Comparing the remineralization potential of undemineralized dentin powder versus chicken eggshell powder on artificially induced initial enamel carious lesions: an in-vitro investigation.

BACKGROUND: White spot lesions are a widespread undesirable effect, especially prevalent during fixed orthodontic treatments. The study compared the in vitro enamel remineralization potential of undemineralized dentin matrix (UDD) versus chicken eggshell powder (CESP) for artificially induced enamel lesions. METHODS: 100 caries-free and sound maxillary premolars were randomly divided into four groups each contain 25 teeth: Group I (Baseline): No treatment was done to the enamel surface. Group II (Negative control ): The enamel surface of the teeth underwent demineralization using demineralizing solution to create artificial carious lesions then kept in artificial saliva. Group III (CESP treated): After demineralizing the tooth surface, the teeth have been suspended in the CESP remineralizing solution. Group IV (UDD treated): After enamel demineralization, the teeth were suspended in UDD remineralizing solution. The remineralization potential was assessed by Vickers microhardness testing, scanning electron microscopic examination (SEM), and energy dispersive X-ray (EDX). RESULTS: The current study demonstrated an increase in the mean microhardness of CESP and UDD-treated groups; however, It was nearer to the baseline level in the UDD group. SEM imaging revealed greater enamel remineralization in the UDD group compared to the remaining groups. The UDD group disclosed complete coverage for the prismatic enamel compared to the CESP group, which revealed a partially remineralized enamel surface. Interestingly, the Ca/P ratio increased significantly in the CESP group compared to the negative control group. In contrast, a higher significant increase in the mean Ca/P ratios was recorded in the UDD group compared to the test groups. CONCLUSION: biomimetic UDD and CESP powder should be utilized to treat enamel early carious lesions. However, UDD demonstrated the most significant remineralization potential.

Evaluation of REFIX Technology on the Remineralization of Artificial Early Enamel Caries Lesion by Laser Speckle Tracking Analysis.

OBJECTIVE: To assess the effectiveness of the REFIX technology in the remineralization process of initial caries simulated on bovine enamel. The assessment involved the analysis of backscatter intensity, which was determined from laser speckle images. METHOD: Twenty-one bovine teeth were divided into three groups: G1 and G7 were submitted to treatment with the REFIX technology for 1 and 7 days, respectively. The control group was treated with deionized water. RESULTS: A significant difference in backscatter was found between the carious and sound areas in all groups (p = 0.0038, p < 0.0001, and p = 0.0002 for the control group, G1, and G7, respectively). The intergroup comparison revealed no significant difference among the groups studied. CONCLUSION: REFIX technology did not alter the optical properties of the samples of bovine teeth with simulated initial caries lesions after 1 and 7 days of treatment.

Investigation of the effect of Tideglusib on the hydroxyapatite formation, crystallinity and elasticity of conditioned resin-dentin interfaces.

OBJECTIVES: To investigate the effect of dentin infiltration with polymeric nanoparticles (NPs) doped with tideglusib (TDg) (TDg-NPs) on hydroxyapatite formation, crystallinity and elasticity of conditioned resin-dentin interfaces. METHODS: Dentin conditioned surfaces were infiltrated with NPs or TDg-NPs. Bonded interfaces were created, stored for 24 h and submitted to mechanical and thermal challenging. Resin-dentin interfaces were evaluated through nanoindentation to determine the modulus of elasticity, X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-filed imaging. RESULTS: TDg-NPs provoked peaks narrowing after the diffraction-intensity analysis that corresponded with high crystallinity, with an increased modulus of Young after load cycling in comparison with the samples treated with undoped NPs. New minerals, in the group of TDg-NPs, showed the greatest both deviation of line profile from perfect crystal diffraction and dimension of the lattice strain, i.e., crystallite, grain size and microstrain and 002 plane-texture. The new minerals generated after TDg-NPs application and mechanical loading followed a well defined lineation. Undoped NPs mostly produced small hydroxyapatite crystallites, non crystalline or amorphous in nature with poor maturity. CONCLUSIONS: Tideglusib promoted the precipitation of hydroxyapatite, as a major crystalline phase, at the intrafibrillar compartment of the collagen fibrils, enabling functional mineralization. TDg-NPs facilitated nucleation of crystals randomly oriented, showing less structural variation in angles and distances that improved crystallographic relative order of atoms and maturity. Nanocrystals inducted by TDg-NPs were hexagonal prisms of submicron size. Thermal challenging of dentin treated with TDg-NPs have provoked a decrease of functional mineralization and crystallinity, associated to immature hydroxyapatite. CLINICAL SIGNIFICANCE: New polycrystalline lattice formation generated after TDg-NPs infiltration may become correlated with high mechanical performance. This association can be inferred from the superior crystallinity that was obtained in presence of tideglusib. Immature crystallites formed in dentin treated with undoped NPs will account for a high remineralizing activity.

