Efficacy of a mouthwash containing 0.8% arginine,PVM/MA copolymer,pyrophosphates, and 0.05% sodium fluoride compared to a commercial mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride and a control mouthwash containing 0.05% sodium fluoride on dentine hypersensitivity: A six-week randomized clinical study

ObjectiveEvaluate the efficacy of 0.8% arginine, potassium nitrate and sodium fluoride mouthwashes on dentine hypersensitivity reduction.MethodsSix week randomized, double blinded, two cell, parallel single centre clinical study in the Dominican Republic; subjects were randomized into three treatment groups: mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (arginine); mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride (potassium nitrate); a control mouthwash containing 0.05% sodium fluoride (negative control). Tactile and air-blast dentine hypersensitivity assessments were conducted at baseline, thirty minutes post rinsing and two, four, and six weeks of twice-daily product use. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise comparisons (α = 0.05) were done.ResultsSeventy-five subjects were enrolled; 69 subjects completed the study. There were no differences after thirty minutes of a single use, among the three groups with respect to mean tactile and air blast hypersensitivity scores compared to potassium nitrate and negative control mouthwashes (p < 0.05). The arginine group presented a statistically significant improvement in the mean tactile scores compared to potassium nitrate and negative control groups after two, four, and six weeks (p < 0.001) of product use; the arginine group showed a statistically significant enhancement in air blast hypersensitivity mean scores compared to potassium nitrate and negative control groups after two (p = 0.001), four (p < 0.001), and six weeks (p < 0.001) of product use.ConclusionA mouthwash containing arginine provides a significant and superior reduction in dentine hypersensitivity compared to potassium nitrate and a negative control mouthwash after two weeks.     

Efficacy of a mouthwash containing 0.8% arginine,PVM/MA copolymer,pyrophosphates, and 0.05% sodium fluoride compared to a negative control mouthwash on dentin hypersensitivity reduction. A randomized clinical trial

ObjectiveThe objective of this eight week, single-center, two-cell, double-blind, and randomized clinical study was to evaluate the dentin hypersensitivity reduction efficacy of a mouthwash using Pro-Argin? Mouthwash Technology containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (“Arginine Mouthwash”) compared to an ordinary mouthwash without any active ingredients (“Negative Control”).MethodsQualifying subjects who presented two hypersensitive teeth with a tactile hypersensitivity score between 10 and 50 g of force, and an air blast hypersensitivity score of 2 or 3 participated in this study and were randomized into one of two treatment groups. Subjects brushed with the toothbrush and fluoride toothpaste provided and then rinsed with 20 mL of their assigned mouthwash for 30 s twice daily. Subjects refrained from eating or drinking for 30 min after rinsing. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at the baseline visit and again after two weeks, four weeks and eight weeks of product use.ResultsNinety (90) subjects entered and completed the eight week study. After two weeks, four weeks and eight weeks of product use, subjects in the Arginine Mouthwash group exhibited statistically significant (p < 0.05) improvements in mean tactile and air blast hypersensitivity scores as compared to the Negative Control Mouthwash.ConclusionThe results of this study support the conclusion that the Arginine Mouthwash provides a significant reduction in dentin hypersensitivity after eight weeks of product use as compared to a Negative Control mouthwash.     

A practice-based randomised controlled trial of the efficacy of three interventions to reduce dentinal hypersensitivity

