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Acidic beverages are believed to elevate the risk of enamel surface erosion. In addition to the intake of soft drinks, the increased consumption of salad dressings has been linked to a higher prevalence of dental erosion. Therefore, the current study aimed to investigate the influence of bottled salad dressings on the development of enamel erosion in the presence or absence of pellicle through in vitro experiment. Preliminary pH and calcium analyses of solutions were performed. Highest pH and calcium content was found for sandwich spread i.e., 4.69 and 55.4 mg/100 g grams, respectively. Eighty tooth specimens (measuring 4 × 4 × 3 mm) were prepared from extracted human premolars and randomly assigned to four groups (group 1: orange juice; group 2: eggless plain mayonnaise; group 3: sandwich spread; and group 4: thousand island dressing) with 20 samples in each group. Ten tooth specimens from each group were immersed in 20 ml of the respective solutions for 5 min (control group). The remaining ten tooth specimens from each group were submerged in 5 mL saliva vials for 3 min to facilitate salivary pellicle formation before being immersed in their respective solutions for 5 min (saliva-covered group). Pre and post-experimental assessments of enamel roughness and hardness were conducted using a surface roughness tester and Knoop Hardness indenter, respectively. Overall, enamel roughness was notably elevated in the control group, with the eggless plain mayonnaise (0.52 ± 0.38) and thousand island dressing groups (0.57 ± 0.29) showing a significant increase in surface roughness post-test (p = 0.05). Nevertheless, there was no significant difference in the enamel roughness between the groups. On the other hand, regardless of the presence/absence of the salivary pellicle, a marked decrease in enamel hardness was observed among all groups except for group 3 (sandwich spread) with a mean score of 311.5 ± 82.6 (p < 0.05). A significant increase in surface roughness and reduction in enamel hardness was observed with salad dressings. However, in vitro formed salivary pellicle showed a protective effect against tooth erosion. [Display omitted] [ABSTRACT FROM AUTHOR]

Soft drinks and sports drinks are acidic beverages with a higher risk of eroding teeth. This study aim was to evaluate the mean mineral density and microhardness of dental enamel after exposure to different drinks with different exposure times using microCT and Vickers microhardness test. An in-vitro study was conducted with a sample size of thirty-six extracted permanent premolars. The teeth were divided randomly into three groups according to the immersion drink (distilled water, Coca-Cola and energy drink). Each group was immersed for 30 minutes every 12 hours over 12 days. Later, tooth mean mineral density and microhardness were measured by microCT and Vicker tester methods. Comparison of groups’ teeth mean mineral density and microhardness values showed a statistically significant difference by (ANOVA) test (p<0.001). The mean and standard deviation for mineral density using Coca-Cola (2.34 ± 0.12), energy drink (2.58 ± 0.08) and distilled water (2.73 ± 0.07) For microhardness the mean and standard deviation for Coca-Cola (373.37± 31.68), energy drinks (406.73 ± 32.77) and distilled water (410.04 ± 23.16) Based on the current study findings, the used energy drink and Coca-Cola were erosive to tooth enamel, with Coca-Cola demonstrating the worst effect. It is recommended to increase public awareness about the effect of these soft drinks on the tooth surfaces, and encourage individuals to pay attention to signs of potential damage, like tooth sensitivity, and seek timely dental care to prevent further complications. [ABSTRACT FROM AUTHOR]

Gastro-oesophageal reflux disease (GORD) is common in children and has numerous extra-oesophageal manifestations which dental practitioners should be aware of. This article illustrates the role of the dentist in recognizing the signs and symptoms of GORD in children. A risk-based management system is illustrated to guide clinicians in managing children exhibiting erosive tooth wear. [ABSTRACT FROM AUTHOR]

Amelogenesis imperfecta (AI), an assemblage of genetic diseases with dental enamel malformations, is generally grouped into hypoplastic, hypomaturation, and hypocalcified types. This study aimed to identify the genetic etiology for a consanguineous Iranian family with autosomal recessive hypocalcified AI. Dental defects were characterized, and whole exome analysis conducted to search for disease-causing mutations. Minigene assay and RT-PCR were performed to evaluate molecular consequences of the identified mutation and expression of the causative gene in human dental tissues. The defective enamel of erupted teeth showed extensive post-eruptive failure and discoloration. Partial enamel hypoplasia and indistinct dentino-enamel junction were evident on unerupted teeth, resembling hypocalcified AI. A novel homozygous ODAPH (previously designated C4orf26) mutation of single-nucleotide deletion (NG_032974.1:g.5103del, NM_178497.5:c.67+1del) was identified to be disease-causing. The mutation would cause a frameshift to different ODAPH transcript variant (TV) products: p.(Ala23Hisfs∗29) for TV1 and p.(Gly23Aspfs∗140) for TV2. Both dental pulps of developing and exfoliating primary teeth expressed ODAPH TV2. Loss-of-function ODAPH mutations can cause AI type IIIB (the hypocalcified, autosomal recessive type), rather than type IIA4 (the hypomaturation, pigmented autosomal recessive type). This study supports a hypothesis that the product of ODAPH TV2 is the single dominant ODAPH protein isoform critical for dental enamel formation and may also play an unappreciated role in development and homeostasis of dentin-pulp complex. Due to genetic heterogeneity and a nonideal genotype-phenotype correlation of AI, it is essential to perform genetic testing for patients with inherited enamel defects to make a definitive diagnosis. [ABSTRACT FROM AUTHOR]

Tooth wear is a multifactorial condition leading to the irreversible loss of dental hard tissues. Although tooth wear is mainly a physiological process, it can become pathological if the wear process is accelerated for various reasons. Since this process is not linear, but can sometimes be inactive and sometimes active, a careful monitoring policy is necessary. The possible monitoring tools are described in this article, and a proposal is made with regard to the frequency of the systematic and periodic collection of information. CPD/Clinical Relevance: The prevalence of tooth wear is increasing and it now carries the third highest risk (after caries and periodontitis) for maintaining the natural dentition. [ABSTRACT FROM AUTHOR]

