A randomised controlled trial to investigate the remineralising potential of Tooth Mousse™ in orthodontic patients.

OBJECTIVE: To investigate the remineralisation of enamel subsurface lesions treated with fluoride toothpaste (1450 ppm) or a combination of fluoride toothpaste in addition to Tooth Mousse™. DESIGN: An in situ, cross-over, randomised controlled trial. SETTING: Orthodontic department at Liverpool University Dental Hospital, UK. PARTICIPANTS: Twelve patients receiving fixed orthodontic treatment. METHODS: Demineralised subsurface enamel lesions were placed in a carrier and attached onto a fixed orthodontic appliance. Interventions were either standard fluoride toothpaste or CPP-ACP paste (Tooth Mousse™) in addition to the fluoride toothpaste. Participants received both interventions in a randomised order. Transverse microradiography analysis was used to compare lesion mineral content profiles. RESULTS: Mineral loss was reduced by 15.4 and 24.6% between the fluoride and CPP-ACP groups, respectively (p = 0.023). Lesion depth was reduced by 1.6 and 11.1% between the fluoride and CPP-ACP groups, respectively (p = 0.037). Lesion width was reduced by 4.5 and 15.3% between the fluoride and CPP-ACP groups, respectively (p = 0.015). CONCLUSIONS: Remineralisation occurred regardless of treatment group allocation. However, the addition of Tooth Mousse™ resulted in a significantly increased remineralisation effect, compared to fluoride alone. Tooth Mousse™ may be beneficial for patients undergoing orthodontic treatment who are at high risk of demineralisation. TRIAL REGISTRATION: Registered on Current Control Trials http://www.controlled-trials.com/ISRCTN04899524.

Quantification of Canine Dental Plaque Using Quantitative Light-Induced Fluorescence.

The aim of this work was to evaluate Quantitative Light-induced Fluorescence (QLF) as an alternative to the established Logan and Boyce method for determining plaque coverage of dogs' teeth. In a series of studies in conscious and anesthetized dogs, QLF showed good intra-photographer repeatability (coefficient of variation [CV] of 7.5% for undisclosed teeth) and inter-photographer reproducibility (CV of 3.2% for undisclosed teeth and 8.5% for disclosed teeth). The QLF software accurately identifies areas of plaque as demonstrated by comparison to the variability of 5 human scorers, manually marking plaque on QLF-acquired images (P = 0.1). There was good agreement with the modified Logan and Boyce method in the percentage reduction in plaque accumulation measured when dogs were fed an oral care chew versus no chew. To see a 15% difference in plaque accumulation, which is considered sufficient by the Veterinary Oral Health Council to differentiate between 2 treatments, a retrospective power analysis (90%) of the data established that only 7 dogs would be required, compared to 19 dogs for the modified Logan and Boyce method. QLF is a reliable method for measuring dental plaque in dogs with the added advantage that it is not subjective and requires fewer animals.

Assessing caries removal by undergraduate dental students using quantitative light-induced fluorescence.

The purpose of this study was to compare detection of enamel and dentinal caries by dental students' and faculty members' visual inspection and by quantitative light-induced fluorescence (QLF). The overall aim was to determine whether QLF is an appropriate technique for use in clinical skills laboratories as a teaching aid for dental undergraduates to detect and assess the removal of enamel and dentinal caries. Sixty students who had no clinical experience with dental caries were asked to select . suitably decayed teeth and mount them in plaster. After recording baseline QLF images, students removed caries according to instructions given by the clinical tutor. On completion of the exercise, the teeth were visually determined to be caries-free by the student, then confirmed by the clinical tutor. A fluorescein in alcohol solution was injected into the cavity for two minutes, rinsed, and dried before QLF images were captured. The images were visually analyzed by two examiners for the presence or absence of caries. From seventy-four images recorded, seventeen were excluded due to exposure of the pulp chamber. The remaining fifty-seven teeth, which by clinical visual examination were judged to be caries-free, were examined using QLF. Fifty-three percent were found to be caries-free, while 47 percent were carious. In this sample of fifty-seven teeth judged to be caries-free by both dental students and faculty members, QLF thus detected caries in almost half of these teeth. These findings suggest that QLF is a useful, noninvasive, nondestructive technique for the detection of caries and can serve as an adjunct to chair-side diagnosis and management of dental caries, which is typically accomplished by visual inspection. QLF may be useful and appropriate as an objective clinical teaching aid for the assessment of dental caries.

Quantification of root caries using optical coherence tomography and microradiography: a correlational study.

PURPOSE: The use of transverse microradiography (TMR) to quantify the amount of mineral lost during demineralization of tooth tissue has long been established. In the present study, the use of an en-face Optical Coherence Tomography (OCT) technology to detect and quantitatively monitor the mineral changes in root caries was investigated and correlated with TMR. MATERIALS AND METHODS: We used an OCT system, developed initially for retina imaging, and which can collect A-scans, B-scans (longitudinal images) and C-scans (en-face images) to quantitatively assess the development of root caries. The power to the sample was 250 microW, wavelength lambda = 850 nm and the optical source linewidth was 16 microm. RESULTS: Both the transversal and longitudinal images showed the caries lesion as volumes of reduced reflectivity. Quantitative analysis using the A-scan (reflectivity versus depth curve) showed that the tissue reflectivity decreased with increasing demineralization time. A linear correlation (r = 0.957) was observed between the mineral loss measured by TMR and the percentage reflectivity loss in demineralized tissue measured by OCT. CONCLUSION: We concluded that OCT could be used to detect incipient root caries, and that the reflectivity loss in root tissue during demineralization, measured by OCT, could be related to the amount of mineral lost during the demineralization.