Jean-Jean Gwo

39546294

Acta Odontol Scand. 2014 Apr 28. [Epub ahead of print]

Remineralization of initial enamel carious lesions using fluoridated milk

in vitro.
Ongtenco KL1, Anthonappa RP, Itthagarun A, King NM, Lalloo R, Nair RG.
Author information
Abstract
Abstract Objectives. Milk is a universal dietary component and it is now recognized as an
effective medium for the delivery of fluoride (F). This study sought (i) to evaluate fluoridated milk
(2.5 ppm, 5 ppm, 10 ppm) for remineralizing carious lesions and (ii) to determine the optimum
frequency for treating carious lesions with fluoridated milk. Materials and methods.
Artificial carious lesions, 90-180 m deep, were created on extracted third molar teeth that were
sectioned to produce specimens of 100-120 m thickness. Specimens were randomly divided into
13 groups (n = 20) for treatment with deionized water, plain milk or fluoridated milk (2.5 ppm, 5
ppm, 10 ppm); once daily, twice daily or on alternate days as part of a 20-day pH cycling model.
Lesion depth (LD) and mineral content were evaluated before and after pH cycling. Paired t-test,
ANOVA and Student-Newman-Keuls tests were employed to make comparisons within and
between the different groups. Results. Fluoridated milk significantly reduced LD and increased
the mineral content of the lesions compared to plain milk and deionized water (p < 0.05). The
greatest reduction in LD was with 2.5 ppm F milk used twice daily (p < 0.05). Conclusions. Milk
with 2.5 ppm F used twice daily demonstrated the greatest remineralization of artificial
enamel carious lesionsin vitro.

Oral Health Prev Dent. 2013;11(3):281-90. doi: 10.3290/j.ohpd.a30170.

Remineralisation of carious lesions and fluoride uptake by enamel exposed to

various fluoride dentifrices in vitro.

Hattab FN.

Abstract

PURPOSE:

To evaluate the relative performance of fluoride (F) dentifrices to promote remineralisation and
enamel F acquisition using an in vitro pH-cycling model. Enamel surface morphology was
investigated.

MATERIALS AND METHODS:

Thirty-six white spot lesions and 36 sound enamel sections from extracted premolars and molars
were randomly assigned to 8 experimental groups and a placebo group. Eight commercially
available brands of Fdentifrices were used: A. 0.8% monofluorophospate (MFP)-silica; B. 0.8%
MFP-calcium carbonate and calcium phosphate; C. 0.8% MFP-calcium carbonate and calcium
phosphate; D. 0.76% MFP-aluminium hydroxide; E. 0.24% sodium fluoride (NaF)-silica and
Jean-Jean Gwo
39546294

sodium pyrophosphate; F. 0.24% NaF-silica and sodium pyrophosphate; G. 0.76% MFP and
0.10% NaF-dicalcium phosphate and sodium pyrophosphate (1450 ppm F); H. 0.76% MFP and
0.33% NaF-silica (2500 ppm F). The placebo (I) contained non-fluoridated silica. The cycling
regimen comprised the following: three 2-min and one 4-min daily treatments with dentifrice
slurries, rinsed with water and stored in fresh whole saliva at 37C until the next experimental
day, when specimens were activated in acid buffer solutions prior to each dentifrice treatment.
This pH cycling continued for 21 consecutive days. Lesion depths and size were measured using
a polarising microscope and enamel F uptake was determined using the acid-etch biopsy
technique. The morphology of enamel surfaces was examined using scanning electron
microscopy. The data were statistically analysed using Student's t-test, analysis of variance
(ANOVA) and Pearson's correlation coefficient (r).

RESULTS:

All tested fluoride dentifrices significantly enhanced remineralisation by reducing the lesion
depths from 6.4 to 17.1 m and lesion sizes by 10% to 34% relative to the pre-cycling
measurements. Overall, the degree of remineralisation was as follows: NaF-silica-pyrophosphate
dentifrices (1000 ppm F) averaged 41%; NaF/MFP-silica (1500/1000 ppm F) 38%; MFP/NaF-
dicalcium phosphate (1000/450 ppm F) 30%; MFP dentifrices (1000 ppm F) ranged from 15 to
23%. Enamel F uptake by NaF and NaF/MFP was significantly greater than MFP dentifrices (P <
0.05 to P < 0.001), with the area under the depth curve being 2.4 and 2.2 times greater,
respectively. At all enamel depths, fluoride dentifrices significantly increased F concentrations
relative to the control (P < 0.001). A strong correlation was found between ionic F levels in
dentifrices and their efficacy. Dentifrices produced different enamel surface morphologies.

CONCLUSIONS:

The present study demonstrates that commercially available dentifrices vary in their degree of
effectiveness and mode of action depending on formulations.

The investigation of non-invasive techniques for treating early

approximal cariouslesions: an in vivo study.

Yazcolu O1, Ulukap H.

Author information

Abstract
Jean-Jean Gwo
39546294

OBJECTIVES:

The aim of this study was to examine non-cavitated approximal caries using non-invasive
treatment methods.

MATERIALS AND METHODS:

Molar and premolar teeth with approximal caries were used in this in vivo study. Approximal
caries lesions were evaluated with visual and radiographic inspection and with the DIAGNOdent
device. Five groups were formed to study non-invasive treatment, and each had at least 25 early
approximal cariouslesions. Patients in the control group were not treated. After the separation,
either ozone application, acidulated phosphate fluoride gel, CPP-ACP-containing material (Tooth
Mousse), or an antibacterial bonding agent (Clearfil Protect Bond) was used. For 18 months after
the non-invasive treatment, radiological controls were used to observe the progress of the initial
and approximal caries in the 1st, 3rd, 6th and 12th months of follow-up. A Mann-Whitney U-test
was used to perform the statistical analysis; in-group comparisons were made with the Wilcoxon
signed-rank test, and a quantitative assessment was performed using a chi-squared test.

