Salivary, acidic and enzymatic degradation of resin composite subjected to different finishing and polishing systems.

PURPOSE: To evaluate the effect of different finishing and polishing systems on the surface roughness of a resin composite subjected to simulated saliva-, acid-, and enzyme-induced degradation. METHODS: 160 specimens (n= 40) were fabricated with Filtek Z350 XT nanofilled composite and analyzed for average surface roughness (Ra). The specimens were finished and polished using: AD - Al2O3-impreginated rubberized discs (medium, fine, and superfine grit, Sof-Lex); SD - silicon carbide and Al2O3-impregnated rubberized discs (coarse, medium and fine grit, Jiffy,); MB - 12- and 30-multiblade burs. The control group (CT) (n= 40) comprised specimens with a Mylar-strip-created surface. Specimens from each group were immersed in 1 mL of one of the degradation methods (n= 10): artificial saliva (ArS: pH 6.75), cariogenic challenge (CaC: pH 4.3), erosive challenge (ErC: 0.05M citric acid, pH 2.3) or enzymatic challenge (EzC: artificial saliva with 700 µg/mL of albumin, pH 6.75). The immersion period simulated a time frame of 180 days. Ra measurements were also performed at the post-polishing and post-degradation time points. The data were evaluated by three-way ANOVA for repeated measures and the Tukey tests. RESULTS: There was significant interaction between the finishing/polishing system and the degradation method (P= 0.001). AD presented the greatest smoothness, followed by SD. After degradation, CT, AD and SD groups became significantly rougher, but not the MB group, which presented no difference in roughness before or after degradation. CT and AD groups showed greater roughness in CaC, ErC and EzC than in ArS. The SD group showed no difference in roughness when the specimens were polished with CaC, EzC or ArS, but those treated with ErC had greater roughness. In the MB group, the lower roughness values were found after using CaC and EzC, while the higher values were found using ErC or ArS. CLINICAL SIGNIFICANCE: As far as degradation resistance of nanofilled composite to hydrolysis, bacterial and dietary acids and enzymatic reactions is concerned, restorations that had been finished and polished with Al2O3-impregnated discs had the smoothest surfaces.

Risk indicators for the severity of erosive wear in deciduous dentition of Mexican schoolchildren aged 5 to 7 years.

The objective of this work was to estimate the prevalence and severity of erosive tooth wear (ETW), and to identify risk indicators of deciduous dentition of a group of schoolchildren from public schools in Tlalnepantla de Baz, State of Mexico. A cross-sectional study was carried out in 352 schoolchildren from 5 to 7 years old. The severity of the ETW was evaluated using the Basic Erosive Wear Examination (BEWE). Risk indicators were evaluated through a survey which included food and beverage consumption, consumption habits, vitamin C consumption, gastroesophageal reflux, heartburn, belching, xerostomia, vomiting and teeth grinding. Multinomial logistic regression models were fitted. The prevalence of ETW was 99.7% (n = 351). Regarding severity, 46.6% were at a null/mild level, 27.3% moderate, and 26.1% severe. Males were more likely to present severe ETW (odds ratio (OR) = 2.23, 95% confidence interval (CI), 1.27-3.93; p = 0.005). The risk indicators for the severity of ETW were the frequent consumption of citrus fruits (OR = 2.09, 95% CI, 1.12-3.89; p = 0.021), fruit juice (OR = 1.99, 95% CI, 1.06-3.75; p = 0.033), processed beverages (OR = 2.15, 95% CI, 1.23-3.78; p = 0.008) and hot sauce (OR = 1.82, 95% CI, 1.03-3.20; p = 0.036). The prevalence of ETW in the deciduous dentition was very high (99.7%) and ~1/3 for severe ETW. The dietary factors associated with severe ETW are part of the regular consumption of Mexican school-age children, which impact their oral health condition. It is important to establish intervention strategies from the infant stage, focused on both children and their caregivers.