Tooth wear in children is a multifactorial process that can be due to either physiological or pathological processes. The most frequent type of tooth wear in children is erosion, and its contribution to overall tooth wear is explained. The prevalence, aetiology, presentation and management of tooth wear, especially erosion, are discussed in this article, with practical clinical advice for the treating clinician and families. The challenges to giving practical preventive advice, and the complexities involved in overcoming dietary and lifestyle changes in an environment of powerful advertising, peer pressure and social media influencers are discussed in detail. CPD/Clinical Relevance: Erosive tooth wear is common in children, so understanding the aetiology and giving families practical and relevant preventive advice is important. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate and compare the protective effect of fluoride varnish (Enamelast™, Ultradent Inc., Cologne, Germany), casein phosphopeptide-amorphous calcium phosphate fluoride/CPP-ACPF (MI Paste Plus, GC Corp., Tokyo, Japan) and self-assembling P11-4 peptide (Curodont™ Protect, Credentis AG, Windisch, Switzerland), against acidic erosion of primary teeth. Methods: Forty primary anterior teeth were randomly assigned to four groups (n = 10): group 1: control, group 2: fluoride varnish, group 3: CPP-ACPF and group 4: self-assembling P11-4 peptide. After applying remineralising agents, except for the control group, all specimens underwent an erosive challenge of carbonated soft drink and artificial saliva for 15 cycles of 6 s each at 6-h intervals for a day. Groups were compared in terms of surface microhardness, roughness readings, and surface scanning with an extra-oral scanner (D800; 3Shape A/S) before and after the erosive process. Results: All experimental groups showed superior results than the control group regarding microhardness, surface roughness, and substance loss. The fluoride varnish group showed significantly favourable results in microhardness change. There was no significant difference between the experimental groups regarding surface roughness and enamel loss measurements. Conclusion: 5% NaF fluoride varnish, CPP-ACPF and self-assembling P11-4 peptide protect the enamel of primary teeth against erosion compared to artificial saliva alone. [ABSTRACT FROM AUTHOR]

Background/purpose: Overlay restorations can be used clinically as a treatment option to preserve natural dentine. However, whether the residual enamel thickness and overlay thickness affect the adhesion between the restoration and tooth is still unknown. This study was to investigate effects of the overlay thickness and residual enamel thickness on bonding strength. Overlays of different thicknesses were prepared with natural teeth which had 2, 4, and 6 mm of occlusal reduction (n = 10). Specimens were subjected to 10,000 cycles in water at 5–55 °C, and finally compressive strength tests were used to evaluate the bonding strength. All groups showed good bond strength (P > 0.05). The overlay restorations of different thicknesses reduced the preparation amount by 30.3%–7.2% and significantly preserved more of the tooth structure (P < 0.005). Compared to the control group, the overlay restoration increased the marginal fitness by about 0.67–0.88 times. The thermal cycling indicated that the decrease in the maximum bearing stress was due to the aging of the ceramic itself. Therefore, the thickness of the overlay had a greater influence on the compressive strength than the bond strength. Based on the above this study recommends an overlay thickness of at least 2 mm in clinical practice. The aging test confirmed that adhesion between the overlay and teeth was quite firm and stable. This shows that a stable adhesive effect of the overlay can be used as a treatment option for preserving a greater amount of a tooth's structure. [ABSTRACT FROM AUTHOR]

Sodium lauryl sulfate (SLS) is an anionic surfactant, which has a wide range of usage in the health sector and in dental pharmaceutical products, especially in toothpastes. The objective of this review was to investigate the effects of SLS containing dentifrices on oral and periodontal health, possible side effects, and its benefits. A thorough literature search was done using databases of PubMed and Google Scholar and finally, 40 articles were included in the study. This narrative review revealed the sources of discrepancy and conflicting results regarding the impact of SLS on oral cavity as well as a lack of sufficient evidence in most topics. Hence, the evidence suggests improved drug bioavailability when used as a solubilizer, improved plaque control, and reduction in bad breath. On the other hand, SLS can serve as a risk indicator of prolonged oral wound healing time, recurrent aphthous stomatitis. [ABSTRACT FROM AUTHOR]

Laryngopharyngeal reflux is an inflammatory condition of the upper aerodigestive tract tissues related to a direct and indirect effect of gastric contents reflux, which induces of upper aerodigestive morphological changes. Laryngopharyngeal reflux (LPR) enhances the proximal migration of gastric contents and may cause poor oral hygiene and dental disorder. The involvement of reflux in the development of dental disorders has been suspected for several decades. Reflux would be responsible for increasing the risk of oral mucosa inflammation, dental caries, and dental erosion. This study aims to explore LPR sufferers who experience a lot of tooth loss which is thought to be due to reflux of the gastric content. The case report presented was a sixty-two-year-old female who suffered from laryngopharyngeal reflux and had poor oral hygiene with DMF 18 since three years ago. A general examination is quite good, she was taking lansoprazole, treatment planning composite filling on the teeth 14,13,11, 44. In conclusion, dental disorders accompanied by laryngopharyngeal reflux, can be treated by taking care of the teeth thoroughly, maintaining oral hygiene, taking medication according to doctor's recommendations, and maintaining a lifestyle, diet, and exercise with the intention of the body being proportional. [ABSTRACT FROM AUTHOR]

Purpose: Reported rates of urethral stricture development after artificial urinary sphincter erosion are highly variable. We hypothesized that the risk of stricture is commensurate with the degree of erosion. Materials and Methods: We reviewed our prospectively maintained quality improvement database for all patients with artificial urinary sphincter erosion from 2011 to 2022. The incidence of postoperative stricture development was compared to the severity of erosion using a graded scale: 1, <25% circumference; 2, 25%-50% circumference; 3, >50% and <100% circumference; and 4, 100% circumference. From 862 artificial urinary sphincter surgeries, 102 erosion cases were identified, and 63 with documented erosion severity were included for analysis. Additional analysis was performed on 28 cases without documented erosion severity for validation. Results: Within the main cohort, urethral stricture developed in 22 (34.9%) patients. The incidence of stricture did not vary by grade of erosion (P[.73) and was not significantly higher in men with grade 4 erosion vs lower-grade erosions (32.7% vs 50.0%, P[ .34). Radiation exposure was associated with a 41.1% higher incidence of stricture (P < .01) and nearly every stricture occurred in the setting of prior radiation (21 of 22; 95.5%). In the validation group, 10 (35.7%) developed stricture, mostly in the setting of radiation (8 of 10; 80%). Overall, 29 of 32 (90.6%) cases of stricture involved a history of radiation. Conclusions: Artificial urinary sphincter erosion does not lead to urethral stricture formation in most cases and is not associated with degree of erosion. Those who develop strictures nearly always have a history of pelvic radiation. [ABSTRACT FROM AUTHOR]

