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Introduction: Visual imaging of subsurface caries lesions is of vital interest in dentistry, which can be obtained by invasive radiography technique as well as by available non-destructive imaging approaches. Thus, as a first step toward the development of a new innovative approach, Spectral-domain optical coherence tomography (SD-OCT) was applied to detect the lesion depth in comparison to the established reference technique (transverse microradiography [TMR]). Methods: Bovine enamel specimens were demineralized for 5 days, following previous studies. For OCT, the resulting artificial lesions were scanned three-dimensionally (SD-OCT) and semi-automated measured (CarLQuant). For TMR, specimens were sectioned and the lesion depth was manually determined (Inspektor Research System). Results: The range of lesion depth detected with OCT was 24.0–174.0 μm (mouth rinse study), 18.0–178.0 μm (toothpastes study) and with TMR 59.2–198.0 μm (mouth rinse study), 33.2–133.4 μm (toothpastes study). We found a strong correlation between both methods in terms of lesion depth (Spearman rankwith outlierp < 0.001, Rho = 0.75, Spearman rankwithout outlierp = 0.001, Rho = 0.79). The two methods produce similar results (Passing-Bablok regression, 1.16). As deeper is the lesion, the smallest is the difference between both methods as indicated by Bland-Altman-plots. Conclusion: Especially in the case of deep lesions, the values obtained by both methods are in agreement, and OCT can potentially substitute TMR to detect and assess lesion depth with the benefit of being non-destructive. [ABSTRACT FROM AUTHOR]

An interesting case of a caries-affected area where bacterial remains were plausibly preserved in situ was found in an isolated tooth of the Plio-Pleistocene dormouse Glis sackdillingensis (Rodentia, Gliridae). The sample is 2.9–2.6 million years old, and may be the only described case of a dental pathological condition preserved in a fossil together with the microbial pathogen responsible for its development. The tooth was investigated using various complementary techniques such as Scanning Electron Microscopy with Energy Dispersive Spectroscopy, Microtomography, and Light Microscopy. Available data on dietary habits and lifestyle of modern dormice are extrapolated to explain the origin of the infection. The results of the investigation are presented within the wider context of the fossil record of dental infections and other microbe-related diseases in vertebrates. Possible methodological reasons for the lack of similar reports are also discussed.

An interesting case of a caries-affected area where bacterial remains were plausibly preserved in situ was found in an isolated tooth of the Plio-Pleistocene dormouse Glis sackdillingensis (Rodentia, Gliridae). The sample is 2.9-2.6 million years old, and may be the only described case of a dental pathological condition preserved in a fossil together with the microbial pathogen responsible for its development. The tooth was investigated using various complementary techniques such as Scanning Electron Microscopy with Energy Dispersive Spectroscopy, Microtomography, and Light Microscopy. Available data on dietary habits and lifestyle of modern dormice are extrapolated to explain the origin of the infection. The results of the investigation are presented within the wider context of the fossil record of dental infections and other microbe-related diseases in vertebrates. Possible methodological reasons for the lack of similar reports are also discussed. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the remineralization potential of calcium sodium phosphosilicate and functionalized tri‐calcium phosphate (f‐TCP) dentifrices in deeper incipient carious lesions (ICLs). Materials and Methods: Artificial ICLs were created by placing premolars into demineralizing solutions. Teeth were randomly assigned into four groups: calcium sodium phosphosilicate (Group 1), f‐TCP (Group 2), 1450 ppm fluoride (Group 3), and distilled water (Group 4), which were subjected to 10‐day pH cycling. Mineral density (MD) was assessed using microcomputed tomography (Micro‐CT), while hardness (H) and elastic modulus (EM) were assessed using nanomechanical testing. Results: MD % gain was higher in Groups 1–3 than in Group 4. In addition, Groups 1 and 2 exhibited significantly higher MD % gain than Group 3. Also, Groups 1–3 showed significantly higher EM and H values than Group 4 in the outer enamel area; yet, Groups 1 and 2 displayed significantly higher EM and H values than Groups 3 and 4 in the inner enamel. Conclusions: The MD, EM, and H of ICLs significantly increased with the addition of calcium sodium phosphosilicate or f‐TCP to fluoridated dentifrices compared to standard fluoride dentifrices. The added active ingredients remineralized the deeper parts of the ICLs, while remineralization at the lesion surface was similar between tested dentifrices. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, a variety of lasers have been widely used in various diseases related to stomatology, including the prevention and treatment of dental caries. OBJECTIVE: To investigate the effect of neodymium-doped:yttrium aluminum perovskite (Nd:YAP) laser combined with two remineralizers on early enamel caries in vitro. METHODS: Early enamel caries models in vitro were artificially established by 60 enamel blocks and randomly divided into 6 groups (n=10). Group A did not undergo any treatment but underwent extracorporeal pH circulation. Group B underwent remineralization of dentin (the main component of casein phosphopeptide-amorphous calcium phosphate composite) and extracorporeal pH circulation. Group C underwent remineralization treatment of Sensodyne toothpaste (the main component of bioactive glass) and then underwent extracorporeal pH circulation. Group D received Nd:YAP laser irradiation and extracorporeal pH circulation. Group E was treated with Nd:YAP laser irradiation, with remineralization of dentin, and then with extracorporeal pH circulation. In group F, Nd:YAP laser irradiation was performed, and then Sensodyne toothpaste was used for remineralization, and the extracorporeal pH circulation was performed; the remineralization treatment was conducted twice a day, and the experimental period was 20 days. Group G was a normal control group, without caries or remineralization, but only underwent extracorporeal pH circulation. After the experiment, the microhardness, morphology and Ca/P ratio of the dental enamel surface were measured in each group. RESULTS AND CONCLUSION: (1) The surface microhardness value of dental enamel in groups B, C and D was higher than that in group A (P < 0.000 1); the surface microhardness value of dental enamel in groups E and F was significantly higher than that in groups B, C and D (P < 0.000 1), and the surface microhardness value of dental enamel in group F was significantly higher than that in group E (P < 0.000 1). (2) Scanning electron microscopy showed that there were a lot of demineralized pores on the enamel surface of group A. There were mineral deposits on the enamel surface of group B, which were uneven and loose. In group C, there were a lot of mineral deposits on the enamel surface, and demineralized pores were found between the calcified masses. The enamel surface of group D was relatively flat; the demineralized pores were significantly smaller than that of group A, and the enamel column interstitium was damaged. In group E, the mineral deposits on the enamel surface were thicker and the demineralized pores were significantly reduced. The mineralized substances deposited on the enamel surface of group F were most dense and uniform and the demineralized pores were small. (3) The Ca/P ratio on the enamel surface of groups B and C was significantly higher than that of group A (P < 0.000 1); the Ca/P ratio on the enamel surface of group E was significantly higher than that of groups B, C and D (P < 0.000 1), and the Ca/P ratio on the enamel surface of group F was higher than that of group E (P < 0.001). (4) These findings indicate that bioactive glass, casein phosphopeptide-amorphous calcium phosphate composite, and Nd:YAP laser after enamel demineralization can promote the remineralization of early enamel caries. Nd:YAP laser combined with bioactive glass or casein phosphopeptide-amorphous calcium phosphate composite can further strengthen the remineralization of dental enamel caries, and the combination of Nd:YAP laser and bioactive glass has the best effect. [ABSTRACT FROM AUTHOR]