Effect of different brushing parameters on erosive tooth wear in primary bovine enamel and dentin.

This in-vitro study aimed to analyse the effect of brushing and different brushing parameters (kind of toothpaste, kind of toothbrush, brushing force) on erosive tooth wear of primary bovine enamel and dentin. Specimens were prepared from primary bovine enamel or dentin (each group n = 12) and cyclically eroded (6 × 60 s/d, citric acid, pH 2.4) and brushed with children's toothbrushes (2 × 15 s/d) over 5 days. The brushing parameters under investigation were: toothpaste (fluoridated, fluoride-free), toothbrush (manual; rotating-oscillating and sonic, each at two different activation modes) and brushing force (1 N, 2 N). Specimens that were only eroded and not brushed served as controls. Enamel and dentin wear was quantified using widefield confocal microscopy. Statistical analysis was performed using three- and one-way ANOVAs followed by Scheffe's (enamel) or Tamhane's (dentin) post-hoc tests (p < 0.05). Brushing with the fluoridated toothpaste was able to significantly reduce erosive wear in enamel (by 15 to 37%, 6 of 10 groups) and in dentin (by 58 to 72%, all groups), while brushing with the fluoride-free toothpaste was not different from the controls. Considering the kind of toothpaste and brushing force, slight differences between the toothbrushes were observed in enamel, but not in dentin. Within the same toothbrush and activation mode, almost no differences between 1 and 2 N brushing force were detected. In conclusion, erosive tooth wear on primary bovine dental hard tissue mainly depends on the kind of toothpaste, rather than on the kind of toothbrush and the brushing force.

Prevention and management of dental erosion and decay.

The 2017 Global Disease Study revealed 2.3 billion untreated cavities and 139 million other oral conditions like dental erosion. Modern treatments prioritise controlling etiological factors and preventing related diseases. This Editorial invites researchers to contribute to the collection, 'Prevention and management of dental erosion and decay'.

The erosive effect of pomegranate juice on enamel: An in vitro study.

AIM: Dental erosion is a chemical-mechanical process that leads to the loss of dental hard tissues. This study aimed to investigate the effect of pomegranate juice on the enamel. METHODS: Enamel blocks were randomly divided into three groups: deionized water, cola, and pomegranate juice. The blocks were immersed in the solutions four times a day for 14 days, and stored in artificial saliva for the remaining period. The surface hardness was measured on days 7 and 14. The surface structures of the demineralized blocks were observed via scanning electron microscopy (SEM), and the depth of demineralization was observed via confocal laser scanning microscopy (CLSM). The pH, calcium, and phosphorus levels of the three solutions were analyzed. RESULTS: The microhardness values of the blocks in the pomegranate juice and cola groups decreased with the increase in the demineralization time. The blocks in the pomegranate juice group exhibited large fractures in the enamel column, whereas those in the cola group had pitted enamels with destruction of the interstitial enamel column. Compared with cola group, fluorescent penetration increased in pomegranate juice (P < 0.01). The pH of cola (2.32 ± 0.09) was lower than that of pomegranate juice (3.16 ± 0.16). Furthermore, the calcium content in pomegranate juice was significantly higher than that in cola (P < 0.01). Alternatively, the concentration of phosphorous in cola was significantly higher than that in pomegranate juice (P < 0.01). CONCLUSION: These findings indicate that pomegranate juice can cause enamel demineralization with an erosive potential comparable to that of cola.

Protective effect of various toothpastes and mouthwashes against erosive and abrasive challenge on eroded dentin: an in vitro study.