RESULTS:

At the end of 18 months, the caries lesions in the control group were observed to progress (P <
0.01). The lesions that were scored as 1a during a visual inspection recovered by using non-
invasive treatments.

CONCLUSION:

Approximal caries lesions that were detected at the early stages remained stationary when using
antibacterial agents and materials that promoted remineralisation.

CLINICAL RELEVANCE:

Antibacterial agents and remineralisation materials can be used in treatment of early approximal
caries lesions.

2013 FDI World Dental Federation.

J Mater Sci Mater Med. 2014 Jul 30. [Epub ahead of print]

Biomimetic remineralization of demineralized enamel with nano-

complexes of phosphorylated chitosan and amorphous calcium
phosphate.
Zhang X1, Li Y, Sun X, Kishen A, Deng X, Yang X, Wang H, Cong C, Wang Y, Wu M.
Author information
Abstract
Jean-Jean Gwo
39546294

Remineralization of enamel plays a crucial role in the progression of carious process and the
management of early caries lesion. Based on the influence of phosphorylated proteins in
biomineralization, the objective of this study was to synthesize nano-complexes of
phosphorylated chitosan and amorphous calcium phosphate (Pchi-ACP), and evaluate their
ability to remineralize enamel subsurface lesions in vitro. Pchi was synthesized using a previously
established chemical method. The biomimetic remineralizing solution containing nano-complexes
of Pchi-ACP was prepared by adding CaCl2 and K2HPO4 into Pchi-ACP solution (0.5 % w/v) in
sequence. The final concentrations of calcium and phosphate ions were 10 and 6 mM,
respectively. The nano-complexes of Pchi-ACP were characterized by Fourier-transform infrared
(FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM), and selected area
electron diffraction (SAED). During testing the enamel lesions were treated with Pchi-ACP and
fluoridated remineralizing solutions, respectively. The remineralizing of enamel lesions was
examined with field emission electron microscope (FE-SEM) and Micro-CT. ACP was stabilized
by Pchi to form nano-complexes that were soluble in water. The size of Pchi-ACP nano-
complexes particles was determined to be less than 50 nm. XRD and SAED results confirmed
their amorphous phases. FE-SEM and Micro-CT results showed that the remineralizing effect of
Pchi-ACP on enamel lesions was similar to that of fluoride. However, the remineralizing rate of
Pchi-ACP treatment was significantly higher than that of fluoride treatment (P < 0.05). This study
highlighted the potential of nanoparticles functionalized with a natural analogue involved in
biomineralization, to remineralize early enamel caries.

PMID:

25074834

[PubMed - as supplied by publisher]

J Dent. 2014 Jun 4. pii: S0300-5712(14)00158-4. doi: 10.1016/j.jdent.2014.05.014. [Epub ahead of print]

The effect of a bioglass paste on enamel exposed to erosive challenge.

Bakry AS1, Marghalani HY2, Amin OA3, Tagami J4.

Author information

Abstract

OBJECTIVES:

The current study is evaluating the effect of using a 45S5 bioglass paste and topical fluoride
application on the cross sectional micro-hardness and the chemical surface changes of eroded
enamel.

METHODS:

Enamel discs were obtained from the buccal surface of one hundred extracted human non-
carious third molars. The enamel surfaces were ground flat and each disc was coated with two
Jean-Jean Gwo
39546294

layers of acid resistant nail varnish except for an exposed treatment window (3mm2mm) on the
buccal surface of the tooth. All specimens were challenged for 60min by orange juice (Tropicana,
Chicago, USA) pH 3.85+0.5. The specimens were divided into four groups: the 45S5 bioglass
paste group, fluoride gel group (5min application), fluoride gel group (24h application) while the
rest of specimens served as control. The cross-sectional micro-hardness of 20 specimens from
each group was measured. Five specimens from each group had their top eroded enamel
surfaces examined by SEM-EDS. One-way ANOVA was used to compare the cross-sectional
micro-hardness of the three groups p<0.05.

RESULTS:

45S5 bioglass paste application significantly improved the sub-surface eroded enamel when
compared to fluoride and control specimens (p<0.05).

CONCLUSION:

45S5 bioglass paste can efficiently improve the micro-hardness of the sub-surface eroded
enamel surface.

CLINICAL SIGNIFICANCE:

The use of the 45S5 Bioglass paste can be used efficiently as a potent remineralizing agent for
the sub-surface enamel lesions resulting from erosive challenges.

Copyright 2014 Elsevier Ltd. All rights reserved.

Braz Dent J. 2013;24(3):253-7. doi: 10.1590/0103-6440201302116.

In vitro enamel remineralization by low-fluoride toothpaste with calcium

citrate and sodium trimetaphosphate.
Hirata E1, Danelon M, Freire IR, Delbem AC.
Author information
Abstract
The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450
gF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on
enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to
determine the surface hardness. After production of artificial carious lesions, the blocks selected
by their surface hardness were submitted to remineralization pH cycling and daily treatment with
dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and
1,100 gF/g and commercial dentifrice (positive control, 1,100 gF/g). Finally, the surface and
cross-section hardness was determined for calculating the change of surface hardness (%SH)
and mineral content (%Z). Fluoride in enamel was also determined. The data from %SH, %Z
and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's
test (p<0.05). The mineral gain (%SH and %Z) was higher for toothpastes diluted in saliva
(p<0.05), except for the 450 gF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP
Jean-Jean Gwo
39546294

toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-
response was observed between fluoride concentration in toothpastes and fluoride present in
enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization
capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds
with affinity to hydroxyapatite.