Search Results (150)

Isotopic investigations focused on determining the mobility and provenance of ancient human civilizations and sourcing of archeological artifacts continue to gain prominence in archeology. Most studies focus on the premise that the geographic variation in isotope systems of interest (e.g., Sr, Pb, Nd, O) in the natural environment is recorded in both human hard tissues of local individuals and raw materials sourced for artifacts within the same region. The introduction of multi-collection–inductively coupled plasma mass spectrometry (MC-ICP-MS) and laser ablation systems are techniques that consume smaller sample sizes compared to previous mass spectrometric approaches due to their higher ionization efficiency and increased sensitivity. This development has facilitated the isotopic measurement of trace elements present at low abundances (e.g., Pb, Nd, <1-to-low ppm range) particularly in human tooth enamel. Accurate interpretation of any isotope ratio measurement for the proveniencing of such low-abundance samples requires the adequate evaluation of post-mortem diagenetic alteration. A synopsis of practices currently in use for identifying post-mortem alteration in human archeological samples is discussed here. Post-mortem shifts in radiogenic isotope signatures resulting from secondary alteration are distinct from those potentially related to the impact of climate change on the bioavailable budgets for these elements. This topic is of interest to the archeological community and discussed here in the context of Holocene-aged samples from burial sites within the Nile River Valley System, and preferred dust source areas from the neighboring Sahara Desert. Full article

Background/Objectives: In-office bleaching commonly employs high concentrations of hydrogen peroxide (HP) or carbamide peroxide (CP), which may compromise enamel integrity. This in vitro paired-design study aimed to compare the chemical and mechanical effects of three commercial bleaching agents—Opalescence Boost (40% HP), Opalescence Quick (45% CP), and BlancOne Ultra+ (35% HP)—on human enamel. The null hypothesis assumed no significant differences between the control and treated samples. Given the ongoing debate over pH, active ingredients, and enamel impact, comparing whitening systems remains clinically important. Methods: Forty-two extracted teeth were assigned to three experimental groups (n = 14) with matched controls. Each underwent a single bleaching session per manufacturer protocol: Opalescence Boost (≤60 min), Opalescence Quick (15–30 min), and BlancOne Ultra+ (three light-activated cycles of 8–10 min). Enamel chemical changes were analyzed by Fourier transform infrared (FTIR) spectroscopy (phosphate and carbonate bands), and surface hardness by Vickers microhardness testing. Paired t-tests (α = 0.05) assessed statistical significance. Results: FTIR analysis revealed alterations in phosphate and carbonate bands for all agents, most notably for Opalescence Boost and BlancOne Ultra+. Microhardness testing showed significant reductions in enamel hardness for Opalescence Boost (control: 37.21 ± 1.74 Hv; treated: 34.63 ± 1.70 Hv; p = 0.00) and Opalescence Quick (control: 45.82 ± 1.71 Hv; treated: 39.34 ± 1.94 Hv; p < 0.0001), whereas BlancOne Ultra+ showed no significant difference (control: 51.64 ± 1.59 HV; treated: 51.60 ± 2.34 Hv; p = 0.95). Conclusions: HP-based agents, particularly at higher concentrations, caused greater enamel alterations than CP-based products. While clinically relevant, the results should be interpreted cautiously due to in vitro limitations and natural enamel variability. Full article

Background: Dental enamel demineralization is a critical early event in the development of dental caries. To address this, bioactive compounds have been explored for their potential to mitigate enamel demineralization and promote remineralization. Previous studies have demonstrated that varnishes containing natural compounds such as trans,trans-farnesol (tt-farnesol), quercetin, and theobromine exhibit antimicrobial activity, suggesting potential in caries prevention. Thus, this laboratory study assessed the ability of these varnishes to prevent enamel caries lesion formation by using a chemical model to determine whether these natural compounds interfered with de- and remineralization processes in the absence of a cariogenic biofilm. Methods: Sixty bovine enamel specimens, each measuring 5 × 5 × 2 mm, were selected according to their initial surface hardness (SHI), measured by Knoop hardness in three indentations spaced 100 µm apart. The specimens were allocated to the following groups in a random manner (n = 15): an experimental varnish without compounds (NC/negative control); experimental varnishes containing the combination of tt-farnesol, quercetin, and theobromine at concentrations of 1.5% (E1) and 4.5% (E2); and Duraphat™ (NaF 5%/gold standard—D). After applying the varnishes, they remained in artificial saliva for 6 h. The specimens were then subjected to 8 pH cycles, including 4 h of demineralization and 20 h of remineralization. Surface hardness was measured again to calculate the percentage of surface hardness loss (%SHL), and three specimens from each group were examined using scanning electron microscopy. Comparisons were made using ANOVA (p < 0.05). Results: The D group (5% NaF) demonstrated a significantly lower %SHL (75.5% ± 7.88) than the other groups (p < 0.05). E1 (86.3% ± 5.33) was statistically similar to NC (81.8% ± 4) but lower than E2. E2 showed the highest %SHL (91.6% ± 3.64) compared to the other groups. Surface demineralization was evident in all specimens post pH cycling. Conclusion: The bioactive varnishes containing tt-farnesol, quercetin, and theobromine at concentrations of 1.5% and 4.5% did not exhibit a protective effect against mineral loss in dental enamel in the absence of a cariogenic biofilm. Full article