The study aimed to compare various toothpastes and mouthwashes on permanent tooth dentin after erosive and abrasive challenges. 130 sound premolars dentin were randomly submitted to an initial erosive challenge and a cycle of erosive and abrasive challenges for five days. The five experimental groups (n = 26) were: (1) Control group (artificial saliva), (2) Elmex erosion protection toothpaste and mouthwash, (3) Vitis anticaries biorepair toothpaste and mouthwash, (4) Oral B Pro-expert toothpaste and Oral B Fluorinse mouthwash, and (5) MI Paste ONE toothpaste and Caphosol mouthwash. Microhardness, surface roughness values, and the topographical characteristics of the dentin surface were assessed. The highest percentage of recovered dentin microhardness (%RDMH) value was observed in groups 2 and 4, followed by groups 5 and 3, respectively. The %RDMH values in groups 2 and 4 did not demonstrate a significant difference (p = 0.855). The highest percentage of improvement in surface roughness was recorded in groups 2 and 4, with no significant differences (p = 0.989). The atomic force microscopy (AFM) findings were consistent with the surface roughness data. The best recovery of dentin microhardness and roughness were measured with the Elmex and Oral B toothpaste and mouthwash, followed by MI Paste ONE toothpaste and Caphosol mouthwash and Vitis anticaries biorepair toothpaste and mouthwash.

Low-fluoride gels supplemented with nano-sized sodium trimetaphosphate reduce dentin erosive wear in vitro.

OBJECTIVE: The study assessed the effect of low-fluoride gels supplemented with micrometric or nano-sized sodium trimetaphosphate (TMP) on dentin erosive wear in vitro. DESIGN: Bovine dentin blocks (n = 154) were selected by surface microhardness and randomly allocated into seven groups (n = 22/group), according to the gels: Placebo; 4500 ppm F (4500F); 9000 ppm F (9000F); 5% TMP microparticulate plus 4500F (5TMPm+4500F); 2.5% TMP nanoparticulate plus 4500 F (2.5TMPn+4500F); 5% TMP nanoparticulate plus 4500F (5TMPn+4500F); and 12,300 ppm F acid gel (APF). All blocks were treated only once for 60 s and cyclically eroded (ERO, citric acid, 4 × 90 s/day) or eroded and brushed (4 × 15 s/day, five strokes/s, ERO+ABR) over five days (each subgroup n = 11). Dentin wear and integrated hardness loss in depth (ΔKHN) were determined, and the data were submitted to two-way ANOVA, followed by Tukey's test, and Spearman's correlation (p < 0.05). RESULTS: For ERO, all gels containing 4500F supplemented with TMP significantly reduced dentin wear compared with their counterpart without TMP, reaching values similar to 9000F. For ERO+ABR, 5TMPn+ 4500F gel led to significantly lower wear than all its counterparts, reaching values similar to 9000F and APF. As for ΔKHN, all gels containing TMP promoted superior protective effects compared with 4500F, reaching values similar to 9000F and APF under both challenges. A positive correlation between dentin wear and mineral content in depth was verified. CONCLUSIONS: Gels containing 4500F supplemented with TMP significantly reduced dentin erosive wear compared with pure 4500F, with additional benefit from the use of nanoparticles.

Toothpaste containing TiF4 and chitosan against erosive tooth wear in situ.

