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To identify the effectiveness of polymer-induced liquid precursors (PILP) on dentin remineralization and the assessment approaches used to evaluate remineralization. The analyses were done into six stages: (1) Identifying the research question; (2) Identifying the studies; (3) Selecting relevant studies; (4) Plotting the data; (5) Reporting results; and (6) Risk of bias. The searches were carried out in the following databases: PubMed, Web of Science, and Scopus. A total of 247 articles were identified in the electronic database search. After applying the eligibility criteria, only 12 articles were included for data extraction. The outcomes of dentin remineralization patterns were plotted in association to PILP agent type and application mode. The intrafibrillar mineralization occurred in 78% of studies where polyaspartic acid (pAsp) was used, and 50% when the polyacrylic acid (PAA) was used. All the studies where PILP was used in a restorative material (resin composite, glass ionomer, and adhesive system)—extra and intrafibrillar mineralization pattern was found. The association of PILP agents with other materials with potential for mineralization showed beneficial results in remineralization, since they provide a medium to high concentration of calcium and phosphate. The pAsp showed better results for interfibrillar remineralization when compared to PAA. The association with Ca/P release materials or solution Ca P are essentials for mineralization via PILP agent. Further studies are needed to assess the effectiveness of remineralization through PILP agents because the level of evidence of the studies was low. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Dental Science is the property of Brazilian Dental Science Journal-ICT-UNESP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We investigated the remineralization effects of Nanoseal (NS) dentin desensitizer on demineralized root dentin. Baseline lesion specimens prepared from bovine root dentin were immersed in artificial saliva (AS) or deionized water (DW) after treatment with NS or fluoride-free Nanoseal (NS(−)). Treatment and control groups comprised: 1, AS; 2, NS/AS; 3, NS(−)/AS; 4,NS/DW; 5, NS(−)/DW; and 6, baseline demineralization. Integrated mineral loss (IML) and lesion depth (LD) were determined by transverse microradiography. Fluoride concentrations in the immersion solutions were measured. AS, NS/AS and NS(−)/AS showed higher mineral volume % at the surface and lesion body than did other groups. NS/AS showed significantly lower IML than did AS. There was no significant difference in IML between NS/AS and NS(−)/AS. The highest concentration of fluoride was in the NS/AS immersion solution. The findings suggest Nanoseal facilitated remineralization of demineralized root dentin, and fluoride and other ions included may have contributed to this effect. [ABSTRACT FROM AUTHOR]

Background: Teeth in the human body are the most mineralized tissue, which contain both organic and inorganic components. Demineralization and remineralization of teeth occur continuously, but demineralization causes structural loss of a tooth. Aim: This study was done to find the effect of ceramic by adding mono-n-Dodecyl phosphate to ceramic in dentin remineralization. Materials and Methods: A total of sixty permanent intact tooth specimens were randomly divided into four equal groups: Group 1: control group, Group 2: dentin was etched and restored with plain ceramic restoration, Group 3: etched dentin restored with ceramic containing 2% mono-n-Dodecyl phosphate, and Group 4: etched dentin restored with ceramic containing 5% mono-n-Dodecyl phosphate. Each sample was immersed completely in simulated body fluid and was kept in an incubator at 37°C to simulate the human body environment. Knoop microhardness measurements were recorded at 10, 20, and 38 days. Results: Knoop microhardness of dentin (KHN) reduced to 32.6% after dentin was etched. No significant difference was found between group 2, 3 and 4 after 10 days. KHN value was increased and showed significant changes restored with group 2 and 3, group 3 showed nonsignificant changes. Conclusion: Through this study, we found that Ceramic can be used as a remineralizing agent to restore marginal dentine around of the cavity and root lesions from secondary caries. [ABSTRACT FROM AUTHOR]

It is crucial to emphasize the biomineralization therapeutic method to repair etched dentin in clinic. Non-collagenous proteins (NCPs) play critical role in the biomineralization of dentine. In this paper, we synthesized the phosphate-terminated polyamidoamine dendrimer (PAMAM-PO3H2) by one-step modification successfully and examined by Fourier-transform infrared spectroscopy (FT-IR) and ¹H-nuclear Magnetic Resonance (¹H-NMR) to characterize the structure of PAMAM-PO3H2. PAMAM-PO3H2 and carboxyl- terminated dendrimers (PAMAM-COOH) were applied as the dual biomimetic analogs of NCPs. Through the characterization of FT-IR, field emission scanning electron microscope (FE-SEM), transmission electron microscope (TEM), energy-dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD), the surfaces of human dentin were covered with regenerated crystals and the dentinal tubules were occluded by PAMAM-PO3H2 and PAMAM-COOH. In summary, the combination of PAMAM-PO3H2 and PAMAM-COOH may be another feasible therapeutic method for the treatment of dentin caries and dentin hypersensitivity. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate the effect of dentifrices or gels containing MMP inhibitors on dentine loss in situ. Materials and methods: Acrylic palatal appliances containing bovine dentine blocks were divided into two rows, corresponding to the groups erosion (ERO) and erosion associated with abrasion (ERO+ABR). For ERO, the appliances were immersed in a cola drink for 5 min, 4 times/day, while for ERO+ABR, the blocks were brushed for 15 sec with a dentifrice slurry after the second and third erosive challenges. Ten volunteers took part in study 1 (S1), where the dentifrices evaluated contained 1100 ppm fluoride as NaF, 0.61% green tea extract, or 0.012% chlorhexidine digluconate. Thirteen volunteers participated in study 2 (S2), in which the treatment was performed only once (1 min) with gels containing 400 μM EGCG (EGCG400), 0.012% chlorhexidine, 1 mM FeSO4, 1.23% F (NaF), placebo, or received no treatment. Dentine loss was analyzed by profilometry (μm). Results: Regarding S1, ERO+ABR induced significantly higher dentine loss compared with ERO and all dentifrices tested led to significantly lower dentine loss when compared with placebo. For S2, regardless of the conditions or times of evaluation, gels containing EGCG, CHX, or FeSO4 led to significantly less wear compared with the other groups. Conclusion: Both dentifrices and gels containing MMP inhibitors significantly reduced dentine loss. Clinical relevance: Dentifrices and gels containing MMP inhibitors are able to increase the protection against dentine wear, although gels have a better effect when compared with fluoride gel, lasting up to 10 days after a single application. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this work was to determine microtensile dentin bond strengths (µTBS) of dentin-resin composite bonds after three-month storage in artificial saliva containing either collagenase (COL) or cholesterol esterase (EST). The null hypothesis tested is that the resin-dentin bond strength is equivalent for each storage medium at the tested storage times. Materials and Methods: Resin composite was bonded to occlusal dentin, and µTBS specimens were formed and stored in the artificial saliva, COL, EST, or synthetic oil. After 24 h and 12-week storage, µTBS was determined and failure modes were characterized by SEM. The interfacial ultrastructure was evaluated by transmission electron microscopy as unstained and stained sections (phosphotungstic acid/uranyl acetate). Statistical analysis was performed by ANOVA and Weibull survival analyses at the 0.05 level of statistical significance. Results: There were significantly weaker bond strengths after 12 weeks for all experimental storage media (p < 0.001). Artificial saliva containing EST lowered bond strengths to a significantly greater extent than did COL after 12 weeks of storage, while no difference between these groups could be discerned after 24 h. Therefore, the null hypothesis of this experiment is rejected. Conclusion: Exogenous enzymatic challenge to resin-dentin bonds decreased bond durability only with EST. However, when further challenges to ideal infiltration of the comonomers into the hybrid layer were carried out using inadequate removal of solvent, additional alterations in hybrid layer ultrastructure were discerned by TEM that may represent different potential degradative processes. The contribution of endogenous enzymatic challenges to the primary degradative process, ie, hydrolysis, is unknown and deserves continued attention. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the bond strength of adhesive resins to artificially carious dentin specimens which were previously exposed to an acid buffer solution for various periods. Materials and Methods: Flat dentin disks were obtained from superficial occlusal dentin of extracted human third molars and polished with wet silicon carbide paper. Dentin disks were immersed in acid buffer solution for different periods to create the demineralized dentin layer. The first group of demineralized specimens was used for the evaluation of demineralization depth under SEM and the second group was used for the bond strength measurement. Shear bond strengths mediated by three dentin adhesives (Clearfil SE Bond, OptiBond Solo Plus Total-Etch, and OptiBond Solo Plus Self-Etch) were examined. A 0.75-mm-diameter area of dentin was bonded according to the manufacturers' instructions before placing a 0.5-mm-high resin composite cylinder. The bonds were stressed in shear at a crosshead speed of 1 mm/min. All data were analyzed using ANOVA and LSD multiple comparison test. Results: Depth of demineralization increased with the prolongation of demineralizing time. After dentin specimens were demineralized for up to 24 h, bond strengths of the self-etching adhesives were significantly higher than those of the total-etch adhesive. However, for longer demineralization periods, no statistical differences in bond strengths were observed. SEM photographs showed that resins cannot thoroughly infiltrate through the whole depth of the demineralized dentin layer. Conclusion: Bond strengths to demineralized, artificially carious dentin were affected by the depth of demineralization and adhesive resins used. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze a resin cement/dentin interface by comparing the diffusion of a resin cement into dentin surfaces pretreated with a self-etching primer with or without pretreatment by conventional acid etching. Materials and Methods: Dentin surfaces of 8 unerupted human third molars were treated with a self-etch primer (Panavia 21) with or without conventional phosphoric acid pretreatment. Panavia 21 resin cement was applied according to manufacturer's instructions. Dentin/resin cement interface sections from each tooth were examined with scanning electron microscopy and micro-Raman spectroscopy. Results: When the self-etch primer was used following conventional acid pretreatment, the resin cement did not penetrate to the depth of the zone of demineralized dentin, leaving a substantial area of exposed dentin matrix at the dentin/cement interface. In contrast, there was substantial resin cement diffusion throughout the demineralized dentin when the self-etch primer was used without acid etching pretreatment. Conclusion: The in vitro evaluation of resin cement penetration throughout the zone of demineralized dentin is an important step in identifying sites of exposed dentin matrix that may promote postoperative sensitivity and may leave the dentin/resin cement interface vulnerable to premature degradation under clinical conditions. In this study, the self-etch primer used alone produced substantial resin cement penetration and left no exposed dentin matrix at the dentin/resin cement interface. [ABSTRACT FROM AUTHOR]