ObjectivesThe aim of this study was to evaluate the efficacy of three different interventions (non-desensitising toothpaste, desensitising toothpaste and professionally applied dentine bonding agent) in reducing dentinal hypersensitivity over a 2-week, 3-month and 6-month-period in a dental practice setting.MethodsThis was a randomised controlled, single-blind; parallel-group trial conducted in general dental practice by a single general dental practitioner. Seventy-five subjects were randomly allocated to three groups; non-desensitising toothpaste (NDT), desensitising toothpaste (DT) and professionally applied desensitising agent (DA). Dentinal hypersensitivity was measured using a Visual Analogue Scale (VAS) to record the response from a standardised short blast of air from a triple syringe. Dentinal hypersensitivity was recorded at baseline, two weeks, three months and six months for all groups.ResultsDentinal hypersensitivity reduced significantly (p < 0.0001) in both groups DT and DA, in addition the reduction in sensitivity was sustained and continued to improve over a 6-month-period. The greatest reduction in dentinal hypersensitivity was recorded in group DA.ConclusionsThe results from this study suggest that application of dentine bonding agents, to teeth diagnosed with dentine hypersensitivity provides the greatest improvement in dentine hypersensitivity at 2 weeks and 6 months. This reduction in dentine hypersensitivity is greater than that achieved by the desensitising toothpaste tested and a non-desensitising toothpaste.     

Mode of action studies of a new desensitizing mouthwash containing 0.8% arginine,PVM/MA copolymer,pyrophosphates, and 0.05% sodium fluoride

ObjectiveThe mode of action of an arginine mouthwash using the Pro-Argin? Mouthwash Technology, containing 0.8% arginine, PVM/MA copolymer, pyrophosphates and 0.05% sodium fluoride, has been proposed and confirmed as occlusion using a variety of in vitro techniques.MethodsQuantitative and qualitative laboratory techniques were employed to investigate the mode of action of the new arginine mouthwash. Confocal laser scanning microscopy (CSLM) and atomic force microscopy (AFM) investigated a hydrated layer on dentine surface. Electron spectroscopy for chemical analysis (ESCA), secondary ion mass spectroscopy (SIMS) and near-infrared spectroscopy (NIR) provided information about its chemical nature.ResultsCLSM was used to observe the formation of a hydrated layer on exposed dentine tubules upon application of the arginine mouthwash. Fluorescence studies confirmed penetration of the hydrated layer in the inner walls of the dentinal tubules. The AFM investigation confirmed the affinity of the arginine mouthwash for the dentine surface, supporting its adhesive nature. NIR showed the deposition of arginine after several mouthwash applications, and ESCA/SIMS detected the presence of phosphate groups and organic acid groups, indicating the deposition of copolymer and pyrophosphates along with arginine.ConclusionThe studies presented in this paper support occlusion of the dentine surface upon the deposition of an arginine-rich layer together with copolymer and phosphate ions from an alcohol-free mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates and 0.05% sodium fluoride.     

In vitro dentine remineralization with a potential salivary phosphoprotein homologue

ObjectiveAdvantages of introducing a salivary phosphoprotein homologue under standardized in vitro conditions to simulate the mineral-stabilizing properties of saliva have been proposed. This study longitudinally investigates the effects of casein, incorporated as a potential salivary phosphoprotein homologue in artificial saliva (AS) solutions with/without fluoride (F) on in vitro dentine lesion remineralization.DesignThin sections of bovine root dentine were demineralized and allocated randomly into 6 groups (n = 18) having equivalent mineral loss (ΔZ) after transverse microradiography (TMR). The specimens were remineralized using AS solutions containing casein 0 μg/ml, F 0 ppm (C₀–F₀); casein 0 μg/ml, F 1 ppm (C₀–F₁); casein 10 μg/ml, F 0 ppm (C₁₀–F₀); casein 10 μg/ml, F 1 ppm (C₁₀–F₁); casein 100 μg/ml, F 0 ppm (C₁₀₀–F₀) or casein 100 μg/ml, F 1 ppm (C₁₀₀–F₁) for 28 days with TMR taken every 7 days.ResultsSurface mineral precipitation, evident in group C₀–F_1, was apparently inhibited in groups with casein incorporation. Repeated measures ANOVA with Bonferroni correction revealed higher ΔZ for non-F and non-casein groups than for their counterparts (p < 0.001). Subsequent multiple comparisons showed that mineral gain was higher (p < 0.001) with 10 μg/ml casein than with 100 μg/ml when F was present in the earlier stages of remineralization, with both groups achieving almost complete remineralization after 28 days.ConclusionCasein is a potential salivary phosphoprotein homologue that could be employed for in vitro dentine remineralization studies. Concentration related effects may be clinically significant and thus must be further examined.     

