Search Results (76)

Objectives: This study aimed to compare in vitro the protective effect of two enamel remineralizing agents, a varnish containing β-tricalcium phosphate with sodium fluoride (β-TCP-F) and a paste containing casein phosphopeptide-amorphous calcium phosphate with sodium fluoride (CPP-ACP-F), on artificially demineralized human enamel. Methods: A total of 120 human third molar enamel specimens were randomly assigned to four groups (n = 30 each): Group I (healthy enamel, control), Group II (initially demineralized, lesioned enamel), Group III (demineralized enamel and treated with β-TCP-F), and Group IV (demineralized enamel and treated with CPP-ACP-F). Groups II–IV underwent, for 15 days, a daily pH cycling regimen consisting of 21 h of demineralization under pH 4.4, followed by 3 h of remineralization under pH 7. Groups III and IV were treated with either β-TCP-F or CPP-ACP-F, prior to each 24 h demineralization–remineralization cycle. Fluoride ion release was measured after each pH cycle. Surface hardness, roughness, wettability, and Streptococcus mutans biofilm formation were assessed on days 5, 10, and 15 after a daily pH cycle. Results: CPP-ACP-F treatment showed a larger improvement in surface hardness (515.2 ± 10.7) compared to β-TCP-F (473.6 ± 12.8). Surface roughness decreased for both treatments compared to initially lesioned enamel; however, the decrease in roughness in the β-TCP-F group only reached a value of 1.193 μm after 15 days of treatment, a significantly larger value in comparison to healthy enamel. On the other hand, the decrease in roughness in the CPP-ACP-F treatment group reached a value of 0.76 μm, similar to that of healthy enamel. Contact angle measurements indicated that wettability increased in both treatment groups (β-TCP-F: 71.01°, CPP-ACP-F: 65.24°) compared to initially lesioned samples in Group II, reaching WCA values similar to or smaller than those of healthy enamel surfaces. Conclusions: Both treatments, β-TCP-F and CPP-ACP-F, demonstrated protective effects against enamel demineralization, with CPP-ACP-F showing superior enhancement of surface hardness and smoother enamel texture under in vitro pH cycling conditions. β-TCP-F varnish and CPP-ACP-F paste treatments counteracted surface modifications produced on human healthy enamel by in vitro demineralization. Full article

White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability. Full article

Objective: This systematic review evaluates the evidence on factors affecting fluoride release from compomer restorative materials to provide clinicians with insights for optimizing their use in caries prevention. Methods: In February 2025, an extensive digital search was conducted across reputable databases such as PubMed, Web of Science, and Scopus. The search utilized carefully chosen keywords: “fluoride release” AND “compomer” and followed the PRISMA guidelines. Initially, 287 articles were identified, but after applying the inclusion criteria, 34 studies were selected for review. Results: This review found that fluoride release from compomers follows an initial burst phase before stabilizing at lower levels. Fifteen studies proved that compomers release less fluoride than glass ionomer cements but more than composite resins, as concluded from six studies. The release rate is significantly influenced by pH, with acidic conditions enhancing fluoride diffusion. Some studies also highlighted the potential for fluoride recharge through external applications such as toothpaste or varnish. Conclusion: Compomer restorative materials offer a steady, moderate fluoride release that supports caries prevention. Their effectiveness is enhanced in acidic environments, supporting their use in high-risk patients. Full article

Background/Objectives: The implementation of preventive treatments in pediatric dental care has been a priority in recent years. Understanding the factors that influence the timing and frequency of childhood preventive treatments, such as the impacts of the COVID-19 pandemic, are the focus of many health informatics researchers. Methods: A retrospective study was approved to assess changes in specific preventive treatments at a pediatric dental school clinic (sealants, fluoride varnish, and silver diamine fluoride) in the three years prior to (2017–2019) and following the COVID-19 pandemic (2020–2022). Results: A detailed analysis of these data revealed significant and unexpected shifts in these preventive services, with significant increases in dental sealants from pre- to post-pandemic (35.1%, p = 0.012), but corresponding decreases in other preventive treatments, such as the number of fluoride varnish (−37.6%, p = 0.011) and SDF treatments (−24.0%, p = 0.032), among this patient population. Conclusions: These data suggest that the selective pursuit of particular preventive dental services and treatments rather than others and understanding these shifts might help health informatics and dental public health researchers understand which factors influenced these decisions and behaviors, such as long-term durability and efficacy (sealants) or changing public perceptions of safety (fluoride and SDF). Full article

