Effects of different primers and colouring solutions on orthodontic bonding: shear bond strength and colour change.

OBJECTIVES: This in vitro study evaluated the effect of different colouring solutions and primer systems used in the bonding of brackets on enamel colour change and bond strength. MATERIALS AND METHODS: 120 premolar teeth were divided into four main groups; brackets were bonded with 37% orthophosphoric acid + Transbond XT Primer in Group 1, 3 M Single Bond Universal in Group 2, Transbond Plus SEP in Group 3, and G-Premio Bond in Group 4. Each group was divided into three subgroups, and the teeth were placed in a cup containing coffee and tea mixture, in a cup containing cola and in distilled water. A bond strength test was applied to all teeth. Colour measurements of all teeth were performed at 2 different times: before bonding and after the bond strength test. RESULTS: The average bond strength of the 37% orthophosphoric acid group was higher than that of the other groups. The effect of primer and solution groups on colour change was statistically significant (p = 0.001 and p = 0.023, respectively). CONCLUSIONS: In this study, the bond strength was clinically sufficient in all primer groups. The highest colour change was observed when the tea-coffee solution and Transbond Plus SEP primer were used. CLINICAL RELEVANCE: This study has identified enamel discoloration and bond strength from different colouring solutions and primer systems used for bonding braces, which can be used to inform clinicians and patients to achieve better treatment results.

Enamel changes of bleached teeth following application of an experimental combination of chitosan-bioactive glass.

BACKGROUND: Considering the extensive use of bleaching agents and the occurrence of side effects such as enamel demineralization, this study aimed to assess the enamel changes of bleached teeth following the experimental application of chitosan-bioactive glass (CH-BG). METHODS: In this in vitro study, CH-BG (containing 66% BG) was synthesized and characterized by Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). Thirty sound human premolars were bleached with 40% hydrogen peroxide, and the weight% of calcium and phosphorus elements of the buccal enamel surface was quantified before and after bleaching by scanning electron microscopy/ energy-dispersive X-ray spectroscopy (SEM, EDX). Depending on the surface treatment of the enamel surface, the specimens were divided into three groups (n = 10): control (no treatment), MI Paste (MI), and CH-BG. Then the specimens were stored in artificial saliva for 14 days. The SEM/EDX analyses were performed again on the enamel surface. Data were analyzed by one-way ANOVA and Tukey's test and a p-value of < 0.05 was considered statistically significant. RESULTS: In all groups, the weight% of calcium and phosphorus elements of enamel decreased after bleaching; this reduction was significant for phosphorus (p < 0.05) and insignificant for calcium (p > 0.05). After 14 days of remineralization, the weight% of both calcium and phosphorus elements was significantly higher compared to their bleached counterparts in both MI and CH-BG groups (p < 0.05). Following the remineralization process, the difference between MI and CH-BG groups was not significant (p > 0.05) but both had a significant difference with the control group in this regard (p < 0.05). CONCLUSIONS: The synthesized CH-BG compound showed an efficacy comparable to that of MI Paste for enamel remineralization of bleached teeth.

The use of mouthwash containing trimetaphosphate as an adjunct therapy to fluoridated toothpaste reduces enamel demineralization.

INTRODUCTION: The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population. MATERIALS AND METHODS: This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001). RESULTS: The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001). CONCLUSION: The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F. CLINICAL SIGNIFICANCE: This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.

Coffee-stained tooth enamel color restoration and surface abrasion with whitening and regular toothpaste.

