Search Results (53)

The aim of this in vivo study was to compare total protein present in the salivary films (F) and acquired enamel pellicle (AEP) on eroded and non-eroded surfaces in patients suffering from GORD symptoms with and without GORD diagnosis (GORD, No-GORD). Thirty-nine patients suffering from GORD symptoms and erosive tooth wear on lower first molars and an unaffected posterior occlusal surface in the same quadrant were recruited from Guy’s hospital, London. Salivary film and AEP were collected from the eroded and uneroded occlusal surfaces, using 0.5% sodium dodecyl sulphate (SDS)-soaked filter papers. Total protein concentration was analysed using bicinchoninic acid assay (BCA). Statistical analysis was conducted using Shapiro–Wilk, ANOVA, and Tukey’s tests (p < 0.05), comparing four GDS sample types and GORD vs. No-GORD groups. The level of significance was set as p < 0.05. Data were compared between eroded and uneroded surfaces in the same patient with GORD symptoms, as well as between those with or without a GORD diagnosis (GORD, No-GORD). The AEP total protein concentration from the eroded [2.17 (0.49) mg/mL] and uneroded surfaces [2.24 (0.66) mg/mL] of the GORD group were statistically significantly lower than those on eroded [3.27 (1.01) mg/mL] and uneroded [3.33 (1.57) mg/mL] surfaces in the No-GORD group (p = 0.007) (p = 0.008), respectively. No statistically significant differences were observed for film and AEP between eroded and uneroded surfaces (p > 0.05). Full article

This study examined the effects of khat chewing on oral gingival conditions by adopting a targeted process which combined physicochemical analyses of the teeth, histopathological examinations of the gums, and bioinformatics modeling. The physicochemical evaluation of teeth in khat consumers compared to non-consumers was carried out using specific analytical techniques; hence, the results of this initial investigation revealed significant erosion of the tooth enamel due to khat chewing, as well as an alteration of the essential chemical composition of the teeth. Additionally, the histopathological analyses complemented preliminary studies by showing severe inflammation of the gums and oral mucosa in khat users. The understanding of these studies was enriched by bioinformatics analysis, where modeling was carried out via computational methods. This analytical phase examined molecular docking mechanisms, including the interaction between cathinone, the main alkaloid of khat, and the protein receptors involved in the protection of gingival tissues against infections. In summary, this multidisciplinary research provided an in-depth view of the oral health issues related to khat chewing, combining experimental studies with bioinformatics perspectives. Full article

This study aimed to assess the effects of fluoridated varnishes supplemented with micrometric or nanosized sodium trimetaphosphate (TMPmicro or TMPnano, respectively) against enamel softening in an early erosive model in vitro. Bovine enamel blocks (with mean surface hardness [SH] between 330.0 and 380.0 kgf/mm²) were selected and randomly assigned according to their SH (n = 8) into the following groups: Placebo (no fluoride/TMP; negative control), 5% NaF (positive control), 5% NaF + 5%TMPmicro, 5% NaF + 2.5%TMPnano and 5% NaF + 5%TMPnano. Blocks received a single application of the varnishes and were immersed in artificial saliva (6 h). Thereafter, the varnishes were removed and the blocks were subjected to four individual erosive challenges (1 min, citric acid, 0.75%, pH = 3.5, under agitation); SH was determined after each challenge. Data were subjected to ANOVA and Student–Newman–Keuls’ test (p < 0.05). Overall, the highest %SH loss was observed for the Placebo, followed by 5% NaF, 5% NaF + 5% TMPmicro, and both varnishes containing TMPnano, without significant differences between 2.5% and 5% TMPnano. It was concluded that TMP enhanced the effects of a 5% NaF varnish against enamel softening in an early erosive model in vitro, with an additional benefit from the use of nanoparticles over microparticles. Full article

