Bioinspired caries preventive strategy via customizable pellicles of saliva-derived protein/peptide constructs.

Dental caries has been the most widespread chronic disease globally associated with significant health and financial burdens. Caries typically starts in the enamel, which is a unique tissue that cannot be healed or regrown; nonetheless, new preventive approaches have limitations and no effective care has developed yet. Since enamel is a non-renewable tissue, we believe that the intimate overlaying layer, the acquired enamel pellicle (AEP), plays a crucial lifetime protective role and could be employed to control bacterial adhesion and dental plaque succession. Based on our identified AEP whole proteome/peptidome, we investigated the bioinhibitory capacities of the native abundant proteins/peptides adsorbed in pellicle-mimicking conditions. Further, we designed novel hybrid constructs comprising antifouling and antimicrobial functional domains derived from statherin and histatin families, respectively, to attain synergistic preventive effects. Three novel constructs demonstrated significant multifaceted bio-inhibition compared to either the whole saliva and/or its native proteins/peptides via reducing biomass fouling and inducing biofilm dispersion beside triggering bacterial cell death. These data are valuable to bioengineer precision-guided enamel pellicles as an efficient and versatile prevention remedy. In conclusion, integrating complementary acting functional domains of salivary proteins/peptides is a novel translational approach to design multifunctional customizable enamel pellicles for caries prevention.

Protection Against Discolouration by Two Over-the Counter Desensitising Products.

PURPOSE: To determine in vitro the protection potential against discolouration of two OTC (over-the-counter) desensitising products on enamel and dentin in comparison to a standard toothpaste and water by means of a spectrophotometer. MATERIALS AND METHODS: A total of 96 samples of bovine enamel-dentin complex and 48 of bovine dentin were alternatively immersed in red wine, tea, coffee or water after having been treated by a sodium monofluorophosphate- and calcium phosphate-based product (Curodont Protect), an amine fluoride-based toothpaste (Elmex Red), a stannous chloride-based toothpaste (Elmex Protection Erosion) or distilled water (negative control). Initial (T0) and final colour (T1, after 4 weeks of immersion in staining solutions) of each specimen were assessed by a spectrophotometer. Statistical analysis was done by means of repeated measures ANOVA followed by Fisher's LSD post-hoc test. Differences between T0 and T1 were considered stastistically significant at p ≤ 0.05. RESULTS: When enamel samples were measured over a black background, ΔE00 values (T0-T1) varied from 2.2 (SD 0.7) for amine fluoride-based product/water to 53.9 (SD 7.6) for amine fluoride-based-product/red wine. When dentin samples were measured over a black background, ΔE00 values (T0-T1) varied from 5.4 (SD 0.9) stannous chloride based product/water to 61.6 (SD 3.7) amine fluoride-based product/red wine. CONCLUSION: Specifically, the application of the sodium monofluorophosphate was able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested only on the enamel-dentin complex, while distilled water and the stannous fluoride-based product were able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested in pure dentin samples.

Influência da adição de sais de cálcio e fósforo na composição do agente clareador sobre os efeitos deletérios no esmalte dental / Influence of calcium and phosphate salts addition in the composition of bleaching agent on the negative effects over dental enamel

