Remineralization effects of Er,Cr:YSGG and/or bioactive glass on human enamel after radiotherapy-an in vitro study.

The aim was to evaluate the effects of Er,Cr:YSGG and/or bioactive glass 45S5 (BG) on the chemical and physical properties of enamel after radiotherapy. Third molar crowns were cut in half (buccal-lingually), and the mid part of the labial/oral surface was subjected to different protocols. All samples were treated with standard 70 Gy. After radiotherapy, enamel was treated with either Er,Cr:YSGG (2780 nm; pulse 60 µs) and BG or only BG, and control samples were kept in deionized water. Vickers microhardness, scanning electron microscopy (SEM), and characteristic X-ray spectroscopy (EDS) were performed before, after radiotherapy, and after treatment. Analysis of variance (ANOVA) was used. A significant drop in enamel microhardness was observed after radiotherapy (p < 0.001). After Er,Cr:YSGG and BG or BG alone, there was a significant increase in microhardness (p < 0.001), which was on average significantly higher compared to the initial measurements for Er,Cr:YSGG with BG (p < 0.001), but not observed in BG alone (p = 0.331). After radiotherapy, SEM showed increased surface roughness with eroded prisms. Er,Cr:YSGG and BG or BG alone both showed disorderly packed glass particles on the enamel surface. Radiotherapy noticeably reduced the concentrations of calcium and phosphorus. Er,Cr:YSGG and BG treatment increased the concentrations of calcium, sodium, phosphorus, and silicate. BG treatment alone increased the concetration of calcium and phosphorus. Directly induced radiotherapy led to potential damage of enamel, but afterwards treatment with Er,Cr:YSGG laser and BG resulted in a higher increase of enamel microhardness compared to BG alone, reflecting in a possible better remineralization effect.

Effect of adhesive coating on calcium, phosphate, and fluoride release from experimental and commercial remineralizing dental restorative materials.

This study investigated the potential of adhesive coating for hindering the reactivity of ion-releasing dental restorative materials. Experimental composites were prepared by replacing 10 or 20 wt% of reinforcing fillers with two types of bioactive glass. A glass ionomer, a giomer, and an alkasite were used as representatives of commercial ion-releasing materials. Restorative material specimens were coated with an etch-and-rinse adhesive, 1-step self-etch adhesive, 2-step self-etch adhesive, or left uncoated. The specimens were immersed in a lactic acid solution and ion concentrations were measured in 4 days intervals for 32 days (atomic absorption spectrometry for calcium, UV-Vis spectrometry for phosphate, ion-selective electrode for fluoride, and pH-meter for pH values). The adhesive coating reduced ion release between 0.3 and 307 times, in a significantly material- and adhesive-dependent manner. Fluoride release was most highly impaired, with the reduction of up to 307 times, followed by phosphate and calcium release, which were reduced up to 90 and 45 times, respectively. The effect of different adhesive systems was most pronounced for phosphate release, with the following rankings: uncoated ≥ 2-step self-etch adhesive ≥ 1-step self-etch adhesive ≥ etch-and-rinse adhesive. The differences among adhesives were less pronounced for calcium and fluoride. It was concluded that the resinous adhesive layer can act as a barrier for ion release and diminish the beneficial effects of remineralizing restorative materials.

Ion release and hydroxyapatite precipitation of resin composites functionalized with two types of bioactive glass.