Abstract Objectives This study evaluated the remineralization potential of calcium sodium phosphosilicate and functionalized tri‐calcium phosphate (f‐TCP) dentifrices in deeper incipient carious lesions (ICLs). Materials and Methods Artificial ICLs were created by placing premolars into demineralizing solutions. Teeth were randomly assigned into four groups: calcium sodium phosphosilicate (Group 1), f‐TCP (Group 2), 1450 ppm fluoride (Group 3), and distilled water (Group 4), which were subjected to 10‐day pH cycling. Mineral density (MD) was assessed using microcomputed tomography (Micro‐CT), while hardness (H) and elastic modulus (EM) were assessed using nanomechanical testing. Results MD % gain was higher in Groups 1–3 than in Group 4. In addition, Groups 1 and 2 exhibited significantly higher MD % gain than Group 3. Also, Groups 1–3 showed significantly higher EM and H values than Group 4 in the outer enamel area; yet, Groups 1 and 2 displayed significantly higher EM and H values than Groups 3 and 4 in the inner enamel. Conclusions The MD, EM, and H of ICLs significantly increased with the addition of calcium sodium phosphosilicate or f‐TCP to fluoridated dentifrices compared to standard fluoride dentifrices. The added active ingredients remineralized the deeper parts of the ICLs, while remineralization at the lesion surface was similar between tested dentifrices.

Abstract Background Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. Methods Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents’ satisfaction with their children’s appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. Results The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children’s appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). Conclusion SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. Trial registration This trial was registered in the clinicaltrials.gov registry (#NCT05642494).

Abstract Background This 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth. Methods Preschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up. Results At baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development. Conclusion At 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo. Trial registration The study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019.

Objectives: To evaluate masking effects of resin infiltration on labial white spot lesions (WSL), by comparing the latter with a remineralization approach (using hydroxyapatite and fluorides) and conventional oral care (using fluoride-free toothpaste). Method and materials: Fifteen patients with at least three WSL were enrolled for a within-person randomized controlled trial, thus allowing for intrapersonal comparisons. Each WSL per tooth in every patient was randomly assigned to one of the following groups. Group 1: lesions were resin-infiltrated with Icon (RI; DMG); Group 2: Remin Pro (RP; VOCO) was used as remineralizing agent; and Group 3 (control): affected teeth were brushed with Complete Care toothpaste (CC; Himalaya). RP and CC were applied by means of a polishing brush, using a low-speed handpiece (5 min), and these procedures were repeated chairside thrice daily for 7 consecutive days. Digital photographs were captured before and after lesion treatment under standardized conditions. The CIE L*a*b* color system was used to analyze the optical outcome, and intrapersonal color differences were statistically evaluated. Results: Compared to RP and CC, RI showed prompt and subjectively satisfactory color improvements, and this was primarily driven by L* and b* shifts. Statistical analysis of the objective color differences (ΔE*) between the three groups revealed significant differences for RI vs RP (P = .029), RI vs CC (P < .001), and RP vs CC (P = .001). Conclusion: Resin infiltration is considered a time-effective treatment option for esthetically camouflaging WSL, while RP and CC failed to improve lesion appearance and oral health in the current short-term trial. [ABSTRACT FROM AUTHOR]

Aim: During orthodontic treatment, dental materials can affect the imaging of caries lesions. Material density and X-ray beam attenuation play important roles in this imaging. This study aims to evaluate the artifacts that are caused by brackets made of different materials and affect the visibility of International Caries Detection and Assessment System (ICDAS) code 5 caries. Methodology: One premolar tooth with ICDAS code 5 caries was examined. Eight periapical radiographs were taken: one without a bracket and seven with different types of brackets (composite with metal slot, self-ligating ceramic, monocrystalline ceramic, polycrystalline ceramic, zirconium, self-ligating stainless steel, and conventional stainless steel). The gray values of the caries region were evaluated using Fiji software (version 1.53f, National Institutes of Health, USA) on periapical radiographs. Results: Conventional stainless steel and self-ligating stainless steel brackets increased the radiopacity of the outer half of the enamel (E1). When these brackets were present, the gray values changed by -13.63633 (p = .026) and - 16.38967 (p = .006), respectively. There was no statistically significant difference in column B due to the brackets. However, numerically, the gray value changes were similar to those in column A. Conclusion: Orthodontic brackets affect the evaluation of periapical images. Ceramic brackets provide more advantages than stainless steel brackets for radiographic imaging. [ABSTRACT FROM AUTHOR]

Background: This 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth. Methods: Preschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up. Results: At baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P < 0.001, χ2 test). After adjusting for confounding factors and clustering effect, the multilevel logistic regression analysis showed no differences in caries development rates between the 3 groups (P > 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development. Conclusion: At 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo. Trial registration: The study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019. [ABSTRACT FROM AUTHOR]

To investigate dental caries prevalence amongst adults in Central Norway and assess changes over the last 45 years. The cross-sectional HUNT4 Oral Health Study was conducted in 2017-2019. A random sample of 4913 participants aged ≥19 years answered questionnaires and underwent clinical and radiographic examinations. Data were compared to findings from previous studies in the same region conducted from 1973 to 2006. Mean number of decayed, missing and filled teeth (D3-5MFT) was 14.9 (95% CI 14.7, 15.1), 56% of adults had one or more carious teeth (D3-5T) and 11.8% had ≥4 D3-5T, with the mean number of 1.4 (95% CI 1.32, 1.42). For initial caries, mean D1-2S was 3.8 (95% CI 3.7, 3.9), being the highest for 19-24-year-olds at 8.6 (95% CI 7.9, 9.3). Comparisons with earlier studies showed a decline in mean D3-5MFT for 35-44-year-olds from 26.5 in 1973 to 10.8 in 2019. In 1973, 4.8% of 35-44-year-olds were edentulous, while in present study edentulousness was found only in individuals >65 years. Despite a substantial reduction in caries experience over the last 45 years, untreated dentine caries was common, evenly distributed across all age groups. Initial caries particularly affected younger individuals, indicating a need to evaluate prevention strategies and access to dental services. [ABSTRACT FROM AUTHOR]

