Plant extracts have dual mechanism on the protection against dentine erosion: action on the dentine substrate and modification of the salivary pellicle.

To investigate the effect of some polyphenol-rich plant extracts on the protection of dentine against demineralization, both acting on the dentine and on the salivary pellicle. Dentine specimens (n = 180) were randomly distributed into 6 experimental groups (n = 30/group): Control (deionized water), Açaí extract, Blueberry extract, Green tea extract, Grape seed extract, and Sn2+/F- (mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the site of action of the substance: on the dentine surface (D) or on the salivary pellicle (P). The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (D), 2 min immersion in experimental substances, 60 min of incubation in saliva (P) or not (D), and 1 min erosive challenge. Dentine surface loss (DSL), amount of degraded collagen (dColl) and total calcium release were analyzed. Green tea, Grape seed and Sn2+/F- showed significant protection, with least DSL and dColl. The Sn2+/F- showed better protection on D than on P, whereas Green tea and Grape seed showed a dual mode of action, with good results on D, and even better on P. Sn2+/F- showed the lowest values of calcium release, not differing only from Grape seed. Sn2+/F- is more effective when acting directly on the dentine surface, while Green tea and Grape seed have a dual mode of action: with a positive effect on the dentine surface itself, but an improved efficacy in the presence of the salivary pellicle. We further elucidate the mechanism of action of different active ingredients on dentine erosion, where Sn2+/F- acts better on the dentine surface, but plant extracts have a dual mode of action, acting on the dentine itself as well as on the salivary pellicle, improving the protection against acid demineralization.

Salivary pellicle modification with polyphenol-rich teas and natural extracts to improve protection against dental erosion.

OBJECTIVE: To investigate the modification of the salivary pellicle with different polyphenol-rich teas and natural extracts for the protection against dental erosion. METHODS: We performed two experiments: one with teas (Green tea, Black tea, Peppermint tea, Rosehip tea, negative control [NC]) and other with natural extracts (Grape seed, Grapefruit seed, Cranberry, Propolis, NC), where NC was deionized water. A total of 150 enamel specimens were used (n = 15/group). Both experiments followed the same design, consisting of 5 cycles of: salivary pellicle formation (30 min, 37 °C), modification with the solutions (30 min, 25 °C), further salivary pellicle formation (60 min, 37 °C) and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), relative surface reflection intensity (rSRI) and amount of calcium release (CaR) were evaluated. Data were analysed with Kruskal-Wallis and Wilcoxon rank sum tests with Bonferroni correction (α = 0.05). RESULTS: Regarding teas, Black and Green teas showed the best protection against dental erosion, presenting higher rSMH and lower CaR than NC. Peppermint tea was not different to NC and Rosehip tea caused erosion, showing the highest CaR and greatest loss of SMH and SRI. Regarding natural extracts, Grape seed and Grapefruit seed extracts presented the best protective effect, with significantly higher rSMH and lower CaR. Cranberry caused significantly more demineralization; and Propolis did not differ from NC. CONCLUSION: Green tea, Black tea, Grape seed extract and Grapefruit seed extract were able to modify the salivary pellicle and improve its protective effect against enamel erosion, but Rosehip tea and Cranberry extract caused erosion. CLINICAL RELEVANCE: Some some bio-products, such as teas and natural extracts, improve the protective effect of the salivary pellicle against enamel erosion. More studies should be performed in order to test the viability of their use as active ingredients for oral care products.

Association of Nd: YAG laser and calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion

Abstract Objective To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. Methodology Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). Results G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). Conclusion All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. Combining Nd YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.

The association between Nd:YAG laser and desensitizing dentifrices for the treatment of dentin hypersensitivity.