The effect on dental enamel of varying concentrations of fluoridated milk with a cariogenic challenge in situ

ObjectivesThis study investigated the effect of two concentrations of fluoride in milk, 2.5 and 5.0 ppm, on the prevention of demineralisation with a cariogenic challenge compared with milk with 0 ppm F.MethodsIn a controlled, randomised, cross-over, double-blind in situ study, 23 subjects wore a lower removable appliance with 2 enamel slabs for 21 days during each study arm. Subjects used F-free toothpaste and the cariogenic challenge comprised of five 2 min dippings per day in 12% sucrose. The slabs were dipped in 50 ml of milk with 0 ppm, 2.5 ppm or 5.0 ppm F twice daily for 5 min. Subjects drank 100 ml twice per day of the same milk. Slabs were analysed with Knoop microhardness to assess changes in mineralisation.ResultsResults showed that enamel was softened in all groups but the extent of enamel softness was reduced with an increasing concentration of F in milk, being highly significant for both F groups compared to the control (p < 0.0001). 5.0 ppm F group showed a trend towards less softening compared to the 2.5 ppm F but was not statistically significant.ConclusionsIn our in situ model, 2.5 and 5.0 ppm F in milk significantly protected enamel from demineralisation.     

Effect of fluoride toothpaste with nano-sized trimetaphosphate on enamel demineralization: An in vitro study

ObjectiveThis study evaluated the effect of toothpastes containing 1100 ppm F associated or not with micrometric or nano-sized sodium trimetaphosphate (TMP) on enamel demineralization in vitro, using a pH cycling model.DesignBovine enamel blocks (4 mm × 4 mm, n = 96) were randomly allocated into eight groups (n = 12), according to the test toothpastes: Placebo (without fluoride or TMP); 1100 ppm F (1100F); 1100F plus micrometric TMP at concentrations of 1%, 3% or 6%; and 1100F plus nanosized TMP at 1%, 3% or 6%. Blocks were treated 2×/day with slurries of toothpastes and submitted to a pH cycling regimen for five days. Next, final surface hardness (SHf), integrated hardness loss (IHL), differential profile of integrated hardness loss (ΔIHL) and enamel fluoride (F) concentrations were determined. Data were analyzed by ANOVA and Student-Newman-Keuls’ test (p < 0.05).ResultsThe use of 1100F/3%TMPnano led to SHf 30% higher (p < 0.001) and IHL ∼ 80% lower (p < 0.001) when compared to 1100F. This toothpaste also resulted in ∼64% reduction of mineral loss (ΔIHL) when compared to 1100F. Moreover, the addition of nano-sized TMP promoted increases in enamel F uptake of 90%, 160% and 100%, respectively for the concentrations of 1%, 3% and 6%, when compared to 1100F (p < 0.001).ConclusionThe addition of nano-sized TMP at 3% to a conventional toothpaste significantly decreased enamel demineralization when compared to its counterparts without TMP or supplemented with micrometric TMP.     

Frequency of intake and amount of fluoride in milk for remineralisation of artificial caries on enamel and dentine: Ex vivo/in situ study

ObjectivesThis study analysed the effect of frequency of intake and amount of fluoride in milk on the remineralisation of artificial enamel and dentine caries lesions ex vivo/in situ.Materials and methodsPre-demineralised bovine enamel and dentine slabs were randomly allocated into 5 groups and fixed in removable appliances used by subjects for 7 days in each phase. Each treatment comprised milk containing 2.5 ppm fluoride daily (T1), or every other day (T2), 5.0 ppm F daily (T3), or every other day (T4) or no treatment (T5).ResultsEnamel alterations were quantified by surface hardness recovery (%SHR) and transversal microradiography (TMR), and in dentine by TMR only. Data were analysed by ANOVA and Tukey’s test (p < 0.05). For enamel, the highest %SHR was found for T1 and T3 compared to control, without significant differences between them. All groups showed positive values of ΔΔZ − T1 (247.3 ± 198.5); T2 (110.9 ± 303.2); T3 (226.0 ± 299.2); T5 (5.0 ± 288.0), except T4 (−274.5 ± 407.3). For dentine, the only group that presented remineralisation was T2 (350.0 ± 657.5).ConclusionsFluoridated milk daily seems to have higher remineralising effect on enamel than its use every other day. Dentine, does not seem to benefit from daily use of fluoridated milk.     

Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children

ObjectiveTo compare the effectiveness of annual topical application of silver diamine fluoride (SDF) solution, semi-annual topical application of SDF solution, and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth.MethodsA total of 212 children, aged 3–4 years, were randomly allocated to one of three groups for treatment of carious dentine cavities in their primary teeth: Gp1-annual application of SDF, Gp2-semi-annual application of SDF, and Gp3-annual application of glass ionomer. Follow-up examinations were carried out every six months to assess whether the treated caries lesions had become arrested.ResultsAfter 24 months, 181 (85%) children remained in the study. The caries arrest rates were 79%, 91% and 82% for Gp1, Gp2 and Gp3, respectively (p = 0.007). In the logistic regression model using GEE to adjust for clustering effect, higher caries arrest rates were found in lesions treated in Gp2 (OR = 2.98, p = 0.007), those in anterior teeth (OR = 5.55, p < 0.001), and those in buccal/lingual smooth surfaces (OR = 15.6, p = 0.004).ConclusionAnnual application of either SDF solution or high fluoride-releasing glass ionomer can arrest active dentine caries. Increasing the frequency of application to every 6 months can increase the caries arrest rate of SDF application.Clinical significanceArrest of active dentine caries in primary teeth by topical application of SDF solution can be enhanced by increasing the frequency of application from annually to every 6 months, whereas annual paint-on of a flowable glass ionomer can also arrest active dentine caries and may provide a more aesthetic outcome.     

Sodium fluoride effect on erosion–abrasion under hyposalivatory simulating conditions

ObjectivesTo investigate the effect of fluoride (0, 275 and 1250 ppm F; NaF) in combination with normal and low salivary flow rates on enamel surface loss and fluoride uptake using an erosion–remineralization–abrasion cycling model.DesignEnamel specimens were randomly assigned to 6 experimental groups (n = 8). Specimens were individually placed in custom made devices, creating a sealed chamber on the enamel surface, connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min followed by artificial saliva at 0.5 (normal flow) or 0.05 (low flow) ml/min, for 60 min. This cycle was repeated 4×/day, for 5 days. Toothbrushing with abrasive suspensions containing fluoride was performed for 2 min (15 s of actual brushing) 2×/day. Surface loss was measured by optical profilometry. KOH-soluble fluoride and enamel fluoride uptake were determined after the cycling phase. Data were analysed by two-way ANOVA.ResultsNo significant interactions between fluoride concentration and salivary flow were observed for any tested variable. Low caused more surface loss than normal flow rate (p < 0.01). At both flow rates, surface loss for 0 was higher than for 275, which did not differ from 1250 ppm F. KOH-soluble and structurally-bound enamel fluoride uptake were significantly different between fluoride concentrations with 1250 > 275 > 0 ppm F (p < 0.01).ConclusionsSodium fluoride reduced enamel erosion/abrasion, although no additional protection was provided by the higher concentration. Higher erosion progression was observed in low salivary flow rates. Fluoride was not able to compensate for the differences in surface loss between flow rates.     