To address tooth enamel demineralization resulting from factors such as acid erosion, abrasion, and chronic illness treatments, it is important to develop effective daily dental care products promoting enamel preservation and surface remineralization. This study focused on formulating four toothpastes, each containing calcined synthetic hydroxyapatite (HAP) in distinct compositions, each at 4%, along with 1.3% birch extract. Substitution elements were introduced within the HAP structure to enhance enamel remineralization. The efficacy of each toothpaste formulation was evaluated for repairing enamel and for establishing the dynamic of the remineralization. This was performed by using an in vitro assessment of artificially demineralized enamel slices. The structural HAP features explored by XRD and enamel surface quality by AFM revealed notable restorative properties of these toothpastes. Topographic images and the self-assembly of HAP nanoparticles into thin films on enamel surfaces showcased the formulations’ effectiveness. Surface roughness was evaluated through statistical analysis using one-way ANOVA followed by post-test Bonferroni’s multiple comparison test with a p value < 0.05 significance setting. Remarkably, enamel nanostructure normalization was observed within a short 10-day period of toothpaste treatment. Optimal remineralization for all toothpastes was reached after about 30 days of treatment. These toothpastes containing birch extract also have a dual function of mineralizing enamel while simultaneously promoting enamel health and restoration. Full article

Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral health needs over a four-year span. Methods: The study involved a thorough examination and analysis of clinical dental health data from both outreach camps. In 2019, 224 patients were examined, and in 2023, the number increased to 354. The assessment covered various dental health parameters, including dental caries, DMFT/dmft indices, enamel fluorosis, dental trauma, oral mucosa lesions, and non-carious tooth surface loss. Results: The analysis demonstrated a significant reduction in dental caries among adolescents and teens, decreasing from 62.5% in 2019 to 35.59% in 2023 (p < 0.0001). Similarly, the prevalence of teeth missing due to caries showed marked reductions from 40.2% to 9.04% in adolescents and teens (p < 0.0001) and from 25.89% to 11.86% among preschool and school-aged children (p = 0.004). Moreover, a significant change was observed in the Basic Erosive Wear Examination (BEWE) scores, with cases showing no erosive tooth wear (BEWE = 0) decreasing from 49.1% to 33.3% (p = 0.016), and cases with initial loss of enamel surface texture (BEWE = 1) increasing from 47.3% to 61% (p = 0.044). Conclusions: The outreach camps conducted in 2019 and 2023 showed tangible improvements in certain dental health metrics, particularly a reduction in dental caries and missing teeth due to caries among adolescents and teens. However, the uptick in non-carious tooth surface loss points to emerging dental health concerns. These results underline the importance of sustained and targeted dental health interventions to improve oral health outcomes in underserved communities such as Zanzibar. Full article

Oral mucosa inflammation can cause severe pain and interfere with eating, reducing quality of life. However, few options for self-care are available. An oral liquid bandage forms a protective film over the affected area. We aimed to assess the acid erosion risk when a newly developed oral liquid bandage (ORAPLA) is accidentally deposited on teeth and to examine the relative acid erosion risk at multiple time points of the maximum recommended duration of continuous use. ORAPLA was applied to both enamel and dentin blocks from 45 bovine anterior mandibular teeth, and an acid challenge was performed in a simulated oral cavity with artificial saliva, with one exposure cycle lasting 6 h. The enamel showed substantial defects and a decrease in Vickers hardness after nine cycles, with no change in surface roughness. Dentin showed an increase in parenchymal defects and surface roughness and a trend toward decreased Vickers hardness with increasing exposure time. We found no significant acid corrosion in enamel after up to nine times the upper limit of normal use time or in dentin after up to six times the upper limit. We conclude that the acid erosion risk due to accidental attachment to teeth is low, and in the human oral cavity with salivary buffering and remineralization, likely even lower. Full article

