Effect of fluoride varnish and gel on dental erosion in primary and permanent teeth

Objective

To assess the effect of a fluoride varnish and gel on the erosive wear of primary and permanent teeth.

Design

Sixty human primary (n = 30) and permanent (n = 30) enamel specimens were randomly assigned to one of the following groups: APF gel (1.23% F), NaF varnish (2.26% F), and control (no treatment). Fluoride gel was applied for 4 min and fluoride varnish for 24 h. Six daily demineralisation-remineralization cycles of 5 min of immersion in a cola drink (pH 2.3) and 30 min in artificial saliva were conducted during 7 days. All specimens were stored in artificial saliva between and after cycles. Surface Knoop microhardness (%SMHC) readings were performed at baseline, 48 h and 7 days. Data were tested using ANOVA and Tukey's tests (p < 0.05).

Results

For primary enamel, the mean %SMHC (±SD) after 48 h and 7 days was, respectively: gel (31.0 ± 14.4 and 36.9 ± 7.5), varnish (26.7 ± 9.5 and 38.3 ± 8.7), and control (35.8 ± 8.6 and 45.0 ± 8.6). For permanent enamel, such values were: gel (37.5 ± 7.7 and 27.8 ± 7.5), varnish (31.7 ± 9.6 and 27.4 ± 11.1) and control (48.6 ± 6.4 and 43.1 ± 6.4). In primary enamel, erosion inhibition by fluoride was not significant at 48 h (p = 0.203) and 7 days (p = 0.082). In permanent specimens, both products showed a significant effect (p < 0.001).

Conclusions

Both fluoride varnish and gel were able to inhibit erosive enamel loss but mainly in the permanent experimental groups. Primary and permanent enamel substrates reacted differently to both demineralization by a cola drink and remineralization by fluoridated compounds.     

Effect of Nd:YAG laser combined with fluoride on the prevention of primary tooth enamel demineralization

Most studies dealing with the caries preventive action of Nd:YAG laser have been done in permanent teeth and studies on primary teeth are still lacking. The aim of this study was to evaluate in vitro the effect of Nd:YAG laser combined or not with fluoride sources on the acid resistance of primary tooth enamel after artificial caries induction by assessing longitudinal microhardness and demineralization depth. Sixty enamel blocks obtained from the buccal/lingual surface of exfoliated human primary molars were coated with nail polish/wax, leaving only a 9 mm2 area exposed on the outer enamel surface, and randomly assigned to 6 groups (n=10) according to the type of treatment: C-control (no treatment); APF: 1.23% acidulated phosphate fluoride gel; FV: 5% fluoride varnish; L: Nd:YAG laser 0.5 W/10 Hz in contact mode; APFL: fluoride gel + laser; FVL: fluoride varnish + laser. After treatment, the specimens were subjected to a des-remineralization cycle for induction of artificial caries lesions. Longitudinal microhardness data (%LMC) were analyzed by the Kruskal-Wallis test and demineralization depth data were analyzed by oneway ANOVA and Fisher's LSD test (á=0.05). APFL and APF groups presented the lowest percentage of microhardness change (p<0.05). Demineralization depth was smaller in all treated groups compared with the untreated control. In conclusion, Nd:YAG laser combined or not with fluoride gel/varnish was not more effective than fluoride alone to prevent enamel demineralization within the experimental period.     

Effects of different amine fluoride concentrations on enamel remineralization

Objectives

The aim of this study was to investigate the effects of decreasing fluoride concentrations on repeated demineralizing challenges on human enamel.

Materials and methods

In 24 teeth, 3 mm × 3 mm windows were prepared on the buccal and lingual sides and treated in a cycling demineralization–remineralization model. Remineralization was achieved with 100, 10 and 0.1 ppm fluoride from anime fluoride. Coronal sections were cut through the artificial lesions, and three sections per tooth were investigated using polarized light microscopy and scanning electron microscopy with quantitative element analysis.

Results

The morphology of the lesions was studied, and the extensions of the superficial layer and the body of the lesion were measured. Using element analysis, the Ca, P and F content were determined. The body of the lesion appeared remineralized after application of 100 ppm fluoride, while remineralization of the lesion was less successful after application of 10 and 0.1 ppm fluoride. The thickness of the superficial layer increased with decreasing fluoride concentrations, and also the extension of the body of the lesion increased. Ca and P content increased with increasing fluoride concentrations.

Conclusions

The effectiveness of fluoride in enamel remineralization increased with increasing fluoride concentration.