Progress in paediatric dentistry over the last half a century has been evident across all areas of the speciality. This article highlights significant changes in the diagnosis, prevention and management of dental caries, traumatic dental injuries, developmental enamel defects, tooth erosion, dental fear and anxiety and safeguarding children. The dedication of clinicians and researchers along with advances in material science and technology have supported this progress. We discuss the importance of working with those both within and outside of the specialty in order to collaborate to improve children's oral health. There have been significant strides in the provision of child-centred holistic care and research. Reviewing the advancements made over this period has set a high precedent for making further progress within paediatric dentistry over the next 50 years. CPD/Clinical Relevance: Knowledge of key advances in the field of paediatric dentistry will facilitate good diagnosis and treatment of younger patients. [ABSTRACT FROM AUTHOR]

Pica is an eating disorder characterized by compulsive eating of non-food items. It can present to dentists through patient medical histories, and also through causing atypical patterns of non-carious tooth surface loss. In highlighting two cases of pica presenting in general practice, we aim to raise awareness of this condition and its dental implications. CPD/Clinical Relevance: This article advises on how pica may present to a general dentist and gives advice on management. [ABSTRACT FROM AUTHOR]

Complex treatment plans can be overwhelming to patients and cause them to put off treatment. A key factor in gaining patient acceptance of a complex treatment plan is the ability to segment the necessary treatment into phases. Providing phased treatment can help with both affordability for the patient and time concerns that the patient may have when scheduling multiple dental appointments in a short amount of time. This case demonstrates the use of a systematic diagnosis and treatment planning protocol that facilitated the phasing of a comprehensive treatment plan. The treatment phases allowed for affordability while lowering the patient's dental risk as each phase of care was completed. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calciumbinding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution. [ABSTRACT FROM AUTHOR]

The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have l ower s alivary flow (OR = 0.079; 9 5%CI = 0.013-0.469; p = 0.005) and l ower o smolality (OR = 0 .993; 9 5%CI = 0 .985-1.000; p = 0 .049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2). [ABSTRACT FROM AUTHOR]

Dental hard tissue conditions can be of pre- or posteruptive nature, such as enamel fluorosis and erosive tooth wear (ETW), respectively. Dental enamel fluorosis is caused by the chronic and excessive intake of fluoride during enamel development, leading to increased fluoride concentration and increased porosity. ETW has become a common clinical condition and often impairs dental function and aesthetics. This in vitro study tested the hypothesis that fluorotic enamel presents different susceptibility to dental erosion-abrasion. It consisted of a 3×3×2 factorial design, considering a) fluorosis severity: sound (TF0), mild (TF1-2), moderate (TF3-4); b) abrasive challenge: low, medium, and high; and c) erosive challenge: yes or no. A total of 144 human teeth were selected according to the three fluorosis severity levels (n=48), and subdivided into six groups (n = 8) generated by the association of the different erosive and abrasive challenges. Enamel blocks (4×4 mm) were prepared from each tooth and their natural enamel surfaces subjected to an erosion-abrasion cycling model. After cycling, the depth of the lesions in enamel was assessed by profilometry. ANOVA showed that the three-way and two-way interactions among the factors were not significant (p > 0.20). Enamel fluorosis level (p=0.638) and abrasion level (p = 0.390) had no significant effect on lesion depth. Acid exposure caused significantly more enamel surface loss than water (p < 0.001). Considering the limitations of this in vitro study, fluorosis did not affect the susceptibility of enamel to dental erosion-abrasion. [ABSTRACT FROM AUTHOR]

This study tested a novel in vitro dental erosion-abrasion model and the performance of cross-polarization optical coherence tomography (CP-OCT) in longitudinally monitoring the simulated lesions. Thirty human enamel specimens were prepared and randomized to receive three dental erosion-abrasion (EA) protocols: severe (s-EA, lemon juice/pH:2.5/4.25%w/v citric acid), moderate (m-EA, grapefruit juice/pH:3.5/1.03%w/v citric acid) and no-EA (water, control). EA challenge was performed by exposing the specimens to acidic solutions 4x/day and to brushing 2x/day with 1:3 fluoridated toothpaste slurry, for 14 days. Enamel thickness measurements were obtained using CP-OCT at baseline (D0), 7 (D7) and 14 days (D14) and micro-computed tomography (micro-CT) at D14. Enamel surface loss was measured with both CP-OCT and optical profilometry at D0, D7 and D14. Data was analyzed with repeated-measures ANOVA and Pearson's correlation (r) (a = 0.05). CP-OCT enamel thickness decreased over time in the s-EA group (D0 >D7 > D14, p < 0.001) and m-EA group (D0 > D14, p = 0.019) but did not change in the no-EA group (p = 0.30). Overall, CP-OCT and micro-CT results at D14 correlated moderately (r = 0.73). CP-OCT surface loss was highest for s-EA (p <0.001) but did not differ between moderate and no-EA (p = 0.25). Enamel surface loss with profilometry increased with severity (no-EA>m-EA>s-EA, p < 0.001). D14 surface loss was higher than D7 for both methods except for the no-EA group with profilometry. CP-OCT and profilometry had moderate overall correlation (r = 0.70). Our results revealed that the currently proposed in vitro dental erosion-abrasion model is valid and could simulate lesions of different severities over time. CP-OCT was a suitable method for monitoring the EA lesions. [ABSTRACT FROM AUTHOR]

