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Randomised in situ clinical trial investigating self-assembling peptide matrix P11-4 in the prevention of artificial caries lesions.

ABSTRACT: The aim was to investigate the ability of self-assembling Peptide P11-4 Matrix (SAPM) to remineralize artificial initial caries lesions compared to the use of fluoride varnish. Volunteers were recruited for this randomised, cross-over in situ trial. Bovine specimens, half including orthodontic brackets, were recessed on the buccal aspects of mandibular appliances. Specimens included internal sound enamel control, a demineralised control and a part exposed during the in situ phase. Each phase lasted four weeks, followed by a one-week washout. Treatment groups were: A: negative control, no treatment,B: positive control, 22,600 ppm fluoride varnish,C: test group, 1,000 ppm SAPM. Laser fluorescence values (LF) were measured before/after demineralisation, and after the in situ period. Micro-CT analysis was used to assess mineral changes within the specimens after the in situ phase. In specimens without brackets, ?LF values after in situ phase were: A: +5.28, B: +0.85, C: -2.89. Corresponding ?LF for specimens with brackets were: A: +5.77, B: +1.30, C: -3.15. LF-values between groups significantly differed from each other (p?

PROVIDER: S-EPMC6343002 | BioStudies |

REPOSITORIES: biostudies

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Near-Surface Studies of the Changes to the Structure and Mechanical Properties of Human Enamel under the Action of Fluoride Varnish Containing CPP-ACP Compound.

Project description:Changes to the features of the enamel surface submitted to induced demineralisation and subsequent remineralisation were studied. The in vitro examination was conducted on polished slices of human molar teeth, divided in four groups: the untreated control (n = 20), challenged by a demineralisation with orthophosphoric acid (H3PO4) (n = 20), and challenged by a demineralisation following remineralisation with fluoride (F) varnish containing casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP) compounds (n = 20). The specimens' enamel surfaces were subjected to analysis of structure, molecular arrangement, mechanical features, chemical composition, and crystalline organization of apatite crystals. Specimens treated with acid showed a significant decrease in crystallinity, calcium, and phosphorus levels as well as mechanical parameters, with an increase in enamel surface roughness and degree of carbonates when compared to the control group. Treatment with fluoride CPP-ACP varnish provided great improvements in enamel arrangement, as the destroyed hydroxyapatite structure was largely rebuilt and the resulting enamel surface was characterised by greater regularity, higher molecular and structural organisation, and a smoother surface compared to the demineralised one. In conclusion, this in vitro study showed that fluoride CPP-ACP varnish, by improving enamel hardness and initiating the deposition of a new crystal layer, can be an effective remineralising agent for the treatment of damaged enamel.

| S-EPMC7277937 | BioStudies

In Vitro Comparison of Fluoride, Magnesium, and Calcium Phosphate Materials on Prevention of White Spot Lesions around Orthodontic Brackets.

Project description:One common negative side effect of orthodontic treatment with fixed appliances is the development of white spot lesions (WSLs) around brackets. This study is aimed at comparing the efficacy of various oral hygiene practices in preventing enamel demineralization around orthodontic brackets under similar in vitro conditions. The study included 90 extracted bovine incisors, which were randomized into six groups: fluoride toothpaste (FT), nonfluoride toothpaste (NFT), fluoride varnish plus fluoride toothpaste (FV+FT), CPP-ACP varnish plus fluoride toothpaste (CPP-ACP+FT), medical minerals gel plus nonfluoride toothpaste (MMG+NFT), and no intervention (control). All groups were subjected to demineralization and remineralization cycles. Visual appraisals were used to evaluate the changes in the enamel surface appearance at the beginning and end of the experiment. The changes in the demineralization degree were evaluated by measuring the Ca+2 concentration in the demineralization solution at different time points. The majority of teeth in the CPP-ACP+FT group exhibited no shift in appearance, whereas in the other groups, a slight change in enamel translucency was observed. At all the time points, the Ca+2 concentration in the demineralization solution in the CPP-ACP+FT group was the least among all other groups. At day 5, MMG+NFT's preventive efficacy was significantly higher than FV+FT's, but at days 10, 15, and 19, their efficacy was similar. However, at all the time points, MMG+NFT's efficacy was significantly higher than that of control, whereas FV+FT's efficacy was decreased at days 10, 15, and 19 and was close to the efficacy of control. To fight WSLs, early diagnosis was of great importance and examination of the tooth surface after air-drying for 5?s was recommended.

| S-EPMC7152941 | BioStudies

Effect of saliva contamination on cementation of orthodontic brackets using different adhesive systems.