A Bifunctional Lactoferrin-Derived Amyloid Coating Prevents Bacterial Adhesion and Occludes Dentinal Tubules via Deep Remineralization.

Dentin hypersensitivity (DH) manifests as sharp and uncomfortable pain due to the exposure of dentinal tubules (DTs) following the erosion of tooth enamel. Desensitizing agents commonly used in clinical practice have limitations such as limited depth of penetration, slow remineralization and no antimicrobial properties. To alleviate these challenges, our study designed a lactoferrin-derived amyloid nanofilm (PTLF nanofilm) inspired by the saliva-acquired membrane (SAP). The nanofilm utilises Tris(2-carboxyethyl)phosphine (TCEP) to disrupt the disulfide bonds of lactoferrin (LF) under physiological conditions. The PTLF nanofilm modifies surfaces across various substrates and effectively prevents the early and stable adhesion of cariogenic bacteria, such as Streptococcus mutans and Lactobacillus acidophilus. Simultaneously, it adheres rapidly and securely to demineralized dentin surfaces, facilitating in-situ remineralization of HAP through a simple immersion process. This leads to the formation of a remineralized layer resembling natural dentin, with an occlusion depth of dentinal tubules exceeding 80 µm after three days. The in vivo and vitro results confirm that the PTLF nanofilm possesses good biocompatibility and its ability to exert simultaneous antimicrobial effects and dentin remineralization. Accordingly, this innovative bifunctional PTLF amyloid coating offers promising prospects for the management of DH-related conditions. STATEMENT OF SIGNIFICANCE: We design a simple, fast, inexpensive, and easy-to-process PTLF nanofilm for nearly any material surface or shape. The PTLF nanofilm modifies surfaces across various substrates and effectively prevents the adhesion of cariogenic bacteria, such as Streptococcus mutans and Lactobacillus acidophilus. The abundant functional groups on the surface of PTLF nanofilm facilitate bioactive hydroxyapatite (HAP) formation and maintain stability at the HAP remineralization interface.

A pH-sensitive, renewable invisible orthodontic aligners coating manipulates antibacterial and in situ remineralization functions to combat enamel demineralization.

During invisalign treatment, as salivary proteins or glycoproteins fill the space between the teeth and the aligners, they can easily adhere to the teeth, forming an acquired cellular film on which bacteria are highly susceptible to colonizing, which in turn leads to the development of enamel white staining lesions (WSLs), one of the major complications of orthodontic treatment. Inhibiting the activity of cariogenic bacteria while promoting the remineralization of demineralized enamel is the key to preventing and treating WSLs. Currently, the drug commonly used in clinical practice for the treatment of WSLs is silver diamine fluoride, which, although it has both antimicrobial and remineralizing effects, suffers from problems such as pulpal irritation and tooth discoloration. In this study, based on the principle of coordination chemistry, copper ions and plant polyphenol tannins were assembled on invisible orthodontic aligners to form a metal-phenol network coating (TA-Cu MPNs), and zwitterionic sulfonamethyldopamine was introduced for bionic mineralization to obtain the multifunctional coating TA-Cu MPNs@ZDS@CaP (TZC). The coating exhibits acid-responsive release of Ca2+ and PO4 3-, and the decomposed CaP layer can be regenerated by a simple dipping method. The TZC coating strongly inhibits common cariogenic bacteria and their biofilms. In addition, the results of the in vitro mineralization experiment show that TZC-coated invisible orthodontic aligner treatment of demineralized enamel has significant remineralization effects. It is worth mentioning that the constructed coating has a durable antibacterial effect and can meet the service cycle of invisible orthodontic aligners. This study provides theoretical and experimental bases for the prevention or treatment of WSLs in invisible orthodontic treatment.