Objective: Non-invasive esthetic treatment options for stained arrested caries lesions have not been explored. This study aimed to develop laboratory models to create stained-remineralized caries-like lesions (s-RCLs) and to test the efficacy of bleaching on their esthetic treatment.Materials and methods: One hundred twelve enamel/dentin specimens were prepared from human molars, embedded, and had their color measured spectrophotometrically at baseline and after demineralization. They were randomly divided into four groups (n = 14) based on the staining/remineralization protocols for a total of 5 days: G1, no staining/no remineralization; G2, no staining/remineralization in artificial saliva (AS); G3, non-metallic staining/remineralization with sodium fluoride/AS; and G4, metallic staining/remineralization with silver diamine fluoride/AS. The lesion mineral loss (ΔZ) and depth (L) were measured using transverse microradiography along with color change (ΔE). Specimens were bleached and color was re-evaluated. Data were analyzed using ANOVA models followed by Fisher's PLSD tests (α = 0.05).Results: s-RCLs in G4 were significantly (p < 0.001) darker than G3, G2, and G1 regardless of substrate type and condition. s-RCLs in G2, G3, and G4 showed significantly lower ΔZ and L than G1 (all p < 0.001), confirming occurrence of remineralization. G4 exhibited significantly lower ΔZ and L compared to G2 (p < 0.001). Bleaching was more effective in non-metallic than in metallic stained lesions regardless of substrate type (p < 0.001).Conclusion: The proposed models created distinct s-RCLs. Non-metallic s-RCLs were lighter and more responsive to bleaching compared to metallic s-RCLs.Clinical relevance: The developed experimental models allow the further investigation of the efficacy and safety of different clinical strategies for the esthetic management of s-RCLs. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of pH on the activation of matrix metalloproteinases (MMPs) of human coronal (CD) and radicular dentin (RD). CD and RD were pulverized to powder, and proteins were extracted with 1% phosphoric acid. The extracted proteins and the demineralized powder were separately incubated in the following solutions: 4-aminophenylmercuric acetate (control) or a buffer solution at different pHs (2.5, 4.5, 5.0, 6.0, and 7.0). After incubation, proteins were separated by electrophoresis to measure MMP activities by zymography. To assess the solubilized dentin collagen, the demineralized dentin powder was sustained in incubation buffer, and the amount of hydroxyproline (HYP) released was measured. Zymography revealed MMP-2 gelatinolytic activities for CD and RD in all experimental groups. For both substrates, the lowest pH solutions (2.5, 4.5, and 5.0) yielded higher gelatinolytic activity than those obtained by the highest pH solutions (6.0 and 7.0). For HYP analysis, no detectable absorbance values were observed for pHs of 2.5 and 4.5. The amount of HYP was higher for pH 7.0 than those of all other groups (p < 0.05), except for pH 6.0. No statistical differences were found between pHs 6.0 and 5.0 and control (p > 0.05). The MMP-2 enzyme from human CD and RD is dynamically influenced by pH: at low pH, the extracted enzyme activates this latent form, whereas collagen degradation by the matrix-bound enzyme is only observed when pHs are close to neutral. [ABSTRACT FROM AUTHOR]

Recent advances regarding the caries process indicate that ecological phenomena induced by bacterial acid production tilt the de- and remineralization balance of the dental hard tissues towards demineralization through bacterial acid-induced adaptation and selection within the microbiota - from the dynamic stability stage to the aciduric stage via the acidogenic stage [Takahashi and Nyvad, 2008]. Dentin and root caries can also be partly explained by this hypothesis; however, the fact that these tissues contain a considerable amount of organic material suggests that protein degradation is involved in caries formation. In this review, we compiled relevant histological, biochemical, and microbiological information about dentin/root caries and refined the hypothesis by adding degradation of the organic matrix (the proteolytic stage) to the abovementioned stages. Bacterial acidification not only induces demineralization and exposure of the organic matrix in dentin/root surfaces but also activation of dentin-embedded and salivary matrix metalloproteinases and cathepsins. These phenomena initiate degradation of the demineralized organic matrix in dentin/root surfaces. While a bacterial involvement has never been confirmed in the initial degradation of organic material, the detection of proteolytic/amino acid-degrading bacteria and bacterial metabolites in dentin and root caries suggests a bacterial digestion and metabolism of partly degraded matrix. Moreover, bacterial metabolites might induce pulpitis as an inflammatory/immunomodulatory factor. Root and dentin surfaces are always at risk of becoming demineralized in the oral cavity, and exposed organic materials can be degraded by host-derived proteases contained in saliva and dentin itself. New approaches to the prevention and treatment of root/dentin caries are required. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this double-blinded, randomized, cross-over in situ study was to evaluate the re- and demineralization characteristics of sound enamel as well as lowly and highly demineralized caries-like enamel lesions after the application of different fluoride compounds.Methods: In each of three experimental legs of 4 weeks, 21 participants wore intraoral mandibular appliances containing 4 bovine enamel specimens (2 lowly and 2 highly demineralized). Each specimen included one sound enamel and either one lowly demineralized (7 days, pH 4.95) or one highly demineralized (21 days, pH 4.95) lesion, and was positioned 1 mm below the acrylic under a plastic mesh. The three randomly allocated treatments (application only) included the following dentifrices: (1) 1,100 ppm F as NaF, (2) 1,100 ppm F as SnF2 and (3) 0 ppm F (fluoride-free) as negative control. Differences in integrated mineral loss (x0394;x0394;Z) and lesion depth (x0394;LD) were calculated between values before and after the in situ period using transversal microradiography.Results: Of the 21 participants, 6 did not complete the study and 2 were excluded due to protocol violation. Irrespectively of the treatment, higher baseline mineral loss and lesion depth led to a less pronounced change in mineral loss and lesion depth. Except for x0394;x0394;Z of the dentifrice with 0 ppm F, sound surfaces showed significantly higher x0394;x0394;Z and x0394;LD values compared with lowly and highly demineralized lesions (p < 0.05, t test).Conclusion: Re- and demineralization characteristics of enamel depended directly on baseline mineral loss and lesion depth. Treatment groups should therefore be well balanced with respect to baseline mineral loss and lesion depth. [ABSTRACT FROM AUTHOR]