Background/Objective: The taste perception of clinical materials used in dental treatment procedures can influence the compliance of autistic children during dental visits due to their heightened anxiety and sensory processing difficulties. This study aimed to evaluate the taste acceptance of different fluoride varnish preparations among children with autism spectrum disorder (ASD) in a clinical setting. Methods: This parallel-arm single-blinded randomized clinical study included autistic children aged 6–14 years, referred to a community dental clinic unit for preventive dental care. Non-verbal behavior, as a measure of taste acceptance, was assessed using the Frankl behavior rating scale. Additionally, subjective taste responses were recorded using a 3-point facial hedonic scale. Data were analyzed using descriptive statistics and the chi-square test. Results: There was no statistically significant difference in non-verbal behavior between the three fluoride varnish groups before application (p = 0.094) or immediately after application (p = 0.718). However, when comparing pre- and post-application responses within each group, Duraphat^® showed a significant improvement in non-verbal behavior (p = 0.020), while no significant changes were observed for Profluorid^® (p = 0.196) or MI Varnish^® (p = 0.704). Subjective taste acceptance, as measured by the 3-point facial hedonic scale, showed no significant differences among the varnish groups (p = 0.406). Conclusions: Flavored fluoride varnishes may improve the compliance of autistic children with preventive oral care procedures. Although no significant differences in taste acceptance were observed among the three varnishes, Duraphat^® was associated with a significant improvement in non-verbal positive behavior, suggesting a more favorable response in autistic children. Full article

Background and Objectives: Contemporary caries treatment seeks to preserve hard dental tissues as well as to promote lesion remineralization and biological tissue regeneration. While fluoride-based treatments remain the gold standard, their effectiveness has limitations, prompting interest in innovative remineralization technologies. Nano-hydroxyapatite (nano-HA) varnish and self-assembling peptide (SAP) P11-4 are promising biomimetic materials that promote enamel repair, yet long-term data on their efficacy are limited. The objectives of this study were to evaluate the effectiveness of nano-HA varnish and peptide P11-4 in restoring enamel surface hardness after artificial lesions in vitro and to compare them to a control group and fluoride varnish. Materials and Methods: Artificial enamel lesions were created on the buccal surfaces of 36 extracted human molars, which were randomly divided into four groups (n = 9): control, peptide P11-4, fluoride varnish, and nano-hydroxyapatite varnish. After applying the materials as per manufacturer instructions, specimens were stored in artificial saliva for 14 days. Enamel surface hardness was measured using the Vickers hardness test (HV) at baseline, after demineralization, and after remineralization. Statistical analysis was performed with “IBM SPSS 27.0” using non-parametric Kolmogorov–Smirnov, Kruskal–Wallis, Dunn’s, and Wilcoxon tests. Results: The mean baseline enamel hardness value was 323.95 (SD 33.47) HV. After 14 days of demineralization, the mean surface hardness of artificial enamel lesions significantly plummeted to 172.17 (SD 35.96) HV (p = 0.000). After 14 days of remineralization, the mean value significantly increased to 213.21 (SD 50.58) HV (p = 0.001). The results of the study revealed statistically significant enamel remineralization of the peptide P11-4 group in regard to the demineralized enamel (p < 0.05). In contrast, there were no significant results in other treatment groups (p > 0.05). Remineralization of enamel was the highest in samples from the P11-4 group (54.1%), followed by the nano-HA group (35.4%), FV group (17.8%), and control group (11.2%). There was a significant difference (p < 0.05) in the remineralizing ability between the peptide P11-4 and all other treatment groups. Conclusions: Self-assembling peptide P11-4 effectively remineralized artificial enamel lesions and proved to be significantly more effective compared to fluoride varnish and nano-hydroxyapatite varnish, showcasing its superior performance as a remineralizing agent. Full article