Remineralizing effect of NSF on artificial enamel caries.

INTRODUCTION: Nanotechnology offers new approaches and endless opportunities for remineralizing tooth decay without being toxic or causing allergies. This study aimed to determine the effect of nanosilver fluoride (NSF) on the remineralization potential of enamel caries-like lesions compared to 5% sodium fluoride varnish in permanent teeth. METHODS: Fifteen teeth (molars and premolars) were gathered, cleaned, and polished using a scaler. After sectioning the teeth mesiodistally and removing the roots, the thirty specimens were subjected to a demineralized solution to induce early enamel lesions and then assigned randomly into two equal groups. The test materials were applied, and then all the specimens were subjected to a pH cycling model for 30 days. DIAGNOdent and surface roughness were investigated, and an evaluation of the enamel Ca and P weight% for Ca/P ratio calculation was done using SEM-EDX to analyze the specimens at the end of the study. The data were analyzed using an independent t-test. RESULTS: The mean values for the DIAGNOdent measurements for NSF and NaF at baseline and after demineralization were not significantly different (p > 0.05). After treatment, NaF varnish showed a significantly higher mean DIAGNOdent measurement (11.8 ± 5.80) than NSF (4.7 ± 1.6). The mean surface roughness of the NaF group (1.64 ± 0.39) was much higher than NSF's mean surface roughness (1.07 ± 0.21). Specimens treated with NSF had statistically significant smoother surfaces (p < 0.001). The NSF group had a higher mean Ca/P ratio (2.9 ± 0.35) than NaF (2.2 ± 0.11). This difference was statistically significant (p = 0.012). CONCLUSION: The study reveals that nano silver fluoride is a more effective treatment than sodium fluoride varnish in enhancing teeth's clinical characteristics, particularly in terms of mineral content and surface roughness, suggesting it could be an improved strategy to prevent dental caries and maintain enamel integrity.

Assessing the impact of different Urushiol primer solvents on dentin remineralization and bond strength.

OBJECTIVES: To investigate urushiol's potential as a dentin cross-linking agent, promoting remineralization of etched dentin and preventing activation of endogenous proteases causing collagen degradation within the hybrid layer. The goal is to improve bond strength and durability at the resin-dentin interface. METHODS: Urushiol primers with varying concentrations were prepared using ethanol and dimethyl sulfoxide (DMSO) as solvents. Dentin from healthy molars underwent grinding and acid etching for 15 s, followed by a 1min application of urushiol primer. After 14 and 28 days of remineralization incubation and remineralization were used to assess by Attenuated Total Reflection Fourier Transform Infrared spectroscopy (ATR-FTIR), Micro-Raman spectroscopy, X-ray Diffraction (XRD), Atomic Force Microscopy (AFM), Vickers Hardness, Scanning Electron Microscopy (SEM), and Energy X-ray dispersive spectroscopy (EDS). The overall performance of urushiol primers as dentin adhesives was observed by microtensile bond strength (µTBS) testing and nanoleakage assessment. Investigated the inhibitory properties of the urushiol primers on endogenous metalloproteinases (MMPs) utilizing in situ zymography, and the cytotoxicity of the primers was tested. RESULTS: Based on ATR-FTIR, Raman, XRD, EM-EDS and Vickers hardness analyses, the 0.7%-Ethanol group significantly enhanced dentin mineral content and improved mechanical properties the most. Pretreatment notably increased the µTBS of restorations, promoted the stability of the mixed layer, and reduced nanoleakage and MMPs activity after 28 days. SIGNIFICANCE: The urushiol primer facilitates remineralization in demineralized dentin, enhancing remineralization in etched dentin, effectively improving the bonding interface stability, with optimal performance observed at a 0.7 wt% concentration of the urushiol primer.