Dentine caries is a process of demineralization and subsequent degradation of the collagenous matrix. Host-derived proteolytic enzymes, such as matrix metalloproteinases ( MMPs), play a role in this process of dentine collagen degradation. Hampering this degradation retards the caries process. Dietary antioxidants, such as the flavonoid hesperidin, can inhibit the proteolytic activity of MMPs and act as natural stabilizers of collagen. The aim of this study was to investigate the anti-collagenolytic activity of hesperidin in an in situ model. A single-blind, split-mouth, in situ experiment was designed. Seventeen participants received two completely demineralized dentine specimens placed contralaterally in the buccal flanges of their partial prosthesis. During the 4-wk experimental period, the participants immersed the dentine specimens in a test solution [1,000 parts per million (p.p.m.) hesperidin] or a control solution (saline), twice daily for 3 min. After the in situ period, the specimens were retrieved and their collagen content was determined. A saliva sample was taken at the start and at the end of the experimental period, to assess collagenolytic activity. A significant protection of collagen, of 24%, was observed in the hesperidin-treated specimens compared with the control-treated specimens. No correlation was found between salivary collagenolytic activity and loss of collagen in the control-treated specimens. The results of this in situ study show that hesperidin could play a role in the preservation of dentine collagen matrix. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to accelerate the remineralization of a completely demineralized dentine collagen block in order to regenerate the dentinal microstructure of calcified collagen fibrils by a novel electric field-aided biomimetic mineralization system in the absence of non-collagenous proteins. Completely demineralized human dentine slices were prepared using ethylene diamine tetraacetic acid (EDTA) and treated with guanidine hydrochloride to extract the bound non-collagenous proteins. The completely demineralized dentine collagen blocks were then remineralized in a calcium chloride agarose hydrogel and a sodium hydrogen phosphate and fluoride agarose hydrogel. This process was accelerated by subjecting the hydrogels to electrophoresis at 20 mA for 4 and 12 h. X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and transmission electron microscopy (TEM) were used to evaluate the resultant calcification of the dentin collagen matrix. SEM indicated that mineral particles were precipitated on the intertubular dentin collagen matrix; these densely packed crystals mimicked the structure of the original mineralized dentin. However, the dentinal tubules were not occluded by the mineral crystals. XRD and EDX both confirmed that the deposited crystals were fluorinated hydroxyapatite. TEM revealed the existence of intrafibrillar and interfibrillar mineralization of the collagen fibrils. A novel electric field-aided biomimetic mineralization system was successfully developed to remineralize a completely demineralized dentine collagen matrix in the absence of non-collagenous proteins. This study developed an accelerated biomimetic mineralization system which can be a potential protocol for the biomineralization of dentinal defects. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the correlation between CT depth, indentation depth determined by a new hardness tester (Cariotester), and the transverse microradiography (TMR) parameters, i.e., lesion depth and mineral loss. For that purpose, this study evaluated the feasibility of using Cariotester as a root caries diagnostic system and capability of Cariotester to detect effect of fluoride application on inhibiting dentin deminerahzation. Fluorides were applied to bovine root dentin specimens, which were subsequently demineralized for 1-21 days and then CT depth and TMR parameters were assessed. There were significant correlations between CT depth and TMR parameters in fluoride and non-fluoride groups. There were significant differences between fluoride and non-fluoride groups for CT depth and TMR parameters respectively. Current results suggested that Cariotester may be capable of providing an objective evaluation of root caries progression and the fluoride effect on inhibiting dentin deminerahzation. [ABSTRACT FROM AUTHOR]

Demineralization in dentinal caries and erosion exposes dentine organic matrix. This exposed matrix, containing type I collagen and non-collagenous proteins, is then degraded by host collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins. The knowledge of the identities and function of these enzymes in dentine has accumulated only within the last 15 years, but has already formed a field of research called 'dentine degradomics'. This research has demonstrated the role of endogenous collagenolytic enzymes in caries and erosion development. In demineralized dentine, the enzymes degrade triple-helical collagen molecules, leading to the gradual loss of collagen matrix. Even before that, they can cleave off the terminal non-helical ends of collagen molecules called telopeptides, leading to the structural changes at the intramolecular gap areas, which may affect or even prevent intrafibrillar remineralization, which is considered essential in restoring the dentine's mechanical properties. They may also cause the loss of non-collagenous proteins that could serve as nucleation sites for remineralization. Here we review the findings demonstrating that inhibition of salivary or dentine endogenous MMPs and cysteine cathepsins may provide preventive means against the progression of caries or erosion. Furthermore, we also suggest the future directions for the new experimental preventive research to gain more knowledge of the enzymes and their function during and after dentine demineralization, and the pathways to find the clinically acceptable means to prevent the functional activity of these enzymes. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Journal of Microscopy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study was designed to evaluate the effects of type I collagen degradation on the durability of three adhesive systems in the early phase of dentin bonding. Methods: Bonded dentin specimens were prepared using three different types of adhesive systems. Micro-tensile bond strength and degradation of collagen were tested before, and after 1 month or 4 months of aging in artificial saliva. The relationship between micro-tensile bond strength and collagen degradation was analyzed by calculating their Pearson’s correlation coefficient. Results: Aging induced time-dependent reduction in micro-tensile bond strengths for all the tested adhesive systems, although such reduction for the single-step self-etching adhesive G-Bond (GB) was not statistically significant. The bond strength of the two-step self-etching primer adhesive system Clearfil SE Bond (SEB) was similar to that of the two-step etch-and-rinse self-priming adhesive system Single Bond 2 (SB), and they were both significantly reduced after one or four months of aging. A negative correlation was found between the degree of collagen degradation and magnitude of micro-tensile bond strength (r = - 0.65, p = 0.003). The Pearson’s correlation coefficient was 0.426, indicating that 42.6% of the aging-induced reduction in bond strength can be explained by the degradation of collagen. Conclusions: In the early phase of dentin bonding, there was a negative correlation between the degree of collagen degradation and the magnitude of micro-tensile bond strength. The reduction of bond strength was accompanied by the degradation of collagen. These results provide evidence for the causative relationship between the degradation of collagen and the deterioration of dentin-adhesive interface. [ABSTRACT FROM AUTHOR]

