Search Results (9)

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

Background and Objectives: Dental caries is still a dramatic public health problem. The effectiveness of an alternative technique using acidulated phosphate fluoride (APF) gel pH 3.5 was evaluated and compared with conventional treatments in reducing dental caries incidence. Materials and Methods: A double-blind randomized controlled trial was conducted, involving 180 children aged 4–11 years. Three groups were formed: NaF varnish (NaFV), APF in tray (APFt), and APF in toothbrush (APFtbru). Clinical examinations were performed using standardized criteria and the ICDAS Index was assessed. The Caries Treatment Needs Index (CTNI) was calculated. Dental examinations were conducted at baseline, 12 months, and 24 months. Results: At baseline, 16,719 dental surfaces were included, with 15,434 surfaces being sound. After 24 months, the Kaplan–Meier analysis showed significant differences between the APFtbru group and the other two groups (p = 0.03). Cox regression analysis revealed that the surfaces treated with NaF varnish had the lowest survival rates (HR = 0.51 95%CI = 0.33/0.81). Occlusal surfaces had the lowest cumulative survival, while other tooth surfaces showed similar performance. Conclusions: The alternative technique of APF gel application with a toothbrush resulted in maintaining dental health over 24 months. This technique can be cost-effective and may offer advantages over traditional fluoride varnish application. Full article

Dentin hypersensitivity is a common disease of the oral cavity, which renders the tooth extremely sensitive to stimuli. These symptoms usually result from the exposure of the dentinal tubules to the external environment. There is a need for a treatment for dentinal hypersensitivity that can overcome the shortcomings of the existing agents. This study thus aimed to assess the therapeutic efficacy of no-ozone cold plasma (NCP), which was developed for safe use in the oral cavity, in conjunction with 1.23% acidulated phosphate fluoride (APF) and hydroxyapatite (HA), which are widely used conventional treatments of hypersensitivity. The fluoride content was evaluated using electron probe micro-analyzer (EPMA) analysis. Moreover, we confirmed the effect of NCP pre-treatment on the dentinal tubule occlusion by APF and HA as follows: scanning electron microscopy and energy dispersive X-ray spectrometry were employed to analyze the exposed dentinal tubules, and the calcium and phosphorus content were measured. Furthermore, an additional experiment was conducted using a metal mesh to analyze the working elements of NCP. All experimental results were analyzed by one-way analysis of variance and then by using the Turkey test as a post hoc test. EPMA analysis confirmed that the fluoride content of the APF and NCP group was significantly higher than that of the APF group (p < 0.001). The fluoride content of the group treated with APF and NCP equipped with a metal mesh was significantly lower than that in the group treated with APF and NCP and the group treated with APF and NCP equipped with a cotton mesh (p < 0.01). Moreover, the group treated with NCP pre-treated with HA and APF exhibited significantly greater dentinal tubule occlusion than the other groups (p < 0.05). The same result was confirmed by calculating the calcium/phosphorus ratio (p < 0.05). Pre-treatment of the enamel and dentin surfaces with plasma improved hypersensitivity by enhancing fluoride deposition with APF and dentinal tubule occlusion with HA. Full article

Sodium monofluorophosphate (Na₂FPO₃, MFP) is mainly used as an ingredient in fluoride-based dentifrices as it has a high safety profile, with one-third of the toxicity of sodium fluoride (NaF), as well as the ability to reach deep into the dentin. The purpose of this study was to assess the prevention of dentin erosion by MFP upon exposure to citric acid, which has a chelating effect, and to compare the effects to those of the conventional acidulated phosphate fluoride (APF) application method. Bovine dentin was used, and four groups were created: (i) APF (9000 ppmF, pH 3.6) 4 min group; (ii) acidulated phosphate MFP (AP-MFP, 9000 ppmF, pH 3.6) 4 min group; (iii) AP-MFP 2 min + APF 2 min (dual) group; and (iv) no fluoride application (control) group. Compared with the conventional APF application method, the application of AP-MFP was shown to significantly reduce substantial defects, mineral loss, and lesion depth; better maintain Vickers hardness; and promote the homogenous aggregation of fine CaF₂ particles to seal the dentin tubules, enhancing acid resistance in their vicinity. The ΔZ value of the AP-MFP group was 2679 ± 290.2 vol% μm, significantly smaller than the APF group’s 3806 ± 257.5 vol% μm (p < 0.01). Thus, AP-MFP-based fluoride application could effectively suppress citric acid-induced demineralization and could become a new, more powerful, and biologically safer professional-care method for preventing acid-induced dentin erosion than the conventional method. Full article

Background: Propolis is a natural resinous substance collected by honeybees, chiefly from buds and the leaves, branches, and bark of trees. Its role as a wound-healing gel has been studied, but the use of a propolis hydrogel in the treatment of dentinal hypersensitivity has not been evaluated. Dentin hypersensitivity (DH) is commonly treated via iontophoresis using fluoridated desensitizers. The aim of the present study was to compare and evaluate the effects of a 10% propolis hydrogel, 2% sodium fluoride (NaF), and 1.23% acidulated phosphate fluoride (APF) when used in conjunction with iontophoresis for the treatment of cervical dentin hypersensitivity (DH). Methods: Systemically healthy patients complaining of DH were selected for this single-centre, parallel, double-blind randomized clinical trial. Three substances were selected as desensitizers for study in the present trial: a 10% propolis hydrogel, 2% sodium fluoride, and 1.23% acidulated phosphate fluoride, all in conjunction with iontophoresis. Any decrease in DH following the application of specific stimuli was assessed at baseline, before and after application, on the 14th day following use, and on the 28th day following the intervention. Results: Intra-group comparisons show diminished values of DH at maximum post-op follow-up intervals which were significantly trimmed down from the baseline (p < 0.05). The 2% NaF demonstrated a significant reduction in DH over 1.23% APF and the 10% propolis hydrogel (p < 0.05). However, there was no statistically significant difference in the mean difference between the APF and propolis hydrogel groups assessed via tactile, cold, and air tests (p > 0.05). Conclusion: All three desensitizers have proved to be useful when used in conjugation with iontophoresis. Within the limitations of this study, a 10% propolis hydrogel can be used as a naturally occurring alternative to commercially available fluoridated desensitizers. Full article