Comparative effect of a stannous fluoride toothpaste and a sodium fluoride toothpaste on a multispecies biofilm

ObjectivesThis paper aimed to compare the mode of action of a stannous fluoride-containing toothpaste with a conventional sodium fluoride-containing toothpaste on anti-biofilm properties.MethodsA three-species biofilm model that consists of Streptococcus mutans, Streptococcus sanguinis and Porphyromonas gingivalis was established to compare the anti-biofilm properties of a stannous fluoride-containing toothpaste (CPH), a conventional sodium fluoride-containing toothpaste (CCP) and a negative control (PBS). The 48 h biofilms were subjected to two-minute episodes of treatment with test agents twice a day for 5 consecutive days. Crystal violet staining and XTT assays were used to evaluate the biomass and viability of the treated biofilm. Live/dead staining and bacteria/extracellular polysaccharides (EPS) double-staining were used to visualize the biofilm structure and to quantify microbial/extracellular components of the treated biofilms. Species-specific fluorescent in situ hybridization and quantitative polymerase chain reaction (qPCR) were used to analyze microbial composition of the biofilms after treatment.ResultsThe biomass and viability of the biofilms were significantly reduced after CPH toothpaste treatment. The inhibitory effect was further confirmed by the live/dead staining. The EPS amounts of the three-species biofilm were significantly reduced by CCP and CPH treatments, and CPH toothpaste demonstrated significant inhibition on EPS production. More importantly, CPH toothpaste significantly suppressed S. mutans and P. gingvalis, and enriched S. sanguinis in the three-species biofilm. In all experiments CPH had a significantly greater effect than CCP (p < 0.05) and CCP had a greater effect than PBS (p < 0.05).ConclusionsStannous fluoride-containing toothpaste not only showed better inhibitory effect against oral microbial biofilm, but was also able to modulate microbial composition within multi-species biofilm compared with conventional sodium fluoride-containing toothpaste.     

The development of a new desensitising mouthwash containing arginine,PVM/MA copolymer,pyrophosphates, and sodium fluoride—A hydraulic conductance study

ObjectiveTo investigate the ability of a novel mouthwash comprised of 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (Pro-Argin? Mouthwash Technology) to reduce dentine permeability.MethodsHydraulic conductance was used to assess the dentine permeability effects of the arginine mouthwash. Aqueous solutions containing arginine and PVM/MA copolymer were studied in the initial stage of the method development. The acid resistance was tested with a cola drink challenge. Finally, a blinded study was carried out to determine the occlusion of the arginine mouthwash in comparison to a negative control mouthwash.ResultsDentine discs treated with the arginine mouthwash showed an average fluid reduction of 42%, which was statistically, significantly better than the fluid reduction for the negative control mouthwash. In addition, experiments using simple solutions of arginine and PVM/MA copolymer, alone and in combination, demonstrated that the combination of the two was required to provide a relevant occlusion benefit. Finally, the occlusion provided by the arginine mouthwash was maintained after exposure to an acid challenge.ConclusionThe exclusive combination of ingredients in the arginine mouthwash has been proven to be efficacious in decreasing dentine fluid flow as measured by hydraulic conductance. The new mouthwash works by occlusion, due to the unique combination of arginine, PVM/MA copolymer and pyrophosphates.     

Combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine

ObjectiveThis study evaluated the combined effect of fluoride varnish to Er:YAG or Nd:YAG laser on permeability of eroded root dentine.DesignSixty slabs of bovine root dentine (2 × 2 × 2 mm) were eroded with citric acid 0.3% (pH 3.2) during 2 h and then kept in artificial saliva during 24 h. Specimens were randomly assigned in 6 groups (n = 10), to receive the following treatments: fluoride varnish; fluoride varnish + Er:YAG laser; fluoride varnish + Nd:YAG laser; non-fluoride varnish; non-fluoride varnish + Er:YAG laser; non-fluoride varnish + Nd:YAG laser. The Er:YAG (100 mJ, 3 Hz) and Nd:YAG (70 mJ, 15 Hz) were applied for 10 s. Specimens were subjected to further erosive challenges with citric acid 0.3% 4×/day, during 1 min, for 5 days, remaining in artificial saliva between cycles. Dentin permeability was then assessed. Two-way ANOVA demonstrated no significant interaction between laser and varnish (p = 0.858).ResultsNo effect was also detected for the main factor varnish (p = 0.768), while permeability of eroded root dentin was significantly lower when such substrate was laser-irradiated, no matter the laser source (p < 0.001).ConclusionsThis study concluded that Er:YAG and Nd:YAG lasers can be employed to control the permeability of eroded root dentin, regardless of fluoride varnish application.     