Currently, it is still a tough task for dentists to remineralize dentine in deep caries. The aim of this study was to remineralize demineralized dentine in a tooth model of deep caries using nanocomplexes of carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP) based on mimicking the stabilizing effect of dentine matrix protein 1 (DMP1) on ACP in the biomineralization of dentine. The experimental results indicate that CMC can stabilize ACP to form nanocomplexes of CMC/ACP, which is able to be processed into scaffolds by lyophilization. In the single-layer collagen model, ACP nanoparticles are released from scaffolds of CMC/ACP nanocomplexes dissolved and then infiltrate into collagen fibrils via the gap zones (40 nm) to accomplish intrafibrillar mineralization of collagen. With this method, the completely demineralized dentine was partially remineralized in the tooth mode. This is a bottom-up remineralizing strategy based on non-classical crystallization theory. Since nanocomplexes of CMC/ACP show a promising effect of remineralization on demineralized dentine via biomimetic strategy, thereby preserving dentinal tissue to the maximum extent possible, it would be a potential indirect pulp capping (IPC) material for the management of deep caries during vital pulp therapy based on the concept of minimally invasive dentistry (MID). [ABSTRACT FROM AUTHOR]

The study investigated the erosion/abrasion-preventing potential of experimental NaF (1,400 ppm F-) and amine fluoride (AmF)/NaF/SnCl2/chitosan (1,400 ppm F-, 3,500 ppm Sn2+, 0.5% chitosan) toothpastes relative to placebo and SnF2 gel (970 ppm F-, 3,000 ppm Sn2+), and the impact of the demineralised dentine matrix on toothpaste effects. The study was a cyclic erosion/intervention experiment (10 days). Samples were stored in mineral salt solution either without or with collagenase (from Clostridium histolyticum type VII; 100 U/ml) for continuous removal of the organic matrix. To produce a comparable order of tissue loss, erosion was performed 6 × 30 s/day with 0.5% citric acid in the latter and 6 × 90 s/day with 1% citric acid in the former. Intervention was toothpaste slurry immersion (2 × 2 min/day); half of the samples were additionally brushed for 15 s within this time (brushing machine, load 200 g). Tissue loss was determined profilometrically (mean ± SD; µm). Tissue loss values (without/with brushing) for placebo, NaF, AmF/NaF/SnCl2/chitosan and SnF2 gel, respectively, were 11.6 ± 3.1/12.2 ± 2.5, 12.7 ± 3.1/10.7 ± 4.5, 8.7 ± 2.1/9.7 ± 2.1 and 8.8 ± 1.8/ 10.9 ± 1.8 in the presence of the organic matrix and 10.7 ± 3.2/11.9 ± 2.1, 8.2 ± 4.0/10.1 ± 4.1, 8.7 ± 2.9/9.1 ± 1.8 and 8.4 ± 1.9/7.5 ± 1.5 in the absence of the organic matrix. Relative to placebo, the NaF formulation had no significant effects; the AmF/NaF/SnCl2/chitosan formulation significantly reduced tissue loss between 20 and 25% except when applied without brushing in the absence of the organic matrix. The effects of the formulations were similar both in the presence and absence of the organic matrix. Sn2+/F-- containing formulations have the potential to reduce erosion/abrasion even in the absence of demineralised collagen; seeking for more effective formulations is desirable. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to determine the origin of the red fluorescence of carious dentine observed with the Soprolife ® camera. Methods: We conducted in vitro studies to evaluate the origin of the red fluorescence using acids and matrix metalloproteinase (MMP) to mimic caries and methylglycoxal (MGO) to evaluate the effect of glycation reactions on the red fluorescence. In every step of these models, we detected the changes of dentin photonic response with Soprolife® in daylight mode and in treatment mode. A Raman spectroscopy analysis was performed to determine the variations of the dentin organic during the in vitro caries processes. Raman microscopy was performed to identify change in the collagen matrix of dentine. Results: The red fluorescence observed in carious dentine using a Soprolife ® camera corresponds to the brownish color observed using daylight. Demineralization using nitric acid induces a loss of the green fluorescence of dentine. The red fluorescence of carious dentine is resistant to acid treatment. Immersion of demineralized dentine in MGO induces a change of color from white to orange-red. This indicates that the Maillard reaction contributes to lesion coloration. Immersion of demineralized dentine in an MMP-1 solution followed by MGO treatment results in a similar red fluorescence. Raman microspectroscopy analysis reveals accumulation of AGE's product in red-colored dentine. Conclusions: Our results provide important information on the origin of the fluorescence variation of dentine observed with the Soprolife® camera. We demonstrate that the red fluorescence of carious dentine is linked to the accumulation of Advanced Glycation End products (AGE). Clinical relevance: The study provides a new biological basis for the red fluorescence of carious dentine and reinforces the importance of the Soprolife® camera in caries diagnostics. [ABSTRACT FROM AUTHOR]

Calcium hydroxide has been used extensively in dentistry for a century. Despite its widespread use as a pulp-capping agent, its mechanisms of action still remain ambiguous. Understanding its modes of action will lead to a broader understanding of the mechanisms associated with induced dentinogenesis and help in optimizing the currently available agents to target specific regenerative processes to obtain the best possible clinical outcomes. A literature search relating to mechanisms of dentinogenesis of calcium hydroxide up to December 2011 was carried out using pubmed and MEDLINE database searches as well as manual searching of cross-references from identified studies. Resulting suggestions regarding dentinogenic mechanisms of calcium hydroxide range from direct irritating action of the material to induction of release of biologically active molecules. The purpose of this article is to discuss various mechanisms through which calcium hydroxide may induce tertiary dentinogenesis in the light of observations made in included studies. [ABSTRACT FROM AUTHOR]

This proof-of-concept study assessed whether the reduction of the degradation of the demineralized organic matrix (DOM) by pre-treatment with protease inhibitors (PI) is effective against dentin matrix loss. Bovine dentin slices were demineralized with 0.87 M citric acid, pH 2.3, for 36 hrs. In sequence, specimens were treated or not (UT, untreated) for 1 min with gels containing epigallocatechin 3-gallate (EGCG, 400 µM), chlorhexidine (CHX, 0.012%), FeSO4 (1 mM), NaF (1.23%), or no active compound (P, placebo). Specimens were then stored in artificial saliva (5 days, 37°C) with the addition of collagenase (Clostridium histolyticum, 100 U/mL). We analyzed collagen degradation by assaying hydroxyproline (HYP) in the incubation solutions (n = 5) and evaluated the dentin matrix loss by profilometry (n = 12). Data were analyzed by ANOVA and Tukey’s test (p < 0.05). Treatment with gels containing EGCG, CHX, or FeSO4 led to significantly lower HYP concentrations in solution and dentin matrix loss when compared with the other treatments. These results strongly suggest that the preventive effects of the PI tested against dentin erosion are due to their ability to reduce the degradation of the DOM. [ABSTRACT FROM PUBLISHER]

Dentine remineralization is clinically significant for prevention and treatment of dentine caries, root caries, and dentine hypersensitivity. However, dentine remineralization is more difficult than enamel remineralization due to the abundant presence of organic matrix in dentine. The objective of this study was to develop a biomimetic method to facilitate remineralization of demineralized dentine through phosphorylation of type I collagen in demineralized dentine using sodium trimetaphosphate. The experimental results indicated that the effect of fluoride on remineralizing dentine was limited when residual mineral crystals were lacking on the surface of demineralized dentine, whereas the phosphorylation and Ca(OH) pretreatment enhanced surface remineralization of the partially demineralized dentine. This biomimetic methodology resulted in favorable surface properties (i.e. highly negative charge and low interfacial free energy between substrate and aqueous medium) for crystal nucleation, and thus could be a promising method to remineralize superficially demineralized dentine lesions. [ABSTRACT FROM AUTHOR]