Clinical relevance

A consistently higher level of fluoride in saliva should be a goal in caries prevention.     

In vitro comparison of the cariostatic effect between topical application of fluoride gels and fluoride toothpaste

The aim of this study was to compare the effect of topical fluoride products [acidulated phosphate fluoride (APF) or neutral gel (NF) x fluoride toothpaste (MFP)], in respect to fluoride uptake and anticariogenic action. One hundred and twenty five blocks of human teeth, sorted in 5 groups according to the treatment, were submitted to pH cycling for ten days. The parameters analyzed were: fluoride uptake before and after pH cycling and surface (SMH) and cross-sectional (CSMH) microhardness of the enamel blocks. The results of fluoride concentration in enamel after the pH cycling showed an enhancement of fluoride uptake for all groups compared to sound control. No significant differences between APF and MFP were observed for surface microhardness, percentage change of surface microhardness and mineral loss. The volume percent mineral obtained from cross-sectional microhardness demonstrated that APF has a different lesion progression rate regarding subsurface carious lesion. The results suggest that professionally applied fluoride gel or frequent fluoride application in low concentration is a positive preventive measure for the control of dental caries.     

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: A double-blind randomized controlled trial

Objectives

To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000 ppm fluoride toothpaste.

Methods

424 preschool children, 2–5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity.

Results

The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p = 0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments.

Conclusions

Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000 ppm fluoride toothpaste.

Clinical significance

In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000 ppm fluoride toothpaste is used daily.     

Interplay between fluoride and abrasivity of dentifrices on dental erosion–abrasion

Objectives

Eroded teeth are more susceptible to toothbrushing wear than sound teeth. We tested the hypothesis that fluoride and abrasivity of dentifrices can interact, modulating the development of erosive–abrasive lesions.

Methods

Human enamel and root dentin specimens were submitted to cycles of demineralization, remineralization and toothbrushing using six dentifrices formulated with three different abrasivity levels: low (L), medium (M) and high (H); with (+F) and without (−F) fluoride. Surface loss was quantified by optical profilometry and compared among groups (α = 0.05).

Results

In dentin, it was ranked: L < M < H, for both +F and −F dentifrices. In enamel, +F dentifrices had similar results; however for −F formulations, M and H did not differ. Fluoride reduced surface loss in enamel, at all abrasive levels. In dentin, the same fluoride effect was observed but only for the low abrasive formulation.

Conclusions

Both fluoride and abrasivity were important modulators of enamel surface loss, while abrasivity had a higher impact than fluoride on dentin.     

An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy

Objectives

This ex vivo study compared the physico-chemical structural differences between primary carious teeth biannually treated with silver diamine fluoride (SDF) and carious teeth without such treatment.

Method

Twelve carious primary upper-central incisors were collected from 6-year-old children. Six teeth had arrested caries after 24-month biannual SDF applications and 6 had active caries when there was no topical fluoride treatment. The mineral density, elemental contents, surface morphology, and crystal characteristics were assessed by micro-computed tomography (micro-CT), energy-dispersive X-ray spectrometry (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM).

Results

Micro-CT examination revealed a superficial opaque band approximately 150 μm on the arrested cavitated dentinal lesion. This band was limited in the active carious lesion. EDX examination detected a higher intensity of calcium and phosphate of 150 μm in the surface zone than in the inner zone, but this zone was restricted in the active cavitated dentinal lesion. SEM examination indicated that the collagens were protected from being exposed in the arrested cavitated dentinal lesion, but were exposed in the active cavitated dentinal lesion. TEM examination suggested that remineralised hydroxyapatites were well aligned in the arrested cavitated dentinal lesion, while those in the active cavitated dentinal lesion indicated a random apatite arrangement.

Conclusions

A highly remineralised zone rich in calcium and phosphate was found on the arrested cavitated dentinal lesion of primary teeth with an SDF application. The collagens were protected from being exposed in the arrested cavitated dentinal lesion.

Clinical significance

Clinical SDF application positively influences dentine remineralisation.     

Radiation therapy alters microhardness and microstructure of enamel and dentin of permanent human teeth

Objectives

To evaluate, in vitro, the effects of ionizing radiation on the mechanical and micro-morphological properties of enamel and dentin of permanent teeth.

