The influence of daily application of fluoride products on subsurface bovine enamel lesions stored in saliva substitutes.

PURPOSE: To evaluate in the laboratory the effects of daily fluoride applications on remineralization of subsurface bovine enamel lesions stored in different saliva substitutes. METHODS: Enamel specimens were prepared (n = 144) and demineralized (subsurface lesions; 37 degrees C; pH 4.95; 10 days). Before and after demineralization, specimen surfaces were partly covered with nail varnish (control of sound/demineralized enamel). The specimens were either stored (5 weeks; 37 degrees C) in mineral water (W, control, S(OCP) 0.7, pH 7.0), Glandosane (G, S(OCP) 0.3, pH 5.2), or modified Saliva Natura (SN, S(OCP) 2.0, pH 5.98), and were submitted to the following treatments twice daily: (0) no treatment; (ES) immersion in pure Elmex Sensitive mouthrinse (10 minutes); (D) brushing with Duraphat toothpaste/storage solution slurry (5 seconds + contact time 115 seconds; ratio 1:3); (ES+D) combination of ES and D treatments. Mineral parameters before and after storage/treatment were evaluated from microradiographs. RESULTS: Specimens stored in G showed significantly higher demineralization compared to the other solutions (P < 0.05, ANOVA, Tukey's post hoc test); the combined treatment with fluoride products significantly reduced the demineralizing effect of G. After 2 and 5 weeks, specimens stored in SN revealed a higher remineralization compared to the control solution (P < 0.05). Daily application of fluoride products did not promote an additional effect on remineralization of specimens stored in SN (P > 0.05).

Tunnel technique with a surgical maneuver to increase the graft extension: case report with a 3-year follow-up.

BACKGROUND: This article reports a clinical case with a 3-year follow-up in which a subepithelial connective tissue graft (SCTG) was used with the tunnel technique to treat multiple gingival recessions, and describes a technique used to enlarge the extension of the graft. METHODS: A 41-year-old female patient was referred for evaluation and treatment of maxillary multiple recessions. Following basic therapy, the plaque index was 23%, and the gingival index was 12%. Thus, SCTG with the tunnel technique was proposed to provide root coverage of Miller Class I recession on teeth #8 through #11 and a Miller Class III recession on tooth #12. After the donor area had been prepared, SCTG was removed and split cross-sectionally to lengthen it. The graft was placed through the tunnel and sutured. RESULTS: Two weeks after the surgical procedure, the tissue color was nearly homogeneous with some reddish regions where the connective tissue was left uncovered, and there were no signs of incisions or suture marks. After 3 years of follow-up, the mean coverage of the recessions was 2.2 +/- 0.7 mm (74.2%), which corresponded to the gain of keratinized tissue. In addition, a gain in tissue thickness was observed. CONCLUSION: In a long-term evaluation, the tunnel technique with the elongated SCTG was used successfully for treatment of multiple gingival recessions with an increase of the soft tissue volume and gain of keratinized tissue.

Enamel and dentine remineralization by nano-hydroxyapatite toothpastes.

OBJECTIVES: This in vitro study evaluated the effects of nano-hydroxyapatite (n-HAp) toothpastes on remineralization of bovine enamel and dentine subsurface lesions. METHODS: Specimens were demineralized, randomly divided into five groups, and exposed to an aqueous remineralizing solution for two and five weeks (37 °C). Brushing procedures were performed with the respective toothpaste/storage solution slurry twice daily (2 × 5 s; total contact time of the slurries 2 × 120s/d): storage in remineralizing solution only (0); additional brushing with B (20 wt% zinc carbonate nano-hydroxyapatite, ZnCO(3)/n-HAp); BS (24 wt% ZnCO(3)/n-HAp); E (0.14 wt% amine fluoride); or A (7 wt% pure n-HAp). Differences in mineral loss (ΔΔZ) before and after storage/treatment were microradiographically evaluated. RESULTS: Dentine groups 0, B, BS, and A showed significantly higher ΔΔZ values compared to E (p < 0.05; ANOVA). Enamel ΔΔZ values of group A were significantly higher compared to group E (p < 0.05), whilst no significant differences of these groups could be observed compared to 0, B, and BS (p > 0.05). CONCLUSIONS: With the in vitro conditions chosen, toothpastes containing n-HAp revealed higher remineralizing effects compared to amine fluoride toothpastes with bovine dentine, and comparable trends were obtained for enamel.

Saliva substitute in combination with high-concentrated fluoride toothpaste: effects on demineralised dentin in vitro.

OBJECTIVES: The aim of this in vitro study was to assess the effects of saliva substitutes (modified with respect to calcium, phosphates, and fluorides) in combination with a high-concentrated fluoride toothpaste on demineralised dentin. METHODS: Before and after demineralisation of bovine dentin specimens (subsurface lesions; 37 degrees C, pH 5.0, 5 d), one-quarter of each specimen's surface was covered with nail varnish (control of sound/demineralised tissue). Subsequently, specimens were exposed to original Saliva natura (saturation with respect to octacalciumphosphate [S(OCP)]: 0.03; SN 0), or to three lab-produced Saliva natura modifications (S(OCP): 1, 2, and 3; SN 1-3) for 2 and 5 weeks (37 degrees C). An aqueous solution (S(OCP): 2.5) served as positive control (PC). Two times daily (2min each), Duraphat toothpaste (5000ppmF(-); Colgate)/saliva substitute slurry (ratio 1:3) was applied gently. Differences in mineral losses (DeltaDeltaZ) and lesion depths (DeltaLD) between values before and after exposure were microradiographically evaluated. RESULTS: After both treatment periods specimens immersed in SN 0 revealed significantly higher mineral losses (lower DeltaDeltaZ values) and lesion depths (lower DeltaLD) compared to PC (p<0.05; ANOVA). After 5 weeks, specimens stored in SN 1 and 2 showed significantly higher mineral losses compared to PC (p<0.05), while those stored in SN 3 showed similar results (p>0.05). No differences in mineral loss could be observed between SN 2 and 3 (p>0.05). CONCLUSIONS: Under the conditions of this limited protocol, the combination of Saliva natura solutions slightly saturated with respect to OCP in combination with a high-concentrated fluoride toothpaste enabled remineralisation of dentin in vitro.