OBJECTIVE: This study compared the protective effect of an experimental TiF4/Chitosan toothpaste with a commercial toothpaste on the prevention of erosive tooth wear (ETW) in situ. METHODS: Fifteen subjects took part in this crossover and double-blind study, in which they wore a palatal appliance containing 4 bovine enamel and 4 dentin in 3 phases (5 days each). Half of the samples were subjected to erosive challenges (90 s in 0.1 % citric acid, pH 2.5, 4 times/day), and the other half to erosive plus abrasive challenges (15 s plus 45 s of contact, 2 times/day). The phases corresponded to the application of the different toothpastes: 1) TiF4 (1400 ppm F-) plus Chitosan, 2) Elmex®, Erosion Protection (1400 ppm F-, Chitosan), and 3) Placebo (negative control). Tooth wear was measured using contact profilometry (µm) and submitted to two-way RM ANOVA/Tukey test (p < 0.05). RESULTS: No significant differences were detected between the experimental and commercial toothpastes, regardless of the challenge on both tissues. Both significantly reduce ETW compared to negative control (p < 0.0006). Tooth wear was increased by brushing only on eroded enamel (p < 0.01), but not on dentin (p = 0.6085). TiF4/Chitosan [erosion 2.98 ± 1.12 µm vs. erosion and abrasion 3.12 ± 1.33 µm] and Elmex® toothpastes [erosion 2.35 ± 0.93 µm vs. erosion and abrasion 2.98 ± 1.0 µm] minimized the impact of brushing compared to placebo on enamel [erosion 4.62 ± 1.48 µm vs. erosion and abrasion 5.15 ± 1.50 µm]. CONCLUSIONS: TiF4 plus chitosan toothpastes showed to be effective in minimizing the ETW as the commercial toothpaste is in situ. CLINICAL RELEVANCE: The experimental toothpaste has similar effect against ETW compared to the commercial toothpaste. Considering the increased ETW prevalence worldwide, this result supports clinical trials and a possible application of this experimental anti-erosive toothpaste in the future.

In vitro effect of fluoride gels supplemented with nano-sized sodium trimetaphosphate on enamel erosive wear.

OBJECTIVE: To assess the protective effect of fluoride (F) gels supplemented with micrometric or nano-sized sodium trimetaphosphate (TMPmicro and TMPnano, respectively) against enamel erosion in vitro. METHODS: Bovine enamel blocks (n = 140) were selected according to their surface hardness, and randomly divided into seven groups (n = 20/group), according to the gels tested: Placebo (without F/TMP), 4,500 µg F/g (4500F), 9,000 µg F/g (9000F), 4500F plus 2.5 % TMPnano (2.5 % Nano), 4500F plus 5 % TMPnano (5 % Nano), 4500F plus 5 % TMPnano (Micro 5 %) and 12,300 µg F/g (Acid gel). Blocks were treated once during one minute with the gels, and submitted to erosive (ERO, n = 10/group) or erosive plus abrasive (ERO+ABR, n = 10/group) challenges 4 times/day, for 90 s for each challenge (under reciprocating agitation), during consecutive 5 days. Blocks were analyzed by profilometry, and by surface (SH) and cross-sectional hardness (∆KHN). Data were submitted to two-way ANOVA, and Fisher's LSD test (p < 0.05). RESULTS: For ERO, both TMPnano-containing gels promoted enamel wear significantly lower than Placebo and 4500F, reaching levels similar to both positive controls (9000F and acid gel); significantly lower softening was observed for enamel treated with 4500F+5 % Micro and 4500F+2.5 % Nano. Also, the lowest ∆KHN values were observed for 4500F+2.5 % TMPnano among the TMP-containing gels. For ERO+ABR, the lowest enamel wear was achieved by the use of 4500F+5 % Nano among all gels, including both positive controls; lower softening was observed for Placebo and 9000F groups. CONCLUSION: The addition of 5 % nano-sized TMP to a low-fluoride gel produced superior protective effects for enamel under both challenges conditions, when compared with micrometric TMP, reaching values similar to or superior than both positive controls, respectively for ERO and ERO+ABR. CLINICAL SIGNIFICANCE: The supplementation of low-F gels with TMP was shown to significantly improve their effects on enamel erosive wear, and the use of nano-sized TMP further enhances this protective action.

Preventive dental erosion with silver diamine fluoride: An in vitro study.