PURPOSE: To evaluate the effectiveness of whitening toothpaste in restoring tooth color after coffee staining and its potential impact on enamel surfaces compared with regular toothpaste. METHODS: Bovine tooth enamel specimens were prepared and stained with coffee solutions before undergoing brushing simulation with different toothpaste slurries (whitening, regular, reference). For precise evaluation, spectrophotometric measurements were taken at intervals to assess color changes using the CIELAB (Commission Internationale de l'Éclairage Lab*) color space. Additionally, profilometric measurements were taken to determine the impact of toothpaste type on the roughness and abraded depth of the enamel surface. To understand the effects of toothpaste and brushing on color change, surface roughness, and abraded depth, while also considering correlations between these factors, the findings were analyzed using mixed-effects models. RESULTS: The whitening toothpaste group demonstrated the highest recovery rate (71%) after 10,000 brushstrokes, followed by the regular toothpaste group (48%) and the reference slurry group (43%). The mixed-effects model analysis revealed that the reference group had a smaller change in lightness (ΔL) than those in the regular toothpaste group. The whitening toothpaste group showed a greater change in lightness on average than those in the regular toothpaste group, with an increase in lightness as the number of brushstrokes increased. According to the roughness and abraded depth data, the whitening toothpaste group was least affected by brushing, while the reference and regular toothpaste groups showed higher levels of roughness and abraded depth at all intervals. CLINICAL SIGNIFICANCE: Gaining a thorough understanding of the effectiveness of whitening toothpaste and its impact on the enamel surface plays a crucial role in refining toothpaste formulations and advancing tooth whitening techniques in dental care.

Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study.

AIM: The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface. MATERIALS AND METHODS: This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed. RESULTS: After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05). CONCLUSION: The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice. CLINICAL SIGNIFICANCE: The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al. Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Effect of antioxidants on adhesive bond strength to bleached enamel.

OBJECTIVE: To evaluate the influence of antioxidants (ATX) resveratrol, winter's bark, green tea and yerba mate on the bond strength between bleached enamel and the nanohybrid composite resin. METHODOLOGY: Bovine incisor crowns (n = 132) were randomly divided into 22 groups (n = 6) according to the application times (5, 10, 15, 30, and 60 min) of each antioxidant. Teeth restored without previous bleaching or ATX constituted the non-bleached control group (NB Ctrl) (n = 6), and teeth restored after bleaching and without ATX represented the bleached control group (B Ctrl) (n = 6). The 35 % hydrogen peroxide was applied for 45 min (3 application of 15 min) to the buccal enamel surface. ATX was used after bleaching for the specified time of each group and removed with air-water spray. The enamel was etched with 37 % phosphoric acid (30 s) and rinsed with air-water spray. The adhesive resin was applied to the enamel dry surface. Teeth were restored using 1 mm composite resin increments (10 × 10 × 3 mm) and sectioned in test specimens of 6 mm in length and 1 mm2 in cross-sectional area submitted to microtensile bond strength test (0.5 mm/min). The load (N) at failure was recorded, and the bond strength (σt) was calculated (MPa). The fracture area was analyzed under optical microscopy, and failures were classified as cohesive, mixed, or adhesive. Data was evaluated by Kruskal-Wallis and Dunn tests (p ≤ 0.05). RESULTS: B Ctrl group presented lower σt than NB Ctrl (p < 0.001). Applying resveratrol for 5 or 10 min, winter's bark for 10 or 15 min, green tea for less than 15 min, and yerba mate for 15 min provided similar σt between bleached enamel and nanohybrid composite to the control group. CONCLUSION: Restorative procedures performed immediately after tooth bleaching compromises adhesion. Experimental antioxidants applied to bleached enamel can increase the immediate bond strength of restorations performed directly after bleaching, with similar values to those observed in unbleached enamel. CLINICAL SIGNIFICANCE: This study presents promising results to support the use of antioxidants on the recently bleached enamel to allow adhesive tooth restorations. The immediate bonding obtained using antioxidants was similar to the one achieved in non-bleached enamel in brief application times. Green tea extract and resveratrol were able to restore the bond strength to bleached enamel in a short application time of 5 min. The reduction in the required application time holds the potential to decrease the overall duration of the clinical section, offering clinical advantages and improving the feasibility of using antioxidants on the bleached enamel prior to adhesive procedures.