The limited durability of resin-dentin bonds severely compromises the lifetime of tooth-colored restorations. Bond degradation occurs via hydrolysis of suboptimally polymerized hydrophilic resin components and degradation of water-rich, resin-sparse collagen matrices by matrix metalloproteinases (MMPs) and cysteine cathepsins. This review examined data generated over the past three years on five experimental strategies developed by different research groups for extending the longevity of resin-dentin bonds. They include: (1) increasing the degree of conversion and esterase resistance of hydrophilic adhesives; (2) the use of broad-spectrum inhibitors of collagenolytic enzymes, including novel inhibitor functional groups grafted to methacrylate resins monomers to produce anti-MMP adhesives; (3) the use of cross-linking agents for silencing the activities of MMP and cathepsins that irreversibly alter the 3-D structures of their catalytic/allosteric domains; (4) ethanol wet-bonding with hydrophobic resins to completely replace water from the extrafibrillar and intrafibrillar collagen compartments and immobilize the collagenolytic enzymes; and (5) biomimetic remineralization of the water-filled collagen matrix using analogs of matrix proteins to progressively replace water with intrafibrillar and extrafibrillar apatites to exclude exogenous collagenolytic enzymes and fossilize endogenous collagenolytic enzymes. A combination of several of these strategies should result in overcoming the critical barriers to progress currently encountered in dentin bonding. [ABSTRACT FROM PUBLISHER]

The advantages, limitations and potential applications of available methods for studying erosion of enamel and dentine are reviewed. Special emphasis is placed on the influence of histological differences between the dental hard tissue and the stage of the erosive lesion. No method is suitable for all stages of the lesion. Factors determining the applicability of the methods are: surface condition of the specimen, type of the experimental model, nature of the lesion, need for longitudinal measurements and type of outcome. The most suitable and most widely used methods are: chemical analyses of mineral release and enamel surface hardness for early erosion, and surface profilometry and microradiography for advanced erosion. Morphological changes in eroded dental tissue have usually been characterised by scanning electron microscopy. Novel methods have also been used, but little is known of their potential and limitations. Therefore, there is a need for their further development, evaluation, consolidation and, in particular, validation. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

It is known that some metal salts can inhibit matrix metalloproteinase (MMP) activity, but the effect of iron has not been tested yet. On the other hand, it has recently been suggested that MMP inhibition might influence dentine erosion. Based on this, the aims of this study were: (1) to test in vitro the effect of FeSO4 on MMP-2 and -9 activity, and (2) to evaluate in situ the effect of FeSO4 gel on dentine erosion. MMP-2 and -9 activities were analysed zymographically in buffers containing FeSO4 in concentrations ranging between 0.05 and 1.5 mmol/l or not. Volunteers (n = 10) wore devices containing bovine dentine blocks (n = 60) previously treated with the following gel treatments: FeSO4 (1 mmol/l FeSO4), F (NaF 1.23%; positive control) and placebo (negative control). The gels were applied once and removed after 1 min. Erosion was performed extraorally with Coca-Cola 4 times per day for 5 min over 5 days. Dentine wear was evaluated by profilometry. The data were analysed by Kruskal-Wallis and Dunn’s tests (p < 0.05). FeSO4 inhibited both MMP-2 (IC50 = 0.75 mmol/l) and MMP-9 (IC50 = 0.50 mmol/l) activities. In the in situexperiment, the mean wear (± SD) found for the F gel (0.79 ± 0.08 μm) was significantly reduced in more than 50% when compared to the placebo gel (1.77 ± 0.33 μm), but the FeSO4 gel completely inhibited the wear (0.05 ± 0.02 μm). Since FeSO4 was able to inhibit MMP in vitro, it is possible that the prevention of dentine wear by the FeSO4 gel in situ might be due to MMP inhibition, which should be investigated in further studies. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Matrix metalloproteinase (MMP) inhibition has been shown to reduce dentin caries progression, but its role in dental erosion has not yet been assessed. This study tested the hypothesis that gels containing MMP inhibitors (epigallocatechin gallate-EGCG and chlorhexidine) can prevent dental erosion. Volunteers (n = 10) wore palatal devices containing bovine dentin blocks (n = 10/group) treated for 1 min with EGCG at 10 (EGCG10) or 400 µM (EGCG400), chlorhexidine at 0.012%, F at 1.23% (NaF), and no vehicle (placebo). Erosion was performed with Coca-Cola® (5 min) 4X/day during 5 days. The wear, assessed by profilometry (mean ± SD, µm), was significantly reduced by the gels containing MMP inhibitors (0.05 ± 0.02a, 0.04 ± 0.02a, and 0.05 ± 0.02a for EGCG10, EGCG400, and chlorhexidine, respectively) when compared with NaF (0.79 ± 0.35b) and placebo gels (1.77 ± 0.35b) (Friedman and Dunn's tests, p < 0.01). The use of gels delivering MMP inhibitors was shown to prevent erosion and opens a new perspective for protection against dental erosion. [ABSTRACT FROM AUTHOR]

Dentine carious lesions can be remineralized under optimal conditions, while the surface characteristics of the caries-attacked area may play an important role in the remineralization process. To understand such a surface mechanism, we examined the microstructures of the remineralized area pretreated with different methods. It was found that dentinal tubules on the remineralized surface orientated differently from intrinsic dentine tubules, with the specific alignment angle determined by different surface treatments. Various surface treatments included in this study were 37% phosphoric acid treatment (the etched group), 37% phosphoric acid etching followed by the application of 10% sodium hypochlorite treatment (the deproteinized group), and untreatment (the control group). These findings are helpful for understanding the non-restorative repair of dentine lesions and the remineralization process of the caries-affected dentin surface. [ABSTRACT FROM AUTHOR]

Erosion of dentine causes mineral dissolution, while the organic compounds remain at the surface. Therefore, a determination of tissue loss is complicated. Established quantitative methods for the evaluation of enamel have also been used for dentine, but the suitability of these techniques in this field has not been systematically determined. Therefore, this study aimed to compare longitudinal microradiography (LMR), contacting (cPM) and non-contacting profilometry (ncPM), and analysis of dissolved calcium (Ca analysis) in the erosion solution. Results are discussed in the light of the histology of dentine erosion. Erosion was performed with 0.05 M citric acid (pH 2.5) for 30, 60, 90 or 120 min, and erosive loss was determined by each method. LMR, cPM and ncPM were performed before and after collagenase digestion of the demineralised organic surface layer, with an emphasis on moisture control. Scanning electron microscopy was performed on randomly selected specimens. All measurements were converted into micrometres. Profilometry was not suitable to adequately quantify mineral loss prior to collagenase digestion. After 120 min of erosion, values of 5.4 ± 1.9 μm (ncPM) and 27.8 ± 4.6 μm (cPM) were determined. Ca analysis revealed a mineral loss of 55.4 ± 11.5 μm. The values for profilometry after matrix digestion were 43.0 ± 5.5 μm (ncPM) and 46.9 ± 6.2 (cPM). Relative and proportional biases were detected for all method comparisons. The mineral loss values were below the detection limit for LMR. The study revealed gross differences between methods, particularly when demineralised organic surface tissue was present. These results indicate that the choice of method is critical and depends on the parameter under study. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Eroded dentine has a complex histological structure, and its organic fraction becomes increasingly exposed as a result of the continual action of acids. The present study sought to investigate the effects of brushing forces up to 4 N on mineralized and organic dentine fractions. The study was a cyclic demineralization and remineralization experiment (carried out over 9 d). Erosion was performed with HCl (6 × 2 min d−1), pH 1.6. Samples exposed to erosion alone served as controls; test samples were eroded and brushed with a powered toothbrush (2 × 15 s d−1), applying forces of 2, 3, or 4 N. Samples were analysed (using profilometry and longitudinal microradiography) before and after the removal of superficial organic material with collagenase. Randomly selected samples were subjected to scanning electron microscopy. Demineralized organic material was present on all samples regardless of brushing force. Loss values (determined using profilometry) after erosion only, and after brushing with forces of 2, 3, and 4 N, were 11.7 ± 5.1, 13.6 ± 11.2, 30.7 ± 19.0, and 25.5 ± 20.3, respectively, before treatment with collagenase, and 111.7 ± 11.6, 122.0 ± 11.8, 121.9 ± 15.7, and 123.0 ± 12.0, respectively, after treatment with collagenase. Microradiography confirmed the results. Significant effects of brushing force were only found on the demineralized organic fraction, and mineral loss was unaffected. The notion that eroded dentine is particularly prone to abrasion should be reconsidered. [ABSTRACT FROM AUTHOR]

