < 0.001) after adjusting for other clinical variables and DSE. CONCLUSION: Molar incisor hypomineralization was associated with a greater impact on OHRQoL in children's oral symptoms.

Coupling xylitol with remineralizing agents improves tooth protection against demineralization but reduces antibiofilm effect.

To explore the efficiency of xylitol chewing gum enriched or not with remineralizing agents to protect tooth against cariogenic biofilm formation and demineralization. Six groups of chewing gums were prepared; Group 1: isomalt (1.8%), Group 2: casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (3%) + isomalt (1.8%), Group 3: hydroxyapatite (HAP) (2.5%) + isomalt (1.8%), Group 4: xylitol (1.8%), Group 5: CPP-ACP (3%) + xylitol (1.8%) and Group 6: HAP (2.5%) + xylitol (1.8%). The antibiofilm properties of different chewing gum extracts using seven oral bacterial species including Streptococcus mutans, Streptococcus constellatus, Streptococcus Salivarius and Streptococcus oralis were explored via the crystal violet staining assay. The remineralizing effects of those products were assessed on thirty human permanent teeth, half-protected with varnish before chemical erosion and thermocycling process with chewing gum. Remineralization was evaluated using scanning electron microscopy and microscopic measurements on polarized light microscopy. The ratio R comparing the thickness between unvarnished and varnished sides was evaluated. While the minimum biofilm inhibitory concentration (MBIC50) was low for xylitol alone compared to isomalt, it was inconsistent when enriched with remineralizing agents. The minimum biofilm eradication concentration (MBEC50) was low for xylitol groups compared to isomalt, for all the studied strains. R was significantly lower in Group 1 and Group 2, while Group 6 showed the highest ratio. Xylitol chewing gums confirmed good antibiofilm properties and showed remineralized potential on eroded teeth. When xylitol is associated to CPP-ACP or HAP, antibiofilm activity decreased while remineralization of eroded teeth increased.

Micro-computed tomography assessment of root dentin around fluoride-releasing restorations after demineralization/remineralization.

Using micro-computed tomography (micro-CT), this study assessed the inhibitory effect of three different types of restorations on root-caries formation under a cariogenic challenge. Bovine-root dentin blocks with a cylindrical cavity were divided into three restoration groups: a fluoride-free self-etch adhesive and a resin composite (SE-ES); a self-etch adhesive and a resin composite with multi-ion release (FL-BF); and a glass ionomer cement (Fuji-VII). After the restorative procedures, the specimens were stored in artificial saliva for 1 d, then subjected to a demineralization solution for 4 d and a remineralization solution for 28 d. Mineral density and mean mineral loss of dentin around the restorations were measured using micro-CT. The mean mineral loss values of dentin around the restorations were highest among SE-ES restorations and lowest among Fuji-VII restorations. Fuji-VII showed the highest mineral density and the lowest mineral loss after 28 d of remineralization. The observations made by scanning electron microscopy demonstrated that Fuji-VII created the smallest outer lesion followed by FL-BF and SE-ES. Fuji-VII has a larger inhibitory effect on root caries around the restorations and enhances remineralization more effectively than either FL-BF or SE-ES. Multi-ion and fluoride release from the restorative materials may be beneficial for inhibition of root-dentin caries around the restorations.

Effect of resin infiltration and microabrasion on the microhardness, surface roughness and morphology of incipient carious lesions.

OBJECTIVE: The effects of resin infiltration and microabrasion on incipient carious lesions by surface microhardness, roughness and morphological assessments, and resistance to further acid attack of treated lesions were evaluated. MATERIAL AND METHODS: Eighty artificially-induced incipient lesions were randomly divided into five groups (n = 16): resin infiltration with an adhesive resin (Excite F, Ivoclar Vivadent, Schaan, Liechtenstein), resin infiltration with a resin infiltrant (Icon, DMG, Hamburg, Germany), microabrasion without polishing (Opalustre, Ultradent, South Jordan, UT, USA), microabrasion with polishing (Opalustre, Ultradent, Diamond Excel, FGM, Joinville, SC, Brazil), and distilled water (control group). All specimens were exposed to demineralization for another 10 d. Microhardness, roughness and morphological assessments were done at baseline, following initial demineralization, treatment and further demineralization. Data were analysed by the Kruskal-Wallis, Friedman's and Bonferroni tests (p < .05). RESULTS: Enamel lesions treated with resin infiltrant and microabrasion demonstrated similar hardness values, with a nonsignificant difference compared with sound enamel. Resin infiltration demonstrated lower roughness values than those of microabrasion, and the values did not reach the values of sound enamel. Further demineralization for 10 d did not affect the hardness but increased the roughness of infiltrated and microabraded enamel surfaces. Polishing did not influence the roughness of microabraded enamel surfaces. After resin infiltration, porosities on enamel were sealed completely. The surface structure was similar to that of the enamel conditioning pattern for microabraded enamel lesions. CONCLUSIONS: Within the limitations of this study, the icon infiltration and microabrasion technique appeared to be effective for improving microhardness. Icon appeared to provide reduced roughness, although not equal to sound enamel. Further research is needed to elucidate their clinical relevance.

The reproducibility of assessment of white spot lesions adjacent to orthodontic brackets, with a quantitative light induced fluorescence digital camera at different rotations of teeth - an in vitro study.