Background/Objectives: In Marburg (Hesse, Germany), the selective intensive preventive program (SIP) with fluoride varnish applications had to be interrupted due to the COVID-19 pandemic. The aim of this retrospective anonymized evaluation was to investigate possible effects of SIP interruption on oral health in socially vulnerable 7- and 8-year-olds. Methods: The caries increment in 7- and 8-year-olds for the test group (N = 180) between last dental check-up before the interruption of SIP (02/2019–02/2020) and the first check-up after restart (01/2022–07/2022) were calculated from dental public health service data. The test group was compared to a control group of children (N = 215; same age and schools, with SIP, data collected between the school year 2017/18 and 2019/20). One dentist conducted the dental examinations. The University of Marburg ethics committee approved the study. The Mann–Whitney U test and Pearson’s chi-square test were used for statistical analysis. Results: There was no significant difference in the caries increment in the first dentition between the test and the control group for both age groups. In the different groups, a maximum of 61% of the children with caries experience were completely treated. There was no significant difference between the test and control groups in either the percentage of sealed first permanent molars or the degree of restoration. Conclusions: The interruption of SIP had no negative impact on caries increment. It is possible that the children examined went through the pandemic without a significant increase in tooth decay because the children were well-trained in tooth brushing since kindergarten. Full article

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions to reduce the risk of WSLs during orthodontic care. Methods: A comprehensive literature search was conducted using MeSH terms such as “white spot”, “fixed orthodontic treatment”, “CPP-ACP”, “topical fluoride”, and “demineralized lesion”, combined with the Boolean operator ‘AND’. Databases searched included PubMed, EMBASE, Scopus, and OpenGrey, focusing on studies published between January 2014 and September 2024. The inclusion criteria required studies to evaluate interventions aimed at reducing WSL risk in patients undergoing fixed orthodontic treatment. A total of 41 articles were screened, with 17 selected based on relevance and methodological rigor. Results: The review identified several effective strategies for preventing WSLs. Topical fluoride applications, particularly high-concentration varnishes, significantly reduced WSL prevalence, with some studies favoring fluoride varnish over other interventions. CPP-ACP and CPP-ACPF formulations demonstrated potential for remineralizing demineralized enamel, especially when combined with fluoride toothpaste. High-fluoride toothpaste and acidulated phosphate fluoride mouthwash were effective in reducing lesion incidence, emphasizing the importance of patient compliance in daily oral hygiene routines. Professional interventions, such as fluoride varnish applications, showed enhanced outcomes when re-applied periodically. Conclusions: Preventing WSLs during orthodontic treatment is crucial for ensuring the aesthetic and functional success of therapy. Strategies combining fluoride-based interventions with casein phosphopeptide formulations offer significant benefits. However, patient education and adherence to recommended oral hygiene practices remain critical. Further research is needed to compare the long-term effectiveness of these interventions and to explore new technologies for WSL prevention. Full article

Oral health is fundamental to overall well-being, especially in childhood, when dental structures and lifelong habits are established. This review provides a comprehensive analysis of children’s dental development, common oral health challenges, and evidence-based preventive strategies. Key topics include the mechanisms of tooth development, the eruption processes of primary and permanent dentition, and the management of developmental abnormalities. The prevalence, risk factors, and health impacts of dental caries in children are examined, underscoring the need for early intervention and targeted prevention. This review evaluates the effectiveness of preventive measures such as dental sealants, fluoride varnishes, and fluoride mouth rinses while highlighting the influence of dietary habits, toothbrush selection, and parental involvement on oral health outcomes. Additionally, it explores the synergistic benefits of combining preventive approaches, such as the concurrent use of dental sealants and fluoride applications, which have demonstrated superior caries prevention compared to either method alone. The effectiveness of these strategies is analyzed across different age groups, from early childhood to adolescence, with tailored recommendations for each developmental stage. Furthermore, the role of education, policy interventions, and community-based programs in addressing oral health disparities is discussed. By integrating developmental insights with epidemiological data and clinical evidence, this review provides a comprehensive framework for advancing pediatric dentistry, informing best practices, and enhancing preventive strategies to reduce the burden of oral diseases in diverse pediatric populations. Full article