Introduction: White Spot Lesions (WSLs), also known as "white opacity," are the result of the demineralisation occurring on tooth surfaces in patients undergoing fixed orthodontic treatment. In addition to the various other factors, development of WSLs can also be influenced by the type of brackets and ligation employed. Aim: Evaluating the prevalence of WSL among patients who underwent fixed orthodontic treatment with passive self-ligation mechanotherapy. Materials and Methods: This retrospective study was conducted using photographic records of patients who received orthodontic treatment using a passive self-ligation system at Saveetha Dental College in Chennai, Tamil Nadu, India. The records of 97 patients in the age range of 10 to 30 years who received orthodontic treatment using the Damon self-ligating system regardless of gender were obtained from April 2016 to April 2021. The presence of WSL was investigated retrospectively before and after treatment. Modified Gorelick's scale was used for scoring the lesions. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) software version 17.0 and paired t-tests were done. Results: Data of total of 97 subjects (45 females (46.39%) and 52 males (54.63%), mean age: 17.70±5.72 years) undergoing orthodontic treatment with self-ligation brackets was included in the study. The overall prevalence percent of WSLs in the study was 71.13%. The prevalence of WSLs among females was 70.5% and in males, it was 73%. There was no statistical significance for association between gender and severity of WSLs and there was a statistical significance for association of age group and severity of WSLs in upper lateral incisors and canines (p<0.05). Conclusion: The most commonly involved teeth were upper central incisors and second premolars, and the overall WSLs incidence in subjects undergoing passive self-ligation therapy was 71.9 %. No influence of the gender was noted and severe lesions were commonly noted in maxillary lateral incisors of young individuals. [ABSTRACT FROM AUTHOR]

Objective: To explore the regulatory effect of recombinant amelogenin peptide TRAP on the remineralization of early enamel carious lesions. Methods: Forty-eight bovine enamel blocks that prepared initial lesions in vitro were split at random into four groups for immersion treatment for 12 days: 1) remineralizing medium; 2) studied peptide 1 (consisting of the N- and C-termini of porcine amelogenin) + remineralizing medium; 3) studied peptide 2 (TRAP) + remineralizing medium; 4) fluoride + remineralizing medium. After demineralization and remineralization immersion, each specimen’s mean mineral loss and lesion depth were measured using micro-computed tomography (micro-CT). The changes in lesion depth (ΔLD) and mineral gain (ΔZ) were computed following remineralization. The enamel samples were then cut into sections and examined with polarized light microscopy (PLM). The cross-section morphology was observed by scanning electron microscopy (SEM). The crystal phase was analyzed by an X-ray micro-diffractometer (XRD). The calcium-binding properties were determined using isothermal titration calorimetry (ITC). Results: Micro-CT analysis revealed a significant reduction in mineral loss in the four groups following the remineralization treatment (p < 0.05). The treatment with fluoride resulted in the greatest ΔZ and ΔLD, whereas the treatment with a remineralizing medium showed the least ΔZ and ΔLD among all groups. The ΔZ and ΔLD of the studied peptide 1 and studied peptide 2 groups were greater than those of the remineralizing medium group. However, there was no significant difference between the studied peptide 1 and studied peptide 2 groups (p > 0.05). All of the samples that the PLM analyzed had a thickening of the surface layer. A negative birefringent band changed in the lesion’s body. The SEM displayed that minerals were formed in all four groups of samples. The XRD results indicated that the products of remineralization of the studied peptide were hydroxyapatite crystals (HA). ITC showed that there were two binding modes between the calcium and peptide TRAP. Conclusion: This study confirmed the potential of the recombinant amelogenin peptide TRAP as a key functional motif of amelogenin protein for enamel remineralization and provided a promising biomaterial for remineralization in initial enamel carious lesion treatment. [ABSTRACT FROM AUTHOR]

Objective To explore effect on the remineralization of demineralized enamel surfaces with glycine-guided carboxymethyl chitosan (CMC)/amorphous calcium phosphate (ACP). Methods Remineralized solultion at different stages were prepared: ①reactive CMC/ACP (CMC/ACP nanoparticles treated with NaClO), ②reactive CMC/ACP+glycine; transmission electron microscopy was used to detect the morphology of the remineralized solution particles. Twenty teeth were randomly divided into two groups: group A and group B. Reactive CMC/ACP was applied to the enamel surface of group A and group B was treated with reactive CMC/ACP remineralization solution containing glycine. Scanning electron microscopy was used to detect the enamel surface morphology before and after remineralization, and nanoindentation was used to detect the mechanical strength (including nanoindentation depth, hardness and elastic modulus) of the enamel surface. Results Under a transmission electron microscope, the particles in the reactive CMC/ACP remineralization solution were smooth, and the increase in particle size was approximately 100-300 nm. After the addition of glycine, the particles in the reactive CMC/ACP remineralization solution particles showed a linear ordered arrangement, and microcrystals were formed in the solution 15 min later, with a crystal length of approximately 5-15 μm. Remineralization in group A was granular and heterogeneous. In group B, the crystal morphology of the demineralized enamel was homogeneous and ordered, similar to that of natural enamel. The nanoindentation depth of group B after remineralization was smaller than that of group A, and it was closest to that of natural enamel, there was no significant difference between group B and natural enamel in terms of the hardness and elastic modulus of the enamel surface after remineralization. Conclusion CMC/ACP nanoparticles treated with NaClO can rapidly and specifically form directional and ordered remineralization on the enamel surface of a model of glycine-guided rapid remineralization of enamel caries. The surface structure of remineralized enamel is similar to that of natural enamel in terms of nanoindentation depth, hardness and elastic modulus.