This in situ/ex vivo study assessed the effect of different concentrations of fluoride in dentifrices on dentin subjected to erosion or to erosion plus abrasion. Ten volunteers took part in this crossover and double-blind study performed in 3 phases (7 days). They wore acrylic palatal appliances containing 4 bovine dentin blocks divided in two rows: erosion and erosion plus abrasion. The blocks were subjected to erosion by immersion ex vivo in a cola drink (60 s, pH 2.6) 4 times daily. During this step, the volunteers brushed their teeth with one of three dentifrices D (5,000 ppm F, NaF, silica); C (1,100 ppm F, NaF, silica) and placebo (22 ppm F, silica). Then, the respective dentifrice slurry (1:3) was dripped on dentin surfaces. While no further treatment was performed in one row, the other row was brushed using an electric toothbrush for 30 s ex vivo. The appliances were replaced in the mouth and the volunteers rinsed with water. Dentin loss was determined by profilometry and analyzed by 2-way ANOVA/Bonferroni test (a = 0.05). Dentin loss after erosive-abrasive wear was significantly greater than after erosion alone. Wear was significantly higher for the placebo than for the D and C dentifrices, which were not significantly different from each other. It can be concluded that the presence of fluoride concentrations around 1,100 ppm in dentifrices is important to reduce dentin wear by erosion and erosion + abrasion, but the protective effect does not increase with fluoride concentration. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

It is an established assumption that eroded dental hard tissues are particularly prone to toothbrush abrasion. Only a few studies have aimed to show this for dentine and, if so, disregarded the complex histological structure of this tissue. Therefore, the present study sought (i) to investigate the effects of toothbrushing on eroded dentine and (ii) to analyze how the organic matrix influences the outcome of established methods for quantifying dental hard tissue loss. The effects of brushing were investigated by optical (P-O) and mechanical (P-M) profilometry, by longitudinal microradiography (LMR), and by scanning electron microscopy (SEM). The SEM images showed that a demineralized organic layer had developed, which was unaffected by brushing. For substance loss, there was no significant difference between eroded and eroded/abraded samples. Considerable differences occurred, however, when results from the different methods were compared. P-O yielded the lowest (7.0 ± 3.4 µm) and LMR the highest (109.8 ± 10.7 µm) substance loss values. When the organic material was removed enzymatically, all methods gave comparable results. The results of this study do not lend support to the notion that brushing increases substance loss of eroded dentine. Profilometry was not suitable for measuring mineral loss, unless the organic material was removed. [ABSTRACT FROM AUTHOR]

It has been suggested that laser fluorescence close to the dental pulp shows higher values than more distant measurements. The aim of this study was to assess fluorescence on the cavity floor and to correlate these measurements with electrical resistance as a measure of residual dentine thickness. Thirty carious lesions were excavated with a bur. The endpoint of caries removal was determined by visual, tactile and auditory means. Fluorescence was measured with the Diagnodent device and with the fluorescence feedback system of a therapeutic Er:YAG laser. Electrical resistance of the residual dentine (Prepometer units, PU) was measured with a proprietary device. Significant differences were observed between the fluorescence systems (p < 0.05). For Diagnodent, a decrease of electrical resistance of the residual dentine resulted in an increase of the fluorescence values of 2.99 units/PU (95% CI = 2.00–3.97) and an increase of 0.30 units/PU (95% CI = 0.19–0.40) for the fluorescence feedback system. For zero electrical resistance, a predicted maximum value of 51.5 units (95% CI = 41.3–61.7) was calculated for the Diagnodent and 5.1 units (95% CI = 4.1–6.2) for the feedback system. The study indicates that using the suggested detection cut-off with the Diagnodent device may be not suited to assess the endpoint of caries removal close to the dental pulp. Employing the Key Laser III, values up to 6 units might be caused solely by close proximity to the pulp, which should be considered when caries removal by laser is controlled by laser fluorescence feedback. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim was to study remineralization in dentin underneath a biofilm. This was done in a constant depth film fermentor (CDFF) which was modified so that two treatments can be applied simultaneously in one experiment. Forty-five Streptococcus mutans biofilms were grown in grooves in dentin. Growth medium (3.7 g/l BHI, 1.5 mM calcium and 25 mM PIPES) was administered alternately with 2% sucrose pulsing 4 × 30 min/day. Fluoride at 135 ppm as NaF only or in a mixture with 0.2% chlorhexidine was applied for 2 × 5 min/day. The treatments started 5 days after inoculation and lasted 15 days. Five specimens per group were removed at various time points. The biofilms were checked for viability (by plating) and acid content (by capillary electrophoresis). The dentin specimens were analysed for mineral loss and lesion depth (by transversal microradiography). Fluoride treatment had no effect on the viability but reduced lactic acid production by 75%. The mixture treatment reduced the viability by 80% and the lactic acid content by 93% on the first day and later reduced the two parameters to below the detection limits. Significant differences in changes in mineral loss and lesion depth were observed between the treatment groups. Partial remineralization but deeper lesions were observed in the fluoride group, while nearly complete remineralization was seen in the mixture group. In conclusion, the CDFF S. mutans biofilm model can be used as a de- and remineralization biofilm model, and the split mode is particularly suitable for testing caries-preventive agents. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Takatsuka T, Hirano J, Matsumoto H, Honma T. X-Ray absorption fine structure analysis of the local environment of zinc in dentine treated with zinc compounds. Eur J Oral Sci 2005; 113: 180–183.© Eur J Oral Sci, 2005It has been reported that zinc oxide (ZnO) inhibits dentine demineralization.By using the X-ray absorption fine structure (XAFS) technique, our aims in this study were to provide information about the local environment of zinc atoms in dentine that had been treated with zinc compounds.We measured the Zn K-edge X-ray absorption near-edge structure (XANES) and theextended X-ray absorption fine structure (EXAFS) of dentine specimens treated with zinc chloride or ZnO. In XAFS analyses, the spectra of dentine specimens treated with ZnO (D-ZO) or with zinc chloride (D-ZC) were similar and obviously different from the reference ZnO spectrum. This suggests that most of the zinc atoms detected in D-ZO are not derived from particles of ZnO. The spectra of D-ZO and D-ZC were similar to the spectrum of the synthetic, zinc-containing hydroxyapatite, but were not similar to that of zinc in ZnCl2-treated collagen. The results of this study suggest that most of the zinc atoms detected were attached to hydroxyapatite and not to collagen. [ABSTRACT FROM AUTHOR]