There is no established method for optimizing the use of dentin to prevent root caries, which are increasing in the elderly population. This study aimed to develop a new approach for root caries prevention by focusing on bioapatite (BioHap), a new biomaterial, combined with fluoride. Bovine dentin was used as a sample, and an acid challenge was performed in three groups: no fluoride (control group), acidulated phosphate fluoride treatment (APF group), and BioHap + APF treatment (BioHap group). After applying the new compound, the acid resistance of dentin was compared with that of APF alone. The BioHap group had fewer defects and an increased surface hardness than the APF group. The BioHap group had the smallest lesion depth and least mineral loss among all groups. Using a scanning electron microscope in the BioHap group showed the closure of dentinal tubules and a coating on the surface. The BioHap group maintained a coating and had higher acid resistance than the APF group. The coating prevents acid penetration, and the small particle size of BioHap and its excellent reactivity with fluoride are thought to have contributed to the improvement of acid resistance in dentin. Topical fluoride application using BioHap protects against root caries. Full article

Sodium monofluorophosphate (MFP) is a component of fluoride-containing dentifrices and is more biosafe than the conventional sodium fluoride (NaF). MFP can respond not only on the tooth surface layer but also deep into the enamel. We aim to confirm that high concentrations of acid phosphate MFP (AP-MFP, 9000 ppmF), used in professional care, could lead to a highly biosafe fluoride application method that acts through the deep enamel layers. Sample groups were respectively treated in vitro with NaF, acidulated phosphate fluoride (APF), MFP, and AP-MFP, and the samples were compared against an untreated group. Characterizations after fluoride application confirmed that MFP and AP-MFP treatments improved the acid resistance of enamel compared to that of conventional methods. Furthermore, the acid resistance of highly concentrated MFPs improved by using phosphoric acid. Although the acid resistance from the AP-MFP method is not as good as that using APF, AP-MFP can act both on the surface layer and deep into the enamel. Moreover, AP-MFP retains fluoride ions as much as APF does on the tooth surface. The proposed fluoride application method using AP-MFP introduces a dental treatment for acid resistance that is highly biosafe and penetrates deep layers of the enamel. Full article

The effect of Fluorine solutions on the surface and bacterial adhesion of lithium disilicate is a concern. The aim was to evaluate the surface roughness and the adhesion of Streptococcus sanguinis on lithium disilicate ceramic, under the influence of different solutions containing Fluorine. Forty lithium disilicate (IPS e.max Press Impulse) discs (2.5 × 5 mm) was divided into 4 groups (n = 10): artificial saliva (Group AS), 0.2% sodium fluoride (Group NaF), 1.23% acidulated phosphate fluoride gel (Group APF), and mouthwash (Group MW). Roughness analyses were performed before and after the immersion. The surface aspect was evaluated by scanning electron microscopy (SEM) and the adhesion of Streptococcus sanguinis were evaluated after immersion in the solutions. The data obtained were submitted to the analysis of variance (ANOVA) and the Tukey test (α = 0.05). The Group APF presented a bigger roughness (3.263), statistically different to the other solutions. The bacterial adhesion in the Group APF (5.85) presented statistical difference to the other solutions. The SEM micrographs showed a rougher surface in Group APF. The 1.23% APF gel promoted major surface roughness and bacterial adhesion and could be inadequate for the use of patients with lithium disilicate ceramic restorations. Clinical significance: The Fluorine solution can affect the lithium disilicate ceramics, generating a rough and non-esthetic surface. This altered surface could be susceptible to bacterial adhesion, being directly related with periodontal health, the longevity of the restoration and the success of the rehabilitation. Full article

This in vitro study evaluated the compositional, crystalline, and morphological effects promoted by Nd:YAG laser on root dentin, and verified the effects of laser and topical acidulated phosphate fluoride application (APF-gel) on dentin erosion. 180 bovine dentin slabs were randomized into 4 groups (n = 45): G1–untreated, G2–APF-gel (1.23% F⁻, 4 min), G3–Nd:YAG (1064 nm, 84.9 J/cm², 10 Hz), and G4–APF-gel application followed by Nd:YAG laser irradiation. The compositional, crystalline, and morphological effects promoted by treatments were investigated on five samples of each experimental group. The other samples were submitted to a 5-day, 10-day, or 15-day erosive and abrasive demineralization and remineralization cycling in order to create erosion lesions. The area and depth of lesions, as well as the optical attenuation coefficient, were assessed, and all data were statistically analysed (p < 0.05). Nd:YAG laser promoted the reduction of carbonate, the formation of tetracalcium phosphate, as well as the melting and recrystallization of the dentin surface. Laser significantly decreased the area and depth of erosion lesions and altered the optical attenuation coefficient when compared to untreated and APF-gel groups, but the association of APF-gel and laser did not promote an additional effect. Nd:YAG laser irradiation can be a promissory treatment to prevent dentin erosion and the abrasion process. Full article