Methods

Enamel and dentin microhardness (n = 12 hemi-sections) was evaluated at three depths (superficial, middle and deep) prior to (control) and after every 10 Gy radiation dose up to a cumulative dose of 60 Gy by means of longitudinal microhardness. Data were analyzed using two-way analysis of variance and Tukey's test at a significance level of 5%. Enamel and dentin morphology was assessed by scanning electron microscopy (SEM) for semi-quantitative analysis (n = 8 hemi-sections). Data were analyzed using Kruskal–Wallis and Dunn's or Fisher exact tests at a significance level of 5%.

Results

The application of ionizing radiation did not change the overall enamel microhardness, although an increase in superficial enamel microhardness was observed. The micro-morphological analysis of enamel revealed that irradiation did not influence rod structure but interprismatic structure became more evident. Dentin microhardness decreased after 10, 20, 30, 50 and 60 Gy cumulative doses (p < 0.05) compared with non-irradiated dentin, mainly in the middle portion of the tissue. The micro-morphological analysis revealed fissures in the dentin structure, obliterated dentinal tubules and fragmentation of collagen fibers after 30 and 60 Gy cumulative doses.

Conclusions

Although ionizing radiation did not affect the enamel microhardness of permanent teeth as a whole, an increase in superficial enamel microhardness was observed. Dentin microhardness decreased after almost all radiation doses compared with the control, with the greatest reduction of microhardness in the middle depth region. The morphological alterations on enamel and dentin structures increased with the increase of the radiation dose, with a more evident interprismatic portion, presence of fissures and obliterated dentinal tubules, and progressive fragmentation of the collagen fibers.

Clinical significance

This study shows that irradiation affects microhardness and micro-morphology of enamel and dentin of permanent teeth. The effects of gamma irradiation on dental substrate might contribute to increased risk of radiation tooth decay associated with salivary changes, microbiota shift and high soft and carbohydrate-rich food intake.     

The effect of 24h non-stop hydrogen peroxide concentration on bovine enamel and dentine mineral content and microhardness

Objectives

Tooth bleaching agents may adversely affect tooth structure. The aim of this study was to investigate the effect of hydrogen peroxide concentration on mineral loss and microhardness of bovine teeth.

Methods

Twenty-six freshly extracted intact bovine incisor teeth were stored in distilled water. Five teeth were sectioned and four samples (2 mm × 2 mm × 1.5 mm) each of enamel and dentine were obtained from each tooth. The samples of enamel and dentine were divided into four groups and immersed in either 0%, 3%, 10% or 30% (w/v) hydrogen peroxide solutions for 24 h at 37 °C. Samples from the solutions were taken for ion release analysis using inductively coupled plasma mass spectrometry. The remaining 21 teeth were mounted in epoxy resin and the upper surface of the specimens were ground and polished to expose the enamel and dentine for microhardness measurements. These specimens were randomly divided into three equal groups and Vickers microhardness values were recorded on the enamel and dentine surfaces of each group before and after bleaching.

Results

The differences in ion release concentration after treatment with 0% (control) and each of 3%, 10% and 30% hydrogen peroxide (w/v) were statistically significant (p < 0.025). The release of calcium and phosphorous ions increased with increasing hydrogen peroxide concentrations. A significant reduction (p < 0.05) in Vickers microhardness values for enamel was recorded after bleaching.

Conclusions

Ion release from both enamel and dentine increased with increasing hydrogen peroxide concentration. Microhardness of enamel decreased significantly with bleaching.     

The effect of ozone on progression or regression of artificial caries-like enamel lesions in vitro

Objective

This study investigated the effect of ozone on the progression or regression of artificial caries-like lesions on enamel following pH cycling conditions in vitro.

Methods

A randomized, single blind, four legs design was used. 20 full thickness enamel slabs were allocated to each of the four groups which were: Fluoride free toothpaste (control); ozone alone; Reductant/Patient Kit alone and a combination of both ozone/Reductant/Patient Kit. Artificial lesions were created and subjected to the pH cycling regime for a 14 days period. Assessments were carried out before and after the pH cycling on the slabs using the microhardness testing and Quantitative Light-induced Fluorescence (QLF).

Results

Statistical significant difference were found in the percentage change of enamel microhardness before and after pH cycling between ozone/Reductant/Patient Kit group and all the other three groups of the study, as well as between Reductant/Patient Kit group and control. There was a statistical significant difference in the change of size and severity of the lesion (ΔQ) between all the three regimes tested and the control with a trend favouring ozone/Reductant/Patient Kit group.