Buchalla W, LennonÁM, Attin T. Comparative fluorescence spectroscopy of root caries lesions. Eur J Oral Sci 2004; 112: 490–496.© Eur J Oral Sci, 2004In this study, the light-emission properties of carious and sound root surfaces were investigated under a wide range of excitation wavelengths. Human molar teeth with exposed root surfaces containing light- and dark-discolored root caries (n= 3 of each) were selected. Emission spectra were recorded from carious and corresponding sound root surface areas from each tooth by using a fluorescence spectrophotometer at excitation wavelengths from 360 nm up to 580 nm, in steps of 20 nm. The spectra were corrected for fluctuations in detector sensitivity and excitation light intensity, and normalized to peak intensity. Excitation spectra were recorded for selected emission wavelengths that showed maximum intensity. Light- and dark-discolored root surface caries showed distinct fluorescence emission bands between 600 and 700 nm that were not present in sound root surface areas. These bands were strongest for excitation wavelengths between 390 and 420 nm. The excitation spectra of root caries revealed maximum excitation at around 405 nm, which is equivalent to the Soret band of porphyrin compounds. The emission spectra of both types of root caries lesions were shifted towards longer wavelengths (red shift at half maximum) when compared to the spectra of corresponding sound root surfaces. The red shift for dark-discolored root caries was higher than for light-discolored lesions at all excitation wavelengths. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the effects of fluoride on erosive mineral loss in human enamel and dentine using a cyclic de- and remineralisation model in situ. The study was a three-treatment (5 days each) crossover design involving 4 (enamel) or 6 (dentine) healthy volunteers. Samples were recessed in palatal mouth appliances and worn day and night except during meals and were demineralised extraorally with 0.05 M citric acid (pH 2.3) for 6 x 5 min daily. Fluoridation was performed with toothpaste (SnF2/Olaflur; 0.14% F-) for 3 x 5 min daily (toothpaste fluoridation) or with toothpaste in combination with a mouthrinse (SnF2/Olaflur; 0.025% F-) for 3 x 5 min daily and with a gel (NaF/Olaflur, 1.25% F-) on days 1 and 3 instead of the toothpaste (intensive fluoridation). In the control group no fluoridation was performed. Mineral loss (microm) was determined with the use of longitudinal microradiography. In enamel, mineral loss was 40.7 +/- 15.1 microm in the control group, 18.3 +/- 12.4 microm after toothpaste fluoridation and 5.0 +/- 12.2 microm after intensive fluoridation. The respective values for dentine were 49.0 +/- 15.4, 35.0 +/- 15.5 and 19.8 +/- 12.0 microm. All differences were statistically significant (p < or = 0.001). The results indicate that intensive fluoridation is effective in preventing enamel and dentine from mineral loss even under severely erosive conditions. [ABSTRACT FROM AUTHOR]

Drying effects in 14 natural lesions were studied with quantitative light-induced fluorescence and optical pathl-ength spectroscopy. Results were compared with clinical judgments of the lesion surface and microradiographical characterizations of the lesions. Relative fluorescence and average pathlength decreased as a function of drying time with a decay time ranging from 35.5 to <1 min. Depth and mineral loss correlated with average pathlength total changes (r = -0.79/-0.60, respectively) and poorly with total fluorescence changes (r ≅ 0.3). The decay time of the drying process for the relative fluorescence correlated well with a theoretical model based on water diffusion in lesion and surface layer, but only for large decay times. Clinical judgments could not be related to the surface layer properties or the changes in the average pathlength, but were weakly related to the changes in the relative fluorescence. We conclude that (i) fluorescence effects are mostly due to the screening by the lesion of the fluorescence from the dentin and enamel- dentin junction; (ii) water evaporation in lesions conforms to the diffusion laws only in large lesions with low surface layer penetrability; (iii) the evaporation process is controlled by the surface layer only for small surface penetrabilities (≈ 0.1 vol% µm-1). [ABSTRACT FROM AUTHOR]

Considerable research during the past two decades has focused upon the development of new technologies for the detection of dental caries. Of these technologies, the method that has been most extensively studied is based upon the indirectly assessed changes in the fluorescence of enamel associated with the loss of mineral. The purpose of this presentation was to review the available information regarding the use of this technology, commonly known as quantitative light fluorescence, for caries detection, particularly early caries detection, and the potential for the routine use of this technology in clinical caries trials. This technology is unique in its ability to measure small changes in the mineral content of enamel lesions quantitatively. The results of recent small-scale clinical trials have indicated that the impact of caries-preventive measures can be determined within a six-month period. With current hardware and software refinements and the results of long-term clinical validation studies that are in progress, it may be that this technology will be the future method of choice for caries clinical trials. [ABSTRACT FROM AUTHOR]

The onset of caries is characterized by demineralization of dental hard tissues. Optimal fluoridation with respective oral hygiene habits and diet may stop the progression of a lesion and even allow for its remineralization. The aim of modern dentistry must be a preventive approach rather than invasive repair of the disease. This is possible only with early detection and respective preventive measures. Some of today's diagnostic tools are not sensitive enough to detect this early onset of destruction. Tools based on fluorescence could have the possibility to overcome this problem. This overview will focus on today's knowledge of one possible tool, the DIAGNOdent. [ABSTRACT FROM AUTHOR]

Substantial pH fluctuations within the biofilm on the tooth surface are a ubiquitous and natural phenomenon, taking place at any time during the day and night. The result may be recordable in the dental tissues at only a chemical and/or ultrastructural level (subclinical level). Alternatively, a net loss of mineral leading to dissolution of dental hard tissues may result in a caries lesion that can be seen clinically. Thus, the appearance of the lesion may vary from an initial loss of mineral, seen only in the very surface layers at the ultrastructural level, to total tooth destruction. Regular removal of the biofilm, preferably with a toothpaste containing fluoride, delays or even arrests lesion progression. This can occur at any stage of lesion progression, because it is the biofilm at the tooth or cavity surface that drives the caries process. Active enamel lesions involve surface erosion and subsurface porosity. Inactive or arrested lesions have an abraded surface, but subsurface mineral loss remains, and a true subsurface remineralization is rarely achievable, because the surface zone acts as a diffusion barrier. The dentin reacts to the stimulus in the biofilm by tubular sclerosis and reactionary dentin. [ABSTRACT FROM AUTHOR]

Since the use of bovine instead of human dentine to evaluate cariogenic and anticariogenic substances is not well established, this in situ study was conducted. Eleven volunteers wore palatal acrylic devices containing 4 dentine slabs (2 human and 2 bovine). Sucrose solution (20%) was dripped over all slabs 4 times a day, simulating a cariogenic challenge. Dentifrice slurries, fluoridated or not, were dripped over specified dentine slabs 3 times a day to evaluate caries reduction. After 14 days, the biofilm formed on the dentine slabs was collected for microbiological analysis. In dentine, mineral loss (ΔZ) and lesion depth (LD) were determined by cross-sectional microhardness and by polarized light microscopy, respectively. The total streptococci and mutans streptococci counts in the biofilm formed either on human or on bovine slabs, whether treated or not with fluoride dentifrice, were not statistically different. The ΔZ and the LD values of dentine treated with fluoride dentifrice were significantly lower than the values of dentine treated with non-fluoride dentifrice. The differences in the ΔZ and LD values between the human and bovine dentine were not statistically significant. The results suggest that bovine dentine can be used instead of human to evaluate caries development and inhibition.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim of the study was the morphological analysis of coronal dentin caries and the modifications induced by different pretreatments with phosphoric acid or sodium hypochlorite. Carious dentin specimens were obtained from human molars affected by carious lesions. Specimens were divided in four groups and submitted to: (1) untreated; (2) 35% phosphoric acid for 15 s; (3) 35% phosphoric acid for 15 s and 5% sodium hypochlorite for 2 min; (4) sodium hypochlorite for 5 min. Specimens were observed under high-resolution SEM. Different areas were identified within the carious lesion: a deeper, inner region revealing closed highly mineralized tubules, and a more superficial outer layer showing an increasing demineralization rate toward the surface of the lesion. Phosphoric acid followed by NaOCl treatment removed all collagen fibrils from greatly altered carious outer-dentin layer. The 5-min treatment with sodium hypochlorite affected both inner and outer dentin, removing all collagen fibrils and increasing the porosities of deeper intertubular hypermineralized dentin. FEISEM analysis confirmed that only inner carious dentin after phosphoric acid treatment may be considered a suitable substrate for dentinal bonding system. On the contrary, the outer dentin is an unstable substrate for any type of bonding systems and must be avoided/removed from any surface before conditioner application. [ABSTRACT FROM AUTHOR]