RESUMO O estudo avaliou se os efeitos deletérios do clareamento no esmalte dental podem ser minimizados pela adição de sais de cálcio e/ou fósforo em variadas concentrações, na formulação do agente clareador, tornando-o progressivamente mais saturado em relação ao conteúdo mineral do esmalte.Inicialmente foi determinada a concentração dos elementos cálcio (Ca) e fósforo (P)no agente clareador,provenientes da dissolução do esmalte dental pelo tratamento até atingir seu ponto de saturação. Para tal amostras de esmalte foram trituradas e expostas ao peróxido de hidrogênio (PH) à 35% em pH7, até que um equilíbrio mineral fosse obtido. A concentração mineral na solução foi determinada através dos métodos de ICP-AES. A seguir o coeficiente de solubilidade de diversos sais de cálcio e fósforo em PH à 35%foi determinado. Aquele mais solúvel para cada elemento foi utilizado para a formulação dos agentes clareadores.Foram preparados 120 espécimes a partir da face vestibular de dentes incisivos bovinos, em formato circular com 4 mm de diâmetro, padronizando-se a espessura de esmalte e dentina em 1mm cada, embutidos em resina branca. Os espécimes foram enumerados e imersos em saliva artificial por 15 dias. Após esse período, foram realizadas leituras iniciais da microdureza Knoop do esmalte empregando um microdurômetro (FM-700, FutureTech, Tóquio, Japão), da rugosidade superficial em um perfilômetro de contato (MarSurf GD 25, Mahr, Goettingen, Alemanha) e da cor das amostras utilizando espectrofotômetro colorimétrico de reflectância (CM 2600d ­ Konica Minolta, Osaka, Japan). Todos os grupos experimentais foram clareados com soluções de PH à 35% (p/p) ajustadas para o pH 7. Os espécimes foram divididos em 6 grupos de acordo com a quantidade de cálcio e fósforo adicionada em cada solução clareadora, baseado na saturação em relação à HA, sendo eles: CN(controle negativo) ­ os espécimes foram tratados com água ultra pura; CP (controle positivo) ­ os espécimes foram clareados com PH sem a adição de qualquer mineral; Ca/P-50 ­ PH suplementado com Ca-P/50%subsaturados em relação à hidroxiapatita; Ca/P100 ­ PH suplementado com Ca-P/100% saturados em relação à hidroxiapatita;; CaCS ­ PH suplementado com o sal de Ca2+ mais solúvel, no seu coeficiente de solubilidade e P-CS ­ PH suplementado com o sal de PO4 3- mais solúvel, no seu coeficiente de solubilidade. Sobre cada espécimes foram aplicados10µl das respectivas soluções clareadoras, removidas após 20 minutos e reaplicadas mais duas vezes. A microdureza e a rugosidade superficial das amostras foram mensuradas imediatamente após o clareamento. Todas as amostras foram imersas em saliva artificial por 7 dias e a cor novamente avaliada. Os dados obtidos foram analisados estatisticamente empregando os testes apropriados, dependendo da normalidade dos dados. Os resultados para o teste de ANOVA a um fator constataram que houveram diferenças significativas para todos os grupos (p=0,005). Os resultados para o teste de Tukey foram para a microdureza:CN 334,48(18,27)a ,CP 226,01(17,49)b , Ca-CS 331,93(23,64)a , P-CS 318,11(19,25)a ,Ca- P/50% 278,86(17,49)c e Ca-P/100% 339,31(28,47)a . Para a rugosidade: CN 0,025 (0,006)a , CP 0,067 (0,030 )b , Ca-CS 0,022 (0,005)a , P-CS 0,025 (0,006)a , Ca-P/50% 0,044 (0,014)c e Ca-P/100% 0,035 (0,012)a . Para a cor ΔE*ab:CN 0,50(0,19)a, CP 4,77(1,79) a , Ca-CS 4,41(1,04) a ; P-CS 4,91(1,43)a , Ca-P/50% 4,75(0,90)a e CaP/100% 4,05(1,06)a . Mediante os resultados desse estudo, podemos concluir que: A adição de cálcio e/ou fósforo em quantidades correspondente ao ponto de saturação ou ao coeficiente de solubilidade dos testados impediram a queda da dureza e o aumento da rugosidade, sem afetar o efeito clareador(AU)