Objective: To compare the agreement of images in white light (WL), fluorescence (FL), and digital radiographs (DR), on the diagnosis and treatment decisions for occlusal caries lesions against a micro-CT gold standard. Material and Methods: Ten extracted third molars, with enamel and/or dentin caries (ICDAS 2-4), were included. Occlusal surface images were acquired with an intraoral camera (SoproLife®) in WL and FL modes. DR was obtained using an intraoral X-ray and a semi-direct digital system. A total of 780 images were needed, organized in a template, to be later examined by twenty-six dentists invited to compose the study. The Generalized Estimation Equations model was used to compare the proportions of the correct answers between the three methods and the gold standard. When significant, Bonferroni post-hoc test was used to identify differences (α=5%). Results: Most of the examiners were specialists (76.9%) with 14.5 years of experience. All diagnostic methods were similar and showed low agreement (DR 12.7%, WL 16.5%, and FL 16.5%) compared with gold standard caries diagnostic scores. Regarding treatment decisions, mean agreement for all diagnostic methods was higher (43.2%; p<0.001), and among all methods, WL (48.1%) and FL (51.2%) modes performed better than DR (30.4%, p<0.001). Conclusion: SoproLife® images could help clinicians to propose rational, minimally invasive treatments for occlusal caries lesions. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the influence of the biomodification of erosive lesions with a chitosan nanoformulation containing green tea (NanoCsQ) on the clinical performance of a composite resin. Methods: The study was performed in a split-mouth, randomized and double-blinded model with 20 patients with 40 erosive lesions. The patient's teeth were randomized into two groups (n=20) according to the surface treatment: 1) Without biomodification (control), and 2) Biomodification with NanoCsQ solution (experimental). The lesions were restored with adhesive (Tetric N-bond, Ivoclar) and composite resin (IPS Empress Direct, Ivoclar). The restorations were polished and 7 days (baseline), 6 months, and 12 months later were evaluated according to the United States Public Health Service (USPHS) modified criteria, using clinical exam and photographics. Data were analyzed by Friedman's and Wilcoxon signed-rank tests. Results: No significant differences were found between the control and experimental groups (p=0.423), and also among the follow-up periods (baseline, six months, and 12 months) (p=0.50). Regarding the retention criteria, 90% of the restoration had an alpha score in the control group. Only 10% of the restorations without biomodification (control) had a score charlie at the 12-month follow-up. None of the patients reported post-operatory sensitivity. Conclusion: The NanoCsQ solution did not negatively affect the performance of the composite resin restorations after 12 months. [ABSTRACT FROM AUTHOR]

Aim: Better understanding of dentists' decision-making about defective restorations is needed to close the evidence-practice gap (EPG). This study aimed to quantify the EPG about defective restorations and identify dentist factors associated with this EPG. Methods: 216 dentists from São Paulo State, Brazil, completed a questionnaire about three clinical case scenarios involving defective composite restorations with cementum-dentin margins (case 1) and enamel margins (case 2), and an amalgam (case 3) restoration. Dentists were asked what treatment, if any, they would recommend, including preventive treatment, polishing, re-surfacing, or repairing the restoration, or replacing the entire restoration. Replacing the entire restoration in any of these three scenarios was classified as inconsistent with the evidence, comprising an EPG. Bivariate analyses using Chi-square, ANOVA, or multiple comparison tests were performed (p<.05). Results: for defective composite restorations, 49% and 55% of dentists chose to replace the entire restoration for cases 1 and 2, respectively. Twenty-nine percent of dentists chose to replace the entire amalgam restoration. Dentists were significantly more likely to choose to replace the defective amalgam restoration than the composite restoration with a defect at the cementum-dentin margins or the enamel margins (both at p < .001). Female dentists were more likely to choose a conservative treatment than male dentists for cases 1 (p=.034) and 2 (p=.009). Dentists with a higher percentage of patients interested in individualized caries prevention were also more conservative in case 1 (p=.045). Conclusion: a substantial EPG regarding treatment decisions for defective restorations exists, especially for composite restorations. This study adds to the international evidence that an EPG exists in this clinical area and that global strategies need to be developed to close the gap. [ABSTRACT FROM AUTHOR]

The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW). The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in μm). A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss. Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful. [ABSTRACT FROM AUTHOR]

Biological tissues have developed structures that fulfil their various specific requirements. Mineralized tissues, such as tooth and bone, are often of mechanical competence for load bearing. Tooth enamel is the hardest and toughest mineralized tissue. Despite a few millimeters thick and with minimal regenerative capacity, human tooth enamel maintains its functions throughout a lifetime. Bone provides skeletal support and essential metabolism to our body. Degenerative diseases and ageing induce the loss of mechanical integrity of the bone, increasing the susceptibility to fractures. Tooth and bone share certain commonalities in chemical components and material characteristics, both consisting of nanocrystalline apatite and matrix proteins as their basic foundational structural units. Although the mechanical properties of such mineralized hard tissues remain unclear, it is plausible that they have an inherent toughening mechanism. Nanoindentation is able to characterize the mechanical properties of tooth enamel and bone at multiscale levels, and the results suggest that such toughening mechanisms of enamel and bone may be mainly associated with the smallest-scale structure–function relationships. These findings will benefit the development of advanced biomaterials in the field of material science and will further our understanding of degenerative bone disease in the clinical community. [ABSTRACT FROM AUTHOR]

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent dental erosion, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm fluoride ions. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the demineralisation of teeth. SDF also inactivates proteolytic peptidases and inhibits dentine collagen degradation. It arrests caries without affecting dental pulp or causing dental fluorosis. Indirect pulp capping with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes pulp necrosis. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF treatment. SDF therapy is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection. [ABSTRACT FROM AUTHOR]

While evidence shows that dental erosion (DE) is often caused by gastroesophageal reflux disease (GERD), the relationship of DE severity to a patient's symptoms and receipt of appropriate medical treatment for GERD is not clearly understood. The purpose of this study was to evaluate the association between DE and GERD. Eighty participants underwent a Basic Erosive Wear Examination for DE and completed the Patient-Reported Outcomes Measurement Information System (PROMIS) survey on symptoms of gastrointestinal reflux (PROMIS Scale vl.0, Gastrointestinal Gastroesophageal Reflux 13a) in English. Patients with observed erosive patterns were referred for gastroenterologic evaluation. The association between DE and GERD was assessed using multiple regression. The results showed that the extent of DE was positively associated with GERD symptoms (B = 0.585; 95% Cl, 0.21-0.96), as measured by the PROMIS survey, in participants without a current diagnosis of GERD. Of the 80 patients in the study, 28 with more severe DE were evaluated in the gastroenterology department. A diagnosis of GERD was established for 27 of the 28,9 of whom denied a past history of the disease. Twenty patients with GERD underwent upper endoscopy, and esophageal lesions were found in 6 patients (erosive esophagitis in 5 and Barrett esophagus in 1). Patients with clinically identified DE may benefit from medical evaluation and, if necessary, management of GERD. For a subset of patients, DE may be the only clinical indication of untreated or undertreated GERD, which could lead to serious esophageal changes. Dentists should consider referring patients with DE to primary care providers or gastrointestinal specialists to ensure that systemic conditions are identified and managed appropriately. [ABSTRACT FROM AUTHOR]