Project description:The enamel condition and the quality of surface are points that need to be considered for achieving optimal efficiency in the treatment with orthodontic brackets. The aim of this study was to assess the immediate bond strength of metallic brackets cemented to dental.Forty human premolars were double-sectioned, placed in PVC matrices and randomly divided into 10 groups (n=8). They received artificial saliva contamination before or after the application of adhesive systems, except for the control groups. The metallic brackets were cemented using two orthodontic cements (Transbond™ Plus Color Change, 3M Unitek e Transbond™ XT Light, 3M Unitek). The specimens were subjected to mechanical shear bond strength testing and classified according to the fracture pattern. The results were analyzed using a two-way ANOVA and Tukey's test for multiple comparisons (p<0.05).ANOVA analysis showed statistically significant differences between the groups (p=0.01). The Tukey's multiple comparison test indicated statistically significant difference between G6 and G7 groups (p<0.05). A high prevalence of adhesive failure in the groups receiving the hydrophobic adhesive system.The saliva contamination prior to the application of a hydrophobic simplified conventional adhesive system was responsible for decreasing the immediate bond strength values of brackets cemented on the dental enamel. Key words:Bonding, orthodontic brackets, shear bond strength, saliva, adhesive systems.

2017-01-01 | S-EPMC5549592 | BioStudies

Micron-scale human enamel layer characterization after orthodontic bracket debonding by intensity-based layer segmentation in optical coherence tomography images.

Project description:In clinical orthodontic practice, fixed brackets are widely used for tooth movement and adjustments. Although years of research and development have improved the workability of fixed orthodontic brackets, there are still controversies regarding its plausible destructive influence on the enamel surface of tooth. This, in turn, makes the quantitative assessment of the enamel surface after specific orthodontic treatment procedures important in order to opt for the most effective treatment procedure. Through this study, we show the practical applicability of optical coherence tomography (OCT) as a non-ionizing and nondestructive assessment tool for measuring enamel loss after each step of orthodontic bracket bonding. Two-dimensional and volumetric OCT images are used for the evaluation of the tooth enamel. From the depth intensity profile analysis of cross-sectional OCT images, the changes in the individual internal layer thickness are calculated. A software algorithm was developed to evaluate the structural connectivity in the enamel for analyzing enamel loss on the tooth surface and for detecting enamel abrasion. An intensity-based layer segmentation algorithm is also developed to analyze and evaluate enamel wear in the tooth after each step. Using the proposed algorithms, the total enamel present after each treatment procedure was measured and tabulated for analysis.

| S-EPMC8149424 | BioStudies

In situ efficacy of an experimental toothpaste on enamel rehardening and prevention of demineralisation: a randomised, controlled trial.

Project description:BACKGROUND:A novel sodium fluoride toothpaste containing lactate ion and polyvinylmethylether-maleic anhydride has been developed to promote enamel remineralisation and resistance to demineralisation. In this in situ study, we compared this toothpaste ('Test') with a stannous fluoride-zinc citrate (SnF2-Zn) toothpaste ('Reference') (both 1100-1150?ppm fluoride) and a fluoride-free toothpaste ('Placebo') using an enamel dental erosion-rehardening model. METHODS:In each phase of this randomised, investigator-blind, crossover study, participants wore palatal appliances holding bovine enamel specimens with erosive lesions. They brushed their natural teeth with either the Test, Reference or Placebo toothpastes, then swished the resultant slurry. Specimens were removed at 2?h and 4?h post-brushing and exposed to an in vitro acid challenge. Surface microhardness was measured at each stage; enamel fluoride uptake was measured after in situ rehardening. Surface microhardness recovery, relative erosion resistance, enamel fluoride uptake and acid resistance ratio were calculated at both timepoints. RESULTS:Sixty two randomised participants completed the study. Test toothpaste treatment yielded significantly greater surface microhardness recovery, relative erosion resistance and enamel fluoride uptake values than either Reference or Placebo toothpastes after 2 and 4?h. The acid resistance ratio value for Test toothpaste was significantly greater than either of the other treatments after 2?h; after 4?h, it was significantly greater versus Placebo only. No treatment-related adverse events were reported. CONCLUSIONS:In this in situ model, the novel-formulation sodium fluoride toothpaste enhanced enamel rehardening and overall protection against demineralisation compared with a fluoride-free toothpaste and a marketed SnF2-Zn toothpaste. TRIAL REGISTRATION:ClinicalTrials.gov; NCT03296072; registered September 28, 2017.

