Evaluation of a novel caries detecting oral rinse.

AIM: LumiCare™ Caries Detection Rinse (LC Rinse), a starch-based rinse, illuminates active initial caries (positive response) using dental curing light, thus augmenting the dentist's visual examination. This clinical study investigated if active caries as assessed by the International Caries Detection and Assessment System (ICDAS) were more likely to have positive LC Rinse response than sound surfaces and inactive caries. METHODS: 25 subjects participated in the study. Caries was assessed on selected teeth and the entire dentition, firstly using ICDAS and then by fluorescence evaluation after LC Rinse application. Data were statistically analyzed using Diagnostic Odds Ratio (OR) and Chi-square test X2 (α = 0.05). Sensitivity (Se), specificity (Sp), and Diagnostic accuracy (DA) were calculated. RESULTS: With selected teeth, active caries were 638.6 times (60.05 with full dentition) more likely to have positive LC Rinse response than sound surfaces and inactive caries combined (X2, p < 0.01) and 191.67 times (18.35 with full dentition) than inactive lesions only (X2, p < 0.01). With combined sound surfaces and inactive caries, Se, Sp, and DA of LC Rinse assessment were 0.94, 0.98, and 0.96 respectively. CONCLUSIONS: LC Rinse can distinguish between active caries, inactive caries and hypomineralization, and can augment caries detection with high sensitivity, specificity, and diagnostic accuracy.

Remineralization of molar incisor hypomineralization (MIH) with a hydroxyapatite toothpaste: an in-situ study.

AIM: This randomized, double-blind, crossover, in-situ study, compared the efficacy of toothpastes based on microcrystalline hydroxyapatite (HAP; fluoride-free) or fluoride, in remineralizing molar incisor hypomineralization (MIH). METHODS: Two lesion-bearing enamel blocks were produced from each of thirty extracted permanent molars diagnosed with MIH. Sixty produced blocks were randomly assigned to two groups (30/group): 20% HAP or 1450 ppm fluoride toothpaste. Each group was subdivided into, etched (n = 20), with lesion surface treated with 32% phosphoric acid-etchant for 5 s, and unetched (n = 10). Blocks were cemented into intra-oral appliances (2 blocks/appliance) worn full-time by 15 subjects. Subjects used the toothpastes in a two-phase crossover manner, lasting 14 days per phase, after one-week washout period. Baseline and post-treatment mineral density (MD) was quantified using microcomputed tomography. RESULTS: Overall, both groups showed statistically significant (paired t-test; p < 0.001) net-gain when MD was compared pre-treatment and post-treatment. HAP: pre-treatment (1.716 ± 0.315) and post-treatment (1.901 ± 0.354), Fluoride: pre-treatment (1.962 ± 0.363) and post-treatment (2.072 ± 0.353). Independent t-test demonstrated a practically significantly (≥10%) higher percentage remineralization with HAP toothpaste (26.02 ± 20.68) compared with fluoride toothpaste (14.64 ± 9.60). Higher percentage remineralization was observed in etched than unetched samples. CONCLUSION: The tested toothpaste based on hydroxyapatite can remineralize MIH lesions. Pre-treating the tooth surface with acid-etchant enhanced remineralization.

Monitoring erosive tooth wear with intraoral 3D scanner: A feasibility study.

PURPOSE: To evaluate in vitro the potential of an intraoral scanner (IOS) to monitor erosive tooth wear (ETW) using different alignment software with distinct quantitative measurement metrics. METHODS: 15 unpolished bovine crowns were exposed to citric acid (pH ~2.5) at 24-hour intervals up to 168 hours. At baseline and after each acid exposure episode, the teeth were scanned with IOS (3Shape TRIOS 3). Scanned images from each data point were superimposed on baseline image using WearCompare software to obtain volume loss (mm³) and area loss (mm²) and using IOS built-in software (3Shape TRIOS Patient Monitoring) to obtain depth loss (mm). Pearson's test was used to determine the correlation between acid exposure time (h) and each outcome measure (α= 0.05). RESULTS: As the acid exposure time increased, the lesion parameters (depth, volume, and area) increased. Friedman's test showed that relative to baseline volume loss became significant (P< 0.05) after 72 hours from median 11.48 mm³ (IQI 25% = 8.72 mm³), eroded area became significant (P< 0.05) from median 48.67 mm² (IQI 25% = 44.46 mm², P< 0.05) after 96 hours, and erosion depth became significant (P< 0.05) from median 0.69 mm (IQI 25% = 0.66 mm²) after 144 hours. A strong correlation was observed between depth (mm²) and time (r= 0.9993 P< 0.0001), volume (mm³) and time (r= 0.9968, P< 0.0001), and area (mm²) and time (r= 0.9475, P= 0.0003). CLINICAL SIGNIFICANCE: Currently, there is no quantitative method for clinical monitoring of erosive tooth wear. The present study demonstrated that the intraoral scanner is a potential clinical tool for detecting and quantitatively monitoring early and advanced erosive tooth wear.

The Potential of Hydroxyapatite Toothpaste to Prevent Root Caries: A pH-Cycling Study.

PURPOSE: The effectiveness of a hydroxyapatite (HAP) toothpaste and a fluoride toothpaste in preventing root tissue demineralization (root caries) was compared using an established pH-cycling caries model. MATERIALS AND METHODS: Sixty dentin blocks were produced from the root tissue of extracted human teeth and were assigned to 3 test groups (n=20/group): 10% hydroxyapatite toothpaste (HAP), 1450 ppm fluoride toothpaste (fluoride), and artificial saliva (artsaliva). Early root caries lesions were developed in each sample by 7-day demineralization using a pH-cycling caries model. The daily cyclic treatment regimen consists of two 2-minute toothpaste-slurry treatment periods, one 6-hour acid challenge using acidified gel (pH 4.5), and then storage in remineralizing solution (artsaliva) for the rest of the time. Demineralization was assessed as the amount of mineral loss (∆z) using transverse microradiography (TMR). Pairwise comparisons (between treatments) were performed using analysis of variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if p<0.05. RESULTS: Both ANOVA and Tukey's HSD indicated no significant (ANOVA; n=20) difference in mean ∆z among the groups, with least ∆z (±Sd) in the HAP (1117±366) compared to fluoride (1392±334) and artsaliva (1406±223). Relative to control, HAP and fluoride inhibited root demineralization by 21% and 6%, respectively. CONCLUSION: Within the limit of the present study, the tested toothpaste containing 10% HAP is an effective root caries control toothpaste. Toothpaste containing 10% HAP was slightly more effective in preventing tooth demineralization than 1450 ppm fluoride provided as sodium fluoride. Thus, this study shows that HAP toothpastes can serve as an effective alternative to fluoride toothpastes for root caries management.