There are many studies and reviews of the relationship between the asthma disease in young individuals on the one hand and caries and dental erosion on the other. The causes of caries and dental erosion might be related to the asthmatic drugs, low pH and the sweeteners that the inhaled drug contains and perhaps even the lifestyle of children and adolescents with asthma. The main focus of this review is therefore to describe various preventive strategies, based on long experience of preventive dental care in Sweden. Two fact boxes are presented, one on fluoride toothpaste as a population-based intervention for different ages and one on diet counselling in children and adolescents with asthma. The most important thing is to introduce fluoride toothpaste early in the child's life and that the parents brush the child's teeth twice a day, in the morning after breakfast and at night before bedtime, up to the age of 10. Moreover, a high-risk approach with an additional fluoride supply at home is presented, together with the application of fluoride varnish at the clinic. Regarding diet counselling, it is important to make sure that the child has regular meals during the day, maximum five to six times a day, to allow the teeth to rest between meals and restrict sweets and soft drinks to once a week. It is important to identify children and adolescents with asthma as early as possible and to refer them to a dental team for preventive treatment. [ABSTRACT FROM AUTHOR]

Vaccinium macrocarpon (cranberry) is a fruit that has an inhibitory effect on matrix metalloproteinases (MMPs) present in dentin and saliva. The inhibition of MMPs has been shown to prevent dentin erosion. The aim of this study was to analyze the effect of cranberry juice on the reduction of dentin erosion in vitro. Specimens of bovine dentin (4×4×2 mm) were randomized and divided into 4 groups (n = 17/group): distilled water (C-control, pH 7.2); green tea extract solution containing 400 µm epigallo-catechin-gallate (EGCg, positive control, pH 4.5); 10% cranberry extract (CrE, pH 3.9), and cranberry juice (CrJ, Cranberry JuxxTM, pH 2.8). Specimens were submitted to erosive pH cycles for 5 days. Each day, four demineralizations were carried out with 0.1% citric acid (90 s). After the acid challenges, specimens were rinsed and kept in treatment solutions for 1 min; afterwards, they were rinsed and stored in artificial saliva for 1 h at 37°C (or overnight at the end of each day). After the experimental period of 5 days, dentin loss was evaluated by contact profilometry. Data were analyzed by ANOVA and Tukey's test (p < 0.05). Dentin loss (µm ± SD) was significantly lower for all treatments (EGCg = 9.93 ± 2.90; CrE = 12.10 ± 5.44; CrJ = 11.04 ± 5.70) compared to control (21.23 ± 11.96), but it did not significantly differ from each other. These results indicate that the commercial cranberry juice, despite its low pH, is able to reduce dentin erosion, which might be due to the ability of cranberry components to inhibit MMPs. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the relationship between intrinsic and extrinsic factors and a high cumulative score of the Basic Erosive Wear Examination (BEWE) in a Chilean adult group. A cross-sectional study was performed with the Ethics Committee's approval from the Universidad de los Andes. A consecutive adult (18 to 46 years old) sampling (n = 553) from the Health Center in San Bernardo-Chile, was selected from September 2016 to January 2017. Dental exams were performed by two trained and calibrated examiners, according to the BEWE index. In order to search for potentially related factors, a hetero-applied questionnaire previously developed and evaluated was applied. Our interest was individuals with severe erosion tooth wear (BEWE = 14). Logistic regression models reporting crude odds ratio (OR) and adjusted OR by age, 95% confidence interval (95%CI), and p-values were estimated. Variables, odds ratios and 95% CI related with BEWE = 14 were: age (OR 1.1 [1.07-1.14]); currently drinking alcohol (OR 1.59 [1.06-2.39]); esophagitis (OR 8.22 [1.60-42.22]); difficulty to swallow (OR 2.45 [1.10-5.44]); chest pain (OR 2.07 [1.18-3.64]); anorexia (OR 3.82 [1.07-13.68]); vitamin C intake (OR 1.92 [1.08-3.43]). Age, alcohol consumption, self-reported esophagitis, history of gastric symptoms, anorexia, and vitamin C intake were related as risk factors to high BEWE scores in this sample of Chilean adults in San Bernardo, Chile. [ABSTRACT FROM AUTHOR]

Objective: To evaluate in vitro erosive effect of analgesics on primary tooth enamel. Material and Methods: The pH and the titratable acidity measurements of the medicines were performed in triplicate using a digital pH meter. Enamel slabs of primary teeth flat and polished were selected by initial surface microhardness analysis. Medications were selected and specimens were assigned into five groups (n=12): Dalsy; Magnopyrol; Paracetamol; Tylenol; and distilled water (negative control). Specimens were immersed in 5 ml of each group solution for 30 min, 4x/day for three days and stored in artificial saliva at 37 °C between immersions and at night. Final microhardness was determined. The data were submitted to Oneway ANOVA and Tukey's test. Scanning electron microscopy (SEM) analysis was performed in three specimens of each group. Results: Medicines showed acidic pH and mean values of titratable acidity ranged from 1.46 to 11.66 ml of 0.1N NaOH. The mineral loss of Magnopyrol was statistically significant in relation to the control group (p<0.01). Magnopyrol showed higher values when compared to Tylenol (p<0.05). SEM images displayed microstructure alterations in the Paracetamol group. Conclusion: Despite the low pH values, only Magnopyrol showed greater enamel softening. Paracetamol demonstrated morphological changes in primary tooth enamel. [ABSTRACT FROM AUTHOR]

Cerebral Palsy (CP) Children have a prevalence of caries 59%, 54% Tooth erosion, bad Oral Hygiene (OH) and 52%-59% Malocclusion higher than general population (3,3% CP children in Indonesia). Because their limitations in motoric and intellectual, to maintain their oral health care require modify and different approaches. Saliva plays an important role of demineralizationremineralization, if there are any disorder will be potential for infectious disease (caries). Saliva is used as a tool to diagnose health and disease status. Changes in saliva flowrate interfere to protection function and total saliva protein and a-amylase. Recent studies indicate that total salivary protein and a-amylase is used as a biomarker for preventive measures and helps diagnose oral cavity disease (Caries Risk Assessment). The authors would like to analyze the relationship between total salivary protein, a-amylase and oral cavity conditions of CP children. Permanent damage to the Central Neuro System causes neuromuscular disorders. The disruption of the osmoreceptor function will reduce the sensitivity of Angio vasopressin, so that CP children experience hypohydration which results in decreased salivary flowrate. Changes in total protein and a-amylase resulted in decreased salivary protective function and decreased oral conditions in CP children. [ABSTRACT FROM AUTHOR]

