RESUMEN

INTRODUCTION: Caries in primary teeth rapidly advances owing to its thin structure, thereby requiring restoration. However, restorations often fail due to various causes such as secondary caries and reduced microtensile bond strength (µTBS), which calls for the use of antimicrobial agents such as silver diamine fluoride (SDF). AIM: This study aims to measure and analyse the effect of SDF application on the µTBS of three regularly used restorative materials to dentin of primary teeth as well as compare the types of bond failure interfaces under SEM. MATERIALS AND METHODS: The study comprised 60 samples equally divided into six groups among three restorative materials, namely, glass ionomer cement (GIC, Groups I and II), resin-modified glass ionomer cement (RMGIC, Groups III and IV), and composite resin (Groups V and VI) with subdivisions of A and B, where A represented samples with SDF application and B represented samples without SDF application. RESULTS AND OBSERVATIONS: It was observed that µTBS of RMGIC to sound and carious dentin irrespective of SDF application was found to be statistically significant (P < 0.05), and when GIC, RMGIC, and composite resins were compared to both sound and carious dentin irrespective of SDF application, it was statistically significant (P < 0.05). SEM analysis revealed predominantly cohesive failures among all the groups. CONCLUSION: Based on the results, it was concluded that SDF has no adverse effect on the µTBS of GIC, RMGIC, and composite resin to both carious and sound dentin of primary teeth.

Asunto(s)

Resinas Compuestas , Recubrimiento Dental Adhesivo , Fluoruros Tópicos , Cementos de Ionómero Vítreo , Compuestos de Amonio Cuaternario , Compuestos de Plata , Resistencia a la Tracción , Diente Primario , Humanos , Fluoruros Tópicos/farmacología , Resinas Compuestas/química , Cementos de Ionómero Vítreo/farmacología , Compuestos de Amonio Cuaternario/farmacología , Compuestos de Amonio Cuaternario/química , Recubrimiento Dental Adhesivo/métodos , Microscopía Electrónica de Rastreo , Dentina/efectos de los fármacos , Ensayo de Materiales , Restauración Dental Permanente/métodos , Caries Dental , Materiales Dentales/química

RESUMEN

This study aimed to evaluate chitosan (CS)-based formulations loaded with 5% sodium fluoride (NaF) and/or 10% nanohydroxyapatite (nHA) to remineralize the demineralized primary tooth enamel surface. Ninety enamel blocks were demineralized and were divided into six groups (n = 15): (1) CS-based hydrogel, (2) CS-based hydrogel loaded with NaF, (3) CS-based hydrogel loaded with nHA, (4) CS-based hydrogel loaded with NaF and nHA, (5) 5% NaF varnish, and (6) negative control with no intervention. After intervention, the specimens were pH cycled by 2 h immersion in demineralizing solution and 22 h immersion in remineralizing solution for 8 days. The remineralization effects were evaluated by Vickers microhardness measurements and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (FESEM-EDS). The best mean ± SD percentage microhardness recovery in remineralized enamel (%REMH) was found in group 4 (56.90 ± 5.49). The %REMH of groups 2 (30.74 ± 3.51) and 5 (29.23 ± 5.65) were statistically the same (p = 0.943). FESEM images confirmed partial coverage of the porous demineralized enamel with a newly formed mineralized layer. Based on EDS findings, the Ca/P ratio values of the treated enamel surfaces with CS-based hydrogels ranged between 1.71 and 1.87, and the highest F content was noticed in group 2 (1.02 ± 0.03). Although, all tested CS-based hydrogels demonstrated the potential to repair demineralized enamel, nHA- and NaF-containing CS-based hydrogel showed the highest remineralization effect. We infer that this new hybrid hydrogel is a potentially useful dental material for tooth biomineralization.

Asunto(s)

Quitosano , Esmalte Dental , Fluoruro de Sodio , Quitosano/química , Quitosano/farmacología , Fluoruro de Sodio/farmacología , Esmalte Dental/efectos de los fármacos , Esmalte Dental/química , Concentración de Iones de Hidrógeno , Humanos , Remineralización Dental/métodos , Fluoruros Tópicos/farmacología , Fluoruros Tópicos/administración & dosificación , Durapatita/química , Durapatita/farmacología , Hidrogeles/química , Biomineralización/efectos de los fármacos , Desmineralización Dental/prevención & control , Microscopía Electrónica de Rastreo , Geles/química

RESUMEN

OBJECTIVE: To investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. METHODS: HUMAN TOOTH BLOCKS WERE RESTORED WITH: SDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. RESULTS: PMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead-to-live ratio in Groups 1-4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. CONCLUSION: SDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. CLINICAL SIGNIFICANCE: SDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.