Introduction: White Spot Lesions (WSLs), also known as “white opacity,” are the result of the demineralisation occurring on tooth surfaces in patients undergoing fixed orthodontic treatment. In addition to the various other factors, development of WSLs can also be influenced by the type of brackets and ligation employed. Aim: Evaluating the prevalence of WSL among patients who underwent fixed orthodontic treatment with passive self-ligation mechanotherapy. Materials and Methods: This retrospective study was conducted using photographic records of patients who received orthodontic treatment using a passive self-ligation system at Saveetha Dental College in Chennai, Tamil Nadu, India. The records of 97 patients in the age range of 10 to 30 years who received orthodontic treatment using the Damon self-ligating system regardless of gender were obtained from April 2016 to April 2021. The presence of WSL was investigated retrospectively before and after treatment. Modified Gorelick’s scale was used for scoring the lesions. Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) software version 17.0 and paired t-tests were done. Results: Data of total of 97 subjects (45 females (46.39%) and 52 males (54.63%), mean age: 17.70±5.72 years) undergoing orthodontic treatment with self-ligation brackets was included in the study. The overall prevalence percent of WSLs in the study was 71.13%. The prevalence of WSLs among females was 70.5% and in males, it was 73%. There was no statistical significance for association between gender and severity of WSLs and there was a statistical significance for association of age group and severity of WSLs in upper lateral incisors and canines (p

During orthodontic treatment enamel demineralization can occur. Its early detection is the basis for efficient preventive measures to arrest or remineralize lesions. In the present study, the application of a novel blue hemoglobin-based liquid (BlueCheck) was evaluated as proof of concept for detection of on artificially demineralized smooth surfaces. 60 samples form extracted human posterior teeth were randomly assigned to four groups (15 per group). In 30 of these samples (groups A and B) superficial enamel was removed to create a ground surface. On the surface of other 30 samples (group C and D) orthodontic metal brackets were bonded. On each surface BC liquid was applied and rinsed with water after three minutes (baseline). All surfaces were checked by two independent observers for presence of blue areas. On each sample, one side was covered by nail varnish to protect this enamel part from demineralization. The samples were demineralized with lactic acid (pH 4.6) for 7 days (group A and C) and 14 days (group B and D), respectively. Mineral loss was determined using quantitative light induced fluorescence (QLF) after demineralization. BlueCheck dye was again applied on the samples and evaluated for presence of stained areas. Histological sections were prepared from randomly selected samples and lesion depth was measured. Kruskal-Wallis test was used for group comparison (α=0.05). After demineralization, median ΔF value for all samples was: -8.25% indicating the presence of an initial demineralization. The difference of ΔF values was not statistically significant between samples at 7 or 14 days of demineralization, nor for samples with and without orthodontic brackets (p=0.13). At baseline none of the sample surfaces showed discoloration, whereas a distinctive blue color was visible after demineralization in all samples exposed to acid-exposed areas, corresponding to 100% sensitivity. The internal control surfaces (without demineralization) did not show any staining, corresponding to 100% specificity. Histologically measured lesion depths ranged between 200 and 254 µm. In this in vitro study, staining demineralized dental enamel surface areas was shown to be reliable. Based on our results, this easily applicable product seems useful to be an adjuvant method to clinical examination to monitor oral health during an orthodontic treatment on tooth surfaces after removal of dental biofilm. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ability of near-infrared light transillumination (NIR-LT) to detect interproximal enamel and dentinal caries lesions compared to clinical-visual inspection aided by fiber-optic transillumination (FOTI)., Method and Materials: From 170 Finnish adolescents aged 15 to 17 years, 5,294 interproximal surfaces of premolars and molars were examined first clinical-visually aided by FOTI (VI&#43;FOTI) using the International Caries Detection and Assessment System (ICDAS) classification. Subsequently, the surfaces were examined using NIR-LT. The extent of lesions was determined using the modified NIR-LT classification based on the Söchtig criteria. For the analyses, data on maxillary and mandibular premolars and molars were combined. Distributions of lesions were presented as frequencies. Differences between VI&#43;FOTI and NIR-LT at the tooth and tooth surface levels were analyzed by chi-square and Fisher exact tests. Sensitivity and specificity of the NIR-LT method to detect any lesion was performed using VI&#43;FOTI as the gold standard., Results: By VI&#43;FOTI, 92.4% surfaces were classified as sound and by NIR-LT, 88.2%. Enamel caries lesions were found on 7.0% of the surfaces by VI&#43;FOTI and on 11.6% by NIR-LT. Nearly double the number of enamel lesions were identified by NIR-LT for all examined teeth groups, except for mandibular molars where this was 1.3-fold. In 66% of the surfaces, the differences between NIR-LT and VI&#43;FOTI findings were statistically significant (P .001). The sensitivity for all teeth of NIR-LT was 48.4% and the specificity was 91.1%., Conclusion: Radiation-free NIR-LT method shows considerable potential as a supplementary method for early detection of caries lesions among low-caries prevalence adolescents.

Objectives: This in vitro study aimed to investigate the optical attenuation of light at 405, 660 and 780 nm sent through sound and carious human enamel and dentin, including respective individual caries zones, as well as microscopically sound-appearing tissue close to a carious lesion. Materials and methods: Collimated light transmission through sections of 1000–125-µm thickness was measured and used to calculate the attenuation coefficient (AC). The data were statistically analysed with a MANOVA and Tukey's HSD. Precise definition of measurement points enabled separate analysis within the microstructure of lesions: the outer and inner halves of enamel (D1, D2), the translucent zone (TZ) within dentin lesions and its adjacent layers, the enamel side of the translucent zone (ESTZ) and the pulpal side of the translucent zone (PSTZ). Results: The TZ could be distinguished from its adjacent layers and from caries-free dentin at 125 µm. Sound-appearing dentin close to caries lesions significantly differed from caries-free dentin at 125 µm. While sound and carious enamel exhibited a significant difference (p < 0.05), this result was not found for D1 and D2 enamel lesions (p > 0.05). At 405 nm, no difference was found between sound and carious dentin (p > 0.05). Conclusions: Light optical means enable the distinction between sound and carious tissue and to identify the microstructure of dentin caries partially as well as the presence of tertiary dentin formation. Information on sample thickness is indispensable when interpreting the AC. Clinical relevance: Non-ionising light sources may be suitable to detect lesion progression and tertiary dentin. [ABSTRACT FROM AUTHOR]

Dental caries, a chronic and irreversible disease caused by caries-causing bacteria, has been listed as one of the three major human diseases to be prevented and treated. Therefore, it is critical to effectively stop the development of enamel caries. Remineralization treatment can control the progression of caries by inhibiting and reversing enamel demineralization at an early stage. In this process, functional materials guide the deposition of minerals on the damaged enamel, and the structure and hardness of the enamel are then restored. These remineralization materials have great potential for clinical application. In this review, advanced materials for enamel remineralization were briefly summarized, furthermore, an outlook on the perspective of remineralization materials were addressed.

Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries.Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions.

Currently, the prevalence of dental caries among children and adults reaches 98%. Multifactorial matter of the carious process is proved by numerous studies. Timely detection, prevention and effective treatment of focal demineralization of the enamel helps to prevent the development of defects of hard tissues and caries complications. The purpose of the study is to evaluate the clinical efficiency of combination of medicines for deep fluorination and laser radiation of low-intensity in the prevention of dental caries. The study involved 120 volunteers aged 20-30. 2 groups of patients were formed, each group was divided into 3 subgroups according to the number of medicines used. The evaluation of the clinical efficiency of medicines: «FtorLux» (TekhnoDent); «Triftorid2 (OmegaDent); «Nanofluor» (Vladmiva). In the first group, all patients underwent a course of fluorination of three procedures including the repeated treatment in 2 weeks, in the second group the usage of these drugs was combined with the application of laser radiation of low-intensity by means of the apparatus «Optodan». A study of clinical efficiency was performed including the enamel resistance test, determination of mineralizing potential of oral liquid. The received results indicated the achievement of the remineralizing effect by the application of medicines for deep fluorination in combination with laser radiation of low-intensity. But, in group of patients in which the laser radiation was applied against the background of using various medicines, the test indices of enamel resistance and mineralization ware significantly higher than in the group in which only medicines were used.

The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of cariogenic challenge on the bond strength of adhesive systems to sound and artificially demineralized enamel of primary and permanent teeth. Materials and Methods: Eighty molars (40 primary, 40 permanent) were randomly assigned to 16 groups (n = 5) according to the type of tooth (primary [PRIM] or permanent [PERM]), enamel condition (sound [S] or demineralized [DEM]), treatment after the restorative procedure (control [C] or cariogenic challenge [pH]), and adhesive system (Adper Single Bond [SB] or Clearfil SE Bond [SE]). Teeth from the DEM group were subjected to cariogenic challenge by pH cycling prior to restorative procedures and pH group specimens were subjected to cariogenic challenge before the microshear test. One of two adhesive systems was applied to the flat enamel surfaces and composite cylinders (0.45 mm²) were built. The microshear bond test was performed. The data (MPa) were subjected to ANOVA and Tukey's test (α = 0.05). Results: No statistically significant differences were detected between the adhesive systems. The S groups exhibited higher bond strength values than the DEM groups, as did C groups compared to pH groups. PERM groups also had higher bond strength values than PRIM groups, excluding PRIM S and PERM S, which had similar values. Conclusion: The bond strength to demineralized enamel of primary teeth was lower than to the demineralized enamel of permanent teeth. Cariogenic challenge negatively influenced enamel bond strength, regardless of the type of tooth and adhesive system. [ABSTRACT FROM AUTHOR]

The present systematic review was conducted to investigate the effect of the self-assembling peptide (SAP) – P11-4 in the remineralization of enamel caries. The systematic search for studies was conducted through CINAHL, EMBASE, MEDLINE, Scopus, PsychINFO, and various key journals. This review was conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42019110156. The methodological quality of the studies was graded through Cochrane's tool of risk of bias in non-randomized studies – of interventions (ROBINS-I). In total, 91 studies were identified for screening, and 12 studies were eligible. Ten studies showed effective enamel remineralization with P11-4 compared to controls. One study showed a combination of P11-4 with fluoride varnish or Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP-ACPF) leads to significantly higher remineralization compared to P11-4 alone. Quality assessment of study showed 6 (50%) studies as medium risk of bias and 6 (50%) studies as low risk of bias. To conclude, the present study results showed SAP- P11-4 is effective in the remineralization of enamel caries. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to identify barriers and enablers for dentists managing non-cavitated proximal caries lesions using non- or micro-invasive (NI/MI) approaches rather than invasive and restorative methods in New Zealand, Germany and the USA. Methods Semi-structured interviews were conducted, focusing on non-cavitated proximal caries lesions (radiographically confined to enamel or the outer dentine). Twelve dentists from New Zealand, 12 from Germany and 20 from the state of Michigan (USA) were interviewed. Convenience and snowball sampling were used for participant recruitment. A diverse sample of dentists was recruited. Interviews were conducted by telephone, using an interview schedule based on the Theoretical Domains Framework (TDF). Results The following barriers to managing lesions non- or micro-invasively were identified: patients’ lacking adherence to oral hygiene instructions or high-caries risk, financial pressures and a lack of reimbursement for NI/MI, unsupportive colleagues and practice leaders, not undertaking professional development and basing treatment on what had been learned during training, and a sense of anticipated regret (anxiety about not restoring a proximal lesion in its early stages before it progressed). The following enablers were identified: the professional belief that remineralisation can occur in early non-cavitated proximal lesions and that these lesions can be arrested, the understanding that placing restorations weakens the tooth and inflicts a cycle of re-restoration, having up-to-date information and supportive colleagues and work environments, working as part of a team of competent and skilled dental practitioners who perform NI/MI (such as cleaning or scaling), having the necessary resources, undertaking ongoing professional development and continued education, maintaining membership of professional groups and a sense of professional and personal satisfaction from working in the patient’s best interest. Financial aspects were more commonly mentioned by the German and American participants, while continuing education was more of a focus for the New Zealand participants. Conclusions Decisions on managing non-cavitated proximal lesions were influenced by numerous factors, some of which could be targeted by interventions for implementing evidence-based management strategies in practice.