Purpose: Acids contained in foods and drinks are involved in the initiation and progression of dental erosion which causes tooth wear. The authors evaluated the neutralizing activity of alkaline electrolyzed water (AEW) in vitro and in vivo.Methods: The neutralizing ability of AEW against eight beverages was investigated in vitro. Furthermore, in an in vivo study, the effect of mouth rinsing with AEW on the pH of the oral cavity acidified with acidic beverages was examined. Following mouth rinsing, the oral pH was measured using a pH meter with a micro pH-sensor at the cervical surface of the mandibular teeth and the surface of soft tissues.Results: Regarding the neutralizing ability, the higher the pH of the AEW, the lower the volume required for neutralization of the tooth surface. Changes in the pH by mouth rinsing with AEW and purified tap water (PTW) were analyzed. The degree of increase of pH with AEW was greater than with PTW at almost all sites.Conclusion: These results suggest that AEW has the potential to prevent the initiation and progression of dental erosion. Mouth rinsing with AEW could be a simple and effective way to prevent the initiation and progression of dental erosion and dental caries. [ABSTRACT FROM AUTHOR]

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This study aimed to obtain early childhood caries (ECC) prevalence and analyze the associations between its risk factors and ECC. A cross-sectional study with a purposive sampling method was carried out with 218 children (24-42 months old) through interviews with their mothers. Intraoral examination of the children was performed by two calibrated examiners to obtain the Silness and Löe index of plaque and Caries Assessment Spectrum and Treatment (CAST) index. The prevalence of ECC was 79.8%, with primarily dentinal lesions with cavities (2.2 teeth/child) observed, followed by enamel lesions (1.73 teeth/child). There were associations between ECC and oral health and hygiene practices, including plaque index, children's toothbrushing supervision, tooth brushing after drinking milk or meal, and tooth brushing before going to bed. There were no statistically significant associations between demographic factors, breastfeeding, complementary feeding patterns, and ECC, but cariogenic snack consumption frequency showed a significant association toward ECC. There were associations between ECC, plaque index, tooth brushing supervision, tooth brushing habits after drinking milk or meal and before going to bed, and cariogenic snack consumption frequency. [ABSTRACT FROM AUTHOR]

Purpose: This study sought to evaluate in vitro the effect of a dentifrice containing sodium trimetaphosphate (TMP) combined or not with low fluoride (500 ppm NaF) on dentine erosion of intrinsic origin. Methods: Human root dentine blocks were selected based on surface microhardness and randomly allocated into five groups (n = 12): negative control (0 ppm F; no TMP); F500 (500 ppm NaF); F1500 (1500 ppm NaF—positive control); TMP (1% TMP); and F + TMP (500 ppm NaF + 1% TMP). The blocks were submitted to erosion cycles (3 ×/day) for 3 days (0.01 M HCl, pH 1.5–30 s), treatment (1 min—1:3 p/p dentifrice/distilled water) and remineralization (artificial saliva/120 min). Dentine alterations were determined according to the percentage of microhardness loss (%HL), surface loss (SL) and surface analysis by scanning electron microscopy. The data were analyzed using one-way ANOVA (p < 0.05). Results: The values of SL and %HL in each group were, respectively: negative control (1.36 ± 0.36; 57.29 ± 14.14), F500 (1.46 ± 0.28; 65.66 ± 5.11), F1500 (1.52 ± 0.36; 61.66 ± 5.15), TMP (1.45 ± 0.45; 62.08 ± 3.83) and F + TMP (1.38 ± 0.42; 63.38 ± 6.47). There was no statistically significant difference in all the parameters (p = 0.873 and p = 0.152). Conclusion: The dentifrices containing TMP combined or not with fluoride were not able to prevent dentine erosion. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study evaluated the prevalence of tooth enamel defects and risk factors associated in primary dentition. Methods: A sample of 656 schoolchildren (population based), aged 4 years old, from Araraquara-SP (Brazil) was evaluated by two trained examiners according to the following indexes: Dental fluorosis (DF), deciduous molar hypomineralization (DMH), non-fluoride related developmental defects of enamel (DDE), tooth erosion and tooth attrition. Structured questionnaires identified socioeconomic condition, medical/dental history, behavior and dietary habits. Data were analyzed using Chi-square tests (p < 0.05). Results: Of the enamel congenital defects, DF was the most prevalent (6.1%, n = 40), followed by DMH (5.6%, n = 37). Of the acquired defects, attrition was the most prevalent (36.9%, n = 242), followed by erosion (2.4%, n = 16). The caries experience was similar between the affected children (29,5%; n = 94) and total sample (30.6%; n = 201). The etiological factors related to congenital defects were: not exclusively fed breast milk (p = 0.003) and jaundice at birth (p < 0.001); the association with acquired defects was found with vomiting frequent episodes (p = 0.037). Conclusion: The general prevalence of enamel defects in primary dentition in Araraquara was 48.6%. Enamel defects may be associated with health-related factors and current lifestyle. [ABSTRACT FROM AUTHOR]

External cervical resorption (ECR) is a relatively uncommon yet aggressive form of dental hard tissue destruction. It is initiated at the cervical aspect of the root surface and extends apicocoronally and circumferentially inside the dentin. Despite the large number of case reports and clinical studies that have investigated ECR, its etiology remains unclear. Recent advancements in clinical assessment measures, such as the use of cone-beam computed tomographic imaging, have provided additional insights into the nature of this lesion. This has facilitated the continued development and improvement of treatment methods for this condition. In this article, we provide an overview of the latest research pertaining to the etiology, histopathology, predisposing factors, diagnosis, classification, and treatment of ECR. Furthermore, we provide a summary of the different classification schemes for ECR and highlight the relevant therapeutic principles. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy of silver diamine fluoride (SDF) and sodium fluoride (NaF) in inhibiting enamel erosion in primary teeth. Methods: 80 primary canine teeth were immersed for 24 h in 2% NaF, 10% SDF, or distilled water. Afterward, some of them underwent a 10-min acid challenge using either 1% or 10% citric acid while others did not. Specimens selected for negative controls were immersed in distilled water but not exposed to the acids, whereas those selected for positive controls were not only immersed in distilled water, but also exposed to the acids. Following, 3-mL samples were collected for calcium and phosphorus analysis by an atomic emission spectrometer. Results: 1% acid caused higher phosphorus loss in the positive control group than in the others (no differences between them). Regarding 10% acid, the SDF group showed lower phosphorus loss compared to the positive control and NaF groups. From calcium loss analysis, SDF and NaF groups presented no significant difference when compared to the positive control groups after both acidic challenges. Conclusion: Considering phosphorus loss values, 10% SDF seems to be effective in inhibiting enamel erosion after 1% and 10% citric acid challenges, whereas 2% NaF only after 1% citric acid challenge. Regarding calcium loss values, both fluoride agents seem to have no impact on inhibiting enamel erosion after 1% and 10% citric acid challenges. [ABSTRACT FROM AUTHOR]