Objectives: This study was conducted to determine the erosive potential of various commercial energy drinks (EDs), sports drinks (SDs), and sugar sweetened beverages (SSBs) and to correlate quantitative changes in tooth enamel volume loss based on the pH and titratable acidity of the drinks. Methods: A flat plane on the facial surface of 36 human incisor teeth was created and embedded in sample holders using resin. After pre-scanning with a profilometer (Proscan 2000, Scantron, Ind Products Ltd., Taunton, UK), the six samples per group were immersed for 4 h into either Monster Energy™ (ED), Rockstar™ (ED), Red Bull™ (ED), or 5-h Energy™ (ED) and, for comparison with a sports drink, Gatorade™ (SD) and a sugar sweetened beverage, Coca-Cola^® (SSB). After immersion and post-scanning, the quantitative volume loss of the tooth enamel of the 36 samples was calculated (Proscan 3D software V2.1.1.15B), and the pH and titratable acidity (TA) of each drink was determined. Results: All drinks tested caused enamel volume loss. The actual amount varied among the different drinks, from 0.39 mm³ for Red Bull™, up to 1.01 mm³ for Gatorade™. The pH measurements differed for each drink, ranging from 2.6 to 3.7. There was a small reverse correlation of 0.326 between the pH of all drinks and volume loss. Among the energy drinks, titratable acidity was similar and there was only a weak correlation between TA and volume loss (0.319 at p = 0.53). Conclusions: Energy drinks, sugar sweetened beverages, and sport drinks all have the potential to cause enamel tooth surface loss resulting in demineralization. Therefore, the pH of a drink cannot be the sole determinant for choosing a less harmful commercial beverage. Full article

This review discusses both preventive measures and clinically implemented therapy procedures that have been developed recently for the prevention and treatment of tooth erosion. Methods: The databases PubMed, Scopus, and Web of Science were used for a thorough search. Studies on the prevention and treatment of dental erosion that were conducted in English and used in vitro were among the inclusion criteria. Results: The search turned up 391 papers in total, with 34 of those publications matching the requirements for inclusion. Varnishes, toothpastes, and solutions containing fluoride and other substances were used as preventive measures. Conclusions: Dental erosion is a significant issue, and taking preventative steps is crucial to lessening the disease’s spread and its effects. Interventions based on fluoride seem to be successful at halting erosion and encouraging remineralization. To effectively address severe tooth erosion, therapeutic methods, including composite restorations, prosthetic crowns, and veneers, are available. Dental erosion causes aesthetic and functional issues that are best addressed with less invasive treatments like direct composite restorations. To improve and broaden the range of available treatments for this common dental issue, additional research and development are required. Full article

Aim: This study aims to assess the impact of various reparative remineralizing agents, specifically topical fluoride (TF) and a combination of a carbon dioxide laser (CO₂ laser) with TF, as well as regenerative agents such as Curodont™ Repair and NR-5™, on two key factors—the micro-Vickers hardness (VH) of eroded enamel and the micro-shear bond strength (µSBS) of composite restoration. Materials and Methods: A total of 50 single-rooted premolars with intact enamel were sectioned mesiodistally into two halves, making a sample size of 100 specimens. All of the samples were then exposed to Coca-Cola^TM for 2 min each day over 1 month to induce erosion on the enamel surface. The specimens were then embedded in acrylic cold-cure resin facing a flat surface upward. The samples were then arbitrarily divided into five groups based on the remineralizing and regenerative agents used, as follows (n = 20): Group 1: No remineralizing agent, Group 2: Curodont™ Repair, Group 3: NR-5™, Group 4: TF, and Group 5: CO₂ laser + TF. The VH of the pretreated enamel surfaces was analyzed and µSBS testing and failure mode of composite restoration were performed using a universal testing machine (UTM) and stereomicroscope. ANOVA and Tukey’s post hoc were performed for data analysis. Results: In Group 3, the (NR-5™)-treated teeth exhibited the highest VH values and µSBS. In Group 1, the (No remineralizing agent)-treated specimens displayed the lowest VH and the lowest µSBS. An intergroup comparison analysis unveiled that Group 3, Group 4 (TF), and Group 5 (CO₂ laser + TF) presented comparable outcomes of microhardness and bond strength. The Group 2 (Curodont™ Repair) samples exhibited no significant difference in VH and µSBS, as compared to Group 1. Conclusions: The use of a combination of NR-5™ technology and a CO₂ laser in conjunction with TF has been shown to significantly augment the natural mineralization process. This enhancement results in increased microhardness and an improved bond strength in the treated enamel. Full article