OBJECTIVES: To evaluate the erosion preventive effect of 38 % silver diamine fluoride (SDF) solution in enamel and dentin of human permanent teeth. METHODS: Ninety enamel and ninety dentin blocks were prepared from permanent molars and allocated into three groups. Gp-SDF received a one-off application of 38 % SDF solution. Gp-SNF received a one-off application of a solution containing 800 ppm stannous chloride and 500 ppm fluoride. Gp-DW received a one-off application of deionized water. The blocks were submitted to acid challenge at pH 3.2, 2 min, 5 times/day for 7 days. All blocks were immersed in human saliva between cycles for one hour. The crystal characteristics, percentage of surface microhardness loss (%SMHL), surface loss, and elemental analysis and surface morphology were examined by X-ray diffraction (XRD), microhardness test, non-contact profilometry, and energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM), respectively. Data of%SMHL and surface loss were analyzed by one-way ANOVA. RESULTS: XRD spectra revealed that fluorapatite and silver compounds formed in Gp-SDF, while fluorapatite and stannous compounds formed in Gp-SNF. Gp-DW presented only hydroxyapatite. The median (interquartile range) of%SMHL in Gp-SDF, Gp-SNF and Gp-DW were 27.86(3.66), 43.41(2.45), and 46.40(3.54) in enamel (p< 0.001), and 14.21(1.57), 27.99(1.95), and 33.18(1.73) in dentin, respectively (p < 0.001). The mean (standard deviation, µm) of surface loss of Gp-SDF, Gp-SNF, and Gp-DW were 2.81(0.59), 4.28(0.67), and 4.63(0.64) in enamel (p < 0.001) and 4.13(0.69), 6.04(0.61), and 7.72(0.66) in dentin, respectively (p < 0.001). SEM images exhibited less enamel corruption and more dentinal tubular occlusion in Gp-SDF compared to Gp-SNF and Gp-DW. EDS analysis showed silver was detected in Gp-SDF while stannous was detected in the dentin block of Gp-SNF. CONCLUSION: 38 % SDF yielded superior results in protecting enamel and dentin blocks from dental erosion compared to SNF and DW. CLINICAL SIGNIFICANCE: Topical application of 38 % SDF is effective in preventing dental erosion in human enamel and dentin.

Anamnestic risk factors for erosive tooth wear: Systematic review, mapping, and meta-analysis.

OBJECTIVES: Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in permanent dentition. STUDY SELECTION: Observational studies reporting anamnestic risk factors for erosive tooth wear. Methodological quality and risk of bias were assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Risk factors were visually presented in a heatmap, and where possible, random-effects meta-analyses were performed for the odds ratios (ORs) of risk factors. SOURCES: Electronic databases (MEDLINE, Embase, Scopus, and Web of Science) and manual searches in February 2023. The protocol was registered in PROSPERO (CRD4202339776). DATA: A total of 87 publications reporting on 71 studies were included in the systematic review. The studies examined a variety of anamnestic risk factors (n = 80) that were categorized into ten domains (socio-demographics, socio-economics, general health, oral diseases, medication, oral hygiene, food, beverages, dietary habits, and leisure-related risk factors). Meta-analyses revealed significant associations between erosive tooth wear and male gender (padj.<0.001; OR=1.30, 95 % CI: 1.16-1.44), regurgitation (padj.=0.033; OR=2.27, 95 % CI: 1.41-3.65), digestive disorders (padj.<0.001; OR=1.81, 95 % CI: 1.48-2.21), consumption of acidic foods (padj.=0.033; OR=2.40, 95 % CI: 1.44-4.00), seasoning sauces (padj.=0.003; OR=1.28, 95 % CI: 1.13-1.44), nutritional supplements (padj.=0.019; OR=1.73, 95 % CI: 1.28-2.35), and carbonated drinks (padj.=0.019; OR=1.43, 95 % CI: 1.17-1.75). Most included studies exhibited low bias risk. CONCLUSIONS: Observational studies investigated a variety of anamnestic risk factors for erosive tooth wear. Future studies should employ validated questionnaires, particularly considering the most important risk factors. CLINICAL SIGNIFICANCE: Erosive tooth wear is a prevalent condition. Clinicians should concentrate primarily on symptoms of gastroesophageal reflux disease and dietary factors when screening patients at risk for erosive tooth wear.