White Spot Lesions in Fixed Orthodontics: A Literature Review on Etiology, Prevention, and Treatment.

White spot lesions (WSLs) are a common complication after treatment using fixed orthodontic appliances. Decalcification of enamel surrounding fixed orthodontic appliances, known as WSLs, poses a significant aesthetic difficulty during and after treatment, as the purpose of fixed orthodontic therapy is to improve facial and dental appearance. Modern dentistry utilizes remineralization therapies to non-invasively treat WSLs to prevent the progression of disease and enhance the strength, appearance, and functionality of the affected tooth. This review aims to identify and assess the etiology, formation, and risk factors, as well as current treatment approaches used in achieving WSLs remineralization, induced by fixed orthodontic appliances. An electronic search on the PubMed and ScienceDirect databases was performed using a selected keyword. A total of 172 studies (from 2013 to 2023) were retrieved. Their references were also checked to find other relevant studies. Duplicate copies were excluded. After the abstract and full-text screening, only 39 studies were included. Even though numerous studies address the different treatment modalities for managing post-orthodontic WSLs, such as antiseptics; fluorides such as dentifrices, mouthwash, and varnish, and remineralizing agents such as casein phosphopeptides amorphous calcium phosphate, biomimetic self-assembling peptides, lasers, bleaching, microabrasion, and resin infiltration. There is a lack of evidence-based studies that examine the long-term effects of WSL treatment. Further well-performed controlled clinical trials with long-term follow-up are needed to establish best clinical practice.

Effects of graphene oxide and graphene quantum dots on enhancing CPP-ACP anti-caries ability of enamel lesion in a biofilm-challenged environment.

OBJECTIVE: To investigate the anticaries effects of graphene oxide (GO) and graphene quantum dots (GQDs) combined with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on enamel in a biofilm-challenged environment. MATERIAL AND METHODS: GO and GQDs were synthesised using citric acid. The antibiofilm and biofilm inhibition effects for Streptococcus mutans were evaluated by scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and colony-forming units (CFU). Remineralisation ability was determined by assessing mineral loss, calcium-to-phosphorus ratio, and surface morphology. To create a biofilm-challenged environment, enamel blocks were immersed in S. mutans to create the lesion and then subjected to artificial saliva/biofilm cycling for 7 days. Anticaries effects of GO, GQDs, GQDs@CPP-ACP, GO@CPP-ACP, and CPP-ACP were determined by broth pH and mineral changes after 7-day pH cycling. Biocompatibility was tested using a Cell Counting Kit-8 (CCK8) assay for human gingival fibroblasts (HGF-1). RESULTS: GQDs and GO presented significant antibiofilm and biofilm inhibition effects compared to the CPP-ACP and control groups (P < 0.05). The enamel covered by GQDs and GO showed better crystal structure formation and less mineral loss (P < 0.05) than that covered by CPP-ACP alone. After 7 days in the biofilm-challenged environment, the GO@CPP-ACP group showed less lesion depth than the CPP-ACP and control groups (P < 0.05). GO and GQDs showed good biocompatibility compared to the control group by CCK8 (P > 0.05) within 3 days. CONCLUSION: GO and GQDs could improve the anti-caries effects of CPP-ACP, and CPP-ACP agents with GO or GQDs could be a potential option for enamel lesion management. CLINICAL SIGNIFICANCE: GO and GQDs have demonstrated the potential to significantly enhance the anticaries effects of CPP-ACP. Incorporating these nanomaterials into CPP-ACP formulations could provide innovative and effective options for the management of enamel lesions, offering improved preventive and therapeutic strategies in dental care.

Effect of cheese and casein phosphopeptide-amorphous calcium phosphate on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups: An in vitro study.