Asunto(s)

Biopelículas , Cariostáticos , Caries Dental , Esmalte Dental , Fluoruros Tópicos , Cementos de Ionómero Vítreo , Microscopía Electrónica de Rastreo , Compuestos de Amonio Cuaternario , Compuestos de Plata , Streptococcus mutans , Compuestos de Plata/uso terapéutico , Compuestos de Plata/farmacología , Humanos , Cementos de Ionómero Vítreo/uso terapéutico , Cementos de Ionómero Vítreo/farmacología , Caries Dental/prevención & control , Caries Dental/microbiología , Compuestos de Amonio Cuaternario/farmacología , Compuestos de Amonio Cuaternario/uso terapéutico , Biopelículas/efectos de los fármacos , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/farmacología , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Esmalte Dental/efectos de los fármacos , Streptococcus mutans/efectos de los fármacos , Restauración Dental Permanente/métodos , Microtomografía por Rayos X , Candida albicans/efectos de los fármacos , Difracción de Rayos X , Microscopía Confocal

RESUMEN

INTRODUCTION: Nanotechnology offers new approaches and endless opportunities for remineralizing tooth decay without being toxic or causing allergies. This study aimed to determine the effect of nanosilver fluoride (NSF) on the remineralization potential of enamel caries-like lesions compared to 5% sodium fluoride varnish in permanent teeth. METHODS: Fifteen teeth (molars and premolars) were gathered, cleaned, and polished using a scaler. After sectioning the teeth mesiodistally and removing the roots, the thirty specimens were subjected to a demineralized solution to induce early enamel lesions and then assigned randomly into two equal groups. The test materials were applied, and then all the specimens were subjected to a pH cycling model for 30 days. DIAGNOdent and surface roughness were investigated, and an evaluation of the enamel Ca and P weight% for Ca/P ratio calculation was done using SEM-EDX to analyze the specimens at the end of the study. The data were analyzed using an independent t-test. RESULTS: The mean values for the DIAGNOdent measurements for NSF and NaF at baseline and after demineralization were not significantly different (p > 0.05). After treatment, NaF varnish showed a significantly higher mean DIAGNOdent measurement (11.8 ± 5.80) than NSF (4.7 ± 1.6). The mean surface roughness of the NaF group (1.64 ± 0.39) was much higher than NSF's mean surface roughness (1.07 ± 0.21). Specimens treated with NSF had statistically significant smoother surfaces (p < 0.001). The NSF group had a higher mean Ca/P ratio (2.9 ± 0.35) than NaF (2.2 ± 0.11). This difference was statistically significant (p = 0.012). CONCLUSION: The study reveals that nano silver fluoride is a more effective treatment than sodium fluoride varnish in enhancing teeth's clinical characteristics, particularly in terms of mineral content and surface roughness, suggesting it could be an improved strategy to prevent dental caries and maintain enamel integrity.

Asunto(s)

Caries Dental , Esmalte Dental , Fluoruros Tópicos , Fluoruro de Sodio , Remineralización Dental , Caries Dental/prevención & control , Humanos , Remineralización Dental/métodos , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/farmacología , Esmalte Dental/efectos de los fármacos , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/farmacología , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Propiedades de Superficie , Compuestos de Plata/farmacología , Microscopía Electrónica de Rastreo , Técnicas In Vitro , Concentración de Iones de Hidrógeno , Espectrometría por Rayos X , Desmineralización Dental/prevención & control

RESUMEN

BACKGROUND: Silver diamine fluoride (SDF) is becoming more widely recognized as a simple, cost-effective approach to minimize sensitivity and arrest caries. However, SDF results in caries that are stained black. Potassium iodide (KI) treatment with SDF may minimize or lessen the staining. However, the effectiveness of KI on staining has not been investigated. Studies demonstrating that potassium iodide reduces the black staining are still insufficient. This paper presents the study protocol for Healthy Smiles, a randomized controlled trial implemented to compare the staining propensity of SDF and SDF+KI. OBJECTIVE: This study, Healthy Smiles, aims to evaluate the staining propensity of SDF and SDF+KI using a Nix Mini color sensor among children aged 4 to 6 years. Another objective of the study is to evaluate the caries-arresting effect of SDF and SDF+KI in the treatment of carious primary teeth. METHODS: This study is a randomized controlled trial. A total of 60 children with caries that meet the criteria of the International Caries Detection and Assessment System (code 1 or above) will be randomly assigned to treatment groups, where group 1 will be treated with SDF and group 2 will be treated with SDF+KI. Discoloration of treated lesions will be assessed digitally using a Nix Mini color sensor. Participants will be followed up at 1, 3, and 6 months after treatment to digitally record the ∆L and ∆E values using the Nix Mini color sensor. Data will be analyzed using SPSS (version 28; IBM Corp). Independent sample t tests and the Mann-Whitney U test will be used to compare the 2 groups. RESULTS: Enrollment started in October 2023. It is estimated that the enrollment period will be 12 months. Data collection is planned to be completed in 2024. CONCLUSIONS: The presented paper describes Happy Smiles, a project that provides an opportunity to address the aesthetic inconvenience of patients without compromising the effectiveness of the SDF treatment. The trial findings will contribute to the limited evidence base related to discoloration after SDF intervention to improve aesthetic appearances in child oral health. If the results from the trial are promising, it will lead to the development of a model for child oral health and pave the way for further research in child oral health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51087.