Clinical performance of preheating thermoviscous composite resin for non-carious cervical lesions restoration: A 24-month randomized clinical trial.

OBJECTIVES: This 24-month, double-blind, split-mouth randomized clinical trial aimed to compare the retention rates of a preheated thermoviscous composite resin (PHT) compared to a non-heated composite resin (NHT) in non-carious cervical lesions (NCCLs). METHODS: A total of 120 restorations were restored on NCCLs using a preheated (VisCalor bulk, Voco GmbH) and a non-heated (Admira Fusion, Voco GmbH) composite resins with 60 restorations per group. A universal adhesive in the selective enamel conditioning was applied. In the PHT group, composite was heated at 68 °C for using a bench heater. In the NHT group, no heating was employed. Both restorative materials were dispensed into caps and inserted into the NCCLs. The restorations were evaluated at baseline, 6, 12, 18, and after 24 months of clinical service using the FDI criteria. Statistical analysis was performed with Kaplan-Meier estimation analysis for retention/fracture rate and Chi-square test for the other FDI parameters (α=0.05). RESULTS: After 24 months 108 restorations were assessed. Seven restorations were lost (two for PHT group and five for NHT group), and the retention rates (95 % confidence interval [CI]) were 96.7 % (81.5-99.9) for PHT group and 90.8 % (81.1-96.0) for NHT group, with no statistical differences between them (p > 0.05). The hazard ratio (95 % CI) was 0.52 (0.27 to 1.01), with no significant difference within groups. In terms of all other FDI parameters that were assessed, all restorations were deemed clinically acceptable. CONCLUSIONS: Both composites showed high rates of retention rates after 24 months. CLINICAL SIGNIFICANCE: The clinical performance of the new preheated thermoviscous was found to be as good as the non-heated composite after 24-month of clinical evaluation in non-carious cervical lesions. REGISTRATION OF CLINICAL TRIALS: RBR-6d6gxxz.

Application of digital technology in the repair of functional and aesthetic defects in patients with acid erosion and severe attrition: a case report.

Noncarious lesions, a multifactorial condition encompassing tooth attrition, abrasion, and erosion, have a surge in prevalence and required increased attention in clinical practice. These nonbacterial-associated tooth defects can compromise aesthetics, phonetics, and masticatory functions. When providing full-arch fixed occlusal rehabilitation for such cases, the treatment strategy should extend beyond by restoring dentition morphology and aesthetics. This report details a complex case of erosive dental wear addressed through a fully digital, full-arch fixed occlusal rehabilitation. A 4D virtual patient was created using multiple digital data sources, including intraoral scanning, 3D facial scanning, digital facebow registration, and mandibular movement tracing. With a comprehensive understanding of the masticatory system, various types of microinvasive prostheses were customized for each tooth, including labial veneers, buccal-occlusal veneers, occlusal veneers, overlays, inlays, and full crowns, were customized for each tooth. The reported digital workflow offered a predictable diagnostic and treatment strategy, which was facilitated by virtual visualization and comprehensive quality control throughout the process.

Sports Diet and Oral Health in Athletes: A Comprehensive Review.

Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20-84%, dental erosion 42-59%, gingivitis 58-77%, and periodontal disease 15-41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes' dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes' health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.

Impact of pH-adjusted fluoride and stannous solutions on the protective properties on the pellicle layer in vitro and in situ.

