Novel calcium phosphate nanocomposite with caries-inhibition in a human in situ model.

OBJECTIVES: Secondary caries at the restoration margins remains the main reason for failure. Although calcium phosphate (CaP) composites are promising for caries inhibition, there has been no report of CaP composite to inhibit caries in situ. The objectives of this study were to investigate the caries-inhibition effect of nanocomposite containing nanoparticles of amorphous calcium phosphate (NACP) in a human in situ model for the first time, and to determine colony-forming units (CFU) and Ca and P ion concentrations of biofilms on the composite restorations. METHODS: NACP with a mean particle size of 116 nm were synthesized via a spray-drying technique. Two composites were fabricated: NACP nanocomposite, and control composite filled with glass particles. Twenty-five volunteers wore palatal devices containing bovine enamel slabs with cavities restored with NACP or control composite. After 14 days, the adherent biofilms were collected for analyses. Transverse microradiography determined the enamel mineral profiles at the margins, and the enamel mineral loss ΔZ was measured. RESULTS: NACP nanocomposite released Ca and P ions and the release significantly increased at cariogenic low pH (p<0.05). Biofilms on NACP nanocomposite contained higher Ca (p=0.007) and P ions (p=0.005) than those of control (n=25). There was no significant difference in biofilm CFU between the two composites (p>0.1). Microradiographs showed typical subsurface lesions in enamel next to control composite, but much less lesion around NACP nanocomposite. Enamel mineral loss ΔZ (mean±sd; n=25) around NACP nanocomposite was 13.8±9.3 µm, much less than 33.5±19.0 µm of the control (p=0.001). SIGNIFICANCE: Novel NACP nanocomposite substantially reduced caries formation in a human in situ model for the first time. Enamel mineral loss at the margins around NACP nanocomposite was less than half of the mineral loss around control composite. Therefore, the Ca and P ion-releasing NACP nanocomposite is promising for caries-inhibiting restorations.

The antimicrobial activity of photodynamic therapy against Streptococcus mutans using different photosensitizers.

UNLABELLED: Several photosensitizers have been used against oral bacteria without standardization. Singlet oxygen ((1)O(2)) is an aggressive chemical species that can kill cells through apoptosis or necrosis. OBJECTIVE: to compare the antimicrobial activity of photodynamic therapy (PDT) with different photosensitizers at the same concentration against Streptococcus mutans. In addition, the (1)O(2) production of each photosensitizer was determined. The photosensitizers (163.5 µM) methylene blue (MB), toluidine blue ortho (TBO) and malachite green (MG) were activated with a light-emitting diode (LED; λ=636 nm), while eosin (EOS), erythrosine (ERI) and rose bengal (RB) were irradiated with a curing light (λ=570 nm). Light sources were operated at 24 J cm(-2). For each photosensitizer, 40 randomized assays (n=10 per condition) were performed under one of the following experimental conditions: no light irradiation or photosensitizer, irradiation only, photosensitizer only or irradiation in the presence of a photosensitizer. After treatment, serial dilutions of S. mutans were seeded onto brain heart infusion agar to determine viability in colony-forming units per milliliter (CFU mL(-1)). Generation of (1)O(2) was analyzed by tryptophan photooxidation, and the decay constant was estimated. Results were analyzed by one-way ANOVA and the Tukey-Kramer test (p<0.05). PDT with irradiation in the presence of the photosensitizers TBO and MG was effective in reducing S. mutans counts by 3 and 1.4 logs, respectively (p<0.01), compared to their respective untreated controls. MB generated 1.3 times more (1)O(2) than TBO, and both produced significantly higher concentrations of singlet oxygen than the other photosensitizers. Since in vitro bulk (1)O(2) production does not indicate that (1)O(2) was generated in the bacterial activity site, the bactericidal action against S. mutans cannot be related to in vitro singlet O(2) generation rate. In vitroS. mutans-experiments demonstrated TBO as the only photosensitizer that effectively reduced 99.9% of these microorganisms.

The effect of diode laser irradiation on dentin as a preventive measure against dental erosion: an in vitro study.

Increasing rates of non-carious cervical lesions due to dental erosion, exposure of dentinal tubules, and hypersensitivity to environmental stimuli have led to the development of new prevention strategies. This study evaluated the effects of a low-intensity diode laser (λ = 808 nm) on the dentinal chemical composition and prevention of demineralization. In addition, the study monitored temperature changes during the course of irradiation. Forty dentin specimens were randomly allocated into four groups (n = 10): G1 - No treatment (control), G2 - irradiated with 15 J/cm(2), G3 - irradiated with 30 J/cm(2), and G4 - irradiated with 60 J/cm(2). Each specimen was partially covered with nail varnish, treated according to the group irradiation levels, and exposed to an erosive challenge (1.0 M hydrochloric acid) for 5 min. Afterwards, dentin loss was profilometrically analyzed and examined by scanning electron microscopy (SEM) combined with energy dispersive X-ray (EDX). Intrapulpal temperatures were measured during the dentin irradiation. One-way ANOVA and Tukey tests (p < 0.05) were performed to assess differences. For all irradiated groups, intrapulpal temperature changes were less than 3°C. The G2 group showed statistically significant differences when compared to the other groups, representing the lowest temperature increase. A quantitative element analysis via EDX did not significantly differ (p < 0.05) for Ca, P, F, O, or C between the four groups when measured after irradiation/erosion. The mean wear rates (± SD, µm) were 35.66 ± 7.28; 40.70 ± 5.03; 38.17 ± 10.81 and 25.25 ± 6.87 for G1-G4, respectively. The G4 group statistically differed from all other groups representing the lowest wear rate. These results suggest that dentin irradiation, using a diode laser with levels set at 60 J/cm(2), may induce inhibitory effects on root dentin demineralization without causing any harmful thermal effects. However, the exact mechanism of the action of the laser remains unclear.