Asunto(s)

Caries Dental , Fluoruros Tópicos , Yoduro de Potasio , Compuestos de Amonio Cuaternario , Compuestos de Plata , Niño , Preescolar , Femenino , Humanos , Masculino , Cariostáticos/administración & dosificación , Cariostáticos/farmacología , Caries Dental/prevención & control , Fluoruros Tópicos/administración & dosificación , Fluoruros Tópicos/farmacología , Compuestos de Amonio Cuaternario/farmacología , Decoloración de Dientes/tratamiento farmacológico , Decoloración de Dientes/inducido químicamente , Ensayos Clínicos Controlados Aleatorios como Asunto

RESUMEN

This study evaluated the effect of fluoride varnishes containing micrometric or nanosized sodium trimetaphosphate (TMP) on dentin erosive wear in vitro. Bovine root dentin blocks were selected by surface hardness and randomly divided into five experimental groups/varnishes (n = 20/group): placebo, 5% sodium fluoride (NaF); 5% NaF+5% micrometric TMP; 5% NaF+2.5% nanosized TMP; and 5% NaF+5% nanosized TMP. Half of the surface of all blocks received a single application of the assigned varnish, with subsequent immersion in artificial saliva for 6 h. Varnishes were then removed and the blocks were immersed in citric acid (90 s, 4×/day, 5 days). After each erosive cycle, ten blocks of each group were immersed in a placebo dentifrice for 15 s (ERO), while the other ten blocks were subjected to abrasion by brushing (ERO+ABR). Dentin erosive wear was assessed by profilometry. Data were submitted to 2-way ANOVA and to the Holm-Sidak test (p<0.05). Dentin erosive wear was significantly higher for ERO+ABR than for ERO for all varnishes. TMP-containing varnishes promoted superior effects against dentin erosive wear compared with 5% NaF alone; and 5% nanosized TMP led to the lowest wear among all varnishes. In conclusion, the addition of TMP to conventional fluoride varnish (i.e., varnish containing only NaF) enhanced its protective effects against bovine root dentin erosion and erosion+abrasion. Additionally, the use of 5% nanosized TMP led to superior effects in comparison to 5% micrometric TMP, both for erosion and erosion+abrasion in vitro.

Asunto(s)

Dentina , Fluoruros Tópicos , Ensayo de Materiales , Polifosfatos , Fluoruro de Sodio , Propiedades de Superficie , Erosión de los Dientes , Bovinos , Animales , Polifosfatos/farmacología , Polifosfatos/química , Dentina/efectos de los fármacos , Fluoruro de Sodio/farmacología , Erosión de los Dientes/prevención & control , Fluoruros Tópicos/farmacología , Análisis de Varianza , Factores de Tiempo , Propiedades de Superficie/efectos de los fármacos , Distribución Aleatoria , Reproducibilidad de los Resultados , Nanopartículas/química , Abrasión de los Dientes/prevención & control , Saliva Artificial/química , Ácido Cítrico/farmacología , Valores de Referencia , Pruebas de Dureza

RESUMEN

INTRODUCTION: Interproximal reduction (IPR) damages the caries protective superficial layer of the enamel, making the enamel surface prone to caries because of the increase in surface roughness. Remineralizing solutions can help in preventing these undesirable side effects. Therefore, this study aimed to compare the effect of nanohydroxyapatite (nHAp) and sodium fluoride (NaF) application on enamel remineralization after IPR and to evaluate changes in surface roughness, composition, and microhardness of the treated enamel. METHODS: A total of 25 patients with Angle's Class I malocclusion, requiring 4 premolar extractions, were selected and randomly divided into 5 groups (n = 5). Group 1 served as the control. In group 2, the extraction of premolars was done immediately after IPR, and in group 3, the extraction of premolars was done 3 months after IPR. In group 4, the extraction of premolars was performed 3 months after IPR with weekly application of nHAp serum. In group 5, the extraction of premolars was performed 3 months after IPR, along with once-a-month application of NaF varnish. The proximal reduction of premolars in all the groups was done using Strauss IPR burs (Strauss Diamond Instruments, Palm Coast, Fla). The extracted teeth were sectioned, and the enamel surfaces were subjected to energy-dispersive x-ray spectroscopy to evaluate elemental composition. Vicker's microhardness test was used to evaluate enamel hardness and atomic force microscopy for enamel surface roughness. Descriptive statistics were calculated for the 5 groups using a 1-way analysis of variance, and Tukey's multiple post-hoc test was used for intergroup comparison. RESULTS: Calcium-to-phosphorous ratio, enamel microhardness, and surface roughness were found to be closest to untouched enamel in patients treated with nHAp, followed by patients who were treated with NaF. A lower calcium-to-phosphorous ratio and weakened and roughest enamel surface was seen in teeth, which were extracted immediately after IPR. CONCLUSIONS: Among the remineralizing agents tested, nHAp serum can be recommended for better remineralization of enamel surfaces after IPR.