Conclusions

In our model, it appeared that ozone treatment alone is not effective in protecting the enamel against demineralisation or promoting remineralisation, unless combined with the Reductant/Patient Kit, which contain high levels of fluoride.     

Artificial enamel dental caries treated with different topical fluoride regimes: an in situ study

OBJECTIVES: To evaluate whether the topical fluoride application (acidulated phosphate fluoride, APF) at high concentration has an additional effect on the control of enamel lesions compared to fluoride dentifrice (FD; low concentration). The frequency of APF treatment on the arrestment of caries lesions and the amount of fluoride deposited on enamel after application of high and low fluoride concentrations were also evaluated. METHODS: Five subjects wore partial dentures with in vitro demineralized blocks during 35 days. All specimens (5p/subject) were brushed three times daily for 1 min with FD (1100 ppmF). Besides the FD treatment, four specimens were submitted to APF gel topical applications (12,300 ppmF) on weekly intervals (one to four applications). The enamel blocks were analyzed at baseline, after demineralization and after intraoral procedures regarding: surface roughness (SR), clinical aspects (brightness and texture), surface microhardness (SMH) and enamel fluoride content. Friedman's test was used to compare SMH and SR among the treatments. Analysis of variance, followed by Tukey's studentized range test, was used to evaluate fluoride content and SR among the groups. The significance level used was 5%. RESULTS: Changes in surface brightness, texture and SR were not detected. FD+3 APF and FD+4 APF were the only treatments capable of increasing SMH values and fluoride content compared to demineralized blocks (p < 0.001), although no differences could be observed within the treatments. CONCLUSIONS: This study showed that > or = 3 APF in addition to FD enhance enamel rehardening and produce a larger reservoir of fluoride.     

Collutorio a base di fitocomplessi ed estratti naturali per la protezione contro la demineralizzazione dello smalto

Objectives

The purpose of this study was to evaluate the enamel protection induced by a new mouthwash containing phytocomplexes and natural extracts against acid attacks.

Materials and methods

Sixteen pairs of enamel fragments obtained from healthy human teeth were used in this study and treated with mouthwash or with deionized water. Ultraviolet/visible (UV/vis) spectrophotometry and SEM ultra-morphological analyses were performed for the evaluation of the enamel protection by the mouthwash after citric and lactic acid challenge.

Results

The ultraviolet/visible (UV/vis) spectrophotometry and the SEM ultra-morphological analysis showed that the specimens treated with the mouthwash containing Lapacho and Chios Mastic presented no sign of enamel demineralisation.

Conclusions

Daily use of this innovative mouthwash may help protect against enamel demineralization caused by bacteria and food.     

Combined effects of nano-hydroxyapatite and Galla chinensis on remineralisation of initial enamel lesion in vitro

Objectives

The aim of the present study was to investigate the combined effects of nano-hydroxyapatite and Galla chinensis on remineralisation of initial enamel lesion.

Methods

Bovine enamel blocks with in vitro produced initial lesion were used. The lesions were subjected to a pH-cycling regime for 12 days. Each daily cycle includes 4 × 3 min application with one of five treatments: NaF (positive control), deionised water (negative control), crude aqueous extract of G. chinensis (GCE), nano-hydroxyapatite (nano-HA) and GCE with nano-HA. The samples were subsequently evaluated using a microhardness tester, polarised light microscopy (PLM), X-ray diffraction (XRD) and scanning electron microscopy (SEM).

Results

Surface hardness measurements and integrated mineral recovery value obtained from cross-sectional microhardness test (CSMH) revealed that all the treatment groups had significantly greater effect on enhancing remineralisation than that of the negative control group. Detailed investigation of both CSMH and PLM indicated that nano-HA would only help mineral deposition predominate in the outer layer of lesion and had limited capacity to reduce the lesion depth significantly. In GCE–nano-HA combined treatment group, more mineral deposition occurred in the lesion body and lesion depth was reduced significantly. Meanwhile, significantly greater mineral deposition in the outer portion of the lesion was also observed in comparison with GCE group. The results of XRD and SEM also showed that GCE could influence the deposition and adsorption of nano-HA.

Conclusion

There was a significant synergistic effect of combined GCE and nano-HA treatment on promoting the remineralisation of initial enamel lesion.     

Comparison of the remineralization potential of CPP-ACP and CPP-ACP with 900 ppm fluoride on eroded human enamel: An in situ study

Objective

The aim of this in situ study was to compare the remineralization potential of pastes containing CPP-ACP and CPP-ACP with 900 ppm fluoride on human enamel softened by a cola drink.