Background: Consumption of acidic beverages favours development of erosions. Modern diagnostic methods are required to detect erosions at an early stage. This study aimed to evaluate the suitability of an intraoral scanner (IOS) for detection of erosive changes on smooth surfaces adjacent to orthodontic brackets. Methods: Orthodontic metal brackets were attached to the buccal surfaces of 58 extracted permanent human teeth. Teeth were randomly divided into groups: A = 6% citric acid, B = Coca-Cola, C = Redbull, D = Powerade, E = Control, no acid exposure. Teeth were exposed to acid in three erosion cycles, followed by rinsing and brushing. Scans of teeth were performed at baseline and after each erosion cycle and enamel loss was measured. Quantitative light-induced fluorescence (QLF) measurements were performed as reference standard. Results: Significant substance loss was measured in all acid groups after the second and third erosion cycle (p < 0.0001). Correlation between scans and QLF were significant (p = 0.001). Conclusions: With IOS, it was possible to detect and quantify enamel erosion at smooth surfaces with and without orthodontic brackets after a short exposure time. Considering the limitations of in vitro results, the use of IOS can be a promising digital tool to detect and monitor erosive enamel changes during fixed orthodontic treatment. Full article

Prenatal Vitamin D has been suggested to be critical for dental health in children, affecting outcomes including the prevalence of enamel defects and tooth erosion. This systematic review aimed to evaluate the potential impact of prenatal Vitamin D levels on these dental health outcomes. A total of seven studies, involving 6978 participants, were included after a comprehensive search of PubMed, Web of Science, and Scopus from 2013 to June 2023. The average age of mothers varied across studies, with Vitamin D levels or supplementation practices displaying significant variation among the study populations. The age of children at examination ranged from 3.6 to 6.6 years. The analysis demonstrated a diverse association between Vitamin D levels and dental outcomes, with enamel defects reported in 21.1% to 64% of the children and opacities ranging from 36% to 79.5% across studies. Maternal Vitamin D insufficiency was identified as a significant risk factor for enamel defects in one study (OR: 3.55), whereas high prenatal Vitamin D levels indicated a protective effect against Hypomineralized Second Primary Molars (OR: 0.84) and Molar Incisor Hypomineralization (OR: 0.95) in another. Conversely, low Vitamin D levels increased the risk of enamel hypoplasia (OR: 1.29) and dental decay. The maternal and child demographics varied greatly across the studies, and the assessment and prevalence of Vitamin D deficiency or insufficiency were heterogenous. This review illuminates the potential influence of prenatal Vitamin D on dental health in children, underscoring the importance of adequate Vitamin D levels during pregnancy. However, more robust research is required to establish the optimal Vitamin D intake during pregnancy to ensure healthy dental outcomes in children. Full article

This study proposed using enamel surface texture and thickness for the objective detection and monitoring of erosive tooth wear (ETW), comparing them to the standard subjective Basic Erosive Wear Evaluation (BEWE). Thirty-two subjects (n = 597 teeth) were enrolled in this longitudinal observational clinical study. Enamel thickness (by cross-polarization optical coherence tomography, CP-OCT) and 3D dental microwear parameters, i.e., area-scale fractal complexity (Asfc), anisotropy (Str), and roughness (Sa) (by white-light scanning confocal profilometry), were obtained from buccal surfaces. Buccal, occlusal, and lingual surfaces were scored for BEWE and the maximum score per tooth (BEWE_Max) was determined at baseline and 12 months (M12). Data outcome relationships were evaluated (alpha = 0.05). Enamel thickness decreased (p < 0.001), BEWE scores, Sa, and Str increased (p < 0.001), while Asfc did not change at M12. Baseline BEWE_Buccal correlated strongly with BEWE_Max (r = 0.86, p < 0.001) and moderately with BEWE_Lingual (r = 0.42, p < 0.001), but not with enamel thickness (r = 0.03, p = 0.43). Change (Δ) in surface texture outcomes correlated poorly but significantly with ΔBEWE_Buccal (r = −0.15–0.16, p < 0.001) and did not correlate with Δenamel thickness (r = 0.02–0.09, p > 0.06). Teeth with BEWE progression revealed a greater increase in ΔSa and ΔStr. These findings suggest that enamel surface roughness can potentially determine ETW severity, and CP-OCT may be relevant for clinically monitoring enamel thickness. Full article