This study evaluates the ideal pH for anti-erosion and anti-adherent efficacy of fluoride and stannous solutions (sodium fluoride (SF), amine fluoride (AF), sodium monofluorophosphate (SMFP), stannous fluoride (SnF2) with 500 ppm fluoride concentration each and stannous chloride (SnCl2, 1563 ppm stannous)). In vitro, solutions were tested at pH 4.5 and 5.5. The main in situ experiments were carried out at the pH of 4.5: For pellicle formation 6 volunteers wore bovine enamel slabs intraorally for 1 min, rinsed with 8 ml solution for 1 min and continued for up to 30 min/8 h. Physiological pellicle samples served as controls. After incubation in HCl (2.0, 2.3) for 2 min mineral release was determined photometrically. Bacterial counts on 8 h biofilms were determined by fluorescence microscopy (BacLight™ and DAPI with Concanavalin A). Modification of the pellicle ultrastructure was examined by TEM. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney-U tests with Bonferroni-correction (p < 0.05). SnF2 showed a significant erosion protection. AF, SnF2, and SnCl2 were most anti-adherent. SnF2 and SnCl2 caused a pronounced basal pellicle with stannous precipitates. Compared to other fluoride monosubstances, stannous ions offer greater protection against erosive acidic attacks. Stannous ions act as crucial co-factor in this process.

Are S-PRG composites able to resist against erosive and abrasive challenges and protect surrounding enamel in situ?

OBJECTIVES: This study evaluated the resistance of S-PRG (Surface Pre-Reacted Glass-ionomer) composites and other restorative materials against erosive and abrasive challenges and their protective effect on enamel adjacent to the restorations. MATERIALS AND METHODS: Bovine enamel blocks were prepared and randomized into 12 groups, including 6 types of material, each of them subjected to erosion_e or erosion+abrasion_ea: Beautifil II (S-PRG); Beautifil Bulk Restorative (S-PRG); Filtek Z250 XT; Filtek Bulk Fill; EQUIA Forte; Riva Light Cure. Cavities were prepared in the middle of enamel blocks and restored with the materials. Initial profiling measurement was performed on the material and on adjacent enamel (100, 200, 300, 600 and 700 µm from the restoration margin). Palatal intraoral appliances with the restored enamel blocks were used by the volunteers (n = 10). During 5 days appliances were immersed in 2.5 % citric acid for 2 min; 6 × /day (erosion_e). For ea condition, blocks were brushed for 1 min after each acid immersion. Final profile assessment was performed. Data were analysed by two and three way ANOVA followed by Tukey's test (p < 0.05). RESULTS: Material wear: Riva Light Cure showed the highest wear followed by EQUIA Forte and then all resin composites, including the ones with S-PRG (p = 0.000). Enamel wear: there was significant interaction among type of restorative material, wear condition and distance (p = 0.014), enamel around materials showed similar wear (p = 0.983) and the enamel subjected to ea exhibited highest wear (p = 0.000). CONCLUSION: SPRG based composites showed resistance against erosive and abrasive challenges but were not able to protect enamel adjacent to the restorations. CLINICAL SIGNIFICANCE: S-PRG composites exhibit resistance to material wear comparable to resin composites. However, they have shown an inability to effectively protect the adjacent enamel under in situ erosive-abrasive conditions, despite the presence of mineral-loss-preventing ions surrounding materials.

Pilot clinical study to evaluate the efficacy of a professionally delivered high fluoride varnish on erosive tooth wear in an in-situ model.