Maternal Diet Associates with Offspring Bone Mineralization, Fracture Risk and Enamel Defects in Childhood and Influences the Prenatal Effect of High-Dose Vitamin D Supplementation.

We previously demonstrated a beneficial effect of high-dose vitamin D in pregnancy on offspring bone and dental health. Here, we investigated the effect of maternal dietary patterns during pregnancy on the risk of bone fractures, bone mineralization and enamel defects until age 6 years in the offspring. Further, the influence of diet on the effect of high-dose vitamin D was analyzed in the COPSAC2010 mother-child cohort including 623 mother-child pairs. A weighted network analysis on FFQs revealed three specific maternal dietary patterns that associated (Bonferroni p < 0.05) with both offspring bone and dental health. The effect of prenatal high-dose (2800 IU/day) vs. standard-dose (400 IU/day) vitamin D on offspring bone mineral content (adjusted mean difference (aMD): 33.29 g, 95% CI: 14.48-52.09, p < 0.001), bone mineral density (aMD: 0.02 g/cm2 (0.01-0.04), p < 0.001), fracture risk (adjusted incidence rate ratio: 0.36 (0.16-0.84), p = 0.02), and enamel defects in primary (adjusted odds ratio (aOR): 0.13 (0.03-0.58), p < 0.01) and permanent molars (aOR: 0.25; (0.10-0.63), p < 0.01) was most pronounced when mothers had lower intake of fruit, vegetables, meat, eggs, sweets, whole grain, offal and fish. This study suggests that prenatal dietary patterns influence offspring bone and dental development, and should be considered in order to obtain the full benefits of vitamin D to enhance personalized supplementation strategy.

Evaluating color stability and enamel surface roughness following resin infiltration treatment.

OBJECTIVE: To assess the impact of resin infiltration treatment on enamel color stability and surface roughness after simulating daily exposure to coffee stains and regular toothbrushing with standard toothpaste. MATERIALS AND METHODS: In this in vitro study, we utilized 47 caries-free human enamel specimens, which were divided into two distinct groups. The teeth in the study group underwent artificial demineralization, Icon resin infiltration, and polishing, while the control group received only polishing. Following this, all teeth from both groups were regularly immersed in freshly brewed coffee for 15 min, twice daily, over a span of 30 days. After each staining session, the teeth underwent 10 heavy circular strokes using a soft toothbrush and standard toothpaste. Color changes were measured on Days 1 and 30 using a spectrophotometer. The L*, a*, b* color system defined by the International Commission on Illumination was used to assess the changes. Surface roughness was evaluated at baseline and after 30 days using a 3D surface Metrology Microscope. RESULTS: After 30 days of immersion in coffee, both the study and control groups showed significant changes in color. However, differences were statistically significant between groups for "L" and "a" parameter but not for "b." The overall color change in the study group was higher than the control group. There were no significant differences in surface roughness within or between the groups before and after staining and brushing. CONCLUSIONS: Resin infiltration leads to a significant increase in staining compared to untreated enamel. These staining properties should be taken into account when making clinical decisions regarding the treatment of white spot lesions.

Does surface enamel composition and characteristics vary with inter proximal enamel reduction?

