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The aim of this study was to evaluate the performance of a pen-type laser fluorescence (LF) device (LFpen: DIAGNOdent pen) to detect and monitor the progression of caries-like lesions on smooth surfaces. Fifty-two bovine enamel blocks were submitted to three different demineralisation cycles for caries-like lesion induction using Streptococcus mutans, Lactobacillus casei and Actinomyces naeslundii. At baseline and after each cycle, the enamel blocks were analysed under Knoop surface micro-hardness (SMH) and an LFpen. One enamel block after each cycle was randomly chosen for Raman spectroscopy analysis. Cross-sectional micro-hardness (CSMH) was performed at different depths (20, 40, 60, 80 and 100 μm) in 26 enamel blocks after the second cycle and 26 enamel blocks after the third cycle. Average values of SMH (± standard deviation (SD)) were 319.3 (± 21.5), 80.5 (± 31.9), 39.8 (± 12.7), and 29.77 (± 10.34) at baseline and after the first, second and third cycles, respectively. Statistical significant difference was found among all periods (p < 0.01). The LFpen values were 4.3 (± 1.5), 7.5 (± 9.4), 7.1 (± 7.1) and 5.10 (± 3.58) at baseline and after the first, second, and third cycles, respectively, among all periods (p < 0.05). The CSMH values after the second and third cycles at 20, 40, 60, 80 and 100 μm were 182.8 (± 69.8), 226.1 (± 79.6), 247.20 (± 69.36), 262.35 (± 66.36) and 268.45 (± 65.49), and for the third cycle were 193.7 (± 73.4), 239.5 (± 81.5), 262.64 (± 82.46), 287.10 (± 78.44) and 284.79 (± 72.63) (n = 24 and 23), respectively. No correlation was observed between the LFpen and SMH values (p > 0.05). One sample of each cycle was characterised through Raman spectroscopy analysis. It can be concluded that LF was effective in detecting the first demineralisation on enamel; however, the method did not show any effect in monitoring lesion progression after three cycles of in vitro demineralisation.

Objective: To investigate the remineralisation of enamel subsurface lesions treated with fluoride toothpaste (1450 ppm) or a combination of fluoride toothpaste in addition to Tooth Mousse™., Design: An in situ, cross-over, randomised controlled trial., Setting: Orthodontic department at Liverpool University Dental Hospital, UK., Participants: Twelve patients receiving fixed orthodontic treatment., Methods: Demineralised subsurface enamel lesions were placed in a carrier and attached onto a fixed orthodontic appliance. Interventions were either standard fluoride toothpaste or CPP-ACP paste (Tooth Mousse™) in addition to the fluoride toothpaste. Participants received both interventions in a randomised order. Transverse microradiography analysis was used to compare lesion mineral content profiles., Results: Mineral loss was reduced by 15.4 and 24.6% between the fluoride and CPP-ACP groups, respectively (p = 0.023). Lesion depth was reduced by 1.6 and 11.1% between the fluoride and CPP-ACP groups, respectively (p = 0.037). Lesion width was reduced by 4.5 and 15.3% between the fluoride and CPP-ACP groups, respectively (p = 0.015)., Conclusions: Remineralisation occurred regardless of treatment group allocation. However, the addition of Tooth Mousse™ resulted in a significantly increased remineralisation effect, compared to fluoride alone. Tooth Mousse™ may be beneficial for patients undergoing orthodontic treatment who are at high risk of demineralisation., Trial Registration: Registered on Current Control Trials http://www.controlled-trials.com/ISRCTN04899524.

Objective: Hard tooth tissue demineralisation is an undesirable side effect of orthodontic treatment with fixed appliances. Whereas both clinically and in digital photographs (DP), demineralisations appear as white spot lesions, WSLs appear as dark areas when quantitative light-induced fluorescence (QLF) imaging is used. This study aims at comparing the reproducibility of the detection of decalcified tooth areas in DP and QLF., Materials and Methods: DP and QLF pairs were acquired from 139 teeth of 32 patients after braces removal. Three raters manually marked the decalcified area on both DP and QLF images. The markings were repeated after 2 weeks. A ground truth was estimated for each tooth and modality using the simultaneous truth and performance level estimation (STAPLE) algorithm. The Dice coefficients (DC) of each rater marking to the ground truth were calculated for all teeth and modalities to quantify the spatial agreement. A three-way repeated measures analysis of variance (ANOVA) was used to compare the means of the DCs for both modalities ([Formula: see text]). Intra-observer and intercycle variabilities were assessed comparing the means across the raters and the cycles for both modalities., Results: ANOVA revealed a statistical significant difference between the modalities [[Formula: see text], [Formula: see text]]. The standard deviation of the DC for the photographs are lower than those for the QLF images. Intra-observer and intercycle differences are rather small as compared to the intermodality differences., Conclusions: The results indicate a higher spatial reproducibility in identifying a decalcified area on a tooth surface using visual inspection of DP rather than QLF images.