Background: The acidic component of liquid medicinal syrups used by pediatric patients may cause erosion and partial demineralization. This study aimed to evaluate the effect of cheese and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosive lesions of primary teeth enamel following exposure to amoxicillin and ibuprofen syrups. Materials and Methods: In this in vitro study, 60 noncarious deciduous molars were used. After measuring the surface microhardness of the samples, they were randomly separated into two groups and immersed in either amoxicillin or ibuprofen for 1 min three times per day. CPP-ACP, cheese, and artificial saliva were then applied to each of the three subgroups (n = 10). After each immersion time, 10 min of therapy was given. Between treatment intervals, the samples were kept in artificial saliva. The microhardness was remeasured after 1 week. Data were analyzed using SPSS software through repeated-measures ANOVA (α = 0.05). Results: All samples' microhardness reduced considerably after immersion in liquid pharmaceuticals (amoxicillin [84.9 kgf/mm2] and ibuprofen [75.1 kgf/mm2]), but increased significantly following exposure to therapeutic solutions. There was no difference between the amoxicillin-cheese and amoxicillin-CPP-ACP subgroups (P = 0.975). A statistically insignificant difference was found between the ibuprofen group and the ibuprofen-CPP-ACP subgroup (P = 0.499). Conclusion: As a result, cheese and CPP-ACP can be utilized to remineralize erosive lesions caused by amoxicillin or ibuprofen exposure.

Understanding the spatial and topographic characteristics of enamel white spot lesions for targeted remineralization.

Introduction: White spot lesions are opaque, chalky white or yellowish discolorations on the surface of teeth that result from the demineralization of the tooth structure. Many methods, including SEM, XRD, and FTIR spectroscopy, are crucial for identifying and evaluating enamel white spot lesions. It is imperative to have a thorough grasp of the morphology, crystallographic structure, mineral composition, and chemical changes associated with enamel white spot lesions. Method: In vitro lesions were meticulously obtained by immersing extracted teeth in hydrochloric acid for a week and drying them using artificial caries. Characterization investigations were conducted with utmost precision and thoroughness using FTIR, XRD, and SEM, ensuring the reliability and validity of the results. Results: FTIR analysis revealed the existence of calcium oxide and hydroxyapatite, and SEM examination assisted in identifying differences in surface shape. The enamel's crystalline nature was revealed via XRD investigation. Conclusion: White spot lesions are associated with the development of deep caries. Advanced imaging strategies are needed for additional validation.

Unraveling Nanomaterials in Biomimetic Mineralization of Dental Hard Tissue: Focusing on Advantages, Mechanisms, and Prospects.

The demineralization of dental hard tissue imposes considerable health and economic burdens worldwide, but an optimal method that can repair both the chemical composition and complex structures has not been developed. The continuous development of nanotechnology has created new opportunities for the regeneration and repair of dental hard tissue. Increasingly studies have reported that nanomaterials (NMs) can induce and regulate the biomimetic mineralization of dental hard tissue, but few studies have examined how they are involved in the different stages, let alone the relevant mechanisms of action. Besides their nanoscale dimensions and excellent designability, NMs play a corresponding role in the function of the raw materials for mineralization, mineralized microenvironment, mineralization guidance, and the function of mineralized products. This review comprehensively summarizes the advantages of NMs and examines the specific mineralization mechanisms. Design strategies to promote regeneration and repair are summarized according to the application purpose of NMs in the oral cavity, and limitations and development directions in dental hard tissue remineralization are proposed. This review can provide a theoretical basis to understand the interaction between NMs and the remineralization of dental hard tissue, thereby optimizing design strategy, rational development, and clinical application of NMs in the field of remineralization.

Adding calcium phosphate agents alongside fluorides may enhance caries prevention and remineralization, although evidence is limited.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effectiveness of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials. Singal K, Sharda S, Gupta A, Malik VS, Singh M, Chauhan A, Agarwal A, Pradhan P, Singh M. J Evid Based Dent Pract. 2022; 22(3):101746. SOURCE OF FUNDING: Indian Council of Medical Research. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

The influence of neutral MDP-Na salt on dentin bond performance and remineralization potential of etch-&-rinse adhesive.