OBJECTIVE: This study aimed to evaluate the chemical composition of the proximal enamel surface and the surface characteristics subjected to different extents of interproximal reduction (IPR) in a clinical setting. MATERIALS AND METHODS: Premolars of orthodontic patients which were designated for extraction were subjected to .2 mm, .3 mm, and .5 mm of IPR. After 1 month, the teeth were extracted and the teeth were subjected to scanning electron microscope (SEM) and energy-dispersive x-ray spectroscopy (EDX). RESULTS: The SEM images of the three experimental groups (taken at magnification of 500 × and 2000 ×) showed that the enamel surfaces were irregular and rough compared to the honey comb appearance of the unstripped group. Small areas of erosion of enamel surface were seen in Group I (0.2 mm) under 2000 × magnification compared to Group IV (control) which showed typical arrangement of enamel rods in alternating orientation. The enamel surfaces of stripped and unstripped enamel contained calcium, phosphorus, carbon, oxygen, and nitrogen. The differences were not statistically significant and neither were the calcium phosphorous stoichiometric ratios between the four groups. CONCLUSIONS: On analyzing the surface characteristics of enamel using SEM between the stripped and unstripped surfaces, there were irregularities and roughness seen in stripped surface whereas honey comb pattern was observed in unstripped enamel surfaces. The elements found in unstripped and stripped enamel surfaces were calcium, phosphorous, carbon, oxygen, and nitrogen. Although the calcium and phosphorus were high in the 0.5 mm IPR group, the difference between stripped and unstripped enamel surfaces was statistically not significant. CLINICAL RELEVANCE: There have been concerns that IPR can remove the superficial mineral-rich layer making the deeper layers more susceptible to carious attack. No study has evaluated the mineral content in different layers of enamel in response to IPR in vivo and this study found no significant difference between pristine enamel and enamel subjected to IPR. The results of this study strengthen the validity of the clinical protocol employed.

Evaluation of ER;CR:YSGG Laser and Remineralization Agents on Mineral Density and Ion Levels of Primary and Permanent Enamel.

Objective: The aim of this study is to evaluate the efficacy of two different fluoride varnishes used alone or in combination with laser treatment on permanent and primary tooth enamel. Methods: Ninety-six primary and 96 permanent molar samples were divided into six groups. The levels of calcium, phosphorus, fluoride, and silver ions of each sample were analyzed using energy-dispersive X-ray spectroscopy (EDS). Six different treatments were applied to 12 different groups (n = 15) as control (g1/G1), fluoride varnish (g2/G2), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-fluoride varnish (g3/G3), laser (g4/G4), laser+fluoride varnish (g5/G5), and laser+CPP-ACP-fluoride varnish (g6/G6). After the procedures, ion levels were reanalyzed with EDS. The teeth were subjected to the artificial caries-forming procedure and ion levels were again evaluated by EDS. One sample from each group was prepared separately for the focused ion beam-scanning electron microscope measurement; initial and final images were recorded. The obtained data were statistically analyzed with the SPSS 23.0 program. Results: Compared with the initial measurement, phosphorus percentages increased in most of the groups in the last measurement. Calcium percentages of primary teeth increased in the last measurement, except for the g1 group, but in permanent teeth, there was an increase only in the G6 group. There was a statistically significant difference between g1/G1 and g6/G6 groups in the last measurement of phosphorus and calcium percentages. Conclusions: The combined use of laser with CPP-ACP-fluoride varnish enhanced remineralization in the primary and permanent teeth. However, in permanent teeth, the use of laser alone was not as effective as in primary teeth. Therefore, combined usage with CPP-ACP-fluoride varnish can enhance its efficacy. This in vitro study was approved by the local ethics committee of Hacettepe University (Project No.: GO 20/441).

Pomegranate extract in polyphosphate-fluoride mouthwash reduces enamel demineralization.