ABSTRACT The study evaluated whether the deleterious effects of bleaching on tooth enamel can be minimized by adding calcium and / or phosphorus salts at varying concentrations in the bleaching agent formulation, making it progressively more saturated relative to the enamel mineral content. Initially, the concentration of calcium (Ca) and phosphorus (P) elements in the bleaching agent were determined, resulting from the dissolution of dental enamel by the treatment until reaching its saturation point. For such enamel samples were crushed and exposed to hydrogen peroxide (PH) at 35% at pH7, until a mineral balance was obtained. The mineral concentration in the solution was determined by ICP-AES methods. Then the solubility coefficient of several calcium and phosphorus salts in PH at 35% was determined. The most soluble for each element was used for the bleaching agent formulation. 120 specimens were prepared from the vestibular face of bovine incisor teeth, in circular format with 4 mm diameter, and the thickness of enamel and dentin was standardized in 1 mm each, embedded in white resin. The specimens were enumerated and immersed in artificial saliva for 15 days. After that, initial Knoop enamel microhardness measurements were performed using a microdurometer (FM700, Future-Tech, Tokyo, Japan), of surface roughness in a contact profilometer (MarSurf GD 25, Mahr, Goettingen, Germany) and of the samples using a colorimetric reflectance spectrophotometer (CM 2600d - Konica Minolta, Osaka, Japan). All experimental groups were cleared with pH solutions at 35% (w / w) adjusted for pH 7. The specimens were divided into 6 groups according to the amount of calcium and phosphorus added in each bleaching solution, based on saturation at relation to HA, they are: CN (negative control) - the specimens were treated with ultra pure water; CP (positive control) - the specimens were cleared with PH without the addition of any mineral; Ca / P-50 - PH supplemented with Ca-P / 50% subsaturated relative to hydroxyapatite; Ca / P-100 - PH supplemented with CaP / 100% saturated relative to hydroxyapatite; Ca-CS-PH supplemented with the most soluble Ca 2+ salt in its solubility coefficient and P-CS-PH supplemented with the most soluble PO43- salt in its solubility coefficient. On each specimen were applied 10 µl of the respective whitening solutions, removed after 20 minutes and reapplied two more times. The microhardness and surface roughness of the samples were measured immediately after bleaching. All samples were immersed in artificial saliva for 7 days and the color evaluated again. The obtained data were statistically analyzed using the appropriate tests, depending on the normality of the data. The results for the one-way ANOVA test revealed that there were significant differences for all groups (p = 0.005). The results for the Tukey test were for the microhardness: CN 334,48 (18,27)a , CP 226,01 (17,49)b , Ca-CS 331,93 (23,64)a , P-CS 318.11 (19.25)a , Ca-P / 50% 278.86 (17.49)a and Ca-P / 100% 339.31 (28.47)a . For roughness: CN 0.025 (0.006)a , CP 0.067 (0.030)b , Ca-CS 0.022 (0.005)a , P-CS 0.025 (0.006)a , Ca-P / 50% 0.044 (0.014)a and Ca-P / 100% 0.035 (0.012)a . For the ΔE *ab color: CN 0.50 (0.19)a , CP 4.77 (1.79)a , Ca-CS 4.41 (1.04)a ; P-CS 4.91 (1.43)a , Ca-P / 50% 4.75 (0.90)a and Ca-P / 100% 4.05 (1.06)a . By the results of this study, we can conclude that: The addition of calcium and / or phosphorus in amounts corresponding to the saturation point or the solubility coefficient of the tested ones prevented the hardness from falling and increasing the roughness, without affecting the bleaching effect(AU)

Histochemical changes of occlusal surface enamel of permanent teeth, where dental caries is questionable vs sound enamel surfaces.

AIM: This in vitro study was to classify questionable for caries occlusal surfaces (QCOS) of permanent teeth according to ICDAS codes 1, 2, and 3 and to compare them in terms of enamel mineral composition with the areas of sound tissue of the same tooth. METHODS: Partially impacted human molars (60) extracted for therapeutic reasons with QCOS were used in the study, photographed via a polarised light microscope and classified according to the ICDAS II (into codes 1, 2, or 3). The crowns were embedded in clear self-cured acrylic resin and longitudinally sectioned at the levels of the characterised lesions and studied by SEM/EDX, to assess enamel mineral composition of the QCOS. Univariate and multivariate random effect regressions were used for Ca (wt%), P (wt%), and Ca/P (wt%). RESULTS: The EDX analysis indicated changes in the Ca and P contents that were more prominent in ICDAS-II code 3 lesions compared to codes 1 and 2 lesions. In these lesions, Ca (wt%) and P (wt%) concentrations were significantly decreased (p = 0.01) in comparison with sound areas. Ca and P (wt%) contents were significantly lower (p = 0.02 and p = 0.01 respectively) for code 3 areas in comparison with codes 1 and 2 areas. Significantly higher (p = 0.01) Ca (wt%) and P (wt%) contents were found on sound areas compared to the lesion areas. CONCLUSIONS: The enamel of occlusal surfaces of permanent teeth with ICDAS 1, 2, and 3 lesions was found to have different Ca/P compositions, necessitating further investigation on whether these altered surfaces might behave differently on etching preparation before fissure sealant placement, compared to sound surfaces.