OBJECTIVES: To investigate the effect of neutral 10-methacryloyloxydecyl dihydrogen phosphate salt (MDP-Na) on the dentin bond strength and remineralization potential of etch-&-rinse adhesive. METHODS: Two experimental etch-&-rinse adhesives were formulated by incorporating 0 wt% (E0) or 20 wt% (E20) neutral MDP-Na into a basic primer. A commercial adhesive, Adper Single Bond 2 (SB, 3 M ESPE), served as the control. Sixty prepared teeth were randomly allocated into three groups (n = 20) and bonded using either one of the experimental adhesives or SB. Following 24 h of water storage, the bonded specimens were sectioned into resin-dentin sticks, with four resin-dentin sticks obtained from each tooth for microtensile bond strength (MTBS) test. Half of the sticks from each group were immediately subjected to tensile loading using a microtensile tester at a crosshead speed of 1 mm/min, while the other half underwent tensile loading after 6-month incubation in artificial saliva (AS). The degree of conversion (DC) of both the control and experimental adhesives (n = 6 in each group) and the adsorption properties of MDP-Na on the dentin organic matrix (n = 5 in each group) were determined using Fourier-transform infrared spectrometry. Furthermore, the effectiveness of neutral MDP-Na in promoting the mineralization of two-dimensional collagen fibrils and the adhesive-dentin interface was explored using transmission electron microscopy and selected-area electron diffraction. Two- and one-way ANOVA was employed to assess the impact of adhesive type and water storage on dentin bond strength and the DC (α = 0.05). RESULTS: The addition of MDP-Na into the primer increased both the short- and long-term MTBS of the experimental adhesives (p = 0.00). No difference was noted in the DC between the control, E0 and E20 groups (p = 0.366). The MDP-Na remained absorbed on the demineralized dentin even after thorough rinsing. The intra- and extra-fibrillar mineralization of the two-dimensional collagen fibril and dentin bond hybrid layer was confirmed by transmission electron microscopy and selected-area electron diffraction when the primer was added with MDP-Na. CONCLUSIONS: The use of neutral MDP-Na results in high-quality hybrid layer that increase the dentin bond strength of etch-&-rinse adhesive and provides the adhesive with remineralizing capability. This approach may represent a suitable bonding strategy for improving the dentin bond strength and durability of etch-&-rinse adhesive.

Influence of cadmium and zinc contamination on the sediment microbiome of estuarine and coastal ecosystems in the Southwest Coast of India.

Metals and their nanoparticles can induce toxicities that influence the survival of both microorganisms and macroorganisms. The current study reports on the impact of heavy metal pollution on the microbiome of estuarine and coastal sediments, where the settling and final remineralization of organic matter occur. Sediment samples collected from the Cochin estuary along the southwest coast of India and its adjacent coast showed high concentrations of cadmium (Cd) and zinc (Zn). The contamination factor (CF), calculated by comparing the concentration of metals in each station with that of shale value for Cd and Zn, ranged from 5.2 to 8.7 and 1.5 to 2.0 respectively, in the estuarine and coastal stations. Microbiome analysis revealed that bacteria were common across all stations but varied in relative abundance. Proteobacteria, Chloroflexi, Actinobacteria, Desulfobacteria, and Acidobacteria were the major bacterial phylum found in all stations. More than 70% of the bacteria were tolerant to 1 mM concentration of Cd. The findings of our study suggest that metal pollution can influence the microbiome of sediments in the estuaries and coasts. Bacteria with metal tolerance may dominate in polluted areas, but their participation in remineralization may be impaired, as evident in our previous reports. This impairment could ultimately influence the dynamics of the food web and the biogeochemical cycling of nutrients, necessitating further research.

Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study.