AbstractDentine root caries is a process of demineralization and degradation of the organic matrix by proteinases. In this in situ study, the presence and activity of the matrix metalloproteinases 1, 2 and 9 (MMP-1, MMP-2, MMP-9) in saliva and in completely demineralized dentine specimens were investigated. Furthermore, the activity of cathepsin B was determined in saliva. A correlation between these enzymes and the level of degraded collagen was investigated. Demineralized dentine specimens were mounted in the partial prosthesis of 17 volunteers. Saliva samples were taken at 0, 2 and 4 weeks. After 4 weeks, the enzymes were extracted from the dentine specimens and the collagen loss was assessed. The collagen loss varied between 0 and 40.3%. Zymography of the saliva and the dentine extract samples showed that (pro-)MMP-2 and (pro-)MMP-9 were present. The levels of active MMPs were assessed, using fluorogenic MMP-specific substrates. All but 3 of the 51 saliva samples showed MMP-1 activity ranging from 1.5 to 101.1 relative fluorescence units (RFU)/s. Forty-eight saliva samples showed gelatinolytic MMP-2/MMP-9 activity (1.7–141.1 RFU/s). MMP-1 activity was shown in all dentine extracts varying between 3.5 and 295.0 RFU/s. From the dentine extracts, 15 showed MMP-2/MMP-9 activity (0.2–13.7 RFU/s). The MMP activity from both saliva and dentine extracts did not correlate with the collagen loss. The activity of salivary cathepsin B varied from 4.8 to 42.2 arbitrary units/min. A positive correlation was found between salivary MMP activity and cathepsin B activity. This study revealed that gelatinolytic enzyme activity was present both in saliva and dentine collagen. No correlation could be observed, however, between the level of enzyme activity and the collagen loss of the dentine specimens.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The possibility for remineralization of advanced root dentin lesions was investigated in vitro. Lesions were produced in acidic buffer solution with 0.1 and 0.5 ppm fluoride, for 3 and 5 weeks, respectively, using a single-section model. Next, the sections were immersed in a remineralization solution containing 0.1 ppm F (as NaF) for 20 weeks. Microradiographs were made after each 4-week-period. The lesions were around 500 μm deep, with mineral loss values between 11,000 and 18,000 vol%·μm. After 20 weeks of remineralization, the absolute amounts of deposited mineral ranged from 7,500 to 10,000 vol%·μm, corresponding to a repair between 50 and 85%. Lesion depth was, on average, reduced by 199 μm. This was not significantly different (at p < 0.05) between the four experimental groups. This study showed that remineralization of advanced dentinal lesions is possible in spite of the virtual absence of mineral in the lesion body after demineralization. The surface layer of the lesion was the preferred site for mineral deposition until mineral content values reached those of sound dentine. The mineral content in the lesion body increased with time, at a rate reflecting the initial severity of the lesion. We conclude that a remineralized surface layer does not inhibit transport of mineral ions to the body and that the remineralization in the lesion body reflected the number of sites for crystal growth. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the validity and reproducibility of laser fluorescence and electrical resistance readings on root carious lesions. One hundred and three freshly extracted human teeth with various forms of natural root caries were investigated by 6 operators using the laser fluorescence device DIAGNOdent (DD) and the Electronic Caries Monitor (ECM III). As a reference, a caries-free root area of each tooth was also examined. Specimens were classified as to colour, surface texture and cavitation depth. Teeth were sectioned through the centre of the lesion and prepared for polarising light microscopy. Histological depth of the lesions was defined as the distance between the surface and zone of translucency. Depths ranged from 0.1 to 3.1 mm. Statistical analysis of the interexaminer reproducibility revealed a significant correlation (Kendall's W) for DD measurements of 0.85 and 0.76 for ECM readings. Moderate correlation between the histological depth and DD (r(s) = 0.45) or ECM scores (r(s) = -0.48) could be demonstrated. Electrical resistance readings revealed a positive correlation (r(s) = 0.43) with the thickness of the remaining dentine, whereas this was negative for laser fluorescence readings (r(s) = -0.43). However, scatter plots suggested that most lesions had very low resistance. This investigation suggests that laser fluorescence and electrical conductance measurements can be obtained reproducibly by different operators and correlate moderately with histological lesion depth and remaining thickness of the dentine bridge. [ABSTRACT FROM AUTHOR]

In this study, the penetration of three proprietary dentine‐bonding agents (Prime & Bond 2.1, Single Bond, Liner Bond 2) and experimental dentine‐bonding systems incorporating an antibacterial monomer, 12‐methacryloyloxydodecylpyridinium bromide (MDPB), into artificial root caries lesions was evaluated, and the bactericidal activity of each material against Streptococcus mutans or Lactobacillus casei impregnated into demineralized dentine blocks was assessed. All of the commercial dentine‐bonding agents were capable of penetrating into the artificial carious lesions to more than 150 µm. The depth penetration of the experimental systems, which were based on Liner Bond 2, was not significantly different from that of their parent product. Liner Bond 2 primer exhibited the greatest bactericidal effects among the three proprietary dentine‐bonding agents tested. Bactericidal activities of experimental primers containing MDPB were greater than those of any other products, and the application of 4% MDPB‐containing primer resulted in complete killing of bacteria in demineralized dentine. The results indicate that the penetration of dentine‐bonding agents into extensively demineralized root dentine is possible in vitro, and the experimental dentine‐bonding systems containing the antibacterial monomer MDPB are capable of killing bacteria within demineralized dentine. This could be of benefit when managing root caries lesions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of phosphoric acid (PA) and a proprietary glutaraldehyde‐HEMA aqueous solution (Gluma Desensitizer; GD) on dentin collagen. Specimens of demineralized bovine dentin collagen were treated with either 37% or 50% PA for 1 or 5 min. An additional set of specimens was treated with 37% PA for 1 min followed by GD for 1 min. All specimens were washed with distilled water, lyophilized, reduced with standardized NaB3H4, hydrolyzed with 6 M HCl and subjected to amino acid and cross‐link analyses. The results demonstrated that the treatment of demineralized dentin with PA under the conditions tested did not significantly alter the collagen cross‐links. The GD‐treated samples showed reduction of free lysine (Lys) and hydroxylysine (Hyl) residues, as well as a decrease in the levels of collagen reducible cross‐links. In addition, unidentified reducible compounds were detected by high‐performance liquid chromatography (HPLC) analysis. These compounds may be derived from cross‐links formed between GD‐derived aldehyde and Lys/Hyl of collagen. The findings indicate that PA treatment does not significantly affect dentin collagen amino acid and cross‐link composition, and that GD treatment affects dentin collagen amino acid and cross‐link composition. [ABSTRACT FROM AUTHOR]