Effects of Diabetes on Elemental Levels and Nanostructure of Root Canal Dentin.

INTRODUCTION: This study evaluated the effects of diabetes mellitus (DM) on the nanostructure of root canal dentin using high-resolution transmission electron microscopy (HRTEM) and inductively coupled plasma mass spectrometry (ICP-MS). METHODS: Twenty extracted human premolars from diabetic and nondiabetic patients (n = 10 in each group) were decoronated and sectioned horizontally into 40 2-mm-thick dentin discs, with each disc designated for a specific test. ICP-MS was used to determine the different elemental levels of copper, lithium, zinc, selenium, strontium, manganese, and magnesium in diabetic and nondiabetic specimens. HRTEM was used to analyze the shape and quantity of the apatite crystals in diabetic and nondiabetic dentin at the nanostructural level. Statistical analysis was performed using Kolmogorov-Smirnov and Student t test (P < .05). RESULTS: ICP-MS revealed significant differences in trace element concentrations between the diabetic and nondiabetic specimens (P < .05), with lower levels of magnesium, zinc, strontium, lithium, manganese, and selenium (P < .05), and higher levels of copper in diabetic specimens (P < .05). HRTEM revealed that diabetic dentin exhibited a less compact structure with smaller crystallites and significantly more crystals in the 2500 nm2 area (P < .05). CONCLUSION: Diabetic dentin exhibited smaller crystallites and altered elemental levels more than nondiabetic dentin, which could explain the higher root canal treatment failure rate in diabetic patients.

Functional role of inorganic trace elements in dentin apatite tissue-part III: Se, F, Ag, and B.

Dentin hydroxyapatite possesses a unique versatile structure which allows it to undergo ionic substitutions. Trace elements play pivotal roles within the oral cavity, especially in dentin apatite tissue. Therefore, it is critical to explore the role of these elements in dentin apatite structure. The roles of other inorganic elements in dentin apatite were discussed in part I (Mg, Sr, Zn, and Fe) and part II (Cu, Mn, Si, and Li) of these series. In the last part of the review series, the role of selenium, fluorine, silver, and boron in the regulation of dentin apatite structure and function was discussed. We evaluated how these elements affect the overall size, morphology, and crystallinity of dentin apatite crystals. Moreover, we investigated the importance of these elements in regulating the solubility of dentin apatite. An electronic search was performed on the role of these trace elements in dentin apatite from January 2010 to January 2022. The concentration of selenium in teeth has been explored only recently, particularly its incorporation into dentin apatite. Silver nanomaterials inhibit the growth of cariogenic microorganisms as well as arrest the degradation of collagen. Fluorine was found to have important roles in dentin remineralization and dentinal tubule occlusion, making it widely used for hydroxyapatite doping. Boron is critical for mineralized tissues like bone, dentin, and enamel, but its exact role in dentin apatite is unknown. Therefore, understanding the impact of these elements on dentin apatite is potentially transformative, as it may help to fill a significant knowledge gap in teeth mechanics.