In-office bleaching with high concentrations of hydrogen peroxide (H₂O₂) agents causes undesirable alterations in the enamel. Surface pre-reacted glass-ionomer (S-PRG) filler is a functional material known for its acid-neutralizing and demineralization-inhibition properties. This study evaluates the effect of S-PRG filler incorporation in H₂O₂-based bleaching on the enamel surface. Bovine enamel surfaces were bleached using a bleaching paste formulated with a liquid (35% H₂O₂) and a powder containing 5% or 10% S-PRG filler. The surface roughness and the Vickers microhardness of the treated enamel surfaces were evaluated. The enamel surfaces were observed under a scanning electron microscope (SEM) and analyzed using energy dispersive X-ray (EDX) technology. The surfaces were challenged by citric acid and observed by SEM. The specimens bleached with the paste containing the S-PRG filler showed lower enamel surface roughness and higher microhardness values than did those bleached with the plain paste (0% S-PRG filler); meanwhile, there were no significant differences between the 5% or 10% S-PRG filler groups. The S-PRG filler groups showed enamel surface morphologies similar to those of the non-bleached enamel, according to SEM observation, and EDX analysis detected the presence of fluoride and strontium ions. The S-PRG filler groups showed a higher resistance to erosion. The S-PRG filler mitigated the detrimental effects of bleaching agents on the enamel surface and provided resistance to erosion. Full article

Purpose: This study evaluates the effects of different toothpastes on the nanohardness and chemical compositions of restorative materials and dental surfaces. Methods: Bovine enamel (n = 72) and dentin (n = 72) blocks were obtained and restored using RMGIC (n = 36) or CR (n = 36) to create the following surfaces: dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to facilitate the creation of control (C) and eroded (E) sides; the latter were achieved by erosion–abrasion cycles as follows: erosion with 1% citric acid: 5 days, four times for 2 min each day; 1% citric acid/abrasion, two times for 15 s, followed by immersion in a toothpaste slurry for 2 min. Toothpastes without fluoride (WF; n = 12), with sodium fluoride (NaF; n = 12), and with stannous fluoride (SnF₂; n = 12) were used for RMGIC or CR. The specimens were analyzed for nanohardness (H), and chemical composition using energy-dispersive X-ray spectroscopy and Raman microscopy. The data were statistically analyzed using two-way repeated measures ANOVA and Tukey’s test (α = 0.05). Results: Lower H values were obtained with NaF for DRMGIC-C, with a statistically significant difference from the H value obtained with WF (p < 0.05). The calcium and phosphorus concentrations in DCR-E were significantly lower with WF than with the other types of toothpaste (p < 0.05). Fluoride-containing toothpastes are capable of preserving the main chemical components of the dentin adjacent to the restorative materials under erosive–abrasive conditions. Full article

Introduction: Epidermolysis bullosa (EB) is a genetically inherited disease characterized by recurrent bullae and erosions on the skin with numerous signs of dental caries and poor oral hygiene. The aim of this study was to investigate the general clinical and oral findings of patients with EB. Materials and Methods: In this prospective study, the clinical and oral findings and family history of 26 cases with EB were evaluated. The type of EB, gender, age, parental consanguinity, dental caries, oral findings, distribution of lesions and presence of associated anomalies, clinical and oral findings correlated with gender were recorded. Results: All 26 patients with EB had a history of consanguinity and siblings with EB to varying degrees. In our study, malnutrition, anemia and growth retardation, gastrointestinal system complications, hair thinning, hand and nail deformity, ocular problems and renal disease (in one case) were observed with variable frequencies. When the intraoral findings of the patients were investigated, extensive dental caries in all EB types, enamel hypoplasia in junctional EB (JEB) and the presence of tooth-root to be extracted in dystrophic EB (DEB), intraoral bullae and lesions, ankyloglossia, vestibular sulcus insufficiency, microstomia and maxillary atrophy were observed. Three cases had restorative treatment and one case had prosthetic rehabilitation. Conclusions: Oral involvement can be seen with varying frequencies depending on the type of EB and the severity of the disease. It may result from delayed oral and dental rehabilitation due to physical disabilities, limitations and more pressing medical problems. Microstomy, pain from mucosal lesions, and restricted access to the mouth can be caused by poor oral hygiene. Oral complications and caloric needs of individuals with EB should be determined, and individual prophylaxis should be applied to prevent caries formation and protect teeth. Full article