| S-EPMC7164289 | BioStudies

Comparison of multiple rebond shear strengths of debonded brackets after preparation with sandblasting and CO2 laser.

Project description:Background. Failure of orthodontic bracket bonds is a common occurrence during orthodontic treatment. Different techniques have been suggested in the literature to remove resin residues from the bracket bases and enamel surfaces to prepare the surfaces again after debonding. This study attempted to compare multiple rebond shear strengths (SBS) of debonded brackets following preparation with sandblasting and CO2 laser. Methods. The brackets were bonded on 30 human and bovine maxillary central incisors using self-curing composite resin. SBS was measured using Hounsfield testing machine. The brackets were rebonded for two other times after composite resin residues on their surfaces were removed, either with air abrasion or CO2 laser. The debonded brackets and enamel surfaces were also evaluated after each debonding procedure under a stereomicroscope in order to determine adhesive remnant index (ARI). SBS of debonded brackets after each step were compared between sandblast and CO2 laser groups. Results. We observed significant differences in SBS values between pre-recycling and first (P = 0.04), second (P = 0.007) and third recycling (P = 0.007) with laser. Recycling with sandblasting resulted in a decrease in SBS after the first and second recycling procedure; however, the SBS increased after the third recycling procedure, with no significant differences. Conclusion. SBS of brackets after recycling with sandblasting and laser beams was not significantly different, and both were at a favorable level. However, repeating the recycling procedure with sandblasting resulted in more favorable SBS compared to laser.

2016-01-01 | S-EPMC5025215 | BioStudies

Enamel Surface Roughness after Lingual Bracket Debonding: An In Vitro Study.

Project description:The aim of the present study was to quantitatively assess changes in enamel roughness parameters before and after lingual bracket debonding. The lingual surface of 25 sound premolars extracted for orthodontic reasons was studied by 3D optical interferometric profilometry before and after debonding of lingual brackets following enamel finishing (with fine diamond) and polishing (with 12- and 20-fluted carbide burs). The roughness parameters tested were the amplitude parameters Sa and Sz, the hybrid parameter Sdr, and the functional parameters Sc and Sv. The parameter differences (after debonding-reference) were calculated, and statistical analysis was performed via a Wilcoxon signed-rank test. Statistically significantly higher values were observed in all the surface roughness parameters of enamel surfaces after finishing and polishing, with the mostly affected parameter being the Sdr. Under the conditions of the present study, the finishing and polishing instruments used after debonding of lingual noncustomized brackets created a surface texture rougher than the control in all the tested roughness parameters.

| S-EPMC6947563 | BioStudies

Randomized Clinical Trial investigating Self-Assembling Peptide P11-4 for Treatment of Early Occlusal Caries.