This study aims to evaluate the association between Nd:YAG laser (with and without a photoabsorber) and two desensitizing dentifrices containing 15% NovaMin or 8% arginine, as potential treatments for dentin hypersensitivity (DH). DH was simulated by EDTA application for 2 min. Specimens were then analyzed with an environmental scanning electron microscope (ESEM) to ensure open dentin tubules (ODT), counted by using ImageJ software. Specimens were randomized into eight groups (n = 10): Laser (L), Laser+Photoabsorber (LP), Arginine (A), Arginine+Laser (AL), Arginine+Laser+Photoabsorber (ALP), NovaMin (N), NovaMin+Laser (NL), and NovaMin+Laser+Photoabsorber (NLP). Laser irradiation was performed with 1 W, 100 mJ, 10 Hz, ≅85 J/cm2; 4 irradiations of 10 s each, with 10 s intervals between them. After treatment, specimens were again analyzed by ESEM and submitted to erosive/abrasive cycling for 5 days. A final ESEM analysis was performed. Data were analyzed with two-way repeated measure ANOVA and Tukey tests (α = 0.05). After treatment, groups N, NL, and NLP presented the lower number of ODT, but they did not different from LP, ALP, and AL. Group A presented the highest number of ODT and it did not differ from group L. Groups L, AL, ALP, and LP presented intermediate results, without differing from each other. After cycling, group A presented the highest number of ODT and did not differ significantly from the other groups, except NLP. None of the associations tested presented better tubule occlusion than NovaMin by itself. Arginine was the only treatment that presented improved tubule occlusion when associated with Nd:YAG laser.

Supplementation of an orange juice with dietary proteins to prevent enamel and dentin erosion.

Protein supplementation may be an alternative to reduce the erosive potential of acidic drinks. The aim of this in vitro study was to evaluate the erosive potential of an orange juice modified by dietary proteins. A commercially available orange juice was added 0.2 g/L casein, 2.0 g/L ovalbumin and their combination. The juice with no additives and a commercially available calcium-modified juice were used as negative and positive controls, respectively. Human enamel and dentin specimens (n=11) were tested in an erosion-remineralization cycling model. Enamel was analyzed by surface microhardness and profilometry, whilst dentin by profilometry only. Statistical analyses were performed using one-way ANOVA followed by Tukey's test (p<0.05). Calcium-modified juice showed the lowest erosive potential for both analyses (p<0.05). For enamel, the protein-added groups did not differ from each other (p>0.05) and showed significantly lower enamel loss compared to negative control (p<0.05). Regarding surface microhardness, casein showed the highest values compared to negative control (p<0.05). For dentin, none of the protein-added groups showed lower values of surface loss compared to negative control (p>0.05). In conclusion, for enamel the protein-modified orange juices presented reduced erosion of enamel, with casein showing a trend for better protection. For dentin, no reduction in the erosive potential was observed for the tested protein-modified orange juices.

Supplementation of an Orange Juice with Dietary Proteins to Prevent Enamel and Dentin Erosion

Protein supplementation may be an alternative to reduce the erosive potential of acidic drinks. The aim of this in vitro study was to evaluate the erosive potential of an orange juice modified by dietary proteins. A commercially available orange juice was added 0.2 g/L casein, 2.0 g/L ovalbumin and their combination. The juice with no additives and a commercially available calcium-modified juice were used as negative and positive controls, respectively. Human enamel and dentin specimens (n=11) were tested in an erosion-remineralization cycling model. Enamel was analyzed by surface microhardness and profilometry, whilst dentin by profilometry only. Statistical analyses were performed using one-way ANOVA followed by Tukey's test (p<0.05). Calcium-modified juice showed the lowest erosive potential for both analyses (p<0.05). For enamel, the protein-added groups did not differ from each other (p>0.05) and showed significantly lower enamel loss compared to negative control (p<0.05). Regarding surface microhardness, casein showed the highest values compared to negative control (p<0.05). For dentin, none of the protein-added groups showed lower values of surface loss compared to negative control (p>0.05). In conclusion, for enamel the protein-modified orange juices presented reduced erosion of enamel, with casein showing a trend for better protection. For dentin, no reduction in the erosive potential was observed for the tested protein-modified orange juices.