Aim: The aim of this study was to determine whether the intake of cheese, paneer, and yogurt may help in reversing the acidogenic challenge after the consumption of chocolate at different time intervals. Materials and methods: A total of 120 caries-free children between the ages of 4 and 13 years, with no decayed, missing, and filled teeth (DMFT), were randomly selected from the school. Baseline pH was obtained, and the subjects were asked to eat chocolate. pH was measured again after 10 minutes. Following chocolate exposure, the subjects were then randomly assigned to three groups-cheese, paneer, and yogurt. Salivary pH was measured at intervals of 15, 30, and 60 minutes using the same procedures for all subjects. The data thus obtained were subjected to statistical analysis, which included analysis of variance (ANOVA) test, post hoc tests for multiple comparisons using Tukey's test, and paired t-test. Results: The highest pH value after 15 minutes was seen in cheese (6.43), followed by paneer (6.31) and yogurt (6.30). After 30 minutes, the maximum pH value was seen in the cheese group (6.63), followed by yogurt (6.46) and paneer (6.34). The mean pH value 60 minutes after the consumption of dairy products was highest in paneer (6.53), followed by cheese (6.43) and yogurt (6.37). Conclusion: All the categories were observed in the zone of remineralization. It should be noted that the maximum pH value overall was seen in the cheese group. Clinical significance: Dairy products help maintain salivary pH, which aids in improving enamel health. Hence, dietary dairy recommendations can be incorporated into patient education and caries prevention plans. How to cite this article: Gautam Y, Srivastava M, Verma P, et al. Anticariogenic Effects of the Dairy Products on Human Saliva: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(4):456-460.

Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study.

Background: Despite the introduction of several anticaries products, dental caries continues to be a global problem. In recent years, there has been a rise in interest in noninvasive treatment for noncavitated caries lesions by employing remineralization concepts. Each remineralizing agent has its own drawbacks. Therefore, it is desirable to seek new agents that offer the advantages of earlier counterparts with lower detrimental reactions. Aim: The purpose of this research is to evaluate the remineralization efficacy of nanoparticle-based materials on white spot lesion (WSL) in children. Materials and methods: A total of 45 children between the age-group of 4 and 8 years with WSLs were selected and randomly divided into three groups. At baseline, the teeth with WSLs were confirmed and identified using International Caries Detection and Assessment System II (ICDAS II) criteria, and the dimensions of the lesions were measured using photographic methods. Then, they were randomly placed into three groups of 15 samples each-group I nanosilver fluoride (NSF), group II nanohydroxyapatite (nano-HAP) serum, and group III MI varnish. Following that, the varnish was applied, and follow-up was done in the 2nd, 4th, 12th, and 24th week. Results: By the 4th week, all three groups had a statistically significant difference (p < 0.05). Baseline measurements for groups I, II, and III showed that their respective mean WSL dimensions were 4.9 ± 0.66, 4.27 ± 0.69, and 5.44 ± 2.95. The dimensions of each group were reduced by the 24th week to 1.22 ± 0.46, 0.93 ± 0.41, and 2.19 ± 1.40, respectively. Overall, group II (nano-HAP serum) showed a statistically significant decrease in the dimension of the lesion at the end of the 24th week, followed by groups I and III. Conclusion: The remineralization of enamel was induced by all three agents. Nano-HAP serum is more successful than MI Varnish and NSF. How to cite this article: Annadurai T, Vundela RR, Chowdhary N, et al. Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study. Int J Clin Pediatr Dent 2024;17(4):425-432.

Comparative Evaluation of Antibacterial Efficacy and Remineralization Potential of Acidulated Phosphate Fluoride Gel with Herbal Dental Gel Containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum: An In Vitro Study.