Asunto(s)

Esmalte Dental , Durapatita , Fluoruro de Sodio , Propiedades de Superficie , Remineralización Dental , Humanos , Remineralización Dental/métodos , Esmalte Dental/efectos de los fármacos , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/farmacología , Durapatita/uso terapéutico , Femenino , Masculino , Diente Premolar , Adolescente , Dureza , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/farmacología

RESUMEN

OBJECTIVES: This study aims to evaluate antibacterial effects of silver diamine fluoride (SDF), SDF/potassium iodide (KI), and nanosilver fluoride (NSF). METHODS: Antimicrobial activity of sterile saline, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), SDF, SDF/KI, NSF, and KI solutions against Streptococcus mutans and Lactobacillus casei was assessed through disc diffusion tests. A dual-species biofilm of S. mutans-L. casei was formed on 48 enamel samples, divided into six groups (n = 8). Group 1 was treated with sterile saline, Group 2 with 5% NaOCl, Group 3 with 2% CHX, Group 4 with SDF, Group 5 with SDF/KI, and Group 6 with NSF. The samples were analysed using confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Statistical analysis utilized Shapiro-Wilk and Kruskal-Wallis tests and multiple comparisons were conducted using Dunn test. RESULTS: SDF, SDF/KI, and NaOCl displayed significantly higher antibacterial activity against dual-species biofilm compared to NSF and CHX (p < 0.050). CONCLUSIONS: In conclusion, SDF and SDF/KI demonstrated greater antibacterial activity than NSF. SDF's antibacterial activity was unaffected by KI. Further research is needed to determine the appropriate content and concentration for achieving effective antibacterial activity with NSF. CLINICAL SIGNIFICANCE: The use of silver-containing materials is increasing in popularity within pediatric dentistry. In this study, an endeavor has been made to assist pediatric dentists in determining which solution might be more advantageous for preventing caries.

Asunto(s)

Antibacterianos , Biopelículas , Fluoruros Tópicos , Lacticaseibacillus casei , Yoduro de Potasio , Compuestos de Amonio Cuaternario , Compuestos de Plata , Streptococcus mutans , Compuestos de Plata/farmacología , Biopelículas/efectos de los fármacos , Yoduro de Potasio/farmacología , Compuestos de Amonio Cuaternario/farmacología , Antibacterianos/farmacología , Streptococcus mutans/efectos de los fármacos , Fluoruros Tópicos/farmacología , Humanos , Lacticaseibacillus casei/efectos de los fármacos , Hipoclorito de Sodio/farmacología , Clorhexidina/farmacología , Esmalte Dental/efectos de los fármacos , Microscopía Electrónica de Rastreo , Microscopía Confocal , Ensayo de Materiales , Fluoruros/farmacología , Nanopartículas del Metal

RESUMEN

BACKGROUND: This study aimed to evaluate dentin wear and biological performance of desensitizing materials. METHODS: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05). RESULTS: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments. CONCLUSIONS: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.

Asunto(s)

Desensibilizantes Dentinarios , Dentina , Fluoruro de Sodio , Animales , Bovinos , Desensibilizantes Dentinarios/farmacología , Fluoruro de Sodio/farmacología , Dentina/efectos de los fármacos , Fluoruros Tópicos/farmacología , Fibroblastos/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Desgaste de los Dientes , Ensayo de Materiales , Polifosfatos/farmacología

RESUMEN

We aimed to evaluate the antibacterial activity of phytochemicals with or without an experimental fluoride varnish against Porphyromonas gingivalis. Five phytochemicals, chrysophanol (CHR), emodin (EMO), anthrarufin (ANT), bavachalcone (BCC), and isobavachromene (IBC), were tested using agar diffusion, minimal inhibition concentration (MIC), and minimum bacterial concentration (MBC) assays. We also assessed the cell viability and cytotoxicity of phytochemicals. All phytochemicals showed clear inhibition zones in the agar diffusion test. The inhibition zones of all phytochemical-containing fluoride varnishes were similar to or larger than that of the positive control, excluding that of 1 mM EMO. With or without the fluoride varnish, BCC exhibited the lowest MIC and MBC levels. Cell viability was high in the presence of all phytochemicals except 200 µM EMO. In conclusion, BCC was most effective as a phytochemical alone, while all phytochemical-containing fluoride varnishes inhibited P. gingivalis growth without cytotoxicity.

Asunto(s)

Antibacterianos , Supervivencia Celular , Pruebas de Sensibilidad Microbiana , Enfermedades Periodontales , Fitoquímicos , Porphyromonas gingivalis , Porphyromonas gingivalis/efectos de los fármacos , Antibacterianos/farmacología , Fitoquímicos/farmacología , Supervivencia Celular/efectos de los fármacos , Enfermedades Periodontales/prevención & control , Enfermedades Periodontales/microbiología , Fluoruros Tópicos/farmacología , Humanos

RESUMEN

BACKGROUND: Nano-silver fluoride (NSF) has been introduced to improve enamel lesions. The effective use of varnishes is important in the prevention of dental caries. OBJECTIVES: The study aimed to compare the effect of conventional sodium fluoride varnish with the same varnish containing 1% and 2% silver nanoparticles (AgNP) on the surface microhardness of enamel. MATERIAL AND METHODS: The baseline surface microhardness of 40 premolar teeth was measured using a Vickers microhardness tester. After immersing the samples in a demineralizing agent for 24 h, the microhardness was measured again. In group B, a layer of conventional fluoride varnish was applied to the tooth surfaces using a microbrush with soft bristles, following the manufacturer's instructions. Groups C and D were treated with 1% and 2% NSF varnishes, respectively, while group A received no varnish. Surface microhardness tests were conducted on all specimens, including those previously tested. RESULTS: The microhardness of the enamel surface increased significantly in all 3 test groups compared to the microhardness after demineralization (p < 0.05). CONCLUSIONS: Conventional fluoride varnish and fluoride varnishes containing 1% and 2% AgNP are equally effective in remineralizing initial caries.