OBJECTIVES: The aim for this pilot study was to investigate the effect of a sodium fluoride varnish on step height measured by a profilometer from human enamel worn by healthy volunteers with a novel in situ/ex vivo erosion design. METHOD: Healthy volunteers aged 18-70 years wore a palatal splint containing 8 human enamel samples and underwent two 3-day treatment periods for 6 h a day with a varnish containing sodium fluoride at 22,600 ppm and the control with the same ingredients but without fluoride. Each splint contained 4 polished and 4 unpolished samples. The interventions were applied to the surface of the enamel samples in randomised order, removed after 6 h, then immersed ex-vivo in 1 %, pH 2.7 citric acid for 2 min, repeated 4 times a day, over 2 days. Measurements of enamel were assessed blindly by microhardness on day 2 and by non-contact laser profilometry on day 3 for the two treatments. RESULTS: 24 volunteers, 2 males and 22 females aged 27-54 years, were screened and recruited. The delta microhardness, from polished samples removed at the end of day 2, for the control and fluoride treatment was 95.7 (22.9) kgf/mm2 and 123.7 (28.9) kgf/mm2, respectively (p < .005). The mean (SD) step height for the control polished enamel surfaces was 3.67 (2.07) µm and for the fluoride varnish was 1.79 (1.01) µm (p < .0005). The control unpolished enamel surfaces had a mean 2.09 (1.53) µm and the fluoride varnish was 2.11 (1.53) µm but no statistical difference was detected. CONCLUSIONS: The results from this pilot study, utilizing an in-situ model where enamel was exposed to acid over the course of 2 days, demonstrated that a high fluoride varnish containing sodium fluoride at 22,600 ppm prevented erosive wear compared to a control on the polished enamel surfaces. CLINICAL SIGNIFICANCE: Intra-oral study demonstrated that a high fluoride varnish containing sodium fluoride at 22,600 ppm reduced erosive tooth wear.

Characteristics of tin-containing fluoride toothpastes related to erosive tooth wear protection.

OBJECTIVES: To assess the effect of different tin-containing toothpastes on the control of erosive tooth wear in enamel and dentin. METHODS: Enamel and dentin slabs were randomly distributed into 7 experimental groups (n = 10/substrate): C-: negative control (Artificial saliva); AmF (regular fluoridated toothpaste without tin); Sn-1 (SnF2/NaF); Sn-2 (SnF2/NaF/SnCl2); Sn-3 (SnCl2/NaF); Sn-4 (SnF2/SnCl2); Sn-5 (SnCl2/AmF/NaF/chitosan). Specimens were submitted to 5-day erosion-abrasion cycling. Surface loss (SL) was determined with an optical profilometer. Tin deposition on the tooth surfaces and some characteristics of the toothpastes (pH, potentially available F-, %weight of solid particles, and RDA) were also assessed. Data were statistically analyzed (α = 0.05). RESULTS: For enamel, the Sn-2 presented the lowest SL, not differing significantly from AmF, C+, and Sn-3. The SL of these groups was significantly lower than the C-, except for Sn-3. Sn-1 and Sn-4 were also not significantly different from C-. For dentin, C- significantly showed the highest SL values, whilst, Sn-1 presented the lowest SL, not differing significantly from AmF, Sn-2, C+, and Sn-3. There was a significant positive association between enamel SL and the pH and tin deposition. Dentin SL was significantly negatively associated with the %weight of solid particles and RDA. CONCLUSIONS: Most of the tin-toothpastes were able to exhibit some protection against ETW. In this process, the toothpastes characteristics play a role, as lower enamel SL was significantly associated with lower pH values and tin deposition; and lower dentin SL was associated with higher %weight of solid particles and RDA of the toothpastes. CLINICAL SIGNIFICANCE: Tin-containing toothpastes can be used for erosive tooth wear protection, but our study showed that their effect depends on the pH, amount of tin deposition, % weight of solid particles and RDA of the toohpastes.

Dental erosion following clopidogrel administration in a dog: A case-based study.

A 10-year-old neutered male Chihuahua presented with unilateral dental erosion that occurred after several months of oral medications mixed with honey. A pH test was performed on all oral medications administered to the dogs to determine the cause of enamel erosion. Among the medications, the only acidic medication was clopidogrel (pH 2.65). To evaluate the effect of clopidogrel on the tooth surface under the same conditions as in the present patient, an additional preliminary study was designed in which two extracted teeth of another dog were immersed in a clopidogrel-honey mixture or only in honey. After a 3-week soaking of the extracted tooth in the clopidogrel-honey mixture, field-emission scanning electron microscope analysis revealed a rougher surface, whereas energy-dispersive X-ray spectroscopy analysis showed a reduced Ca/C ratio compared to the control tooth. In this case, prolonged exposure of the tooth surface to clopidogrel may be a cause of dental erosion.