Aim: This in vitro study was to evaluate the irradiation efficacy of the Diode laser and the Nd-YAG laser either un-assisted or assisted by acidulated phosphate fluoride (APF) treatment on enamel's acid resistance., Methods: Seventy-two enamel samples, obtained from 12 extracted human molars, were randomly assigned to 6 groups as follows: (1) Control (C); (2) Exposed to APF gel (F); (3) Diode laser (DL); (4) Irradiated with Diode laser through APF gel (DL/F); (5) Nd-YAG laser (NL) and (6) Irradiated with Nd-YAG laser through APF gel (NL/F). The specimens were individually demineralised in an acidified hydroxyethylcellulose system, and the acid resistance was evaluated by determining the calcium ion dissolution using atomic absorption spectrometry., Results: The average concentration of the calcium ion determined in groups 1 to 6 was 901, 757, 736, 592, 497 and 416 parts per million micrograms/gram, respectively. The results showed that demineralisation in the NL/F group was significantly less than the other groups and the control group was significantly greater than the other groups (P < 0.001)., Conclusion: The effect of Nd-YAG laser irradiation, used alone or in combination with APF, in decreasing the enamel demineralisation was greater than all the other groups.

Objectives: The purpose of this study was to evaluate the ability of Zn-free vs Zn-containing amalgams to induce remineralisation at the dentine interface., Methodology: Sound and caries-affected dentine surfaces (CAD) were subjected to both Zn-free and Zn-containing dental amalgam restorations. Dentine surfaces were studied by nano-indentation, Raman spectroscopy/cluster analysis, X-ray diffraction (XRD), field emission electron microscope (FESEM) and energy-dispersive analysis (EDX), for mechanical, morphological and chemical characterisation. Analyses were performed before and after placement amalgam restorations., Results: Zn-containing amalgams restorations promoted an increase in the nano-mechanical properties of sound and CAD surfaces. In samples from sound or CAD restored with Zn-containing amalgams, it was evidenced: (a) new mineral calcium-phosphate deposits (intratubular and intertubular) with augmented crystallographic maturity; these crystals were identified as hydroxyl-apatite, and (b) a generalised crosslinking reduction plus an increase in those values testing nature and secondary structure of collagen. It indicates an optimal preservation, molecular organisation and orientation of collagen fibrils., Significance: Zn-containing amalgams promote remineralisation of subjacent dentine, which is more evident in caries affected dentine surfaces., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: The ability of a dentifrice containing the bioactive material calcium sodium phosphosilicate (CSPS) to remineralise the surface of dentine and physically occlude patent tubules was investigated in a 20 day in situ randomised clinical study., Methods: Changes in surface microhardness and surface topography of dentine specimens treated for 5, 10, 15 and 20 days, twice daily with either a dentifrice containing 5% CSPS or a fluoride-only containing placebo dentifrice were compared. The substantivity of any mineral deposits formed on the surface of dentine were investigated by the application of an intra-oral dietary acid challenge twice daily during the final 10 days of treatment., Results: After 5 and 10 days of treatment, the dentine samples in both treatment groups demonstrated an increase in surface microhardness. After 10 days of treatment the increase in surface hardness was directionally greater for the specimens treated with 5% CSPS dentifrice. Introducing an intra-oral acid exposure resulted in a reduction in surface microhardness which was significantly greater for the specimens treated with the placebo dentifrice compared to the dentifrice containing 5% CSPS, at day 20. Occlusion of the patent tubules was evident at each time-point and was significantly greater for the 5% CSPS containing dentifrice on days 5 and 10. On day 15 both dentifrices demonstrated the same degree of occlusion., Conclusion: This in situ study demonstrated that dentifrice containing 5% CSPS may have potential to mineralise and occlude the dentine in the oral environment., Clinical Significance: This work provides evidence of potential agents that can be used to reduce the pain of dentine hypersensitivity when formulated into dentifrice and applied as part of a normal oral hygiene routine., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Abstract: Alkali metal cations were suspected ofbeing highly melassigenic by holding sugar in the molasses and preventing it from being recovered as crystalline sugar. An electrodialysis operation using a pilot plant equipped with an improved stack with a high alkali content, temperature and organic resistance was conduced on Moroccan beet sugar syrup, juice and molasses. The optimised conditions to remove melassigenic ions especially temperature and Brix were investigated for each solution. The study shows that the quality of each solution was improved. On the basis of the running industrial condition and on the electrodialysis results, recommendations were proposed concerning the best conditions to remove melassigenic ions for this study. [Copyright &y& Elsevier]