Effects of heat-inactivated Bifidobacterium BB12 on cariogenicity of Streptococcus mutans in vitro

ObjectiveSince some probiotic bacteria are cariogenic themselves, their suitability for caries management is questionable. Inactivated bacteria or their supernatants have been found to exert probiotic effects, whilst having several advantages compared with living bacteria. We hypothesized that viable and heat-inactivated Bifidobacterium animalis BB12 reduces the cariogenicity of Streptococcus mutans (SM) in vitro.DesignWe assessed mono- and mixed species biofilms of SM and viable or heat-inactivated BB12. Biofilms were grown in a continuous-culture-system under cariogenic conditions on smooth proximal enamel or cavitated dentine. For each of eight experimental subsets (4 biofilms × 2 hard-tissue conditions), a total of 32 specimens was used. After 10 days, bacterial numbers of 12 biofilms per group were analysed, and all specimens submitted to transversal microradiography.ResultsMineral loss was higher in cavitated dentine than smooth enamel for all biofilms (p < 0.001, t-test). BB12-monospecies biofilms induced significantly less mineral loss than SM in both enamel (p < 0.05) and dentine (p < 0.001). Viable BB12 did not significantly reduce cariogenicity of SM (p > 0.05), whilst heat-inactivated BB12 decreased cariogenicity of SM in dentinal cavities (p < 0.01). Bacterial numbers were higher on dentine than enamel (p < 0.05), but not significantly influenced by biofilm species (p > 0.05).ConclusionsHeat-inactivated BB12 reduced the cariogenicity of SM in dentinal cavities in vitro. Inactivated probiotics might be suitable for caries control.     

Effects of dual antibacterial agents MDPB and nano-silver in primer on microcosm biofilm,cytotoxicity and dentine bond properties

ObjectivesThe objective of this study was to investigate the effects of dentine primer containing dual antibacterial agents, namely, 12-methacryloyloxydodecylpyridinium bromide (MDPB) and nanoparticles of silver (NAg), on dentine bond strength, dental plaque microcosm biofilm response, and fibroblast cytotoxicity for the first time.MethodsScotchbond Multi-Purpose (SBMP) was used as the parent bonding agent. Four primers were tested: SBMP primer control (referred to as “P”), P + 5% MDPB, P + 0.05% NAg, and P + 5% MDPB + 0.05% NAg. Dentine shear bond strengths were measured using extracted human teeth. Biofilms from the mixed saliva of 10 donors were cultured to investigate metabolic activity, colony-forming units (CFU), and lactic acid production. Human fibroblast cytotoxicity of the four primers was tested in vitro.ResultsIncorporating MDPB and NAg into primer did not reduce dentine bond strength compared to control (p > 0.1). SEM revealed well-bonded adhesive–dentine interfaces with numerous resin tags. MDPB or NAg each greatly reduced biofilm viability and acid production, compared to control. Dual agents MDPB + NAg had a much stronger effect than either agent alone (p < 0.05), increasing inhibition zone size and reducing metabolic activity, CFU and lactic acid by an order of magnitude, compared to control. There was no difference in cytotoxicity between commercial control and antibacterial primers (p > 0.1).ConclusionsThe method of using dual agents MDPB + NAg in the primer yielded potent antibacterial properties. Hence, this method may be promising to combat residual bacteria in tooth cavity and invading bacteria at the margins. The dual agents MDPB + NAg may have wide applicability to other adhesives, composites, sealants and cements to inhibit biofilms and caries.     