Imaging human teeth by phosphorus magnetic resonance with nuclear Overhauser enhancement.

Three-dimensional phosphorus MR images ((31)P MRI) of teeth are obtained at a nominal resolution of 0.5 mm in less than 15 minutes using acquisition pulse sequences sensitive to ultra-short transversal relaxation times. The images directly reflect the spatially resolved phosphorus content of mineral tissue in dentin and enamel; they show a lack of signal from pulp tissue and reduced signal from de-mineralized carious lesions. We demonstrate for the first time that the signal in (31)P MR images of mineralized tissue is enhanced by a (1)H-(31)P nuclear Overhauser effect (NOE). Using teeth as a model for imaging mineralized human tissue, graded differences in signal enhancement are observed that correlate well with known mineral content. From solid-state NMR experiments we conclude that the NOE is facilitated by spin diffusion and that the NOE difference can be assigned to a higher water content and a different micro-structure of dentin. Thus, a novel method for imaging mineral content without ionizing radiation is proposed. This method has potential use in the assessment of de-mineralization states in humans, such as caries of teeth and osteoporosis of bones.

Prenatally administered HMB modifies the enamel surface roughness in spiny mice offspring: An atomic force microscopy study.

OBJECTIVE: The aim of this research was to check the effect of the prenatally administered ß-hydroxy ß-methylbutyrate (HMB) on the development of enamel surface of the spiny mice offspring. DESIGN: The spiny mice dams were randomly assigned into three groups: control group (not supplemented with HMB) and two experimental groups in which powdered HMB was given at the daily dosage of 0.2g/kg of body weight (group I) and 0.02g/kg of body weight (group II) during the last period of gestation. Newborn pups were euthanized by CO2 inhalation. The morphology of incisor teeth was analysed using atomic force microscopy (AFM) in semi-contact mode in the height, magnitude and phase domains. Height images became a basis for determination of surface roughness parameters. RESULTS: Conducted study indicated that maternal HMB administration markedly influences enamel development. Enamel of offspring's teeth in both experimental groups was characterized by significantly smaller values of indices describing surface roughness and profile. HMB supplementation influenced the calculated parameters regardless of the diet type and offspring sex, however higher dose of HMB caused stronger changes in enamel surface's physical properties and could be observed in higher intensity in the male group. CONCLUSIONS: HMB administration caused reduction in the irregularities of enamel surface, thereby possibly reducing the probability of bacteria adhesion and caries development. These observations may serve to improve nutrition and supplementation of animals and could be a lead for further research.

The effect of air-abrasion on the susceptibility of sound enamel to acid challenge.

OBJECTIVE: To evaluate the effect of air-abrasion using three abrasive powders, on the susceptibility of sound enamel to an acid challenge. METHODS: 40 human enamel samples were flattened, polished and assigned to 4 experimental groups (n=10); a: alumina air-abrasion, b: sodium bicarbonate air-abrasion, c: bioactive glass (BAG) air-abrasion and d: no surface treatment (control). White light confocal profilometry was used to measure the step height enamel loss of the abraded area within each sample at three stages; after sample preparation (baseline), after air-abrasion and finally after exposing the samples to pH-cycling for 10 days. Data was analysed statistically using one-way ANOVA with Tukey's HSD post-hoc tests (p<0.05). Unique prismatic structures generated by abrasion and subsequent pH cycling were imaged using multiphoton excitation microscopy, exploiting strong autofluorescence properties of the enamel without labelling. Z-stacks of treated and equivalent control surfaces were used to generate non-destructively 3-dimensional surface profiles similar to those produced by scanning electron microscopy. RESULTS: There was no significant difference in the step height enamel loss after initial surface air-abrasion compared to the negative control group. However, a significant increase in the step height enamel loss was observed in the alumina air-abraded samples after pH-cycling compared to the negative control (p<0.05). Sodium bicarbonate as well as BAG air-abrasion exhibited similar enamel surface loss to that detected in the negative control group (p>0.05). Surface profile examination revealed a deposition effect across sodium bicarbonate and BAG-abraded groups. CONCLUSION: This study demonstrates the importance of powder selection when using air abrasion technology in clinical dentistry. Pre-treating the enamel surface with alumina air-abrasion significantly increased its susceptibility to acid challenge. Therefore, when using alumina air-abrasion clinically, clinicians must be aware that abrading sound enamel excessively renders that surface more susceptible to the effects of acid erosion. BAG and sodium bicarbonate powders were less invasive when compared to the alumina powder, supporting their use for controlled surface stain removal from enamel where indicated clinically.