Design

Forty-five enamel specimens obtained from human third molar teeth were eroded in a cola drink for 8 min and then attached to intra-oral devices worn by five volunteers. The specimens were subjected to three different in situ remineralization protocols using: (1) CPP-ACP (Group I), (2) CPP-ACP with 900 ppm fluoride (Group II), and (3) saliva (Group III, control). Vickers microhardness measurements were obtained at baseline followed by demineralization and remineralization stages.

Results

The CPP-ACP, CPP-ACP with 900 ppm fluoride and saliva controls resulted in 46.24%, 64.25% and 2.98% increase in post-erosion microhardness values, respectively. One-way ANOVA revealed statistically significant differences in the mean microhardness values between pastes containing CPP-ACP and CPP-ACP with 900 ppm fluoride.

Conclusions

Both CPP-ACP and CPP-ACP with 900 ppm fluoride substantially remineralized the softened enamel, with the CPP-ACP and fluoride combination showing higher remineralization potential than CPP-ACP. This study confirmed the synergistic effect of fluoride with CPP-ACP on remineralization of eroded enamel.     

Effects of fluoride concentration and temperature of milk on caries lesion rehardening

Objectives

The aim of the present in vitro study was to investigate the effects of fluoride concentration and temperature of milk on caries lesion rehardening under pH cycling conditions.

Methods

Incipient caries-like lesions were formed in human enamel specimens, characterized using Vickers surface microhardness (VHN) and assigned to seven treatment groups (n = 18 per group): fluoride was tested at five levels (0, 2.5, 5, 10, 20 mg/l, all 22 °C) and milk temperature at three levels (4, 22, 60 °C), but only for 10 mg/l F. Lesions were pH cycled for 15d (4×/daily 10 min milk treatments, 1×/daily 4 h acid challenge, remineralization in human/artificial saliva mixture). VHN of specimens were measured again and changes from lesion baseline were calculated. Subsequently, enamel fluoride uptake (EFU) was determined using the micro drill technique.

Results

Lesions responded to fluoride in a dose–response manner with higher fluoride concentrations resulting in more lesion rehardening (20 > 10 ≥ 5 ≥ 2.5 > 0 mg/l F). Furthermore, fluoridated milk at 60 °C was found to be more efficacious than at 4 °C (60 ≥ 22 > 4 °C). EFU results were similar (20 > 10 > 5 > 2.5 ≥ 0 mg/l F; 60 > 22 ≥ 4 °C).

Conclusions

Both fluoride concentration and milk temperature are likely to contribute to the anti-caries potential of fluoridated milk.     

EFFECT OF FLUORIDATED VARNISH AND SILVER DIAMINE FLUORIDE SOLUTION ON ENAMEL DEMINERALIZATION: pH-CYCLING STUDY

Objective:

In the present investigation, the anticariogenic effect of fluoride released by two products commonly applied in infants was evaluated.

Methods:

Bovine sound enamel blocks were randomly allocated to each one of the treatment groups: control (C), varnish (V) and diamine silver fluoride solution (D). The blocks were submitted to pH cycles in an oven at 37°C. Next, surface and cross-sectional microhardness were assessed to calculate the percentage loss of surface microhardness (%SML) and the mineral loss (∆Z). The fluoride present in enamel was also determined.

Results:

F/Px10^-3(ANOVA, p<0.05) in the 1^stlayer of enamel before pH-cycling were (C, V and D): 1.61^a; 21.59^band 3.98^c. The %SMH (Kruskal-Wallis, p<0.05) were: - 64.0^a, -45.2^band -53.1^c. %∆Z values (ANOVA, p<0.05) were: -18.7^a, -7.7^band -17.3^a.

Conclusion:

The data suggested that the fluoride released by varnish showed greater interaction with sound enamel and provided less mineral loss when compared with silver diamine solution.     

Surface conditioning of natural enamel caries lesions in deciduous teeth in preparation for resin infiltration

Objectives

As a conditioning step for resin infiltration into caries lesions, the relatively impermeable surface layer should be removed using hydrochloric acid gel (15%) to achieve improved infiltration, as it could be shown for permanent teeth. It is unclear whether this etching regimen can be transferred to the deciduous dentition, where differences in surface structure have been reported. Thus, the aim of the present study was to evaluate the effect of phosphoric and hydrochloric acid gels on the surface layer reduction of natural lesions of primary teeth.