BACKGROUND: A quantitative light-induced fluorescence digital (QLF-D) camera is able to assess demineralizations adjacent to orthodontic brackets. Rotations of teeth during and the presence of the orthodontic appliances may influence the longitudinal follow-up of such lesions over time. METHODS: Brackets were bonded on extracted teeth: 54 incisors and 31 canines. Demineralizations were formed in vitro directly cervical of the bracket. Images were captured using a QLF-D camera mounted on an optical bench, equipped with a goniometer on a turntable. The teeth were placed in the goniometer simulating buccolingual rotation (0°, 10°, 20°), the turn-table was used for mesiodistal rotations (0°, 10°, 20°). Standardized QLF-D images were made before (with and without a wire) and after debonding at combinations of aforementioned angles of rotation. The image after debonding at 0° buccolingual and 0° mesiodistal rotation served as a control. RESULTS: The presence of a bracket resulted in a significantly higher fluorescence loss, yet a smaller lesion area (p < 0.05) in comparison to the control. A significant higher fluorescence loss was seen for rotations towards lingual relative to the 0° buccolingual and 0° mesiodistal rotation, while the effect was less explicit towards buccal. CONCLUSIONS: Fluorescence loss and lesion size are influenced by the angle of rotation under which the demineralization is photographed. The full extent of demineralizations is only apparent after debonding when photographed at rotations of 0° mesiodistal and up to 20° buccal. Precaution must be taken into account assessing demineralizations of patients undergoing treatment with fixed appliances when using a QLF-D camera.

Effect of 5,000 ppm Fluoride Dentifrice or 1,100 ppm Fluoride Dentifrice Combined with Acidulated Phosphate Fluoride on Caries Lesion Inhibition and Repair.

High fluoride dentifrice (FD; 5,000 ppm F) has been recommended to arrest root dentine lesions and to control enamel caries in high-risk patients. Also, standard FD (1,100 ppm F) in combination with professional fluoride application has been recommended to control dentine caries, but the effect of this combination on enamel has been considered modest. Considering the lack of evaluation comparing the use of 5,000 ppm FD (5,000-FD) versus acidulated phosphate fluoride (APF) application combined with 1,100 ppm FD (1,100-FD) on the inhibition and repair of caries lesions in both enamel and dentine, we conducted this in situ, double-blind, crossover study of 3 phases of 14 days. In each phase, 18 volunteers wore palatal appliances containing enamel and root dentine specimens, either sound or carious, to evaluate the effect of the treatments on the inhibition or repair of caries lesions, respectively. The treatments were non-FD (negative control), 5,000-FD, or 1 APF gel application on dental specimens combined with 1,100-FD used twice per day (APF + 1,100-FD). The reduction of demineralization and enhancement of remineralization were assessed by surface and cross-sectional hardness. Fluoride concentration was determined on dental specimens and on the formed biofilm. For enamel, APF + 1,100-FD and 5,000-FD did not differ regarding the inhibition of demineralization and repair of caries lesions. However, for dentine the difference between these treatments was inconclusive because while APF + 1,100-FD was more effective than 5,000-FD in caries lesion reduction and repair, 5,000-FD was more effective than APF + 1,100-FD in the reduction of surface demineralization. Therefore, the findings show that the combination of APF + 1,100-FD is as effective as 5,000-FD in enamel inhibition of demineralization and enhancement of remineralization.

[Local enamel demineralization diagnostics and treatment]. / Ochagovaia demineralizatsiia émali. Metody diagnostiki i lecheniia.

The article describes focal enamel demineralization - the most common disease of teeth hard tissues. Local and general factors of this pathological process advent and development were described. The main tools of focal enamel demineralization diagnostics and treatment were observed. The main role of enamel mesoporous structure in the remineralization therapy possibility was underlined. There are still a lot of questions in focal enamel demineralization diagnostics after publications analysis because of the existing methods subjectivity. The question of indications for different remineralization tools applications optimization depending on the focal enamel demineralization degree is still open.

[Spectrophotometric method for objective focal enamel demineralization diagnostics]. / Spektrofotometricheskii metod diagnostiki ochagovoi demineralizatsii émali zubov.

The article presents the results of spectrophotometric tooth enamel scanning. Research was conducted in vitro on extracted teeth. Numeric color parameters measurements were made by VITA EasyShade spectrophotometer after the 37% phosphoric acid enamel conditioning, that was made for an artificial tooth enamel demineralization reconstruction. Then transverse section of this enamel part was evaluated by scanning electronic microscopy. The scale of enamel demineralization depth in mm/microns and its' lightness parameter compliance was created.

Sodium trimetaphosphate enhances the effect of 250 p.p.m. fluoride toothpaste against enamel demineralization in vitro.

This in vitro study investigated the effect of sodium trimetaphosphate (TMP), added to toothpaste containing 250 p.p.m. fluoride, on enamel demineralization. Bovine enamel blocks (n = 96) were subjected to five pH cycles over a 7-d period and treatment with suspensions of toothpastes containing 0, 250, 500, and 1,100 p.p.m. fluoride (as sodium fluoride), as well as with 250 p.p.m. fluoride containing TMP at 0.25, 0.5, 1.0, and 3.0%. Treatment with toothpaste suspensions was performed under agitation twice a day, for 1 min. Surface and cross-sectional hardness, and fluoride firmly bound to enamel, were quantified. Data were subjected to one-way anova, followed by Tukey's test. Low-fluoride toothpastes containing TMP at 0.25-1.0% resulted in enamel mineral loss similar to that seen for the toothpaste containing 1,100 p.p.m. fluoride. Also, the addition of TMP to the toothpaste containing 250 p.p.m. fluoride promoted enamel fluoride concentrations similar to those obtained for the 500 p.p.m. fluoride group. The toothpaste containing 250 p.p.m. fluoride and 0.25% TMP led to the lowest mineral loss among all groups. It was concluded that the addition of as little as 0.25% TMP to a toothpaste containing 250 p.p.m. fluoride can reduce enamel demineralization to levels similar to those seen for a conventional toothpaste containing 1,100 p.p.m. fluoride, in vitro.