Aim: To compare caregiver satisfaction and children’s acceptance of silver fluoride/potassium iodide (AgF + KI) treatment (Riva Star Aqua^®, SDI Limited, Victoria, Australia) and glass-ionomer cement (GIC) application (Ionostar Plus + Easy Glaze, VOCO, Germany) in reducing hypersensitivity in permanent molars affected by molar incisor hypomineralisation (MIH) with the MIH treatment need index (MIH-TNI) 3 and 4 immediately after its application and after 12 weeks. Materials and Methods: This prospective, comparative, clinical study recruited schoolchildren with at least one hypersensitive MIH molar with a Schiff cold air sensitivity score (SCASS) of 2 and 3. Caregivers in both groups (AgF + KI and GIC + glaze) answered a questionnaire (5-Point Likert Scale) regarding the perception of the treatment immediately (15 min post application) and in the 12 weeks follow-up. Children’s behaviour during both applications was assessed using FBRS (Frankl Behaviour Rating Scale). Results: A total number of 47 children (n = 22 for AgF/KI and n = 25 for GIC) with a mean age of 8.6 ± 1.42 were recruited. A high proportion of the children in both arms (n = 40 out of 44; 90.1%) reported a reduction in hypersensitivity in the last 12 weeks. On average, children (n = 39; FBRS ≥ 3) in both groups showed positive behaviour, with a significantly more definitely positive behaviour in the GIC group (p < 0.05, independent student t-test). Caregiver satisfaction with both study procedures was high after immediate assessment (n = 19 out of 22, 86.4% for AgF/KI and n = 19 out of 25, 76.0% for GIC application) and in 12 weeks of follow-up (n = 17 out of 20, 85.0% for AgF/KI and n = 22 out of 24, 91.6% for GIC application). However, the taste AgF/KI is more frequently considered not acceptable for the child (n = 10; 45%) than smell (n = 2; 9%). Interestingly, there was a statistically significant difference in caregivers’ preference toward alternative desensitisation treatment (tooth restoration coverage, desensitisation paste, stainless steel crown and fluoride varnish) in both treatment groups (p < 0.05, Mann–Whitney U test). Conclusions: Both GIC and AgF/KI applications can be considered acceptable approaches to reduce hypersensitivity in permanent molars affected by MIH both immediately and in long-term follow-up for schoolchildren based on caregivers’ assessments. Full article

Objectives: Dental erosion has evolved into a common condition with growing concern in the dental community. The aim of this study was to explore the protective effects of two highly fluoridated products, silver fluoride solution (silver diamine fluoride-potassium iodide solution, SDF-KI) and fluoride varnish, on dental erosion in mouse. Methods: Two groups of ten young CD-1 mouse were given a cola drink ad libitum over a 6-week period. A prophylactic treatment with a silver fluoride solution (38% SDF 48,000 ppm F with a silver concentration of 253,900 ppm) and a fluoride varnish (NaF, 22,600 ppm F) were applied on the mandibular molars, performed under sedation twice a week during the whole experiment. Furthermore, two control groups of ten mice were included, a positive (cola drink) and a negative (distilled water) control. A terminal procedure was followed by dissection of mandibular molars and analysis of them using scanning electron microscopy (SEM). The first molars were transversely ground, further analyzed by SEM, and measured for tooth height and tooth tissue loss. Results: Analyses of mandibular molars treated with a fluoride varnish indicated a 5% decreased tooth tissue loss, compared to the molars which served as a positive control. The best effect was achieved with the application of silver fluoride solution, displaying a 35% decreased tooth tissue loss compared to the positive control group. Conclusions: Preventive treatment with a solution of silver fluoride solution exhibits greater protection against dental erosion compared to a traditional fluoride varnish. This study indicates that silver fluoride solution is an effective fluoride compound and is highly beneficial in a clinical setting with the aim of preventing dental erosion. Full article

Research with nanoparticles for the treatment and prevention of dental caries is of special interest given the high prevalence of the disease worldwide. Several studies support the use of nanoparticles associated with materials given their antimicrobial properties and potential demineralization reduction. This study aimed to evaluate the impact of the application of silver nanoparticles (AgNPs) and chitosan gel in combination with commercial fluoride varnish on the remineralization of dental enamel. Ninety-six tooth blocks were macroscopically evaluated via stereomicroscopy, ICDAS II, and laser fluorescence. Enamel blocks were subjected to artificial demineralization and divided into four exposure groups (24, 48, 120, and 168 h), and five different remineralizing agents were applied, namely, FV (fluoride varnish), FV + CG (fluoride varnish + chitosan gel), FV + AgNPs (fluoride varnish + AgNPs), FV + AgNPs + CG (fluoride varnish + AgNPs + chitosan gel), and AgNPs + CG (AgNPs + chitosan gel). Enamel surface changes were evaluated via laser fluorescence, X-ray diffraction, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Laser fluorescence results obtained from demineralized blocks and subsequently exposed to remineralizing treatment indicate significant differences. After exposure to remineralizing agents, hydroxyapatite and modified apatite phases were identified mainly in the samples treated with FV + AgNPs + CG in the groups exposed for 24, 48, and 120 h. The FV + AgNPs + CG and AgNPs + CG indicate good performance in terms of the Ca/P ratio in in vitro demineralization compared to the group treated with fluorine varnish. Full article