A suplementação de proteína pode ser uma alternativa na redução do potencial erosivo de bebidas ácidas. O objetivo deste estudo in vitro foi avaliar o potencial erosivo do suco de laranja modificado por proteínas da dieta. A um suco de laranja disponível comercialmente foi adicionado 0,2 g/L de caseína, 2,0 g/L de ovalbumina e suas combinações. O suco sem aditivos, e um suco suplementado com cálcio foram utilizados como controles negativos e positivos, respectivamente. Espécimes de esmalte humano e de dentina radicular (n=11) foram testados em um modelo de ciclagem de erosão-remineralização. O esmalte foi analisado por microdureza de superfície e perfilometria, enquanto que a dentina, apenas por perfilometria. As análises estatísticas foram realizadas utilizando ANOVA um fator seguido pelo Teste de Tukey (p<0.05). O suco suplementado com cálcio mostrou o menor potencial erosivo para ambas as análises (p<0,05). Em relação ao esmalte, os grupos com adição de proteína não diferiram entre si (p>0,05) e mostraram significativamente uma menor perda de esmalte em relação ao grupo controle negativo (p<0,05). Para a microdureza, a caseína apresentou os maiores valores em relação ao controle negativo (p<0,05). Para a dentina, nenhum dos grupos com adição de proteína apresentou valores de perda de superfície menores quando comparados ao grupo controle negativo (p>0,05). Conclui-se que, para o esmalte os sucos de laranja modificados por proteínas apresentaram uma redução da erosão, com a caseína mostrando uma tendência para melhor proteção. Para a dentina, nenhuma redução da erosão foi observada para os sucos de laranja modificados por proteínas testados neste estudo.

Erosion protection by calcium lactate/sodium fluoride rinses under different salivary flows in vitro.

This study investigated the effect of a calcium lactate prerinse on sodium fluoride protection in an in vitro erosion-remineralization model simulating two different salivary flow rates. Enamel and dentin specimens were randomly assigned to 6 groups (n = 8), according to the combination between rinse treatments - deionized water (DIW), 12 mM NaF (NaF) or 150 mM calcium lactate followed by NaF (CaL + NaF) - and unstimulated salivary flow rates - 0.5 or 0.05 ml/min - simulating normal and low salivary flow rates, respectively. The specimens were placed into custom-made devices, creating a sealed chamber on the specimen surface connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min, followed by artificial saliva (0.5 or 0.05 ml/min) for 60 min. This cycle was repeated 4×/day for 3 days. Rinse treatments were performed daily 30 min after the 1st and 4th erosive challenges, for 1 min each time. Surface loss was determined by optical profilometry. KOH-soluble fluoride and structurally bound fluoride were determined in specimens at the end of the experiment. Data were analyzed by 2-way ANOVA and Tukey tests (α = 0.05). NaF and CaL + NaF exhibited significantly lower enamel and dentin loss than DIW, with no difference between them for normal flow conditions. The low salivary flow rate increased enamel and dentin loss, except for CaL + NaF, which presented overall higher KOH-soluble and structurally bound fluoride levels. The results suggest that the NaF rinse was able to reduce erosion progression. Although the CaL prerinse considerably increased F availability, it enhanced NaF protection against dentin erosion only under hyposalivatory conditions.

Development of an orange juice surrogate for the study of dental erosion.

The aim of this study was to create a synthetic juice (SJ) to be used as a surrogate for natural orange juices in erosion studies, verifying its erosive potential. The SJ was formulated based on the chemical composition of orange juices from different locations. Forty enamel and 40 root dentin specimens were randomly assigned into 4 experimental groups (n = 10): SJ; 1% Citric Acid (CA); Minute Maid Original® (MM) and Florida Natural Original® (FN). The specimens were immersed in their respective solutions for 5 min, 6x/day for 5 days, in an erosion-remineralization cycling model. Enamel specimens were analyzed by surface Knoop microhardness and optical profilometry and dentin specimens only by optical profilometry. Outcomes were analyzed statistically by ANOVA followed by Tukey's test considering a significance level of 5%. For enamel, the surface loss and microhardness changes found for MM and SJ groups were similar (p>0.05) and significantly lower (p<0.01) than those found in the CA group. For dentin, CA promoted significantly greater (p<0.01) surface loss compared with all the other groups. No significant difference (p>0.05) was observed in dentin surface loss between MM and SJ. In conclusion, CA was the most erosive solution, and SJ had a similar erosive potential to that of MM natural orange juice.