Asunto(s)

Cariostáticos , Esmalte Dental , Fluoruros Tópicos , Fluoruros , Dureza , Nanopartículas del Metal , Compuestos de Plata , Fluoruro de Sodio , Esmalte Dental/efectos de los fármacos , Humanos , Fluoruros Tópicos/farmacología , Fluoruros Tópicos/administración & dosificación , Cariostáticos/farmacología , Cariostáticos/administración & dosificación , Compuestos de Plata/farmacología , Compuestos de Plata/administración & dosificación , Nanopartículas del Metal/administración & dosificación , Fluoruro de Sodio/farmacología , Fluoruro de Sodio/administración & dosificación , Desmineralización Dental/prevención & control , Plata/farmacología , Remineralización Dental/métodos , Diente Premolar , Propiedades de Superficie , Caries Dental/prevención & control

RESUMEN

OBJECTIVE: To evaluate the effect of fluoride consistency and composition to protect enamel and dentin against the dental erosion. MATERIALS AND METHODS: Bovine enamel and dentin specimens were treated with artificial saliva, neutral fluoride gel (NFG), acidulated phosphate fluoride gel (AFG), neutral fluoride foam (NFF), and acidulated phosphate fluoride foam. The samples were subjected to cycling. Micro energy-dispersive X-ray fluorescence spectrometry, surface roughness (Ra), contact angle (CA), and scanning electron microscopy (SEM) were performed. Composition, CA and Ra data were analyzed by ANOVA and multiple comparison test (p < 0.05). RESULTS: The dentin protected had a significantly higher mineral content than in the control. Eroded unprotected enamel had higher Ra values than normal surfaces. Fluoride treatments increased the Ra in dentin samples. AFG increased the CA in enamel. Fluoride foams increased CA in dentin with reduced mineral loss. SEM analysis found a deposited layer on enamel treated with AFG and remnants of deposits on dentin treated with NFG and NFF. CONCLUSION: Regardless of the form of application, fluoride provided protection against erosion, however with different levels. CLINICAL SIGNIFICANCE: Applying the adequate fluoride form is relevant since the formulations have different effects on both enamel and dentin.

Asunto(s)

Esmalte Dental , Dentina , Fluoruros , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Propiedades de Superficie , Erosión de los Dientes , Animales , Erosión de los Dientes/prevención & control , Bovinos , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Fluoruros/farmacología , Fluoruro de Fosfato Acidulado/farmacología , Saliva Artificial , Fluoruros Tópicos/farmacología

RESUMEN

OBJECTIVES: To evaluate the erosion preventive effect of 38 % silver diamine fluoride (SDF) solution in enamel and dentin of human permanent teeth. METHODS: Ninety enamel and ninety dentin blocks were prepared from permanent molars and allocated into three groups. Gp-SDF received a one-off application of 38 % SDF solution. Gp-SNF received a one-off application of a solution containing 800 ppm stannous chloride and 500 ppm fluoride. Gp-DW received a one-off application of deionized water. The blocks were submitted to acid challenge at pH 3.2, 2 min, 5 times/day for 7 days. All blocks were immersed in human saliva between cycles for one hour. The crystal characteristics, percentage of surface microhardness loss (%SMHL), surface loss, and elemental analysis and surface morphology were examined by X-ray diffraction (XRD), microhardness test, non-contact profilometry, and energy-dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM), respectively. Data of%SMHL and surface loss were analyzed by one-way ANOVA. RESULTS: XRD spectra revealed that fluorapatite and silver compounds formed in Gp-SDF, while fluorapatite and stannous compounds formed in Gp-SNF. Gp-DW presented only hydroxyapatite. The median (interquartile range) of%SMHL in Gp-SDF, Gp-SNF and Gp-DW were 27.86(3.66), 43.41(2.45), and 46.40(3.54) in enamel (p< 0.001), and 14.21(1.57), 27.99(1.95), and 33.18(1.73) in dentin, respectively (p < 0.001). The mean (standard deviation, µm) of surface loss of Gp-SDF, Gp-SNF, and Gp-DW were 2.81(0.59), 4.28(0.67), and 4.63(0.64) in enamel (p < 0.001) and 4.13(0.69), 6.04(0.61), and 7.72(0.66) in dentin, respectively (p < 0.001). SEM images exhibited less enamel corruption and more dentinal tubular occlusion in Gp-SDF compared to Gp-SNF and Gp-DW. EDS analysis showed silver was detected in Gp-SDF while stannous was detected in the dentin block of Gp-SNF. CONCLUSION: 38 % SDF yielded superior results in protecting enamel and dentin blocks from dental erosion compared to SNF and DW. CLINICAL SIGNIFICANCE: Topical application of 38 % SDF is effective in preventing dental erosion in human enamel and dentin.