The aim of this research was to determine the association between sorptivity of water and the state of mineralization in carious enamel of different stages of severity. As a preliminary work, water droplets of 1.5 μL were placed on the surfaces of hydroxyapatite (HA) discs of different densities. The water droplet profile was dynamically recorded every second over a period of 10 s using a contact angle meter to determine the relationship between sorptivity and density. To measure and calculate sorptivity on enamel surfaces, varnish was painted on the labial surface of 96 extracted caries-free human teeth, leaving two 1.4 ± 0.1 mm diameter circular exposed test sites. The specimens were randomly divided into 6 groups (n = 16) and subjected to 0(G0), 7(G7), 14(G14), 21(G21), 28(G28) and 35(G35) days of pH cycling, respectively. A 0.7 μL water droplet was placed on each exposed site and Optical Coherence Tomography was used to measure its height every 10 seconds for 2 min. Sorptivity was computed by considering sorption equations and Washburn's analysis of capillary kinetics and correction for evaporation was also performed. Micro-Computed Tomography scans of the specimens were obtained and delta Z (ΔZ) is the parameter used to measure mineral loss. ΔZ at 10 μm (ΔZ 10) and 50 μm (ΔZ 50) from the surface were calculated. One-way ANOVA and Post-hoc Tukey tests were used to compare sorptivity between groups and bivariate correlations were used to analyze the association between sorptivity and ΔZ. Sorptivity was found to be inversely and linearly correlated with HA density with R2 value of 0.95. With enamel, there is a general trend of increase in mean sorptivity from G0 to G35, except for a decrease in G21. The same trends were observed for both ΔZ 10 and ΔZ 50. The decrease in sorptivity in G21 coincided with the presence of a surface hypermineralized layer in G21 samples. Post-hoc Tukey showed significant differences in mean sorptivity between G0 and G14, G0 and G21 as well as G14 and G21. Post-hoc Dunnett's T3 showed significant differences for ΔZ 10 between G0 and G14 as well as G14 and G21. Significant correlation between mean sorptivity and ΔZ 10 was detected with Pearson correlation coefficient of 0.461. For ΔZ 50 , post-hoc Tukey showed significant differences between G0 and G14 but no significant difference was detected between G14 and G21. No correlations were detected between mean sorptivity and ΔZ 50. Sorptivity was found to be inversely and linearly correlated with HA density with R2 value of 0.95. With enamel, there is a general trend of increase in mean sorptivity from G0 to G35, except for a decrease in G21. The same trends were observed for both ΔZ 10 and ΔZ 50. The decrease in sorptivity in G21 coincided with the presence of a surface hypermineralized layer in G21 samples. [ABSTRACT FROM AUTHOR]

Remineralization treatment, which offers the advantage of being non-invasive, is increasingly being used as a minimal intervention treatment in managing incipient enamel caries. The aim of this review was to develop EBM guideline for optimized strategies for non-invasive treatment of incipient enamel caries. Japanese Society of Conservative Dentistry (JSCD) guideline committee formulated a Guideline for treating incipient enamel caries using the GRADE system, which is the global, mainstream standard for guideline development. The committee selected the most frequent clinical questions (CQs) in treating incipient enamel caries and identified clinically important outcomes in evaluating the efficacy of treatments. Using extensive electronic and manual searches, relevant randomized controlled trials and controlled clinical trials were identified. Based on evidence profiles produced by the committee, the panel discussed the effects, benefits and disadvantages of the selected treatments, as well as their cost effectiveness and feasibility, in order to achieve a consensus in treating incipient enamel caries non-invasively. A recommendation was made for each clinical question after voting by the panel members. Based on the evidence profile and panel discussions for each CQ, the experts strongly recommended application of topical fluoride to inhibit cavitation of incipient enamel caries, and to diminish white spot lesions. [ABSTRACT FROM AUTHOR]

With the gradual discovery of functional domains in natural proteins, several biologically inspired peptides have been designed for use as biomaterials for hard tissue regeneration and repair. In this study, we designed a tuftelin‐derived peptide (TDP) and tested its effects on hydroxyapatite crystallization and remineralization of initial enamel carious lesions in vitro. Using circular dichroism spectroscopy, we found that TDP contained 36.1% β‐sheets and β‐turns, which could be influenced by calcium ions. We verified the ability of TDP to crystallize hydroxyapatite using transmission electron microscopy and its ability to bind to the enamel surface and hydroxyapatite using confocal laser scanning microscopy and Langmuir adsorption isotherms (K = 881.56, N = 1.41 × 10−5). Artificial enamel lesions were generated on human enamel blocks and subjected to a 12‐day pH cycling model and were treated with 25 μM TDP, 1 g/L sodium fluoride (NaF), or deionized water. We analyzed the results of remineralization by surface microhardness testing, polarized light microscopy, and transverse microradiography. The TDP group showed significantly higher surface microhardness recovery (49.21 ± 1.66%), shallower lesions (34.89 ± 4.05 μm), and less mineral loss (871.33 ± 81.49 vol%·μm) after pH cycling than the deionized water group (p <.05). There were no significant differences between the TDP and NaF groups. Our experiment indicated that TDP could regulate hydroxyapatite crystallization and promote remineralization of enamel caries in vitro. [ABSTRACT FROM AUTHOR]

Objective: To explore caries development in children from 5 to 12 years of age, and to study whether enamel caries and dentine caries at 5 years of age could predict caries prevalence at 12 years of age, controlled for child characteristics. Methods: The study included 3282 children examined at 5 and 12 years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved. Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5 years of age had at 12 years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p <.05). Dentine caries experience at 12 years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5 years of age. Family status and parental education were related to caries development. Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. [ABSTRACT FROM AUTHOR]

This study evaluates the effects of resin infiltrant composition and caries histological zone on the hydrolytic degradation of resininfiltrated artificial bovine enamel caries (RI-AEC). Different resin infiltrants were tested (n=26 per group): Icon (G1); TEGDMA 60%, UDMA 20%, and HEMA 20% (TUH); TEGDMA 80% and HEMA 20% (TH); and TEGDMA 75% and Bis-EMA 25% (TB). Following caries infiltration, samples were cut perpendicularly, and transverse microhardness were analyzed (at two histological zones: surface layer and lesion body) before and after 21 days of water immersion. TB presented lower decrease in microhardness (due to hydrolytic degradation) than the other groups, with a large effect size (Hedge's G from 0.83 to 1.19) and high power (84 to 99%). Neither histological zone nor its interaction with resin infiltrant composition significantly affected the outcome. In conclusion, resin composition affected microhardness of RI-AEC upon water immersion, and TB was the least affected. [ABSTRACT FROM AUTHOR]

