The effects of re-irradiation on the chemical and morphological properties of permanent teeth.

This study aimed to assess the in vitro effects of re-irradiation on enamel and dentin properties, simulating head and neck cancer radiotherapy retreatment. Forty-five human permanent molars were classified into five groups: non-irradiated; irradiated 60 Gy, and re-irradiated with doses of 30, 40, and 50 Gy. Raman spectroscopy, scanning electron microscopy (SEM), and energy dispersive x-ray spectroscopy (EDS) were employed for analysis. Raman spectroscopy assessed intensity, spectral area, and specific peaks comparatively. Statistical analysis involved Kolmogorov-Smirnov and One-Way ANOVA tests, with Tukey's post-test (significance level set at 5%). Significant changes in irradiated, non-irradiated, and re-irradiated enamel peaks were observed, including phosphate (438 nm), hydroxyapatite (582 nm), phosphate (960 nm), and carbonate (1070 nm) (p < 0.05). Re-irradiation affected the entire tooth (p > 0.05), leading to interprismatic region degradation, enamel prism destruction, and hydroxyapatite crystal damage. Dentin exhibited tubule obliteration, crack formation, and progressive collagen fiber fragmentation. EDX revealed increased oxygen percentage and decreased phosphorus and calcium post-reirradiation. It is concluded that chemical and morphological changes in irradiated permanent teeth were dose-dependent, exacerbated by re-irradiation, causing substantial damage in enamel and dentin.

Optical coherence tomography and gray scale digital analysis as noninvasive techniques for evaluating molar-incisor hypomineralization severity: A comparative study with microcomputed tomography.

Molar-incisor hypomineralization (MIH) is a qualitative defect of dental enamel characterized by demarcated opacities present in permanent first molars and other teeth. It is considered a major clinical challenge in dentistry because it makes affected teeth more susceptible to fractures and dental caries. Its diagnosis is mainly clinical and there are few technological resources that allow for a more accurate diagnosis, especially with respect to the depth of the defect in the dental enamel. In this context, optical coherence tomography (OCT), which is routinely used in ophthalmology, can produce images of the depth of the dental enamel, making it a promising method. In this study, 33 teeth with different MIH severities were evaluated using OCT and microcomputed tomography (microCT). Semi-quantitative methods of grayscale pattern analysis were used to compare images obtained from different severities of MIH with the mineral density obtained through microCT. MicroCT evaluation revealed that hypomineralized enamel had a significantly lower mineral density than intact enamel. However, this difference was not observed between the mild and severe MIH lesions. In the OCT evaluation, significant differences were observed between the intact and hypomineralized enamel, and the gray value comparison provided a method for quantitative differentiation between the two. This study suggests that OCT could be a useful adjunct to traditional diagnostic methods for MIH, offering a noninvasive approach to evaluate enamel defects. RESEARCH HIGHLIGHTS: Combining optical coherence tomography with grayscale digital analysis shows potential as a promising method for diagnosing molar-incisor hypomineralization and assessing its level of severity.

Use of Optical Coherence Tomography for Differential Diagnosis of Severity of Molar Incisor Hypomineralization (MIH).

Purpose: To evaluate descriptively and quantitatively teeth affected by enamel hypomineralization (EH) using optical coherence microtomography (OCT). Methods: Twenty teeth were classified according to the European Academy of Pediatric Dentistry's molar incisor hypomineralization (MIH) index and separated into groups according to the degree of EH severity. For each tooth, scans were performed on both the affected and the non-affected areas, and their corresponding optical images were captured. Results: In the qualitative analyses, in most of the images bright lines were observed in relation to the enamel surface and a high level of photon scattering immediately below the enamel surface. This showed that the shading distribution can be identified as hypomineralized areas in which the scattering signal can be used as a diagnostic criterion. In the quantitative analyses, Tukey's test was performed to evaluate the means of the optical attenuation coefficient, which did not present significant differences. However, considering the correlation, homogeneity and contrast analyses, a statistically significant difference was observed between the groups. The group with severe MIH showed greater homogeneity and correlation, but less contrast. Conclusion: Currently, MIH has its severity measured by essentially clinical means. OCT processing techniques reveal advances in the diagnostic imaging of MIH, showing that image texture analysis can be a promising and useful method to aid in its diagnosis.

Chemical and morphological changes of femtosecond laser-irradiated enamel using subablative parameters.

Chemical composition of dental enamel has a great relationship with the prevention of caries. The objective of the present work was to evaluate the chemical and morphological changes of femtosecond laser-irradiated enamel with subablative parameters using Raman spectroscopy, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM). Bovine incisor teeth were used to obtain 30 enamel specimens (5 × 5 mm2 ). The chemical composition of the control sample was analyzed by Raman spectrometry to acquire the absorption spectrum, delimiting the areas under the carbonate and phosphate bands. This analysis was used to evaluate the change in the chemical composition of the sample after irradiation. The specimens were irradiated (IRR) with a Ti:Sapphire laser system (pulsed and focused modes, femtosecond regime 70 fs, average power of 1 W and exposure time of 15 s). After irradiation, the areas under the carbonate and phosphate absorption bands were delimited in each specimen. Raman spectrometry data were analyzed using Student's t-test (α = 5%). By comparing the spectra of the IRR and non-irradiated (NI) specimens, the results showed a significant increase in the area value for the phosphate peaks and a significant reduction in the area value for the carbonate peak and the carbonate:phosphate ratio. CLSM and SEM analyses did not reveal structural alterations in the subsurface nor morphological alterations in the IRR enamel surface, respectively. It was concluded that femtosecond laser irradiation using subablative parameters reduced the carbonate content and the carbonate/phosphate ratio without altering the structure and morphology of the dental enamel.

Advanced Glycation Endproducts as Biomarkers for Risk of Diabetes and Cardiovascular Diseases by Skin Autofluorescence: A Noninvasive Optical Screening.

Objective: The aim of this research is to study skin autofluorescence and the associations between skin glycated proteins and clinical characteristics of healthy and unhealthy subjects for noninvasive screening of diabetes and cardiovascular disease (CVD) risks. Background data: Accumulated advanced glycation endproducts (AGEs) promote increased oxidative stress and inflammation, as well as cross-linking of proteins leading to tissue damage and several diseases, including diabetes. Materials and methods: One hundred and four subjects with or without diabetes and stroke aged 20-80 years and with Fitzpatrick skin type (I to IV) participated in this study. The fluorescence spectrometer was used to illuminate a skin surface of 1 cm2. The skin of forearm was positioned on the spectrometer to assess skin AGEs. Anthropometric data and body composition also were evaluated. Results: Elevated skin autofluorescence was found in subjects >50 years old, as well as in patients with insulin resistance (IR), diabetes, and stroke. There was a positive correlation between the skin autofluorescence and age (r = 0.7, p = 0.0001), body mass index (BMI) (r = 0.5, p = 0.001), body fat (r = 0.5, p = 0.0001), waist circumference (r = 0.45, p = 0.001), and systolic blood pressure (BP) (r = 0.45, p = 0.0001). Conclusions: Elevated skin autofluorescence can provide a noninvasive screening of diabetes and CVD risks.