OBJECTIVES: To evaluate the anti-demineralizing effect of a mouthwash comprising pomegranate peel extract (PPE 3%), sodium trimetaphosphate (TMP 0.3%), and fluoride (F 225 ppm) in an in situ study, and to assess its irritation potential in an ex vivo study. METHODS: This double-blind crossover study was conducted in four phases with 7 days each. Twelve volunteers used palatal appliances containing enamel blocks, which were subjected to cariogenic challenges. The ETF formulation (PPE + TMP + F, pH 7.0), TF formulation (TMP + F, pH 7.0), deionized water (W, pH 7.0), and essential oil commercial mouthwash (CM, 220 ppm F, pH 4.3) were dropped onto the enamel twice daily. The percentage of surface hardness loss, integrated loss of subsurface hardness, calcium, phosphorus, and fluoride in enamel and biofilms were determined. In addition, alkali-soluble extracellular polysaccharide concentrations were analyzed in the biofilms. The irritation potential was evaluated using the hen's egg chorioallantoic membrane test through the vascular effect produced during 300-s of exposure. RESULTS: ETF was the most efficacious in preventing demineralization. It also showed the highest concentrations of calcium and phosphorus in the enamel and in the biofilm, as well as the lowest amount of extracellular polysaccharides in the biofilm. In the eggs, ETF produced light reddening, whereas CM led to hyperemia and hemorrhage. CONCLUSIONS: The addition of PPE to formulations containing TMP and F increased its anti-demineralizing property, and this formulation presented a lower irritation potential than the CM. CLINICAL RELEVANCE: ETF can be a promising alternative alcohol-free mouthwash in patients at high risk of caries.

An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

OBJECTIVES: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. METHOD AND MATERIALS: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. RESULTS: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). CONCLUSIONS: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

Predictors of Developmental Defects of Enamel in Primary Maxillary Central Incisors Using Bayesian Model Selection.

INTRODUCTION: Localized non-inheritable developmental defects of tooth enamel (DDE) are classified as enamel hypoplasia (EH), opacity (OP), and post-eruptive breakdown (PEB) using the enamel defects index. To better understand the etiology of DDE, we assessed the linkages amongst exposome variables for these defects during the specific time duration for enamel mineralization of the human primary maxillary central incisor enamel crowns. In general, these two teeth develop between 13 and 14 weeks in utero and 3-4 weeks' postpartum of a full-term delivery, followed by tooth eruption at about 1 year of age. METHODS: We utilized existing datasets for mother-child dyads that encompassed 12 weeks' gestation through birth and early infancy, and child DDE outcomes from digital images of the erupted primary maxillary central incisor teeth. We applied a Bayesian modeling paradigm to assess the important predictors of EH, OP, and PEB. RESULTS: The results of Gibbs variable selection showed a key set of predictors: mother's prepregnancy body mass index (BMI); maternal serum concentrations of calcium and phosphorus at gestational week 28; child's gestational age; and both mother's and child's functional vitamin D deficiency (FVDD). In this sample of healthy mothers and children, significant predictors for OP included the child having a gestational period >36 weeks and FVDD at birth, and for PEB included a mother's prepregnancy BMI <21.5 and higher serum phosphorus concentration at week 28. CONCLUSION: In conclusion, our methodology and results provide a roadmap for assessing timely biomarker measures of exposures during specific tooth development to better understand the etiology of DDE for future prevention.

Bleached enamel reversal using grape seed extract, green tea, curcumin-activated photodynamic therapy, and Er: YAG on microleakage and bond integrity of composite material bonded to the enamel surface.

AIMS: Bleached enamel reversal using antioxidants sodium ascorbate (SA), Green tea extract (GTE), grape seed extract (GSE), Curcumin photosensitizer (CP) and Er: YAG laser on the adhesive strength and marginal leakage of composite material bonded to the bleached enamel surface. MATERIALS AND METHODS: Enamel surface of hundred and twenty sound human first premolar teeth was cleansed using pumice and bleached with 35 % hydrogen peroxide. The samples were randomly divided into 5 groups based on the antioxidants used. n = 20 Group 1 (Control): No antioxidant agent, Group 2: 10 % SA solution, Group 3: 6.5 % GSE, Group 4: 5 % GTE, Group 5: Er: YAG laser and Group 6: CP. Following reversal, the composite was built and cured for 40 s. All the specimens were stored in distilled water at room temperature for 1 day. Microleakage, SBS, and failure mode were analyzed. Kolmogorov-Smirnov test, one-way analysis of variance, and Tukey's multiple post hoc test were used to analyze the data statistically. RESULTS: Group 2 (SA) (20.11 ± 5.79 nm) exhibited minimum value of microleakage and highest SBS (10.22 ± 1.62 MPa). Whereas, Group 1 (No antioxidant agent) displayed maximum scores of marginal leakage (28.11±8.89 nm) and lowest SBS (7.02 ± 1.22 MPa). CONCLUSION: CP, GTE and GSE can be used as a potential alternative to the commonly used SA solution to reverse the negative impact of bleaching on the enamel surface. The use of reversal agents CP, GTE and GSE improves bond values with a decrease in microleakage scores However, future studies are still warranted to conclude the outcomes of the existing study.