This study aimed to clarify the effects of high-concentration fluoride varnish application on the inhibition of the progression of initial enamel caries. Remineralization capacity and acid resistance following high-concentration fluoride varnish application were compared with untreated models and models treated with fluoride mouthwash. Bovine enamel was used to create a model of initial enamel caries. The high-concentration fluoride varnishes Enamelast and Clinpro White Varnish and the fluoride mouthwash Miranol were used. Specimens were evaluated using Contact Microradiography (CMR) and an Electron Probe Micro-Analyzer (EPMA). While a single application of high-concentration fluoride varnish and short-term fluoride mouthwash use did not appear to cause remineralization in the subsurface demineralized layer, improvements in acid resistance were observed, leading to reduced demineralization under subsequent acidic challenges. Full article

In-office teeth bleaching is an esthetic dental procedure performed to whiten teeth. A desensitizing procedure often requires prior in-office bleaching to relieve tooth hypersensitivity. The objective of this study was to evaluate the bleaching efficiency of teeth specimens pre-treated with different desensitizing agents by analyzing the color parameters. A total of 25 bovine specimens were stained and divided into five groups (n = 5). The specimens were pre-treated with GLUMA, ICON, bonding, or fluoride varnish according to the manufacturer’s instructions. Subsequently, the samples underwent three consecutive 20 min bleaching sessions using an in-office bleaching product. Color values in the CIE L*, a*, and b* color space were initially recorded, both before any treatment and after each bleaching session. The color difference (ΔE) was then computed. The data were analyzed using SPSS 24.0 software. The color alteration after pre-treatment was analyzed using a one-way ANOVA test, and the color alteration in each bleaching session was compared using a repeated-measure ANOVA test. A one-way ANOVA analysis showed a statistically significant difference in the bleaching efficiency of teeth specimens pre-treated with different desensitizers (p < 0.001). The repeated-measure ANOVA analysis showed no statistically significant difference in additional bleaching sessions (p = 0.133). The ICON and bonding pre-treatment showed the color alteration of teeth specimens before the bleaching procedure. Although the different desensitizer pre-treatments showed significant differences in bleaching efficiency, the differences in color parameters of the teeth specimens at the end of three bleaching sessions were statistically insignificant. Desensitizer pre-treatment influenced the degree of color change during multiple bleaching sessions; however, the outcome of bleaching was not affected by desensitizer pre-treatment. Full article

Background: Molar–incisor hypomineralization (MIH) is an enamel defect affecting molars and incisors, often leading to hypersensitivity, enamel breakdown, and increased caries risk. Non-invasive treatments, such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and fluoride varnish, show potential in remineralizing affected enamel and reducing sensitivity, but their efficacy is still debated. This study systematically reviews and analyzes the effectiveness of CPP-ACP and other non-invasive agents in improving remineralization and reducing hypersensitivity in MIH-affected teeth. Methods: A systematic search was conducted on PubMed, Embase, and Central in July 2024, including interventional and observational studies on remineralization and hypersensitivity in pediatric MIH patients (<18 years). A total of 1566 studies were found, with 15 included in the meta-analysis. A random-effects model was applied, including subgroup analysis by lesion severity. Results: CPP-ACP showed no statistically significant advantage over fluoride in remineralization (MD −3.80, 95% CI: −8.57; 0.98), but it significantly reduced hypersensitivity compared to fluoride varnish (MD −2.36, 95% CI: −3.83; −0.89). Although this reduction in hypersensitivity may be clinically relevant, the high heterogeneity (I² = 83%) and wide confidence intervals limit the reliability of these findings. Conclusions: CPP-ACP has a moderate effect in reducing hypersensitivity but does not outperform fluoride in remineralization. Other agents, such as calcium glycerophosphate and silver diamine fluoride, showed mild benefits. The current evidence base is limited and heterogeneous, highlighting the need for high-quality, long-term studies to confirm these findings and guide MIH management. Full article