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article

Objectives: The aim of this study was to compare the hardness, chemical composition, and microstructure of various self-ligating ceramic orthodontic brackets and enamel. Methods: Sixty ceramic brackets (0.022″ × 0.028″) from six different orthodontic firms (Damon^® Clear 2, Genius^® Crystal, Empower^® 2 Clear, Clarity^® Ultra, Alpine SL^® Clear, and Experience Ceramic^®) were tested using a microhardness tester and a scanning electron microscope (SEM) equipped with energy-dispersive spectroscopy (EDS). Results: The hardness of the ceramic brackets ranged from 1969.8 to 2567.3 VH. The statistical analysis using the Kruskal–Wallis and Mann–Whitney tests revealed significant differences in microhardness between most of the ceramic brackets. Additionally, this study found that passive self-ligating brackets exhibited a significantly higher hardness than that of active self-ligating brackets (p = 0.01). The SEM analysis showed that the variations in the oxygen and alumina composition between the six bracket types were also statistically significant (p = 0.01). Conclusions: Among all of the ceramic brackets tested, Alpine^® brackets displayed the lowest hardness values, making them a potential choice for minimizing enamel damage. Notably, the hardness of self-ligating ceramic brackets was found to be at least six times greater than that of enamel, raising concerns about their potential to cause trauma to the enamel of antagonistic teeth. Consequently, the researchers recommend avoiding bonding ceramic brackets to the mandibular teeth or elevating occlusion with turbo-bites to prevent traumatic contact during treatment. Full article

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

Multi-principal element alloys (MPEAs) exhibit distinct characteristics compared to conventional single-principal element-based metallic materials, primarily due to their unique design, resulting in intricate microstructural features. Currently, a comprehensive understanding of the fabrication processes, compositional design, and microstructural influence on the tribological and corrosion behavior of multi-component alloys remains limited. While the hardness of MPEAs generally correlates positively with wear resistance, with higher hardness typically associated with improved wear resistance and reduced wear rates, quantitative relationships between these properties are not well established. In this study, the Al₁₀Cr₁₇Fe₂₀NiV₄ alloy was selected as a model system. A homogeneous Al₁₀Cr₁₇Fe₂₀NiV₄ alloy was successfully synthesized via mechanical alloying followed by spark plasma sintering (SPS). To further investigate the correlation between hardness and wear rate, varying concentrations of alumina nanoparticles were incorporated into the alloy matrix as a reinforcing phase. The results revealed that the Al₁₀Cr₁₇Fe₂₀NiV₄ alloy exhibited a single-phase face-centered cubic (FCC) structure, which was maintained with the addition of alumina nanoparticles. The hardness of the Al₁₀Cr₁₇Fe₂₀NiV₄ alloy without nano-alumina was 727 HV, with a corresponding wear rate of 2.9 × 10⁻⁴ mm³·N⁻¹·m⁻¹. The incorporation of nano-alumina increased the hardness to 823 HV, and significantly reduced the wear rate to 1.6 × 10⁻⁴ mm³·N⁻¹·m⁻¹, representing a 45% reduction. The Al₂O₃ nanoparticles effectively mitigated alloy wear through crack passivation and matrix strengthening; however, excessive addition reversed this effect due to the agglomeration-induced brittleness and thermal mismatch. The quantitative relationship between hardness (HV) and wear rate (W) was determined as W = 2348 e^(−0.006HV). Such carefully bounded empirical relationships, as demonstrated in studies of cold-formed materials and dental enamel, remain valuable tools in applied research when accompanied by explicit scope limitations. Full article