Comparative study of radiopacity of resin-based and glass ionomer-based bulk-fill restoratives using digital radiography.

This study investigated the radiopacity values of glass ionomer- and resin-based bulk-fill restoratives of different thicknesses using digital radiography. Two glass ionomer-based and three resin-based bulk-fill restoratives, and a conventional composite were studied. Five disc-shaped specimens were prepared from each of these materials at three different thicknesses; specimens of enamel and dentin with the same thicknesses were also prepared. Materials were placed over a complementary metal oxide-semiconductor sensor together with the tooth specimen and an aluminum step-wedge, and then exposed using a dental X-ray unit. The images were analyzed using a software program to measure the mean gray values (MGVs), which were converted to equivalent aluminum thicknesses. Two-way ANOVA was used to investigate the significance of differences among the groups. The GCP Glass Fill specimens showed the lowest radiopacity values, and the Quixfil specimens had the highest values. All materials had higher radiopacity values than enamel and dentin, except for GCP Glass Fill, which had a radiopacity similar to that of enamel. The resin-based bulk-fill restoratives had significantly higher radiopacity values than glass ionomer-based restoratives. All of the tested materials showed radiopacity values higher than that of dentin, as recommended by the ISO.

Brief communication: Comparative patterns of enamel thickness topography and oblique molar wear in two Early Neolithic and medieval population samples.

Enamel thickness has been linked to functional aspects of masticatory biomechanics and has been demonstrated to be an evolutionary plastic trait, selectively responsive to dietary changes, wear and tooth fracture. European Late Paleolithic and Mesolithic hunter-gatherers mainly show a flat wear pattern, while oblique molar wear has been reported as characteristic of Neolithic agriculturalists. We investigate the relationships between enamel thickness distribution and molar wear pattern in two Neolithic and medieval populations. Under the assumption that dietary and/or non-dietary constraints result in directional selective pressure leading to variations in enamel thickness, we test the hypothesis that these two populations will exhibit significant differences in wear and enamel thickness patterns. Occlusal wear patterns were scored in upper permanent second molars (UM2) of 64 Neolithic and 311 medieval subadult and adult individuals. Enamel thickness was evaluated by microtomography in subsamples of 17 Neolithic and 25 medieval individuals. Eight variables describing enamel thickness were assessed. The results show that oblique molar wear is dominant in the Neolithic sample (87%), while oblique wear affects only a minority (42%) of the medieval sample. Moreover, in the Neolithic molars, where buccolingually directed oblique wear is dominant and greatest enamel lost occurs in the distolingual quadrant, thickest enamel is found where occlusal stresses are the most important-on the distolingual cusp. These results reveal a correlation between molar wear pattern and enamel thickness that has been associated to dietary changes. In particular, relatively thicker molar enamel may have evolved as a plastic response to resist wear.

Comparison of Knoop and Vickers surface microhardness and transverse microradiography for the study of early caries lesion formation in human and bovine enamel.

OBJECTIVE: The aims of the present laboratory study were twofold: a) to investigate the suitability of Knoop and Vickers surface microhardness (SMH) in comparison to transverse microradiography (TMR) to investigate early enamel caries lesion formation; b) to compare the kinetics of caries lesion initiation and progression between human and bovine enamel. DESIGN: Specimens (90×bovine and 90×human enamel) were divided into six groups (demineralization times of 8/16/24/32/40/48h) of 15 per enamel type and demineralized using a partially saturated lactic acid solution. SMH was measured before and after demineralization and changes in indentation length (ΔIL) calculated. Lesions were characterized using TMR. Data were analyzed (two-way ANOVA) and Pearson correlation coefficients calculated. RESULTS: ΔIL increased with increasing demineralization times but plateaued after 40h, whereas lesion depth (L) and integrated mineral loss (ΔZ) increased almost linearly throughout. No differences between Knoop and Vickers SMH in their ability to measure enamel demineralization were observed as both correlated strongly. Overall, ΔIL correlated strongly with ΔZ and L but only moderately with the degree of surface zone mineralization, whereas ΔZ and L correlated strongly. Bovine demineralized faster than human enamel (all techniques). CONCLUSIONS: Lesions in bovine formed faster than in human enamel, although the resulting lesions were almost indistinguishable in their mineral distribution characteristics. Early caries lesion demineralization can be sufficiently studied by SMH, but its limitations on the assessment of the mineral status of more demineralized lesions must be considered. Ideally, complementary techniques to assess changes in both physical and chemical lesion characteristics would be employed.