Development and characterisation of dental composites containing anisotropic fluorapatite bundles and rods

ObjectivesTo develop dental composites incorporating fluorapatite (FA) crystals as a secondary filler and to characterise degree of conversion, key mechanical properties and fluoride release.MethodsFA rod-like crystals and bundles were hydrothermally synthesised and characterised by scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS), X-ray diffraction (XRD) and ¹⁹F MAS-NMR. Composites were formulated containing BisGMA/TEGDMA/BisEMA and barium-aluminium-silicate glass (0FA). FA crystals were incorporated at 10 (10FA), 20 (20FA), 30 (30FA) and 40 wt% (40FA) maintaining a filler content of 80 wt% (63–67 vol%). Degree of conversion (DC), flexural strength (FS), flexural modulus (FM), fracture toughness (K_1C), Vickers hardness (HV) and 2-body wear were measured. Fluoride release was measured in neutral and acidic buffers.ResultsXRD and ¹⁹F MAS-NMR confirmed that only FA was formed, whilst SEM revealed the presence of single rods and bundles of nano-rods. DC ranged between 56–60% (p > 0.05). FA composites showed lower FM and lower FS (p < 0.05), but comparable wear resistance and HV (p > 0.05) to 0FA. 30FA and 40FA showed similar K_1C to 0FA (p > 0.05), with SEM showing evidence of toughening mechanisms, whereas 10FA and 20FA showed lower K_1C (p < 0.05). FA containing composites released fluoride that was proportional to the amount of FA incorporated (p < 0.05) but only under acidic conditions.SignificanceThe addition of FA to the experimental composites reduced strength and stiffness but not the DC, hardness or wear rate. 30FA and 40FA had a higher K_1C compared to other FA groups. Fluoride release occurred under an accelerated acidic regime, suggesting potential as a bioactive ‘smart’ composite.     

Measuring the impact of practice-based research networks on member dentists in the Collaboration on Networked Dental and Oral Health Research,CONDOR

ObjectivesThe National Institute of Dental and Craniofacial Research funded three practice-based research networks (PBRNs), NW-PRECEDENT, PEARL and DPBRN to conduct studies relevant to practicing general dentists. These PBRNs collaborated to develop a questionnaire to assess the impact of network participation on changes in practice patterns. This report presents results from the initial administration of the questionnaire.MethodsQuestionnaires were administered to network dentists and a non-network reference group. Practice patterns including caries diagnosis and treatment, pulp cap materials, third molar extraction, dentine hypersensitivity treatments and endodontic treatment and restoration were assessed by network, years in practice, and level of network participation. Test–retest reliability of the questionnaire was evaluated.Results950 practitioners completed the questionnaire. Test–retest reliability was good–excellent (kappa > 0.4) for most questions. Significant differences in responses by network were not observed. The use of caries risk assessment forms differed by both network participation (p < 0.001) and years since dental degree (p = 0.026). Recent dental graduates are more likely to recommend third molar removal for preventive reasons (p = 0.003).ConclusionsPractitioners in the CONDOR research networks are similar to their US colleagues. As a group, however, these practitioners show a more evidence-based approach to their practice. Dental PBRNs have the potential to improve the translation of evidence into daily practice. Designing methods to assess practice change and the associated factors is essential to addressing this important issue.     

Salivary levels of calcium,phosphorus, potassium,albumin and correlation with serum biomarkers in hemodialysis patients