This in vitro study evaluated the effects of incorporating quercetin (QC) at varying concentrations (0.25%, 0.5%, and 1%) into a 35% hydrogen peroxide (H₂O₂) bleaching gel on esthetic outcomes, enamel hardness and roughness, and H₂O₂ transamelodentinal diffusion. Bovine enamel/dentin discs (n = 180; 12/per group for each analysis) were allocated into five groups: (1) negative control (NC), (2) 35% H₂O₂ (HP), (3) HP + 0.25% QC, (4) HP + 0.5% QC, and (5) HP + 1% QC. Treatments were applied for 40 min per session across three sessions with 7-day intervals. Color changes were evaluated using the CIELab* color system (ΔE_ab), with further analysis performed using the CIEDE2000 formula (ΔE₀₀) and the whitening index (ΔWI_D). Enamel surface hardness, roughness, cross-sectional hardness, and H₂O₂ diffusion were also evaluated. Data were analyzed using ANOVA, followed by the Student–Newman–Keuls test, with statistical significance set at p < 0.05. All experimental gels resulted in significant color changes (p < 0.001), with similar ΔE_ab, ΔE₀₀, and ΔWI_D across QC groups. The HP group showed greater reductions in hardness and increased roughness compared to others (p < 0.0001), while the HP/1%QC group resulted in no statistically significant alterations under the tested conditions. H₂O₂ diffusion was significantly greater in the HP group, while it was notably lower in the HP/1%QC group (p < 0.05). The incorporation of 1% quercetin into a 35% H₂O₂ gel maintains its bleaching efficacy while protecting enamel properties and reducing hydrogen peroxide diffusion. Quercetin-enriched H₂O₂ gels may enhance bleaching safety by protecting dental tissues while maintaining esthetic benefits. Full article

Minimizing the risk of secondary caries in dentistry is achieved by using adhesive systems that provide a strong bond between the natural hard tissue and the restorative material. Evaluating the effectiveness of these systems requires studying both their interaction with dentin and enamel and their behavior in environments with varying acidity. In this work, the interaction of a reactive monomer, 4-methacryloxyethyl trimellitic anhydride (4-META), used in adhesive systems with both dentin-like hydroxyapatite (HA) and hydroxyapatite ceramics, was investigated. Kinetic studies showed that under experimental conditions, 4-META was hydrolyzed and amorphized. Dentin-like HA possessed greater adsorption capacity to 4-META than ceramic HA. Immersion of HA into a solution of 4-META led to formation of an acidic calcium phosphate phase over time in both systems. Studies on the solubility of the synthetic nanosized hydroxyapatite and its derivative with 4-META in 0.1 mol/L lactic acid, also containing CaCl₂, Na₂HPO₄, and NaF (pH 4.5), and in distilled water (pH 6.3) indicated the occurrence of dissolution, complexation, and crystallization processes, causing changes in the liquid and solid phases. The total Ca²⁺ concentration upon dissolution of hybrid HA-4-META in a lactic acid solution was three times lower than the total Ca²⁺ concentration upon dissolution of pure HA. This suggested that 4-META-treated dentin-like surfaces demonstrate greater resistance to dissolution in acidic environments compared to untreated surfaces, highlighting the potential for these hybrids in dental applications. 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

Outdoor stone relics, including inscriptions, statues, temple grottoes, etc., are continuously subjected to natural weathering and air pollutants. Those made of marbles and other carbonate rocks are particularly vulnerable to acid rains, which can be protected by acid-resistant coatings. A novel method to prepare enamel-like hydroxyapatite coating on marble surfaces is presented in this paper and analyzed using optical microscopy, a scanning electronic microscope, grazing incident X-ray diffraction, and nano-indentation. The described coating is composed of tightly arranged hydroxyapatite nanorods, perpendicular to the marble substrate, with a thickness of 3–5 μm. Not only does the coating exhibit high acid resistance, it also has considerably higher elastic modulus and hardness compared to that synthesized by the well-known diammonium phosphate (DAP) method owing to the wellarranged microstructure. Consequently, the enamel-like hydroxyapatite coating would probably be more effective and durable for marble protection than the existing calcium phosphate coating. Full article

Hybrid ceramics exhibit low wear on antagonist tooth enamel, which may positively impact the oral rehabilitation of head-and-neck irradiated patients who experience alterations in tooth microstructure and wear resistance. This study aimed to evaluate the wear resistance of hybrid ceramics after gamma radiation exposure in contact with irradiated tooth enamel, as well as their mechanical and chemical properties. Notably, no previous studies focusing on the effects of radiation on hybrid ceramics were found in the literature. Vita Enamic discs and tooth fragments were subjected to daily doses of 2 Gy, totaling 0, 20, 40, 50, 60, and 70 Gy. The wear resistance of hybrid ceramics and a ceramic enamel analog (steatite) was tested against tooth enamel using a chewing simulation machine. Hybrid ceramic specimens underwent hardness, biaxial flexural strength, roughness, and FT-IR analyses. The data were analyzed using an ANOVA and Tukey’s test (α = 0.05). Enamic exposed to 60 and 70 Gy exhibited higher wear and caused less tooth enamel loss compared to steatite. The mechanical and chemical properties remained unchanged after irradiation. The roughness decreased across all groups after a chewing simulation but was not affected by irradiation. In conclusion, ionizing radiation did not alter the material’s properties but increased its wear. Full article