Dental caries is the most common type of oral health problem globally. Despite credible scientific advances and the fact that caries is preventable, the disease continues to be a major public health problem. In developing countries, changing lifestyles and dietary patterns are markedly increasing the incidence of caries. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. The aim of the study is to assess the prevalence of dental caries in school going children in the age group of 5 - 14 years using the International Caries Detection and Assessment System (ICDAS II). The retrospective study was conducted in a university hospital setting, among 100 school children of Chennai in the Department of Pedodontics and Preventive Dentistry in December 2019. The study was conducted between the age group of 5 - 14 years. Each student was examined intraorally by using the ICDAS system. This data was entered in the Excel sheet for tabulation and SPSS importing was done, Chi - Square association test was performed. 25.25% of females were highly prevalent in code 2. The highest coding percentage was seen in code 2 and females were highly prevalent which showed p value = 0.354 (p>0.05) (not significant). Age group of 5-8 years had the highest prevalence of dental caries (23%) which showed p value = 0.354 (p>0.05) (not significant). Within the limitations of the study age group of 5-8 years were highly prevalent to dental caries. The surfaces with early caries lesion (ICDAS code 2) are more common in the surveyed population. [ABSTRACT FROM AUTHOR]

This study was to investigate hydroxypropyl methylcellulose (HPMC) film as a carrier for amorphous fluorinated calcium phosphate (AFCP) nanoprecursors to continuously deliver biomimetic remineralization of enamel artificial caries lesions (ACL). The AFCP/HPMC films were comprised of 25 wt% AFCP nanoparticles and 75 wt% HPMC. They were characterized by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and biocompatibility tests. Forty enamel ACL were prepared and randomly divided into four groups (n = 10): The enamel surfaces were covered with a pure HPMC film, Tooth Mousse Plus (contains 10% CPP-ACP and 0.2% NaF), and AFCP/HPMC film, or without any things (serving as negative control). Subsequently, all samples were alternatively kept in artificial saliva and a modified pH-cycling before they were characterized by Micro-CT, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflectance (ATR)-FTIR, XRD, and nanoindentation. After the enamel ACL was challenged by pH cycling, Tooth Mousse Plus and AFCP/HPMC film groups exhibited less lesion depth and mineral loss than the negative control and pure HPMC film groups. Additionally, the AFCP/HPMC film group revealed a highest remineralization rate of 55.34 ± 3.10 % among the all groups (p < 0.001). The SEM findings showed that the enamel ACL were densely deposited with minerals in the AFCP/HPMC film group, and the EDX results suggested a higher content of fluorine in the remineralized tissues. In particular, the AFCP/HPMC film group exhibited the best nanomechanical performance after 2 weeks of pH cycling (p < 0.05), with the hardness (H) restored from 0.29 ± 0.19 to 2.69 ± 0.70 GPa, and elastic modulus (Er) restored from 10.77 ± 5.30 to 68.83 ± 12.72 GPa. The AFCP/HPMC film might be used as a promising strategy for arresting or reversing incipient enamel caries lesions. [ABSTRACT FROM AUTHOR]

Objective: This in vivo pilot study investigated the role of argon laser irradiation and combined fluoride and argon laser treatment in accelerated natural caries development in sound enamel surfaces beneath plaque-retentive orthodontic bands. Method and materials: Five patients (3 female, 2 male, ages 19 to 28 years) requiring tooth extraction prior to orthodontic treatment, participated in the study. Buccal surfaces were treated with either: (1) argon laser (250 mW for 10 seconds, ARGO-MOD); (2) topical fluoride (0.5% fluoride ion, Thera-Flur-N) followed by argon lasing; or (3) no treatment (control). Orthodontic bands with plaque-retentive slots on buccal surfaces were placed on the teeth slated for extraction (n = 14). Following a minimum of 5 weeks of intraoral exposure, the teeth were extracted for laboratory analysis. The teeth underwent serial longitudinal sectioning (12 sections per tooth). The sections were imbibed in water, and lesion depths were determined with each section, using polarized light microscopy. Comparisons were made among treatment groups (analysis of variance, Duncan's multiple range test for paired samples). Results: Mean lesion depths were: 261 ± 24 μm for the no treatment control group (n = 84 sections); 147 ± 18 μm for the argon laser group (n = 24 sections); and 99 ± 12 μm for the fluoride and argon laser group (n = 60 sections). Both the argon laser (44%) and the fluoride and argon laser groups (62%) had significant lesion depth reductions compared to controls. The addition of fluoride treatment prior to argon lasing resulted in a 32% reduction in lesion depth compared to argon laser treatment alone. Conclusions: Within this clinical pilot study, in vivo natural caries formation was affected significantly by a single exposure to low fluence argon laser irradiation. Topical fluoride treatment in combination with argon lasing provided an even greater degree of resistance against in vivo enamel caries development. A simple technique for reducing the caries susceptibility of enamel may be a clinical reality. [ABSTRACT FROM AUTHOR]

Objective: To assess the potential of DIAGNOdent (DD) readings for detecting secondary enamel and dentin carious lesions associated with resin composite restorations in a set of preserved extracted adult teeth. Method and materials: Thirty test sites adjacent to resin composite restorations in 15 extracted teeth were evaluated visually and with DD readings for enamel and dentin caries. The results were compared to gold standard diagnosis determined by sectioning through each site and subsequent microscopic observation. Sensitivity, specificity, accuracy, and likelihood ratios at optimum threshold values for enamel and dentin caries were determined. Receiver operator characteristic (ROC) analysis was performed to compare visual and DD diagnostic methods. Results: Histologic incidence of enamel caries was 20% and dentin caries was 36.67%. All composite restorations in the sample teeth fluoresced (range 5 to 22). For enamel caries detection with DD, the optimum threshold of ≥26 produced a sensitivity of .67 and a specificity of .79. For dentin caries detection with DD, the optimum threshold of ≥22 produced a sensitivity of .73 and a specificity of .84. ROC analysis showed that the DD readings do contain diagnostic information. DD readings for dentin caries diagnosis produced better diagnostic results compared to visual readings for the 30 test sites in the study, but these results were not significantly different. Conclusion: DIAGNOdent readings may have potential for resin composite secondary enamel and dentin carious lesion detection. DIAGNOdent instrument design factors and technique should be optimized to improve performance prior to clinical trial for this application. (Quintessence Int 2003;34: 109-116) [ABSTRACT FROM AUTHOR]