Effect of lactoferrin on enamel characteristics of primary and permanent teeth: an in-vitro study.

BACKGROUND: Lactoferrin, a glycoprotein naturally found in breast milk, is known for its bactericidal and antiviral properties, as well as its capacity to modulate the immune system; therefore, pediatricians routinely recommend it as dietary support. The objective of this study was to determine how lactoferrin oral suspension could affect the enamel surface characteristics of primary and permanent teeth. METHODS: This research was conducted on 40 unidentified extracted teeth, including primary and permanent teeth. Experimental teeth were free of cracks or enamel defects, as confirmed by careful examination using a dental operating microscope. The crowns were bisected into 80 specimens and assorted into two groups based on the type of dentition. Group DM included 40 specimens of second deciduous molars, while Group PM contained 40 samples of first premolars. Each of the DM and PM specimens was subsequently split based on the type of dispersion medium into two subgroups: a control subgroup (artificial saliva) and a test subgroup (lactoferrin suspension). The specimens were immersed in lactoferrin suspension for two minutes, then kept in artificial saliva for the rest of the 24 h for 30 successive days. This is a pioneering study about the effect of orally supplemented lactoferrin on teeth; therefore, we examined enamel hardness, ultra-morphology, and mineral contents. RESULTS: Our findings indicated a highly significant decrease (p < 0.01) in the microhardness of the lactoferrin subgroup in Group DM (second deciduous molars) and a significant reduction (p < 0.05) in the microhardness of the lactoferrin subgroup in Group PM (premolars). Calcium weight% was not statistically different (p > 0.05) compared with a significant decline (p < 0.05) in phosphorus weight% in lactoferrin subgroups in both DM and PM groups. The enamel surface of lactoferrin subgroups in both DM and PM groups was demineralized and porous, with the enamel of deciduous teeth being more affected by lactoferrin than permanent teeth. CONCLUSION: Lactoferrin suspension decreased the microhardness of enamel and both calcium and phosphorus weight percentages. Both dentitions exhibited erosions in the enamel surface, with primary teeth being more affected than the permanent teeth.

EFFECTS OF PROFESSIONAL ORAL HYGIENE AND TEETH WHITENING ON THE MICROELEMENT COMPOSITION OF ENAMEL.

OBJECTIVE: Aim: The objective of this study is to investigate the impact of professional teeth cleaning and the substances used in modern dentistry for whitening on the microelement composition of tooth enamel. PATIENTS AND METHODS: Materials and Methods: To study the morphology and microelement composition of the enamel, scanning electron microscopy was performed using the MiraLM microscope equipped with a Schottky field emission electron gun from Tescan. RESULTS: Results: A comparative analysis between the areas subjected to mechanical cleaning and those where it was not applied revealed a significant difference in the research results, particularly in carbon, which changed from 25.16±1.04 to 32.02±1.8. An analysis of the enamel's chemical composition before and after whitening revealed a decrease in carbon from 45.91±1.20 to 42.46±1.74. The change in phosphorus content was determined to be from 9.77±0.39 to 9.56±0.75. A decrease in calcium from 15.96±0.64 to 15.21±1.22 and magnesium from 0.07±0.01 to 0.01±0.01 was also observed. CONCLUSION: Conclusions: Professional dental hygiene does not have a direct impact on the microelement composition of enamel, such as the levels of calcium, phosphorus, fluoride, and other microelements. However, it can have an indirect and temporary influence due to the use of abrasive materials that affect dental deposits, pellicle, and the surface layer of enamel. Teeth whitening can affect the microelement composition of enamel, but these changes are mostly temporary and associated with processes of demineralization/ remineralization and oxygenation.