Asunto(s)

Esmalte Dental , Dentina , Fluoruros Tópicos , Dureza , Microscopía Electrónica de Rastreo , Compuestos de Amonio Cuaternario , Compuestos de Plata , Espectrometría por Rayos X , Erosión de los Dientes , Difracción de Rayos X , Humanos , Compuestos de Amonio Cuaternario/farmacología , Esmalte Dental/efectos de los fármacos , Fluoruros Tópicos/farmacología , Erosión de los Dientes/prevención & control , Dentina/efectos de los fármacos , Concentración de Iones de Hidrógeno , Apatitas , Compuestos de Estaño/farmacología , Saliva/efectos de los fármacos , Saliva/química , Propiedades de Superficie , Ensayo de Materiales , Factores de Tiempo

RESUMEN

OBJECTIVE: The study objectives were to examine the physical properties and enamel remineralization potential of fluoride (F) varnishes incorporated with arginine (Arg). METHODS: Four commercial F varnishes: 1) Duraphat®; 2) Flúor Protector®, 3) Fluor Protector S®, and 4) Fluorimax™ were supplemented with 2% w/v. Arg. The control/experimental varnishes underwent rheometric analysis to assess varnish density (δ), velocity (ν), and associated viscosity, both quantitatively (ν/δ) and qualitatively based on determined mass, volume, distance flow, and time under experimentation. The varnish wet/dry weights (at 2 h) were also analysed. Further, sound enamel specimens (T0) with artificial incipient caries-like lesions (T1) were treated with control/experimental varnishes and subjected to remineralization assay with artificial saliva for 6 h. Thereafter (T2), the specimens were characterized to estimate precipitated Ca and net enamel F uptake. Additionally, mineral density (MD) was assessed using micro-CT at T0, T1, and T2 to derive mineral gain (MG) and % remineralization for the treatment groups. RESULTS: When Arg is incorporated, the physical properties of the F-containing varnishes undergo a significant transformation, resulting in higher density, varnish weight, dry varnish weight, and viscosity compared to their respective control varnishes (p < 0.05). Incorporating Arg-in Duraphat®, Fluor Protector S®, and Fluorimax™ significantly improved both enamel Ca precipitation and F uptake compared to the respective controls (p < 0.05). Additionally, the enamel F uptake was significantly higher with all the tested varnishes when enriched with Arg (p < 0.05). The combined data for MD, MG, and % remineralization suggests that the remineralization potential of F-varnishes significantly increased when enriched with Arg (p < 0.05). CONCLUSION: Incorporating Arg in inorganic F varnishes improves their physical properties and enhances the enamel remineralization potential of the varnishes. CLINICAL SIGNIFICANCE: This study highlights the possibility of incorporating Arg in distinct F-source varnishes. The synergism between active components (Arg-F) aids in enhanced remineralization and superior varnish physical properties, demonstrating a promising approach for high caries-risk patients.

Asunto(s)

Arginina , Cariostáticos , Esmalte Dental , Fluoruros Tópicos , Remineralización Dental , Arginina/uso terapéutico , Arginina/farmacología , Esmalte Dental/efectos de los fármacos , Remineralización Dental/métodos , Fluoruros Tópicos/farmacología , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Viscosidad , Microtomografía por Rayos X , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/farmacología , Animales , Calcio , Caries Dental , Humanos , Reología , Ensayo de Materiales , Saliva Artificial/química , Bovinos , Fluoruros/uso terapéutico

RESUMEN

OBJECTIVE: To assess the clinical evidence for silver diamine fluoride (SDF) to reduce dentine hypersensitivity in adults. METHODS: Two independent researchers searched the English literature in five databases (Scopus, PubMed, Web of Science, EMBASE and the Cochrane Library) up to 15th July 2023 for clinical trials investigating the desensitising effect of professionally applied SDF to manage dentine hypersensitivity in adults aged 18 or above at any follow-up period. The primary outcome was the change in dentine hypersensitivity between baseline and follow-up visits after SDF application regarding any validated pain outcome measures. The Cochrane guidelines were used for the risk of bias assessment. RESULTS: Three hundred and thirty-one studies were identified, and four of them were finally included. Three of the included studies were rated as having a 'low risk' of bias. The SDF solution reduced dentine hypersensitivity in adults. The percentage reduction in dentine hypersensitivity ranged from 23 % to 56 % after a single application of SDF solution. Moreover, the SDF solution was more effective than potassium nitrate, potassium oxalate and glutaraldehyde plus hydroxyethyl methacrylate in reducing dentine hypersensitivity. Meta-analysis indicated a more significant reduction in visual analogue scales (1-10) by 1.35 (95 % CI:0.9-1.8; p<0.00001) after receiving the SDF application than controls. CONCLUSION: The included clinical trials showed that SDF solution reduced dentine hypersensitivity in adults. However, clinical trials are few, and their protocol varied from one another. Further well-designed clinical trials should be conducted to provide more evidence on its use to manage dentine hypersensitivity. CLINICAL SIGNIFICANCE: SDF is cleared as desensitizing agents by the US Food and Drug Administration to manage dentine hypersensitivity, which induces pain, limits food choice, and impacts the quality of life. Evidence from this systematic review informs clinicians and provides researchers insight for future research on SDF use for dentine hypersensitivity. THE INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO) REGISTRATION NUMBER: CRD42023462613.