Hierarchical modelling of elastic behaviour of human enamel based on synchrotron diffraction characterisation.

Human enamel is a hierarchical mineralized tissue with a two-level composite structure. Few studies have focused on the structure-mechanical property relationship and its link to the multi-scale architecture of human enamel, whereby the response to mechanical loading is affected not only by the rod distribution at micro-scale, but also strongly influenced by the mineral crystallite shape, and spatial arrangement and orientation. In this study, two complementary synchrotron X-ray diffraction techniques, wide and small angle X-ray scattering (WAXS/SAXS) were used to obtain multi-scale quantitative information about the structure and deformation response of human enamel to in situ uniaxial compressive loading. The apparent modulus was determined linking the external load and the internal strain in hydroxyapatite (HAp) crystallites. An improved multi-scale Eshelby model is proposed taking into account the two-level hierarchical structure of enamel. This framework has been used to analyse the experimental data for the elastic lattice strain evolution within the HAp crystals. The achieved agreement between the model prediction and experiment along the loading direction validates the model and suggests that the new multi-scale approach reasonably captures the structure-property relationship for the human enamel. The ability of the model to predict multi-directional strain components is also evaluated by comparison with the measurements. The results are useful for understanding the intricate relationship between the hierarchical structure and the mechanical properties of enamel, and for making predictions of the effect of structural alterations that may occur due to the disease or treatment on the performance of dental tissues and their artificial replacements.

Detection of artificial demineralization bordering different types of laminate veneers using visual inspection and storage phosphor radiography.

OBJECTIVE: The objective of this study is to compare the diagnostic accuracy of visual inspection (VI) and storage phosphor plate (SPP) radiography for the detection of artificial demineralization bordering different laminate veneers. MATERIALS AND METHODS: Twenty human maxillary canine teeth were prepared. All-ceramic (A) and hybrid ceramic (H) laminate veneers were fabricated and luted. Veneered teeth were covered except for a circular window on the proximal surface bordering restorations. Teeth were kept in acetic acid buffer to create demineralization and imaged with a SPP system. Ten observers evaluated all teeth first visually then with SPP images for the presence/absence of demineralization. Teeth were examined using scanning electron microscopy (SEM) as well. The accuracy was expressed as the area under the ROC curves (A(z)). Pair-wise comparisons were performed using two-way ANOVA and post hoc t test (p = 0.05). Fleiss kappa (κ) was used for agreement. RESULTS: SPP radiography was better than the VI for both veneers (p = 0.004). The A(z)s of two veneers were different for both VI (p < 0.005) and SPP (p < 0.005). SEM evaluation revealed lesions confined to enamel. κ was fair for H, and fair to moderate for A. Agreement was higher for the radiographic evaluation for both veneers. CONCLUSION: Enamel demineralizations bordering hybrid and ceramic laminate veneers can be detected better with SPP radiography than VI and detectability was better for all-ceramic veneers than the hybrid ceramic ones. CLINICAL RELEVANCE: Early detection of enamel demineralizations bordering laminate veneers would result in time-saving and less-invasive treatment methods; therefore, SPP radiography may be recommended in clinically suspicious cases since it provides better diagnostic accuracy.

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.

Ultrasound imagery for dental implant diagnosis and treatment planning in a porcine model.