Effect of the association of microparticles and nano-sized ß-calcium glycerophosphate in conventional toothpaste on enamel remineralization: In situ study.

OBJECTIVES: This in situ study aimed to assess the remineralizing effect of a fluoride toothpaste supplemented with ß-calcium glycerophosphate in both micro (ß-CaGPm) and nano-sized forms (ß-CaGPn). METHODS: This blind and cross-over study was performed in 4 phases, each spanning 3 days. Twelve volunteers utilized palatal appliances containing four bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned to the following treatment groups: Placebo (no F-ß-CaGPm-ß-CaGPn); 1100 ppm F alone (1100F); 1100F plus 0.5% micrometric ß-CaGP (1100F-0.5%ß-CaGPm); and 1100F plus 0.25%nano-sized ß-CaGP (1100F-0.25%ß-CaGPn). Participants were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), ensuring that the enamel blocks were exposed to the natural toothpaste slurries. Following each phase, evaluations were conducted to determine the percentage of surface hardness recovery (%SHR), integrated recovery of subsurface hardness (ΔIHR), profile subsurface lesion through polarized light microscopy (PLM), as well as fluoride (F), calcium (Ca), and phosphorus (P) concentrations within the enamel. Data were analyzed by ANOVA and Student-Newman-Keuls test (p < 0.001). RESULTS: Treatment with 1100F-0.25%ß-CaGPn resulted in %SHR ∼69 % and ∼40 % higher when compared to 1100F and 1100F-0.5%ß-CaGPm (p < 0.001). The reduction in lesion body (ΔIHR; PLM) was ∼40 % higher with 1100F-0.25%ß-CaGPn (p < 0.001) compared to 1100F. The addition of ß-CaGPm and ß-CaGPn did not influence enamel F concentration (p > 0.001). Treatment with 1100F-0.25%ß-CaGPn led to an increase in the concentration of Ca and P in the enamel (p < 0.001). CONCLUSION: The addition of 0.25%ß-CaGPn into 1100F formulation increased the bioavailability of calcium and phosphate, promoting a higher remineralizing effect. CLINICAL SIGNIFICANCE: Toothpaste containing 1100F-0.25%ß-CaGPn showed a potential of higher remineralization to 1100 ppm F and 1100 ppm F micrometric ß-CaGP could be a strategy for patients at caries activity.

The Impact of Prenatal Vitamin D on Enamel Defects and Tooth Erosion: A Systematic Review.

Prenatal Vitamin D has been suggested to be critical for dental health in children, affecting outcomes including the prevalence of enamel defects and tooth erosion. This systematic review aimed to evaluate the potential impact of prenatal Vitamin D levels on these dental health outcomes. A total of seven studies, involving 6978 participants, were included after a comprehensive search of PubMed, Web of Science, and Scopus from 2013 to June 2023. The average age of mothers varied across studies, with Vitamin D levels or supplementation practices displaying significant variation among the study populations. The age of children at examination ranged from 3.6 to 6.6 years. The analysis demonstrated a diverse association between Vitamin D levels and dental outcomes, with enamel defects reported in 21.1% to 64% of the children and opacities ranging from 36% to 79.5% across studies. Maternal Vitamin D insufficiency was identified as a significant risk factor for enamel defects in one study (OR: 3.55), whereas high prenatal Vitamin D levels indicated a protective effect against Hypomineralized Second Primary Molars (OR: 0.84) and Molar Incisor Hypomineralization (OR: 0.95) in another. Conversely, low Vitamin D levels increased the risk of enamel hypoplasia (OR: 1.29) and dental decay. The maternal and child demographics varied greatly across the studies, and the assessment and prevalence of Vitamin D deficiency or insufficiency were heterogenous. This review illuminates the potential influence of prenatal Vitamin D on dental health in children, underscoring the importance of adequate Vitamin D levels during pregnancy. However, more robust research is required to establish the optimal Vitamin D intake during pregnancy to ensure healthy dental outcomes in children.