Asunto(s)

Caries Dental , Sensibilidad de la Dentina , Humanos , Cariostáticos/uso terapéutico , Caries Dental/tratamiento farmacológico , Sensibilidad de la Dentina/tratamiento farmacológico , Sensibilidad de la Dentina/prevención & control , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/farmacología , Dolor , Calidad de Vida , Compuestos de Amonio Cuaternario/uso terapéutico , Compuestos de Amonio Cuaternario/farmacología , Compuestos de Plata/uso terapéutico , Compuestos de Plata/farmacología

RESUMEN

OBJECTIVES: The aim for this pilot study was to investigate the effect of a sodium fluoride varnish on step height measured by a profilometer from human enamel worn by healthy volunteers with a novel in situ/ex vivo erosion design. METHOD: Healthy volunteers aged 18-70 years wore a palatal splint containing 8 human enamel samples and underwent two 3-day treatment periods for 6 h a day with a varnish containing sodium fluoride at 22,600 ppm and the control with the same ingredients but without fluoride. Each splint contained 4 polished and 4 unpolished samples. The interventions were applied to the surface of the enamel samples in randomised order, removed after 6 h, then immersed ex-vivo in 1 %, pH 2.7 citric acid for 2 min, repeated 4 times a day, over 2 days. Measurements of enamel were assessed blindly by microhardness on day 2 and by non-contact laser profilometry on day 3 for the two treatments. RESULTS: 24 volunteers, 2 males and 22 females aged 27-54 years, were screened and recruited. The delta microhardness, from polished samples removed at the end of day 2, for the control and fluoride treatment was 95.7 (22.9) kgf/mm2 and 123.7 (28.9) kgf/mm2, respectively (p < .005). The mean (SD) step height for the control polished enamel surfaces was 3.67 (2.07) µm and for the fluoride varnish was 1.79 (1.01) µm (p < .0005). The control unpolished enamel surfaces had a mean 2.09 (1.53) µm and the fluoride varnish was 2.11 (1.53) µm but no statistical difference was detected. CONCLUSIONS: The results from this pilot study, utilizing an in-situ model where enamel was exposed to acid over the course of 2 days, demonstrated that a high fluoride varnish containing sodium fluoride at 22,600 ppm prevented erosive wear compared to a control on the polished enamel surfaces. CLINICAL SIGNIFICANCE: Intra-oral study demonstrated that a high fluoride varnish containing sodium fluoride at 22,600 ppm reduced erosive tooth wear.

Asunto(s)

Erosión de los Dientes , Desgaste de los Dientes , Masculino , Femenino , Humanos , Fluoruros/uso terapéutico , Fluoruro de Sodio/farmacología , Fluoruro de Sodio/uso terapéutico , Fluoruros Tópicos/farmacología , Fluoruros Tópicos/uso terapéutico , Proyectos Piloto , Erosión de los Dientes/prevención & control , Erosión de los Dientes/tratamiento farmacológico

RESUMEN

INTRODUCTION: This study aimed to investigate the remineralisation effect of combined use of a bioinspired self-assembling peptide (P26) and fluoride varnish on artificial early enamel caries lesions. METHODS: Bovine enamel blocks with artificial early enamel caries lesions were prepared. The blocks were randomly allocated to four experimental groups to receive the following treatments: A = P26 + fluoride varnish, B = P26, C = fluoride varnish, and D. distilled water (negative control). The treated blocks were subjected to pH cycling. Enamel blocks were collected at time points of 7 days (d7) and 21 days (d21). The mineral gain, elemental analysis and crystal characteristics of the caries lesion were assessed by micro-computed tomography, scanning electron microscopy with energy dispersive X-ray and X-ray diffraction (XRD), respectively. RESULTS: The mean ± standard deviation of mineral gain of group A to D were 17.4 ± 4.2%, 10.7 ± 2.2%, 10.1 ± 1.2%, and 6.8 ± 0.5% at d7, respectively, and 15.2 ± 2.6%, 8.7 ± 3.1%, 9.7 ± 1.2%, and 7.8 ± 2.3% at d21, respectively. A significant higher mineral gain was observed in group A when compared to other groups at both d7 and d21 (p < 0.05). The calcium-to-phosphate ratio remained consistent across all groups, ranging between 1.2 and 1.4. XRD analysis indicated that crystal composition on the surfaces was apatite for all groups. CONCLUSION: In conclusion, the present study provided a first indication of better remineralisation effects of the combined use of the bioinspired self-assembling peptide P26 and fluoride varnish compared to the effects of the respective individual uses of P26 or fluoride varnish.