OBJECTIVES: To prepare experimental composites with bioactive glass (BG) and investigate their release of calcium (Ca), phosphate (PO4), and fluoride (F), as well as pH changes and apatite precipitation after immersion. METHODS: Experimental composites were prepared with 0, 10, or 20 wt% of either BG 45S5 or a customized low-Na F-containing BG. Three commercial ion-releasing materials were used for reference. Material specimens were immersed in lactic acid (pH = 4.0) and artificial saliva (pH = 6.4). Ion concentrations (atomic absorption spectrometry for Ca, UV-vis spectrometry for PO4, and ion-selective electrode for F) and pH were measured after 4, 8, 12, 16, 20, 24, 28, and 32 days. After immersion, composite specimens were analyzed using scanning electron microscopy (SEM) and Fourier-transform infrared (FTIR) spectroscopy. RESULTS: Material-dependent concentrations of Ca, PO4, and F were measured in the lactic acid solution, while a decrease of Ca and PO4 concentrations was observed in artificial saliva. The uptake of ions from artificial saliva indicates their precipitation on specimen surfaces, which was supported by the results of SEM and FTIR investigations. In experimental composites functionalized with both bioactive glass types and a commercial "alkasite" material, apatite was precipitated not only in artificial saliva but also in the lactic acid solution. CONCLUSIONS: Experimental BG-containing composites and selected commercial restorative materials demonstrated the potential for releasing multiple ion types and increasing pH. CLINICAL SIGNIFICANCE: The observed effects can be beneficial for preventing demineralization and promoting remineralization of dental hard tissues, while apatite precipitation can additionally help in sealing marginal discontinuities.

Experimental Bioactive Glass-Containing Composites and Commercial Restorative Materials: Anti-Demineralizing Protection of Dentin.

The purpose of this in vitro study was to investigate whether different types of experimental and commercial restorative dental materials can protect dentin against acid-induced softening. Experimental composites were prepared with a photocurable mixture of methacrylates and two types of bioactive glass (45S5 and a customized low-Na F-containing formulation). Human dentin samples were prepared from mid-coronal tooth slices and immersed in lactic acid solution (pH = 4.0) at 5 mm from set specimens of restorative material. After 4, 8, 12, 16, 20, 24, 28, and 32 days, surface microhardness of dentin samples and pH of the immersion solution were measured, followed by replenishing of the immersion medium. Microstructural analysis was performed using scanning electron microscopy. The protective effect of restorative materials was determined as dentin microhardness remaining statistically similar to initial values for a certain number of acid additions. Scanning electron microscopy showed a gradual widening of dentinal tubules and proved less discriminatory than microhardness measurements. To produce a protective effect on dentin, 20 wt% of low-Na F-containing bioactive glass was needed, whereas 10 wt% of bioactive glass 45S5 was sufficient to protect dentin against acid-induced demineralization. The anti-demineralizing protective effect of experimental and commercial restoratives on dentin was of shorter duration than measured for enamel in a previous study using the same experimental approach.

Direct Induced Effects of Standard and Modified Radiotherapy Protocol on Surface Structure of Hard Dental Tissue.

INTRODUCTION: Radiotherapy is used to treat neo plasmatic lesions and the common side effects of this process are pain, swelling and sensitivity of mucous membranes in domain of radiation, reduced salivation, caries, and periodontal disease and, in total, low life quality. The purpose of this research was to estimate the outcome of direct irradiation on physical and surface characteristics of hard dental tissues. MATERIALS AND METHODS: Twenty, caries free third molars were involved in the research. Prior to different submission protocols, tooth halves were randomly assigned to subject and control groups by using a draw method. The first group (n=20) was submitted to conventional irradiation protocol (2 Gy for 35 days), second group (n=20) was submitted to one powerful, exploratory dose of 70 Gy. Each sample served as its own control. Radiation was performed with a linear accelerator radiotherapy unit. The surface microhardness and roughness were measured at the beginning (initially), and upon completion of irradiation procedure. The average change in microhardness and roughness after different treatments was compared by t-test for independent samples. Normality was tested by the Shapiro-Wilk test. RESULTS: Significant differences were found after the standard radiation protocol and the exploratory dose of 70 Gy, with decreased mean microhardness and increased mean roughness (p<0.001) of both hard dental tissues. Enamel and dentin surface microhardness and roughness did not vary notably with regards to different irradiation protocols. CONCLUSION: Head and neck conventional irradiation protocol leads to possible breakdown of enamel and dentin with reduced microhardness and increased surface roughness regardless of used irradiation protocol.