Development of an orange juice surrogate for the study of dental erosion

The aim of this study was to create a synthetic juice (SJ) to be used as a surrogate for natural orange juices in erosion studies, verifying its erosive potential. The SJ was formulated based on the chemical composition of orange juices from different locations. Forty enamel and 40 root dentin specimens were randomly assigned into 4 experimental groups (n=10): SJ; 1% Citric Acid (CA); Minute Maid Original® (MM) and Florida Natural Original® (FN). The specimens were immersed in their respective solutions for 5 min, 6x/day for 5 days, in an erosion-remineralization cycling model. Enamel specimens were analyzed by surface Knoop microhardness and optical profilometry and dentin specimens only by optical profilometry. Outcomes were analyzed statistically by ANOVA followed by Tukey’s test considering a significance level of 5%. For enamel, the surface loss and microhardness changes found for MM and SJ groups were similar (p>0.05) and significantly lower (p<0.01) than those found in the CA group. For dentin, CA promoted significantly greater (p<0.01) surface loss compared with all the other groups. No significant difference (p>0.05) was observed in dentin surface loss between MM and SJ. In conclusion, CA was the most erosive solution, and SJ had a similar erosive potential to that of MM natural orange juice.

O objetivo deste estudo foi criar um suco sintético (SJ) para ser usado como substituto do suco de laranja natural em estudos de erosão dental, verificando o seu potencial erosivo. O SJ foi formulado com base na composição química de sucos de laranja de diferentes locais. Quarenta espécimes de esmalte e 40 de dentina radicular foram aleatoriamente alocados em 4 grupos experimentais (n=10): SJ; 1% Citric acid (CA); Minute Maid Original® (MM) e Florida Natural Original® (FN). Os espécimes foram imersos nas suas respectivas soluções por 5 min, 6x/dia por 5 dias, em um modelo de ciclagem de erosão-remineralização. Os espécimes de esmalte foram analisados por microdureza de superfície Knoop e perfilometria ótica, enquanto que os espécimes de dentina foram analisados somente por perfilometria. Os resultados foram analisados estatisticamente com o teste de ANOVA, seguido pelo teste de Tukey, considerando um nível de significância de 5%. Para o esmalte, a perda superficial e as alterações de microdureza encontradas para os grupos MM e SJ foram similares (p>0,05) e significantemente menores (p<0,01) do que as encontradas para o grupo CA. Para dentina, CA promoveu significantemente (p<0,01) a maior perda de superfície quando comparada aos outros grupos. Não foram encontradas diferenças significantes (p>0,05) entre a perda de superfície de dentina dos grupos MM e SJ. Concluiu-se que CA foi a solução mais erosiva e SJ apresentou um potencial erosivo semelhante ao do suco de laranja natural MM.

Evaluation of the furcation area permeability of deciduous molars treated by neodymium:yttrium-aluminum-garnet laser or adhesive.

The purpose of this in vitro study was to compare the effects of a self-etch adhesive system and neodymium:yttrium-aluminum-garnet (Nd:YAG) laser application on the dentinal permeability of the furcation area of primary molars. After endodontic access, 39 extracted human deciduous molars were divided into three groups: control group (CG), no treatment; adhesive group (AG), self-etching adhesive was applied to the furcation area; laser group (LG), specimens were irradiated with Nd:YAG laser. To evaluate dentin permeability of the furcation area, we immersed the specimens in 0.5 % methylene blue dye for 4 h. Then, they were longitudinally sectioned into two halves and photographed. The images were analyzed by two qualified evaluators using TpsDig software to calculate the percentage of the dye penetration area in comparison with the total furcation area. Additional analyses by scanning electron microscopy (SEM) were performed. The analysis of variance (ANOVA), complemented by Student's t-test, showed that mean dye penetration in the LG was statistically significant lower than that in all the other groups (P < 0.05). The SEM analysis showed mostly dentinal tubules obliterated by smear layer in the CG; in the AG the smear layer was modified by the adhesive, and, in the LG, melted surfaces were observed. It can be concluded that the Nd:YAG laser was capable of reducing the dentinal permeability of the furcation area of deciduous molars.