Objectives: To summarise the chemical, biological and host factors that impact enamel mineral loss, to highlight approaches to contemporary management of clinical conditions involving mineral loss and summarise emerging trends and challenges in this area., Data Sources: "Medline" and "Scopus" databases were searched electronically with the principal key words tooth, enamel, *mineral*, caries and erosion. Language was restricted to English and original studies and reviews were included. Conference papers and abstracts were excluded., Conclusions: Enamel mineral loss leads to the degradation of the surface and subsurface structures of teeth. This can impact their shape, function, sensitivity and aesthetic qualities. Dental caries is a multifactorial disease caused by the simultaneous interplay of dietary sugars, dental plaque, the host and time. There is a steady decline in dental caries in developed countries and the clinical management of caries is moving towards a less invasive intervention, with risk assessment, prevention, control, restoration and recall. Tooth wear can be caused by erosion, abrasion and attrition. Dental erosion can be the result of acid from intrinsic sources, such as gastric acids, or extrinsic sources, in particular from the diet and consumption of acidic foods and drinks. Its prevalence is increasing and it increases with age. Clinical management requires diagnosis and risk assessment to understand the underlying aetiology, so that optimal preventative measures can be implemented. Overall, prevention of enamel mineral loss from caries and tooth wear should form the basis of lifelong dental management. Evidence based oral hygiene and dietary advice is imperative, alongside preventive therapy, to have a healthy lifestyle, whilst retaining hard tooth tissue., (© 2014 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this paper is to review current knowledge and technologies for tooth remineralisation., Data Sources: The literature was searched using the "Scopus" and "Web of Knowledge" database from the year 1971, with principal key words of *miner*, teeth and enamel. Language was restricted to English. Original studies and reviews were included. Conference papers and posters were excluded., Conclusion: The importance of oral health for patients and consumers has seen a steady increase in the number of tooth remineralisation agents, products and procedures over recent years. Concomitantly, there has been continued publication of both in vivo and in vitro tooth remineralisation and demineralisation studies. It is clear that fluoride treatments are generally effective in helping to protect the dental enamel from demineralisation and enhancing remineralisation. Continued efforts to increase the efficacy of fluoride have been made, in particular, by the addition of calcium salts or calcium containing materials to oral care products which may enhance the delivery and retention of fluoride into the oral cavity. In addition, the calcium salts or materials may act as additional sources of calcium to promote enamel remineralisation or reduce demineralisation processes. Inspired by the concept of bioactive materials for bone repair and regeneration, bioglass and in particular calcium silicate type materials show potential for enamel health benefits and is a growing area of research., (© 2014 Elsevier Ltd. All rights reserved.)

The risk of low energy fracture of the bone increases with age and osteoporosis. This paper investigates the effect of strain rate and mineral level on the peak stress and toughness of whole ovine bones. 40 fresh ovine femurs were subjected to 3-point bending at high (17.14s(-1)) and low (8.56 × 10(-3)s(-1)) strain rates with or without a controlled amount of demineralisation. Mineral removal was achieved by ultrasonically assisted exposure in Ethylene diamine tetra-acetic acid (EDTA). The ultimate stress for whole bones of normal mineral content was 200 MPa at the high rate of strain and 149 MPa at the low rate of strain. With changes in bone mineral levels such as may occur in osteomalacia and osteoporosis, the change in toughness varied at different strain rates; a mean value of 3.7 ± 1.4 MJ/m(3) was obtained for the toughness of normal quality whole bone tested at slow loading rate and a reduction of approximately 25% was observed in the demineralised whole bone specimens at the slow loading rate (mean 2.8 ± 0.9 MJ/m(3)). When tested at the high loading rate there was a negligible difference in the toughness between the two (2.0 ± 0.6 MJ/m(3)) mineral levels. This indicated that there was a strain rate dependant effect for the mineral density, and that the removal of mineral alone did not explain all of the reduction in mechanical properties that occur with age or disease. Thus, the reduction in mechanical properties at high strain rates was likely to be due to other phenomena such as increased porosity or reduced collagen quality, rather than loss of mineral. With decreasing mineral levels, as measured by DEXA in clinical practice, the increased fracture risk is dependent on the velocity of the impact. Thus the estimates of increased fracture risk given clinically for a lower DEXA value should be different for high and low energy injuries., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: To investigate the inhibitory effects of 38% silver diamine fluoride (SDF) on demineralised dentine., Methods: Human dentine blocks were demineralised and allocated to four groups: SF, F, S and W. The blocks in group SF received a topical application of 38% SDF solution (253,900ppm Ag, 44,800ppm F), group F received a 10% sodium fluoride solution (44,800ppm F), group S received a 42% silver nitrate solution (253,900ppm Ag) and group W received deionised water (control). They were subjected to pH cycling using demineralisation solution (pH 5) and remineralisation solution (pH 7) for 8 days. The surface morphology, crystal characteristics, lesion depth and collagen matrix degradation of the specimens were investigated by scanning electron microscopy (SEM), X-ray diffraction (XRD), micro-CT testing and spectrophotometry with a hydroxyproline assay., Results: The surface morphology under SEM showed evident demineralisation with exposed collagen in groups S and W, but not in group SF. Clusters of granular spherical grains were observed in the cross-sections of specimens in groups SF and F. XRD revealed precipitates of silver chloride in groups SF and S. The mean lesion depths (±SD) of groups SF, F, S and W were 182 ± 32μm, 204 ± 26μm, 259 ± 42μm and 265 ± 40μm, respectively (SDF, F