Chronic kidney disease (CKD) is an extremely widespread pathology characterized by numerous metabolic alterations, including impairments of calcium–phosphorus and of vitamin D metabolisms, which lead to a condition known as CKD–mineral and bone disorders (CKD-MBDs). In CKD children, this pathological condition induces anomalies in physiological growth processes, alterations in bone morphology, renal osteodystrophy and rickets. CKD-MBDs are not only associated with systemic complications but also show dental and maxillofacial manifestations in children. In fact, children affected by CKD-MBDs present defects in enamel development and dental anomalies when compared to healthy children. Therefore, the aims of this narrative review are to focus on the hard dental tissues and to investigate the possible correlation between the CKD-MBDs in children and the presence of developmental defects of enamel. In addition, the possible risk and protective factors of dental caries in CKD pediatric patients are analyzed. The review describes, with a multidisciplinary nephrological–dental approach, the pathogenic mechanisms that can cause anomalies in dental structure in CKD pediatric patients. Full article

This study investigates the microstructure of dental enamel following demineralization and re-mineralization processes, using DIAGNOdent scores and images obtained via scanning electron microscopy (SEM), atomic force microscopy (AFM), and microhardness (Vickers). The research evaluates the effects of two experimental hydrogels, Anti-Amelogenin isoform X (ABT260, S1) and Anti-Kallikrein L1 (K3014, S2), applied to demineralized enamel surfaces over periods of 14 and 21 days. The study involved 60 extracted teeth, free from cavities or other lesions, divided into four groups: a positive group (+), a negative group (−) and groups S1 and S2. The last three groups underwent demineralization with 37% phosphoric acid for 20 min. The negative group (−) was without remineralization treatment. The DIAGNOdent scores indicate that the S1 group treated with Anti-Amelogenin is more effective in remineralizing the enamel surface compared to the S2 group treated with Anti-Kallikrein. These findings were corroborated by SEM and AFM images, which revealed elongated hydroxyapatite (HAP) nanoparticles integrated into the demineralized structures. Demineralization reduced enamel microhardness to about 1/3 of a healthy one. Both tested hydrogels restored enamel hardness, with S1 being more effective than S2. Both peptides facilitated the interaction between the newly added minerals and residual protein binders on the enamel surface, thereby contributing to effective enamel restoration. Full article

Objectives: Among modern metal-free materials, zirconia, a high-performance ceramic material that can only be manufactured through CAM procedures, has certainly exponentially gained popularity thanks to its mechanical strength, biocompatibility, esthetic, and versatility. However, one of the main debates that has been raised in relation to zirconia is its usage as an adhesive material. The present case report describes the clinical outcome of a multidisciplinary case finalized with adhesive minimally invasive zirconia veneers for the treatment of discolored teeth after a 24-month follow-up. Methods: A 19-year-old female patient with discolored upper frontal teeth (first premolar to first premolar) negatively affecting her self-esteem and social life was visited by a prosthodontic specialist. The treatment plan included orthodontic treatment, soft and hard tissue management through surgical procedures, and, lastly, minimally invasive adhesive zirconia veneers. The zirconia veneers bonding was performed under a rubber dam by conditioning the dental substrate by sandblasting the enamel with 40-micron aluminum oxide, etching with orthophosphoric acid 37%, and using a proper adhesive system. Monolithic zirconia restorations were sandblasted with 70-micron aluminum oxide at 0.2 MPa, then cleaned with a specific cleaner, and treated with a primer. Results: At the last follow-up (24 months), neither biological nor mechanical complications were observed. The patient anecdotally reported being very satisfied with the functional and esthetic results obtained. Therefore, the case was considered successful. Conclusions: Within the limitations of the present case report, the reported case on the use of minimally invasive resin-bonded zirconia veneers for the treatment of discolored teeth showed excellent outcomes after a 24-month follow-up. The use of zirconia as an adhesive material seems to be emerging. However, more clinical studies are required to validate the procedure. Full article