Project description:Non-invasive caries treatment is a major focus in modern dentistry. The present study was designed to evaluate the effectiveness of monomeric self-assembling peptide P11-4 (SAP P11-4) in combination with fluoride varnish or polymeric self-assembling peptide matrix (SAPM) in treatment of non-cavitated occlusal caries. Ninety children and adolescents were included in this randomized, gold-standard-controlled clinical trial. Test Group 1 received SAP P11-4 and twice fluoride varnish at baseline and Day 180, Test Group 2 received SAP P11-4 on baseline and twice weekly SAPM (home-application), and Control Group received fluoride varnish on baseline and Day 180. Caries progression was measured by laser fluorescence, Nyvad Caries Activity, ICDAS-II-codes, and investigator assessments. Laser fluorescence changes demonstrated superior results for Test Group 1 and 2, as values decreased compared to an increase for the Control Group (p?<?0.0005). ICDAS-II codes at Day 360 showed partial regression for Test Group 1 (6.7%) and Test Group 2 (20.0%) and partial progression for Control Group (23.3%) (p?<?0.01). Nyvad Caries Activity yielded superior caries inactivation for Test Groups, compared to Control Group (p?=?0.002). This trial showed that SAP P11-4, applied either in combination with fluoride varnish or twice weekly SAPM, was a superior treatment for early caries compared to fluoride varnish alone.

| S-EPMC7060217 | BioStudies

Influence of resin-modified glass ionomer and topical fluoride on levels of Streptococcus mutans in saliva and biofilm adjacent to metallic brackets.

Project description:Decalcification of enamel during fixed orthodontic appliance treatment remains a problem. White spot lesions are observed in nearly 50% of patients undergoing orthodontic treatment. The use of fluoride-containing orthodontic materials has shown inconclusive results on their ability to reduce decalcification. The aims of this investigation were to compare the levels of Streptococcus mutans (SM) in saliva and biofilm adjacent to orthodontic brackets retained with a resin-modified glass ionomer cement (RMGIC) (Fuji ORTHO LC) and a light cured composite resin (Transbond XT), and to analyze the influence of topical application of the 1.23% acidulated phosphate fluoride (APF) on SM counts. In a parallel study design, two groups (n=14/15) were used with random allocation and high salivary SM counts before treatment. Biofilm was collected from areas adjacent to the brackets on teeth 13, 22, 33, and 41. Both saliva and biofilm were collected on the 7th, 21st, 35th, and 49th days after appliance placement. Topical fluoride application was carried out on the 35th day. Bonding with RMGIC did not alter SM counts in saliva or biofilm adjacent to the brackets. On the other hand, the biofilm adjacent to brackets retained with composite resin showed a significant increase in SM counts along the trial period. Topical application of 1.23% APF did not reduce salivary or biofilm SM counts regardless of the bonding material. In conclusion, fluoride topical application did not show efficacy in reducing SM. The use of RMGIC as bonding materials allowed a better control of SM cfu counts in dental biofilm hindering the significant increase of these microorganisms along the trial period, which was observed in the biofilm adjacent to the composite material.

2017-01-01 | S-EPMC5393540 | BioStudies

In vitro and in vivo evaluation of electrophoresis-aided casein phosphopeptide-amorphous calcium phosphate remineralisation system on pH-cycling and acid-etching demineralised enamel.

Project description:Casein phosphate-amorphous calcium phosphate (CPP-ACP), as a remineralisation agent, is extensively used in managing demineralised enamel; however, its remineralisation kinetics is low. This study aimed to improve remineralisation kinetics of CPP-ACP by introducing a rapid remineralisation method with electrophoresis. In vitro, a pH-cycling enamel model was used to test remineralisation potentials of electrophoresis-aided CPP-ACP. For verifying remineralisation potentials of electrophoresis-aided CPP-ACP in vivo in a rabbit model, acid-etched enamel surface on rabbit maxillary incisors was remineralised by electrophoresis-aided CPP-ACP with 1.0 mA (group A) or 0.5 mA (group B). Both in vitro and in vivo, it was observed that electrophoresis was benefit to improve remineralisation kinetics of CPP-ACP, and the demineralised enamel was completely remineralised after 5 h. The Ca/P ratio in remineralised enamel consisted with that of hydroxyapatite, the microstructure in native enamel. Meanwhile, in vivo the micro-hardness of acid-etched enamel in group A (322.55 ± 31.90) and group B (322.55 ± 31.90) recovered up to the value of native enamel after 5 h remineralisation (p > 0.05). The Hematoxylin-eosin stain demonstrated that the electric field used in this study was safe on rabbit dental pulp. Therefore, this efficient and safe method has the potential to be applied in treating enamel deminerlisation.

| S-EPMC5995962 | BioStudies

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