This study evaluated the effect of repeated etching cycles on resin infiltrant penetration. Enamel samples measuring 4 × 4 × 3 mm 3 were obtained from the facial aspect of 50 extracted bovine teeth. Samples were immersed in a demineralization solution for 21 days to create artificial lesions and divided into five equal groups (n = 10). A 15% hydrochloric acid gel was administered to each group. The acid etching application time differed between groups: Group 1; 2 min, Group 2; 2 × 2 min, Group 3; 3 × 2 min, Group 4; 4 × 2 min, and Group 5; 5 × 2 min. Resin infiltration was visualized using a confocal laser scanning microscopy. The lesion, penetration and erosion depth (µm) were calculated, and data were statistically analyzed. The highest penetration depth (75.59 ± 9.42 µm) was seen in Group 5, followed by Groups 4, 3, 2 and 1. However, there were no statistically significant differences in the penetration depths between Groups 4 and 5 and between Groups 2, 3 and 4 ( p > 0.05). In conclusion, a repeated etching cycle enhanced resin infiltrant penetration., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

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The principles of minimally invasive dentistry clearly dictate the need for clinically effective measures to remineralize early enamel caries lesions. While fluoride-mediated remineralization is the cornerstone of current caries management philosophies, a number of new remineralization strategies have been commercialized or are under development that claim to promote deeper remineralization of lesions, reduce the potential risks associated with high-fluoride oral care products, and facilitate caries control over a lifetime. These non-fluoride remineralizing systems can be broadly categorized into biomimetic enamel regenerative technologies and the approaches that repair caries lesions by enhancing fluoride efficacy. This paper discusses the rationale for non-fluoride remineralization and the mechanism of action, challenges, and evidence behind some of the most promising advances in enamel remineralization therapies. [ABSTRACT FROM AUTHOR]

Objectives: Initial dental caries often occurs in clinic. Reduction of cariogenic bacteria and promotion of remineralization are effective ways to control them. This study was to develop bifunctional anticaries peptides with antibacterial and remineralizing properties. Methods: We designed peptides TDH19, TNH19, and TVH19 and selected one through comparing their minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs) against Streptococcus mutans and their reaction on mineralization. Then the bifunction of the selected peptide was studied through: (a) effects on S. mutans biofilm, (b) remineralizing effects on initial lesions and (c) stability in saliva and cytocompatibility to human oral keratinocytes (HOKs). Results: TVH19 showed the lowest MIC and MBC and a better mineralizing ability. It inhibited new biofilm formation and reduced the viability of old biofilm (p < 0.05). Treating initial caries with TVH19 led to greater recovery of surface microhardness, shallower lesion depth, and higher mineral content (p < 0.05). No significant differences were observed between TVH19 and NaF samples (p > 0.05). TVH19 was stable in saliva and had little effect on HOKs. Conclusions: The novel bifunctional anticaries peptide TVH19 was developed with remarkable antibacterial activity and the potential to enhance remineralization of initial caries. [ABSTRACT FROM AUTHOR]

Highlights • All fluorescence parameter from three generations of QLF devices showed good to excellent validity in detecting enamel caries and in differentiating caries severity. • Δ F (which indicates the mineral contents) did not differ between the first-, second-, and third-generation QLF devices. • Δ R (indicating not only the microbial activity but also the mineral contents) had a higher validity for the third-generation device than for the first- and second-generation devices. Abstract Background This study compared two fluorescence parameters (fluorescence loss [Δ F ] and red fluorescence gain [Δ R ]) among three generations of quantitative light-induced fluorescence (QLF) systems with the aim of determining the validities of these parameters in the three devices for differentiating the severity of enamel caries. Methods Forty-one extracted human premolars and molars with suspected enamel caries were selected. Fluorescence images of all teeth were obtained using first-, second-, and third-generation QLF systems (Inspektor Pro, QLF-D, and Qraycam, respectively). Fluorescence parameters were then calculated using proprietary software. All of the specimens were also categorized histologically using polarized-light microscopy (PLM) based on histological levels related to the lesion depth into sound enamel (S), caries limited to the outer half of the enamel (E 1), and caries involving the inner half of the enamel (E 2). The Mann-Whitney test with Bonferroni correction was used to compare fluorescence parameters among the three generations of systems. The sensitivity, specificity, and area under the receiver operating characteristics curve (AUC) at two thresholds (S/E 1 for detecting enamel caries lesions and E 1 /E 2 for differentiating the caries severity) were calculated for evaluating the validities of the fluorescence parameters obtained using all three generations of QLF devices. Results Δ F did not differ significantly between the devices at any histological level. In addition, Δ F showed large AUCs at the thresholds of S/E 1 and E 1 /E 2 (0.97–0.98 and 0.89–0.90, respectively). On the other hand, Δ R was significantly higher for the third-generation device than for the first- and second-generation devices for E 2 lesions (P < 0.001). At the S/E 1 threshold, Δ R values of the first- and third-generation devices showed larger AUCs (0.96–0.97) compared with that of the second-generation device (0.91), whereas at the E 1 /E 2 threshold the AUC was the largest for the third-generation device (0.87). Conclusions The Δ F fluorescence parameter did not differ between the three generations of QLF devices, and showed high validity values. In terms of Δ R , the devices of all generations also showed good diagnostic performance for quantifying and detecting enamel caries lesions, but the third-generation QLF system produced superior results. [ABSTRACT FROM AUTHOR]

Abstract Titanium tetrafluoride (TiF4) is known for interacting with enamel reducing demineralization. However, no information is available about its potential antimicrobial effect. Objectives This study evaluated the antimicrobial and anti-caries potential of TiF4 varnish compared to NaF varnish, chlorhexidine gel (positive control), placebo varnish and untreated (negative controls) using a dental microcosm biofilm model. Material and Methods A microcosm biofilm was produced on bovine enamel previously treated with the varnishes, using inoculum from human saliva mixed with McBain saliva, under 0.2% sucrose exposure, for 14 days. All experiments were performed in biological triplicate (n=4/group in each experiment). Factors evaluated were: bacterial viability (% dead and live bacteria); CFU counting (log10 CFU/mL); and enamel demineralization (transverse microradiography – TMR). Data were analysed using ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p

The article presents the results of electron microscopy of 52 teeth with various enamel caries, that were considered to be infiltrated material «Icon» (DMG, Germany). The investigation has proved, that in case of white carious spots infiltrant occupied almost the entire volume of a pathologic focus (in 81,8 ± 6,71% of cases). However, in case of pigmented spots no infiltration of the lesion to its full depth was observed. In 78,9 ± 9,35% of this group non-infiltrated teeth caries spots were located within the surface layers of dentin. Extrapolating of these results to the clinic, it can be assumed that the infiltration of caries in the primary stage of pigmented spots does not guarantee stabilization of the caries process.