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      Remineralization of eroded enamel by a NaF rinse containing a novel calcium phosphate agent in an in situ model: a pilot study

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          Abstract

          Purpose

          An in situ study evaluated the remineralization potential of 225 ppm fluoride (F) rinses with and without a calcium phosphate agent (TCP-Si-Ur) on eroded enamel.

          Methods

          20 human patients participated in this IRB approved study. Enamel blocks extracted from 20 human molars were assigned to each of the three study phases (G1, G2, G3). Each block was eroded using 1% citric acid (pH = 2.5), with a slice cut from each block to establish baseline lesion parameters (ie, integrated mineral loss ΔZ, and lesion depth LD) using transverse microradiography (TMR). Participants and assigned blocks were randomly divided into three 28-day phases. The blocks were mounted into modified orthodontic brackets and bonded to the buccal surface of one of the subject’s mandibular molars. The appliance remained in the subject’s mouth for 28 days. Prior to each study phase, participants observed a one-week-washout period using a fluoride-free dentifrice. In each phase, participants brushed with the fluoride-free dentifrice for 1 min, followed by one of the following coded treatments: G1: 225 ppm F + 40 ppm TCP-Si-Ur rinse (1 min); G2: 225 ppm F rinse (1 min); G3: no rinse (saliva-only). After each phase, appliances were removed and specimens were analyzed using TMR.

          Results

          TMR data (ie, ΔZ and LD) revealed all three groups significantly remineralized eroded enamel (paired t-tests, P < 0.001). Net mineralization (% change in ΔZ, LD) were as follows (mean (std.dev): G1: 44.1 (22.6), 30.5 (27.0); G2: 30.0 (7.4), 29.4 (10.5); G3: 23.8 (16.4), 25.7 (15.5). Furthermore, G1 was found to cause significantly more remineralization than G2 ( P = 0.039) and G3, ( P = 0.002).

          Conclusion

          Mouthrinse containing 225 ppm F plus TCP-Si-Ur provided significantly greater remineralization relative to 225 ppm F only or saliva alone.

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          Most cited references23

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          In vitro remineralisation of eroded enamel lesions by saliva.

          It is speculated that saliva, with its mineral content, may possess a reparative effect on an early erosion which is characterised by softened surface and slight subsurface demineralisation in addition to a crater. This study aimed to determine the possible remineralisation of early enamel erosion by saliva. Eroded lesions were produced in bovine incisors by 1-h immersion in orange juice. Control sections and three experimental slabs were produced from each tooth. The three slabs were assigned randomly to one of three remineralising agents: clarified natural saliva (NS), artificial saliva (AS) and remineralising solution (RS). All solutions had a pH of 7.2, a fluoride concentration of 0.022 ppm, and were changed daily. NS was collected daily from the same individual at the same time of day. The specimens were exposed to their respective remineralising agents for 28 days. Using microradiography and image analysis, the mineral loss (Delta z) and lesion depth (ld) were quantified in sections cut from the control and experimental slabs. A significant (p<0.001) amount of mineral was gained following exposure to each remineralising agent. Significantly less Delta z and ld were observed for the experimental groups compared with the control group (p<0.001; paired t-test). This effect was greatest with RS and least with AS. Inter-group comparison (Duncan multiple tests) showed no significant difference in Delta z among the experimental groups, however ld was significantly higher for AS (p<0.001) compared with RS and NS, and no difference was observed between RS and NS. Saliva as well as remineralising solutions can remineralise early enamel erosion.
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            Preparation, characterization and in vitro efficacy of an acid-modified beta-TCP material for dental hard-tissue remineralization.

            A blended material composed of beta-tricalcium phosphate (beta-TCP) and fumaric acid (FA) was prepared using a mechanochemical process. The structure and properties of the TCP-FA material was probed using particle size analysis, infrared, (31)P and (13)C solid-state nuclear magnetic resonance (NMR) spectroscopy, powder X-ray diffraction and calcium bioavailability. NMR studies showed that orthophosphate environments within beta-TCP remain largely unaffected in the presence of FA during mechanochemical processing; alternately, (13)C data indicated the carboxylic groups of FA are strongly affected during processing with beta-TCP. X-ray results reveal beta-TCP diffraction plane shifting with lattice contractions likely arising at the C(3) symmetry site. While milled beta-TCP (mTCP) produces a higher flux of bioavailable calcium relative to native beta-TCP, the mechanochemical conditioning of TCP-FA generates more than seven times the level of ionic calcium relative to mTCP. Collectively, the results from these studies indicate FA interfaces with calcium oxide polyhedra of the beta-TCP hexagonal crystal lattice, especially with the underbonded CaO(3) cluster manifested within the C(3) symmetry site of the beta-TCP motif. An in vitro remineralization/demineralization pH cycling dental model was then used to assess the potential of the TCP-FA material in reversing early stage non-cavitated enamel lesions. Characterization of the remineralization via surface and longitudinal microhardness measurements demonstrated that the TCP-FA material provides statistically superior remineralization relative to milled and native beta-TCP. Copyright 2009 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
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              Effect of an iron mouthrinse on enamel and dentine erosion subjected or not to abrasion: an in situ/ex vivo study.

              This in situ/ex vivo study evaluated whether a rinse with an iron solution could reduce wear and the percentage of microhardness change of human enamel and dentine submitted to erosion followed by brushing after 1 or 30min. During 2 experimental 5-day crossover phases (wash-out period of 10 days), 10 volunteers wore intraoral palatal devices, with 12 specimens (6 of enamel and 6 of dentine) arranged in 3 horizontal rows (4 specimens each). In one phase, the volunteers immersed the device for 5min in 150mL of cola drink, 4 times a day. Immediately after immersion, no treatment was performed in one row. The other row was brushed after 1min using a fluoride dentifrice and the device was replaced into mouth. After 30min, the remaining row was brushed. In the other phase, the procedures were repeated, but after immersion the volunteers rinsed for 1min with 10mL of a 10mM ferrous sulphate solution. Changes in surface microhardness (%SMH) and wear (profilometry) of enamel and dentine were measured. Data were tested using ANOVA and Tukey's tests (p<0.05). The enamel presented more wear than dentine, under all experimental conditions. The iron solution caused a significant reduction on the %SMH in enamel, and a significant reduction on the wear in dentine, regardless the other conditions. Rinsing with an iron solution after an erosive attack, followed or not by an abrasive episode, may be a viable alternative to reduce the loss of dental structure.
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                Author and article information

                Journal
                Clin Cosmet Investig Dent
                Clin Cosmet Investig Dent
                Clinical, Cosmetic and Investigational Dentistry
                Dove Medical Press
                1179-1357
                2010
                25 August 2010
                : 2
                : 93-100
                Affiliations
                [1 ]University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
                [2 ]Indiana Nanotech, Indianapolis, IN, USA
                Author notes
                Correspondence: Robert L Karlinsey, Indiana Nanotech, 351 West 10th street, Suite 309, Indianapolis, IN, 46202 USA Tel +1 317 278 7892 Fax +1 317 278 4102 Email rkarlins@ 123456gmail.com
                Article
                ccide-2-093
                10.2147/CCIDEN.S11844
                3645458
                23662086
                1b0ddb3d-4534-4fbb-ad4f-af59e62d44c7
                © 2010 Amaechi et al, publisher and licensee Dove Medical Press Ltd

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Original Research

                tcp-si-ur,fluoride,antierosion,tricalcium phosphate,double-blind

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