Asunto(s)

Cariostáticos , Caries Dental , Esmalte Dental , Fluoruros Tópicos , Microscopía Electrónica de Rastreo , Remineralización Dental , Difracción de Rayos X , Remineralización Dental/métodos , Animales , Caries Dental/prevención & control , Bovinos , Esmalte Dental/efectos de los fármacos , Fluoruros Tópicos/farmacología , Técnicas In Vitro , Cariostáticos/farmacología , Cariostáticos/química , Cariostáticos/uso terapéutico , Microtomografía por Rayos X , Péptidos , Espectrometría por Rayos X , Concentración de Iones de Hidrógeno , Fluoruro de Sodio/farmacología , Fluoruro de Sodio/uso terapéutico

RESUMEN

We aimed to determine whether adhesive components could increase the release time of effective fluoride concentration from an experimental fluoride varnish applied to bovine teeth. An experimental fluoride varnish containing 5% sodium fluoride (EX1) was prepared and combined with 35% hydroxyethyl methacrylate (HEMA) (EX2), 5% glutaraldehyde (EX3), or 35% HEMA/5% glutaraldehyde mixture (EX4). Two commercially available fluoride varnishes were used for comparison. Each group was applied to bovine incisors, and the fluoride release and pH were monitored for 30 days. Cell viability analysis, scanning electron microscopy, and energy-dispersive spectroscopy were performed. EX4 released the highest and most effective concentration of fluoride for the longest period and reached neutral pH at the earliest; the release was maintained for up to 30 days without cytotoxicity. In conclusion, EX4 is considered to be the most effective varnish to prevent dental caries.

Asunto(s)

Caries Dental , Fluoruros , Metacrilatos , Animales , Bovinos , Fluoruros/farmacología , Fluoruros Tópicos/farmacología , Fluoruros Tópicos/química , Cariostáticos/farmacología , Cariostáticos/química , Caries Dental/prevención & control , Glutaral , Fluoruro de Sodio/farmacología , Fluoruro de Sodio/química

RESUMEN

This study evaluated the efficacy of a formulated remineralizing gallic acid (GA) varnish in treating artificial enamel caries lesions. Fifty-five intact bovine incisors were collected. Enamel blocks (5 × 9 mm) were prepared. A third of each block's surface remained intact. Primary carious lesions were induced on the middle and bottom thirds of the blocks by immersing the samples in a demineralization solution for 6 h. The bottom third of the blocks were further remineralized by randomly applying 0.5%, 2%, or 8% GA varnishes and 2.26% fluoride varnish (V varnish, Vericom, Seoul, Korea), or the varnish base without active ingredients (n = 11 each). The specimens were immersed in a remineralizing solution for 4 h and then subjected to a 2-hour immersion in the demineralizing solution. After six days of pH cycling, the surface microhardness was measured at depths of 30, 75, and 120 µm. The percentage of surface microhardness recovery (SMHR%) was compared among the groups using the Shapiro-Wilk, ANOVA, and Tukey HSD post-hoc tests (α = 0.05). The SMHR% of all experimental groups was higher than the control group at 30 µm (p < 0.05). The 0.5% GA varnish showed the highest SMHR% at all depths; however, the difference with the other experimental groups was significant at a depth of 30 µm (p < 0.05). The SMHR% of the fluoride and the 2% and 8% GA varnishes was comparable at all depths. All treatments potentially remineralize enamel lesions, with 0.5% GA varnish having the greatest effect, particularly on the top surface layer. As such, this newly developed varnish may emerge as a promising alternative to fluoride varnish.

Asunto(s)

Caries Dental , Fluoruros Tópicos , Animales , Bovinos , Caries Dental/prevención & control , Esmalte Dental , Fluoruros Tópicos/farmacología , Fluoruros Tópicos/uso terapéutico , Remineralización Dental

RESUMEN

OBJECTIVES: To compare the antibacterial effect of Nanosilver Fluoride varnish (NSF) varnish, P11-4 and Sodium Fluoride (NaF) varnish against salivary Streptococcus mutans (S. mutans) and Lactobacilli. METHODS: 66 patients aged 10-24 years old were randomly assigned to receive single application of NSF, P11-4 or NaF varnish. Baseline unstimulated saliva samples were collected before the agents were applied and S.mutans and Lactobacilli colony forming units (CFU) were counted. After one, three and six months, microbiological samples were re-assessed. Groups were compared at each time point and changes across time were assessed. Multivariable linear regression compared the effect of P11-4 and NSF to NaF on salivary S. mutans and Lactobacilli log count at various follow up periods. RESULTS: There was a significant difference in salivary S. mutans log count after 1 month between P11-4 (B= -1.29, p = 0.049) and NaF but not at other time points nor between NSF and NaF at any time point. The significant reduction in bacterial counts lasted up to one month in all groups, to three months after using P11-4 and NaF and returned to baseline values after six months. CONCLUSION: In general, the antimicrobial effect of P11-4 and NSF on salivary S. mutans and Lactobacilli was not significantly different from NaF varnish. P11-4 induced greater reduction more quickly than the two other agents and NSF antibacterial effect was lost after one month. CLINICAL RELEVANCE: NSF varnish and P11-4 have antimicrobial activity that does not significantly differ from NaF by 3 months. P11-4 has the greatest antibacterial effect after one month with sustained effect till 3 months. The antibacterial effect of NSF lasts for one month. NaF remains effective till 3 months. TRIAL REGISTRATION: This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT04929509 on 18/6/2021.

Asunto(s)

Antiinfecciosos , Caries Dental , Compuestos de Plata , Adolescente , Niño , Humanos , Adulto Joven , Antibacterianos/farmacología , Antiinfecciosos/farmacología , Caries Dental/prevención & control , Caries Dental/microbiología , Fluoruros/farmacología , Fluoruros Tópicos/farmacología , Sodio/farmacología , Fluoruro de Sodio/farmacología , Streptococcus mutans , Nanoestructuras