The primary objective of this in vitro study was to investigate the erosive potential of enamel under the use of clear aligners (CA), by simulating in vivo conditions experienced by patients who do not remove their CA during the consumption of acidic beverages. In addition, the difference in erosion protection conferred by artificial and human saliva was also evaluated. Sound-extracted human premolars (n = 20) had half of their surfaces protected with acid-resistant nail polish and were randomly distributed into two experimental groups (n = 10): teeth immersed in human saliva or artificial saliva. All teeth had half of their lingual surfaces enclosed by a CA device. The erosive challenges consisted of individual immersion of each sample in citrus acid three times a day, intermediated by immersion in human saliva or artificial saliva for 2 h, during ten days of the erosive protocol. The enamel mineral content was analyzed by high-resolution microtomography. The differential mineral concentration profiles were obtained by subtracting the profile of the mineral concentration of the exposed area and enamel under the CA area from the respective sound area (control). In addition, enamel wear and enamel volume loss were measured. Scanning electron microscopy (SEM) was also performed to analyze the enamel surface. Data were analyzed by two-way ANOVA, followed by the Student-Newman-Keuls test. The enamel wear was higher in teeth immersed in artificial saliva, when compared to human saliva (p < 0.001). The volume loss of the exposed enamel area was lower for tooth immersed in human saliva than in artificial saliva (p < 0.001), during the acid challenge protocol. The use of CA during acid challenges promoted wear and mineral loss of dental enamel, being these changes more pronounced on the enamel surface under the CA. These results open a new path for the development of further studies adopting clinical protocols that promote more accurate responses in the clinical practice during orthodontic treatment. • Clear aligners (CA) during acid challenges promote wear and mineral loss of enamel. • These changes are more pronounced on the enamel surface under the CA. • Human saliva provided a greater anti-erosion effect than artificial saliva. • Insights open a new path for the development of more studies in clinical practice. [ABSTRACT FROM AUTHOR]

The article presents a case of a 57-year-old female who was rushed to a clinic due to altered passive eruption of her maxillary anterior teeth to discuss the effectiveness of the iTero Element 2 intraoral scanner from Align Technology, Inc. in impression-taking during zirconia-based treatment. Her condition was diagnosed as secondary condition to tooth erosion due to long-standing gastroesophageal reflux disease (GERD).

Purpose: To investigate the effect of slurry abrasive levels and acidic challenges on the development of non-carious cervical lesions.Methods: Ninety-six extracted upper premolars were affixed in pairs to acrylic blocks and had their root surfaces covered by acrylic resin except for 2 mm from the cemento-enamel junction. The specimens were distributed into six groups (n = 8 pairs) based on two experimental factors: (1) slurry abrasivity level [low/medium/high] and (2) citric acid challenge [yes/no]. Specimens were brushed for 5,000, 15,000, 35,000, and 65,000 strokes. Volume loss (VL) was determined based on optical profilometry scans of specimens impressions at the baseline and at subsequent brushing levels. Data were analyzed using repeated measures analysis of variance and Bonferroni pairwise comparison (α = 0.05).Results: Higher VL values were associated with high-abrasivity slurries relative to low- and medium-abrasivity slurries (P < 0.001). Increasing the slurry abrasivity level increased the VL regardless of the acidic challenge, which did not have a significant effect (P = 0.184). After 65,000 strokes, significant VL was recorded in all groups relative to preceding brushing levels (P < 0.001).Conclusion: Higher values of time-dependent surface loss were associated with increased dentifrice slurry abrasivity, regardless of the citric acid challenge. [ABSTRACT FROM AUTHOR]

First, as has recently been pointed out by Kelleher and Blum8, thought should be given to minimising further tooth destruction [in dentitions already damaged by TW], preserving the remaining sound tooth structure using additive techniques with minimal or no tooth preparation. Figure 2 presents such a case - my first "Dahl" TW case in 1998, in which there was no aesthetic component, merely the need to cover the worn and wearing palatal surfaces of the patient's maxillary incisor teeth. Graph If general dental practitioner readers can remember back to the halcyon (even if we did not think that it was thus at the time!) pre-pandemic times, they will be aware that the incidence of tooth wear (TW) is their patients was increasing, the volume of the problem being confirmed by a 2018 review of having a prevalence globally of 20% to 45%, and erosion in permanent teeth in the UK being between 12% and 100% depending upon which study was cited.1. Secondly, another reason - referral of a patient to another clinic might mean that the patient doesn't return to the practitioner's care. [Extracted from the article]