STATEMENT OF PROBLEM: Currently, there is no commercially available method to provide non-invasive, non-ionizing, real-time imaging of the gingival form and bony architecture of implant sites, before, during, and after implant placement. PURPOSE: The purpose of this study was to demonstrate the feasibility of 2-dimensional (2-D) ultrasound imaging of soft and hard tissues for implant diagnosis and treatment planning. MATERIAL AND METHODS: A sector scanning ultrasound system was applied. Five representative clinical features (implant in an edentulous ridge, single implant tooth replacement, implant dehiscence, tooth dehiscence, and mental foramina) were created or identified in each of the 5 porcine jaws, which were then covered with soft tissue and imaged in an acoustic water tank. RESULTS: All of the 5 model features, in all 5 jaws, were clearly visible with the ultrasound. Most objects were visible over a large range of positions and angles. Each of the features, as well as the soft tissue and bone surfaces, were recognized by specific acoustic signatures, with the same signature recurring for each object type among all 5 of the jaw specimens. All implants were highly reflective and clearly visualized. CONCLUSIONS: A 2-D sector scanning ultrasound system was demonstrated to be capable of imaging representative features for implant treatment planning in a porcine model; these included implants placed in edentulous ridges; implants placed for single tooth replacement; implants with simulated dehiscences; teeth with simulated dehiscences; and mental foramina. Specific acoustic signatures for these features were defined. Qualitative differences between ultrasound and other dental imaging techniques were described.

Assessment of enamel-dentin caries lesions detection using bitewing PSP digital images.

OBJECTIVES: The aim of this study was to evaluate the detection of enamel-dentin occlusal caries using photostimulable phosphor plates. MATERIAL AND METHODS: The ability to detect enamel-dentin occlusal caries in 607 premolars and molars from 47 patients between 10 and 18 years old, referred to the School of Dentistry of the Federal University of Bahia, Brazil, was evaluated based on clinical and radiographic examinations, using the criteria proposed in a previous study. A total of 156 bitewing digital images were obtained using Digora® (Soredex Medical Systems, Helsinki, Finland) phosphor plates. The plates were scanned and the images were captured and displayed on a computer screen. Image evaluation was done using Digora® for Windows 2.1 software, Soredex®. The radiologists were allowed to use enhancement tools to obtain better visibility during scoring of the teeth based on the radiographic criteria proposed in a previous study. Descriptive analysis and chi-squared proportion tests were done at 5% significance level. RESULTS: The results of clinical examination showed a higher prevalence of teeth with a straight dark line or demineralization of the occlusal fissure (score 1) and a lower prevalence of sealed teeth (score 5). In the bitewing digital images, 47 teeth presented visible radiolucency, circumscribed, in dentin under occlusal enamel (enamel-dentin caries lesions). CONCLUSIONS: Correlating the clinical and radiographic findings, it was found that in the majority of teeth diagnosed by radiographic images as having enamel-dentin caries, no caries could be detected by clinical examination.

Laser-induced fluorescence and X-ray spectral analysis of carious process in hard dental tissues.

Morphological and spectral X-ray analysis of carious and noncarious extracted teeth showed the patterns of dentin ossification in caries of different degree. Parietal ectopic ossification of the canal and cavity lumens in stages III and IV dental caries is regarded as a specific structural marker of pathological regeneration. The X-ray spectral analysis showed that the progress of carious process is paralleled by loss of mineral components. Laser-induced fluorescent study of tissues in extracted teeth showed 4 spectral bands corresponding to mineral and protein components of the tooth. The progress of carious process was associated with reduction of the fluorescence intensities of the spectral bands characteristic of dental collagen and mineral components.

Effect of lesion characteristics and mineralizing solution type on enamel remineralization in vitro.

The aim was to study the effect of lesion preparation technique and solution composition on remineralization of artificial lesions in vitro. Lesions were prepared with similar total mineral loss, but different mineral distribution, i.e., low (14.0) or high R (34.8) values. Lesions from both groups were remineralized (10 days, 37 degrees C) in two different solutions, with similar supersaturation with respect to hydroxyapatite (St), but calcium:phosphate ratios representing either hydroxyapatite stoichiometry or plaque fluid (PF). Remineralization was quantified microradiographically, mineral distribution was compared with natural white-spot lesions. Mineral loss and depth decreased significantly, and surface-zone mineral content (Zmax) increased significantly, in all lesions. Overall there was a significant relationship of decreasing remineralization with increasing Zmax, but not within either lesion type. PF was significantly more efficient than St in high-R lesions, with lesions remineralizing almost completely in PF. Remineralization was not significantly different in PF or St for low-R lesions but in high-R lesions, PF was more efficient than St, possibly through differences in relative saturations with respect to different calcium phosphates. Differences in area:solution ratios and baseline Zmax values may also have explained the different response to PF. Low-R lesions were similar to natural white-spot lesions in terms of mineral distribution, whereas high-R were not. Concluding, both lesion and remineralizing solution type had a marked influence on remineralization. It is proposed that use of low-R lesions would be more appropriate where more physiologically relevant mineral distribution is required, whereas high-R lesions would be appropriate for studying inherent remineralizing efficiency.