Effect of enamel surface coating on staining capability due to iron containing supplements on primary teeth: An in vitro study.

Background: Iron supplements prescribed to anemic children may results in teeth staining. Possible methods for preventing staining of primary teeth following exposure to iron supplements are need of an hour. Aim: This study was conducted with the aim to assess effect of enamel surface coating on staining capability of iron containing supplements in primary teeth. Settings and Design: This is an in vitro Experimental study. Methods: Hundred and forty-four primary incisors with intact crowns were sequentially numbered and randomly divided into four main groups of 36 samples receiving different enamel surface coating such as no surface coating, MI fluoride varnish™, GC G-coat Plus™ and GC-Equia®-forte-coat. Each group was subdivided into two groups, namely A (sound teeth) and B (artificially demineralized teeth). All the samples were immersed in 250 ml artificial saliva containing 10 ml of iron supplement to make the iron concentration 100 mg. The shade of the teeth was measured at baseline and at 90 days, using VITA Easy shade® V digital spectrophotometer. The data was statistically analyzed using the Kruskal-Wallis test and Mann-Whitney U test. Descriptive and inferential statistical analyses was made via SPSS 23. Results: Overall color change was found to be significantly less at the end of 90th day in sound samples when GC-Equia®-forte-coat was used as an enamel surface coating with pvalue of 0.017. In demineralized samples the overall color change was least at the end of 90th day when MI Varnish™ used as an enamel surface coating with P = 0.042. Conclusions: GC-Equia®-forte-coat, MI Varnish™ and GC-G-coat-plus™ can be used as a preventive or a precautionary measure to minimizes the staining of teeth. The amount of color change at the end of 90 days with GC-Equia®-forte-coat was least followed by MI varnish™, GC G coat Plus™ and control group.

Evaluation of the impact of fluoride in drinking water and tea on the enamel of deciduous and permanent teeth.

BACKGROUND: Systemic fluoride intake is predominantly derived from drinking water and tea. It's been noted that water and tea containing fluoride, within the boundaries set by the World Health Organization, can lessen the prevalence of dental caries. A review of the literature did not uncover any study that has examined the impact of fluoride in bottled drinking water and tea on enamel of deciduous and permanent teeth. Thus, we assessed the effects of fluoride present in seven different brands of bottled water from distinct geographical regions of Turkey, and a type of tea produced and packaged in Turkey, on the enamel of deciduous and permanent teeth. MATERIALS AND METHODS: Fluoride analysis was performed on drinking water sourced from seven different regions of Turkey and a brand of tea brewed with these waters. The tea was harvested and packaged in Turkey. The analysis was conducted using an ion-selective electrode. In total, 112 tooth enamel samples (56 deciduous molars and 56 permanent molars) were randomly divided into eight distinct groups. These were kept in water for 15 min and tea for 15 min every day for a month. The eighth group was treated with fluoride gel prior to tea and water applications. The amount of fluoride in the tooth enamel structure was evaluated using an SEM EDX device before and after the experiment. RESULTS: Statistically significant differences were found in fluoride content of enamel between water brands and tooth type (deciduous and permanent teeth). Fluoride levels were higher in the enamel of deciduous teeth than in permanent teeth. CONCLUSION: Regular exposure of enamel samples to black tea and water led to an increase in fluoride levels in the enamel; thus, regular consumption of black tea and fluoride water could help reduce the prevalence of dental caries.