Acid-induced enamel demineralisation affects many individuals either by exposure to acidic diets, acidic gas pollution (dental erosion) or to dental plaque acids (dental caries). This study aimed to develop in situ X-ray and light imaging methods to determine progression of enamel demineralisation and the dynamic relationship between acid pH and mineral density. Hourly digital microradiograph time-lapse sequences showed the depth of enamel demineralisation in 500 µm thick sections progressed with time from the surface towards the dentine following a power-law function, which was 21% faster than the lateral demineralisation progression after exposure for 85 h to lactic acid (10%, pH 2.2). The minimum greyscale remaining (mineral content) within the induced enamel lesion followed an exponential decay, while the accumulated total greyscale loss with time was linear, which showed a constant anisotropic mineral release within the enamel architecture. This 85 h demineralisation method studied by polarised light microscopy time-lapse sequences showed that once the demineralisation front reached the enamel Hunter-Schreger bands, there was preferential demineralisation along those bands. Mineral density loss was linear with increasing pH acidity between pH 5.2 and pH 4.0 (with 0.4 pH increments) when incubated over a 3-week period exposed to 0.5% lactic acid. At pH 4.0, there was complete mineral loss in the centre of the demineralised area after the 3-week period and the linear function intercepted the x-axis at ~ pH 5.5, near the critical pH for hydroxyapatite (HAp). These observations showed how intrinsic enamel structure and pH affected the progression of demineralisation. Hydroxyapatite crystallites (HAp) in human enamel dissolve when exposed to an acidic environment but little is known about how the intrinsic structures in enamel and pH influence the demineralisation kinetics. We have developed a time-lapse in situ microradiography method to quantify microscopic anisotropic mineral loss dynamics in response to an acid-only caries model. Correlation with polarised light microscopy time-lapse sequences showed that larger structures in enamel also influence demineralisation progression as demineralisation occurred preferentially along the Hunter-Schreger bands (decussating prismatic enamel). The pH-controlled enamel mineral release in a linear manner quantifying the relationship between HAp orientation and acid solubility. These findings should direct the development of improved anti-demineralisation/ remineralisation treatments to retain/ restore the natural intrinsic enamel structure. Image, graphical abstract [ABSTRACT FROM AUTHOR]

This study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 μm2) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear perfThis study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 μm2) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear performed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions.ormed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions. [ABSTRACT FROM AUTHOR]

The present study sought to evaluate the protective effect of Epigallocatechin-3-gallate (EGCG) and commercial green tea (GT) on eroded dentin using in vitro and in situ experimental models. For the in vitro experiment, matrix metalloproteinases (MMPs) were extracted from demineralized human coronary dentin powder (citric acid, pH 2.3) and assessed via a colorimetric assay and electrophoresis in gelatin. The gels were exposed to buffers with: control (no treatment), 0.05% sodium fluoride (NaF), 0.12% chlorhexidine digluconate (CHX), GT infusion, and 0.1% EGCG, and their respective activity was analyzed by zymography. For the in situ experiment, 20 healthy volunteers (aged 20-32 years) participated in this single-center, blind, crossover study. The subjects wore upper removable devices containing four human dentin blocks. Erosive challenge (coke-1 min) was performed four times/day/5 days. Blocks were treated for 1 min with: control (No treatment), 0.05% NaF, 0.1% EGCG, and GT. Thereafter, the specimens were subjected to stylus profilometry and SEM. ANOVA was used to evaluate dentin roughness and wear, with a significance level of 5%. In the zymography analysis, 0.12% CHX, GT, and 0.1% EGCG were found to inhibit the action of MMPs; however, in the colorimetric assay, only green tea inhibited the activity of MMPs. There were no significant differences observed in dentin roughness or wear (p > 0.05). Herein, EGCG and GT inhibited the activity of endogenous proteases, resulting in protection against erosion-induced dentin damage; however, they could not prevent tooth tissue loss in situ. [ABSTRACT FROM AUTHOR]

The ultrastructural and mechanical properties of enamel surface were evaluated after prolonged bleaching treatments with 10% carbamide peroxide in the presence or absence of orange juice (erosive challenge) and toothbrushing (abrasive challenge). In total, 145 incisor bovine teeth were used in this study. Twenty-five samples were prepared for the ultrastructural evaluations, and 120 samples were prepared for microhardness and roughness tests. These 120 samples were divided into eight experimental groups (n = 15): G1- artificial saliva; G2- abrasion; G3- erosion; G4- dental bleaching; G5- erosion + abrasion; G6- bleaching + abrasion; G7- bleaching + erosion; and G8- bleaching + erosion + abrasion. All groups were tested at T0 (before treatment), T1 (14 days), T2 (21 days), and T3 (28 days). Two-way analysis of variance for repeated measures and the post hoc Sidak tests (p = 0.05) were used. The roughness evaluation demonstrated an increase in damage for all experimental groups with an increase in the time period. For microhardness, the groups exposed to artificial saliva (AS) and abrasive challenge did not show any differences at any time points, while the other groups showed a decrease in microhardness from T0 to T3. Ultrastructural evaluation showed different surface alterations in response to the treatments. Despite prolonged bleaching periods, the procedure caused lesser enamel surface alterations than exposure to orange juice alone or in combination with brushing. [ABSTRACT FROM AUTHOR]

Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the erosive potential of powdered juice drinks on dental enamel in 2 stages: physico- chemical characterization and erosive challenge testing. In stage 1, the pH and titratable acidity of 5 commercially available powdered juices in 10 different flavors were analyzed. Five treatment groups were then established based on the pH values, titratable acidity, and presence of citric acid in the juices, and their energy-dispersive X-ray (EDX) spectroscopy profiles were studied. In stage 2, the erosive effect of the juices was tested using a pH cycling model; polished bovine dental enamel blocks (n = 8) were treated 4 times daily on 5 consecutive days with 1% citric acid (positive control) or lemon, orange, pineapple, or cashew juice. The specimens were immersed in the erosive solutions, under agitation (100 rpm), for 1 minute at 25°C. Overnight and between treatments, the blocks were stored in artificial saliva without agitation. At the end of cycling, the enamel surfaces were evaluated by profilometry and scanning electron microscopy. The stage 2 results were submitted to 1-way analysis of variance followed by Tukey test (α = 0.05). The pH values of the juices ranged between 2 86 (lemon) and 3.84 (cashew), while the titratable acidity ranged from 14.5 (cashew) to 90.00 (lemon) mmol/L. Lemon juice showed the least calcium content (2.76%) and no (0.00%) phosphorus concentration. Orange, pineapple, and cashew juices showed the greatest concentrations of calcium and phosphorus and were therefore less erosive than lemon juice. The mean [SD] surface loss was higher in the lemon juice group (0.52 [0.16] μm), with no significant differences (P > 0.05) from the control (0.39 [0.09] μm) and orange juice (0.41 [0.12]μnm). In groups exposed to pineapple juice (0.36 [0.04] (μm) and cashew juice (0.16 [0.08] μm), the surface loss was significantly lower (P< 0.05) than that found in lemon juice. The results demonstrate that powdered juice drinks (especially lemon juice) present erosive potential and lead to surface loss of dental enamel. [ABSTRACT FROM AUTHOR]