Aim: The aim of the study is to evaluate and compare the antibacterial efficacy and remineralization potential of acidulated phosphate fluoride (APF) gel with herbal dental gel containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum. Materials and methods: Ethanolic extracts of Z. officinale, S. persica, and C. zeylanicum were prepared. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these extracts were determined against Streptococcus mutans and Lactobacillus acidophilus using the resazurin method and agar plate streaking method, respectively. The herbal dental gel was formulated, and its cytotoxicity was evaluated using an 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The antibacterial susceptibility of APF gel and the herbal dental gel was assessed using the agar well diffusion method and time-kill assay. The remineralizing potential was evaluated using a stereomicroscope. Results: Herbal dental gel showed better antibacterial efficacy as depicted by the zone of inhibition of 20 and 21 mm obtained against S. mutans and L. acidophilus, respectively, compared to 11.50 and 16.50 mm zone of inhibition obtained by APF gel. The herbal dental gel also showed better remineralization potential than APF gel after a time interval of 24 and 48 hours, as depicted with a statistically significant p-value of 0.0061 and 0.0219, respectively. In the cytotoxicity test, the fibroblasts showed 100% viability in the presence of both study groups. Conclusion: The results of our study concluded that herbal dental gel is safe and nontoxic, having anticariogenic potential due to its good antibacterial action and remineralization potential as compared to conventional APF gel. How to cite this article: Kohli N, Hugar SM, Hallikerimath S, et al. Comparative Evaluation of Antibacterial Efficacy and Remineralization Potential of Acidulated Phosphate Fluoride Gel with Herbal Dental Gel Containing Zingiber officinale, Salvadora persica, and Cinnamomum zeylanicum: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(3):307-315.

Examining the Effectiveness of Polyamidoamine (PAMAM) Dendrimers for Enamel Lesion Remineralization: A Systematic Review.

White spot lesions (WSLs) and demineralized enamel surfaces are common dental issues that can lead to further complications if untreated. The potential of various remineralizing agents has been extensively studied, but the efficacy of polyamidoamine (PAMAM) dendrimers in promoting enamel remineralization remains to be fully elucidated. This systematic review aims to evaluate the remineralizing potential of PAMAM on WSLs and demineralized enamel surfaces. To identify relevant studies, a comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library. Inclusion criteria comprised in vitro and in vivo studies that assessed the effects of PAMAM on WSLs or demineralized enamel. Data extraction and quality assessment were performed independently by two reviewers. The primary outcomes measured were changes in enamel microhardness, surface morphology, and mineral content. Five studies met the inclusion criteria, comprising in vitro studies. The results indicated that PAMAM demonstrated a significant remineralizing effect on demineralized enamel surfaces, as evidenced by increased microhardness and improved surface morphology. The studies varied in their methodological approaches but collectively supported the potential of PAMAM in enamel remineralization. PAMAM dendrimers exhibit promising remineralizing properties for treating WSLs and demineralized enamel surfaces.

Efficacy of different remineralization agents on microhardness and chemical composition of enamel white spot lesion.

Background: White spot lesions (WSLs) are frequently linked with low microhardness and mineral content changes. several strategies have been employed to deal with these problems. This investigation aimed to analyze the microhardness and mineral content changes after remineralization with bioactive glass (BAG) and casein phospho-peptide-amorphous calcium phosphate with fluoride (CPP-ACPF). Methods: Twenty sound maxillary first premolars extracted were used to obtain a total of one hundred enamel samples. forty enamel slabs were split into four experimental groups (n = 10 each): Group I, BAG; Group II, BAG+CPP-ACPF; Group III, CPP-ACPF varnish; and Group IV, artificial saliva (negative control). To create artificial WSLs, all samples were preserved in a prepared demineralizing agent for 72 h before treatment with remineralizing agents. Vickers microhardness test was performed. Additionally, 60 enamel samples were selected for analysis using energy dispersive spectroscopy (EDX) and assigned to six experimental groups; the first four groups were similar to that used in the microhardness test along with Group V: WSLs, and Group VI: baseline. The statistical analyses employed in this study included Tukey's HSD (p<0.05), one-way ANOVA, and Shapiro-Wilk. Result: Regarding surface microhardness, the BAG+CPP-ACPF group showed the most favorable recovery, which was better than the outcomes of the BAG and CPP-ACPF groups. A statistically significant change (p <0.05) was not observed between them. Similarly, for mineral content change, the BAG+CPP-ACPF group demonstrated the greatest result, The BAG group came next, and the CPP-ACPF group came last. Conclusion: The BAG+CPP-ACPF group might be regarded as the best course of treatment for enhancing both the surface microhardness and mineral content (Ca, P), while the control group (Artificial saliva) showed the least satisfactory results in comparison. After demineralization, mineral content and microhardness decreased in all samples. Therefore, BAG+CPP-ACPF significantly improved the surface microhardness and mineral content.