ObjectivesEvidences suggest that hemodialysis patients have reduced salivary flow and changes in the composition of salivary secretion. These changes may reflect local and systemic disorders. The objectives of this study were to compare the salivary levels of calcium (Ca), phosphorus (P), potassium (K) and albumin in hemodialysis patients and healthy subjects, and to investigate a possible correlation between their serum and salivary levels.DesignA case–control study was conducted with 60 hemodialysis patients (HD group) and 37 systemically healthy individuals (control group). Stimulated saliva samples were collected for biochemical analysis (Ca, P, K and albumin). Serum data were collected in the HD group. Statistical analysis included t-test, Pearson correlation and simple linear regression.ResultsThe HD group exhibited higher salivary levels of Ca, P, and albumin (p < 0.05). There was a significant positive correlation between serum PTH and salivary phosphorus (r = 0.342, p = 0.009), and between serum PTH and salivary potassium (r = 0.306, p = 0.020). An increase of 100 pg/dL in serum PTH was associated with an elevation of salivary P levels (0.34 mg/dL, p = 0.009), and salivary K levels (0.20 mmol/dL, p = 0.02), in the HD group.ConclusionsThe findings suggest that HD patients present increased levels of salivary components (Ca, P, and albumin), and changes commonly observed in HD patients, such as hyperparathyroidism, appear to have an influence on salivary composition.     

Novel fluoride rechargeable dental composites containing MgAl and CaAl layered double hydroxide (LDH)

ObjectiveThis study aims to incorporate 2:1 MgAl and 2:1 CaAl layered double hydroxides (LDHs) in experimental dental-composites to render them fluoride rechargeable. The effect of LDH on fluoride absorption and release, and their physico-mechanical properties are investigated.Methods2:1 CaAl and 2:1 MgAl LDH-composite discs prepared with 0, 10 and 30 wt% LDH were charged with fluoride (48 h) and transferred to deionized water (DW)/artificial saliva (AS). Fluoride release/re-release was measured every 24 h (ion-selective electrodes) with DW/AS replaced daily, and samples re-charged (5 min) with fluoride every 2 days. Five absorption-release cycles were conducted over 10 days. CaAl and MgAl LDH rod-shaped specimens (dry and hydrated; 0, 10 and 30 wt%) were studied for flexural strength and modulus. CaAl and MgAl LDH-composite discs (0, 10, 30 and 45 wt% LDH) were prepared to study water uptake (over 7 weeks), water desorption (3 weeks), diffusion coefficients, solubility and cation release (ICP-OES).ResultsCaAl LDH and MgAl LDH-composites significantly increased the amount of fluoride released in both media (P < 0.05). In AS, the mean release after every recharge was greater for MgAl LDH-composites compared to CaAl LDH-composites (P < 0.05). After every recharge, the fluoride release was greater than the previous release cycle (P < 0.05) for all LDH-composites. Physico-mechanical properties of the LDH-composites demonstrated similar values to those reported in literature. The solubility and cation release showed a linear increase with LDH loading.SignificanceLDH-composites repeatedly absorbed/released fluoride and maintained desired physico-mechanical properties. A sustained low-level fluoride release with LDH-composites could lead to a potential breakthrough in preventing early stage carious-lesions.     

Evaluation of the Candida albicans removal and mechanical properties of denture acrylics cleaned by a low-cost powered toothbrush

PurposeTo investigate the effects of using a low-cost powered toothbrush for cleaning on dental prostheses made of heat polymerized poly(methyl methacrylate), PMMA.MethodsHeat cured PMMA specimens beam with the dimensions of 45.0 mm × 6.5 mm × 4.5 mm were fabricated. The specimens were kept in water storage at 37 °C constant temperature for 0, 1, 7, 15, 30 and 60 days and randomly assigned for testing or control. Test specimens underwent brushing by using a powered toothbrush at an applied force of 2.00 N for 22 min with water as medium. Surface roughness measurement (R_a), flexural strength and efficacy of brushing to remove coated Candida albicans biofilm were investigated.ResultsThe results of the mean surface roughness value and the flexural strength were analysed by using two-way ANOVA and Tukey post hoc test at 5% significance level. In general, the specimens showed no significant changes in flexural strength after brushing. However, the flexural strength and the surface roughness value were significantly lower in specimens group after 7 days in water storage compared to the control. SEM micrographs of post-brushed specimens revealed satisfactory removal of C. albicans biofilm.ConclusionA low-cost powered toothbrush together with a liquid medium successfully removed C. albicans biofilm on dental acrylic PMMA-based prostheses, without compromising the mechanical properties.