Effects of a new titanium fluoride derivative on enamel de- and remineralization.

The potential of a new titanium fluoride (TiF) derivative for caries prevention was tested in a pH-cycling model. Daily treatments with various concentrations (100, 250, and 500 p.p.m.) of TiF were compared with similar sodium fluoride (NaF) treatments given at the same pH. Bovine enamel lesions were subjected to 3 wk of pH cycling. The effects were assessed by analyzing calcium uptake and loss in the re- and demineralizing solutions, respectively, and by post pH cycling microradiographic analysis of the lesions. Treatments with NaF reduced calcium loss, enhanced calcium uptake, and induced overall lesion remineralization. Treatments with TiF derivative gradually caused almost complete inhibition of calcium loss and uptake (lesion 'arrestment'), irrespective of the concentration of the TiF derivative. To test the permanence of protection, sound enamel was pretreated with either TiF derivative or NaF, and demineralized for 14 d at pH 4.4 and 4.6. Calcium loss data show that up to 80% inhibition of demineralization could be achieved for the TiF derivative, which was not possible for NaF treatments. This inhibition was obtained through a combination of concentration and number of treatments. The TiF derivative is a promising agent for the prevention of dental caries, especially when aimed at preventing the onset of caries.

Effect of various Ca2+/PO4(3-) concentrations of linseed-based saliva substitutes on enamel in vitro.

Remineralization might be hampered by various polymers used in saliva substitutes. Thus, the present study evaluated the effects of various calcium and phosphate concentrations of linseed-based solutions on the mineral loss of pre-demineralized bovine enamel in vitro. A commercially available saliva substitute (Salinum) based on linseed was tested as well. Enamel specimens were prepared from bovine incisors and embedded in epoxy resin. One-third of each sample was covered with nail varnish (control of sound enamel). After demineralization (37 degrees Celsius; pH 5.0; 14 days) another third of the samples was nail-varnished again. Subsequently, the specimens (n = 10) were exposed to 12 linseed-based solutions (Ca(2+) addition 0-2 mM; PO4(3-) addition 0-3.2 mM) at pH 5.5 and 6.5 as well as to Salinum) for 14 days (37 degrees Celsius). The differences in mineral loss between the values prior to and after the storage in the various solutions were evaluated from microradiographs of thin sections (100 mum). The general linear model revealed a significant dependency for the mineral loss on 'calcium' (P = 0.003), but not on 'pH' (P = 0.397) and 'phosphate' (P = 0.094). Salinum) induced a significant greater mineral loss compared with equivalently saturated solutions (P < 0.05; anova, Bonferroni). The solution with the highest calcium and phosphate concentration showed the greatest mineral gain (P = 0.033; paired t-test). The addition of calcium and phosphate seems to have a positive effect on the remineralizing qualities of linseed-based saliva substitutes.

The Neanderthalian molar from Hunas, Germany.

In this paper, we present a well-preserved isolated human molar found in 1986 in the Hunas cave ruin, south-east Bavaria. The tooth was located at the bottom of layer F2, which belongs to a long stratigraphic sequence comprising faunal remains as well as archaeological levels (Mousterian). A stalagmite from layer P at the base of the stratigraphic sequence was recently dated to 79.373+/-8.237 ka (base) and 76.872+/-9.686 ka (tip) by TIMS-U/Th (Stanford University). We identified the tooth as a right (possibly third) mandibular molar. Characteristic parameters such as crown and root morphology, fissure pattern, enamel thickness, occlusal and interproximal wear, dental dimensions and indices, and radiological features indicate that the Hunas molar represents the tooth of a Neanderthal. This is corroborated by both the palaeontological and archaeological findings (Mousterian) of layer F2.