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      In vitro evaluation of the efficacy of laser fluorescence (DIAGNOdent) to detect demineralization and remineralization of smooth enamel lesions

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          Abstract

          Objective:

          Early detection of smooth surface lesions is important for appropriate management and monitoring of dental caries. The purpose of this in vitro study was to evaluate the efficacy of laser fluorescence to detect demineralization and remineralization of smooth enamel surfaces.

          Materials and Methods:

          In this in vitro study, 132 enamel blocks of semi-impacted human third molars were obtained; artificial caries lesions were induced and they were submitted to the pH-cycling process to create remineralization. Superficial microhardness (SMH) and laser fluorescence (LF) analysis were performed at baseline, after demineralization, and remineralization processes. The data were analyzed by Statistical Package for Social Sciences (SPSS)-16 using analysis of variance (ANOVA), Paired samples t-test, and Pearson's correlation test.

          Results:

          There was a significant difference between SMH values at baseline, after demineralization and after remineralization. Also, a statistically significant difference was observed between LF values in these three stages. The LF values increased after demineralization and then decreased after remineralization, and the SMH values decreased after demineralization and increased after remineralization. There was an inverse relationship between SMH and LF only at baseline and after demineralization, but not after remineralization.

          Conclusion:

          The results showed that LF is an appropriate method for detection of demineralization in an in vitro condition in smooth enamel lesions, but it was not so efficient in the detection of remineralization.

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          Most cited references29

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          pH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations

          Despite a plethora of in situ studies and clinical trials evaluating the efficacy of fluoridated dentifrices on caries control, in vitro pH cycling models are still broadly used because they mimic the dynamics of mineral loss and gain involved in caries formation. This paper critically reviews the current literature on existing pH-cycling models for the in vitro evaluation of the efficacy of fluoridated dentifrices for caries control, focusing on their strengths and limitations. A search was undertaken in the MEDLINE electronic journal database using the keywords "pH-cycling", "demineralization", "remineralization", "in vitro", "fluoride", "dentifrice". The primary outcome was the decrease of demineralization or the increase of remineralization as measured by different methods (e.g.: transverse microradiography) or tooth fluoride uptake. Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. One hundred and sixteen studies were included, of which 42 addressed specifically the comparison of dentifrices using different pH-cycling models. The other studies included meta-analysis or reviews, data about the effect of different fluoride sources on de-remineralization, different methods for analysis de-remineralization and chemical variables and characteristics of dental hard tissues that might have influence on de-remineralization processes. Generally, the studies presented ability to detect known results established by clinical trials, to demonstrate dose-related responses in the fluoride content of the dentifrices, and to provide repeatability and reproducibility between tests. In order to accomplish these features satisfactorily, it is mandatory to take into account the type of substrate and baseline artificial lesion, as well as the adequate response variables and statistical approaches to be used. This critical review of literature showed that the currently available pH-cycling models are appropriate to detect dose-response and pH-response of fluoride dentifrices, and to evaluate the impact of new active principles on the effect of fluoridated dentifrices, as well as their association with other anti-caries treatments.
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            Potential agents to control enamel caries-like lesions.

            To assess whether pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and calcium sodium phosphosilicate (CSP) control artificial caries lesion progression. Enamel slabs of bovine teeth were embedded in polyester resin and had their enamel surfaces serially polished, and tested for surface microhardness (SMH, 25 g, 5 s). Incipient caries-like lesions were pre-formed and specimens were evaluated by microhardness test (SMH(post-lesion)) and randomly assigned to five treatment groups (n=15): (1) regular dentifrice (RE, 1,100 ppm F); (2) dentifrice with calcium sodium phosphosilicate (CSP); (3) amorphous calcium phosphate stabilized by casein phosphopeptide (CPP-ACP); (4) CPP-ACP with 900 ppm F (CPP-ACP+F) and (5) control group-unexposed to any remineralizing agent. Treatments were applied five times, after the de-remineralization period in the cariogenic challenges. Post-treatments SMH measurements were conducted (SMH(post-treatment)). ANOVA was applied for data evaluation and revealed a significant difference among the treatments (p=0.0161). Tukey's test was conducted and the percentage of mineral loss was calculated. Specimens exposed to CSP (7.1%), RE (6.7%) and CPP-ACP+F (3.8%) showed lower mineral loss than those that in the control group (-11.0%). CPP-ACP group (3.2%) differed from the control, CSP and RE groups. Depending on the agent used, a remineralizing effect may be expected, which reflects in caries lesions progression.
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              Emerging technologies for diagnosis of dental caries: The road so far

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                Author and article information

                Journal
                J Conserv Dent
                J Conserv Dent
                JCD
                Journal of Conservative Dentistry : JCD
                Medknow Publications & Media Pvt Ltd (India )
                0972-0707
                0974-5203
                Jul-Aug 2013
                : 16
                : 4
                : 362-366
                Affiliations
                [1]Department of Pedodontics, Shahid Sadoughi University of Medical Sciences, Faculty of Dentistry, Yazd, Iran
                Author notes
                Address for correspondence: Dr. Mona Kabudan, Postgraduate of Pedodontics, Shahid Sadoughi University of Medical Sciences, Faculty of Dentistry, Yazd, Iran. E-mail: mkabudan2@ 123456yahoo.com
                Article
                JCD-16-362
                10.4103/0972-0707.114360
                3740651
                23956542
                27dee0d1-882b-4d21-9389-8341c1961b75
                Copyright: © Journal of Conservative Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 December 2012
                : 28 April 2013
                : 14 May 2013
                Categories
                Original Article

                Dentistry
                demineralization,diagnodent,enamel,laser fluorescence,remineralization,smh,smooth surfaces
                Dentistry
                demineralization, diagnodent, enamel, laser fluorescence, remineralization, smh, smooth surfaces

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