Methods

Thirty-two extracted or exfoliated primary molars with lesions confined to enamel were selected. Paired lesion halves were partially etched with either 37% phosphoric (H₃PO₄) or 15% hydrochloric acid gel (HCl) for 30 s, 60 s, 90 s, or 120 s, respectively.

Results

Etching with H₃PO₄ resulted in incomplete reduction of the surface layers in all groups [highest percentage reduction (SD) at 120 s: 54 (28)%] as observed with confocal microscopy. In contrast, surface layers could be eroded almost completely [99 (3)%] by etching with HCl for 120 s.

Conclusion

An effective erosion of the surface layer of natural enamel caries in deciduous teeth can be achieved by etching with 15% hydrochloric acid gel for 90–120 s.     

Prevention of caries progress in xerostomic patients by topical fluoride applications: a studyin vivo andin vitro

Fluoride uptake by the surface enamel of teeth was studiedin vivo andin vitro in xerostomic patients and in extracted human teeth respectively, following various topical fluoride applications (Duraphat varnish, 2·26 per cent F; APF gel, 1·23 per cent F; Elmex gélee, 0·4 per cent F). Fluoride increments known to be effective for inhibition of caries in xerostomic patients were achievedin vivo andin vitro from all preparations. Arrest of caries was observed only in patients who were cooperative in the preventive fluoride programme. It was concluded, on the basis that the fluoride incorporation found in the experimentsin vitro was not stable, that topical fluoride applications in xerostomic patients had to be used frequently to ensure a prophylactic success.     

Effects of different fluoride recharging protocols on fluoride ion release from various orthodontic adhesives

Objective

The purpose of this study was to find the most effective fluoride recharging protocol for orthodontic adhesives.

Methods

Five orthodontic adhesives were used: a non-fluoride-releasing composite, a fluoride-releasing composite, a polyacid-modified composite (compomer), and two resin-modified glass-ionomer cements (RMGICs). Each specimen was placed into deionized water (DW) and the initial fluoride ion release was measured for 2 months. Each specimen was then subjected to four different treatments to simulate a fluoride recharge: 1000 ppm NaF solution, acidulated phosphate fluoride gel (APF), fluoride-containing dentifrice and DW (control). After topical fluoride treatment, each specimen was submitted to fluoride re-release tests.

Results

Fluoride-containing adhesives initially showed higher rates of fluoride ion release, but significantly declined to lower levels. The overall cumulative fluoride ion release during the initial period was RMGICs > compomer > fluoride-containing composite > non-fluoride-releasing composite. After topical fluoride treatment, the amount of fluoride ion re-released was proportional to the amount of fluoride ion previously released from the adhesives. However, the amount of fluoride ions released only lasted for 2 days and then returned to the levels before fluoride application. The overall cumulative fluoride ion re-release according to the fluoride treatments was APF and NaF solution > dentifrice.

Conclusion

This study suggests that using the combination of RMGICs and a fluoride-containing mouth rinse solution is the most effective protocol for long-term fluoride re-release from orthodontic adhesives, given the difficulty of routine use of APF at home, although all topical fluoride treatments can recharge fluoride ion in adhesives.     

Mineral density of hypomineralised enamel

Objectives

To characterize molar–incisor hypomineralisation (MIH) defects of different severities quantitatively and qualitatively using X-ray microtomography (XMT) and to measure the range of reduction in mineral density (MD) of MIH enamel compared with the normal range.

Methods

Ten sound teeth and ten MIH teeth were scanned using a commercial XMT system. Four hydroxyapatite phantoms of different densities were used as calibration standards with each scan. A calibration equation derived from the phantoms with each tooth was used for MD calibration. MD was traced from the cementum–enamel junction (CEJ) to the cusp tip and from the dentine–enamel junction (DEJ) to the outer enamel surface.

Results

In sound teeth, MD increased from CEJ to cusp/incisal tip, while in MIH teeth MD dropped from the CEJ to the occlusal region, then increased again at the cusp tip. MD was highest midway between DEJ and outer enamel in sound teeth. In MIH, enamel showed normal thickness and MD was highest near the DEJ and then decreased towards the outer enamel. MD of MIH enamel was on average about 19% lower than sound enamel. The MIH defects seemed to follow the incremental lines of enamel formation.

Conclusions

MIH defects are hypomineralised defects of different severities that follow the natural incremental lines of enamel formation. Cuspal areas are usually only mildly affected and cervical enamel always appears to be sound.