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  1. Mohamad Saberi FN, Sukumaran P, Ung NM, Liew YM
    Biomed Eng Online, 2022 Dec 03;21(1):83.
    PMID: 36463182 DOI: 10.1186/s12938-022-01055-x
    Tooth demineralization is one of the most common intraoral diseases, encompassing (1) caries caused by acid-producing bacteria and (2) erosion induced by acid of non-bacterial origin from intrinsic sources (e.g. stomach acid reflux) and extrinsic sources (e.g. carbonated drinks). Current clinical assessment based on visual-tactile examination and standardized scoring systems is insufficient for early detection. A combination of clinical examination and technology is therefore increasingly adapted. This paper reviews various procedures and technologies that have been invented to diagnose and assess the severity of tooth demineralization, with focus on optical coherence tomography (OCT). As a micron-resolution non-invasive 3D imaging modality, variants of OCT are now available, offering many advantages under different working principles for detailed analytical assessment of tooth demineralization. The roles, capabilities and impact of OCT against other state-of-the-art technologies in both clinical and research settings are described. (139 words).
    Matched MeSH terms: Tooth Demineralization*
  2. Gan SC, Fok ASL, Sedky RA, Sukumaran P, Chew HP
    Dent Mater, 2020 11;36(11):1379-1387.
    PMID: 32907752 DOI: 10.1016/j.dental.2020.08.003
    OBJECTIVE: The aim of this research was to determine the association between sorptivity of water and the state of mineralization in carious enamel of different stages of severity.

    METHODS: As a preliminary work, water droplets of 1.5 μL were placed on the surfaces of hydroxyapatite (HA) discs of different densities. The water droplet profile was dynamically recorded every second over a period of 10 s using a contact angle meter to determine the relationship between sorptivity and density. To measure and calculate sorptivity on enamel surfaces, varnish was painted on the labial surface of 96 extracted caries-free human teeth, leaving two 1.4 ± 0.1 mm diameter circular exposed test sites. The specimens were randomly divided into 6 groups (n = 16) and subjected to 0(G0), 7(G7), 14(G14), 21(G21), 28(G28) and 35(G35) days of pH cycling, respectively. A 0.7 μL water droplet was placed on each exposed site and Optical Coherence Tomography was used to measure its height every 10 seconds for 2 min. Sorptivity was computed by considering sorption equations and Washburn's analysis of capillary kinetics and correction for evaporation was also performed. Micro-Computed Tomography scans of the specimens were obtained and delta Z (ΔZ) is the parameter used to measure mineral loss. ΔZ at 10 μm (ΔZ10) and 50 μm (ΔZ50) from the surface were calculated. One-way ANOVA and Post-hoc Tukey tests were used to compare sorptivity between groups and bivariate correlations were used to analyze the association between sorptivity and ΔZ.

    RESULTS: Sorptivity was found to be inversely and linearly correlated with HA density with R2 value of 0.95. With enamel, there is a general trend of increase in mean sorptivity from G0 to G35, except for a decrease in G21. The same trends were observed for both ΔZ10 and ΔZ50. The decrease in sorptivity in G21 coincided with the presence of a surface hypermineralized layer in G21 samples. Post-hoc Tukey showed significant differences in mean sorptivity between G0 and G14, G0 and G21 as well as G14 and G21. Post-hoc Dunnett's T3 showed significant differences for ΔZ10 between G0 and G14 as well as G14 and G21. Significant correlation between mean sorptivity and ΔZ10 was detected with Pearson correlation coefficient of 0.461. For ΔZ50, post-hoc Tukey showed significant differences between G0 and G14 but no significant difference was detected between G14 and G21. No correlations were detected between mean sorptivity and ΔZ50.

    SIGNIFICANCE: Sorptivity was found to be inversely and linearly correlated with HA density with R2 value of 0.95. With enamel, there is a general trend of increase in mean sorptivity from G0 to G35, except for a decrease in G21. The same trends were observed for both ΔZ10 and ΔZ50. The decrease in sorptivity in G21 coincided with the presence of a surface hypermineralized layer in G21 samples.

    Matched MeSH terms: Tooth Demineralization*
  3. Mohd. Bakri, M, Mat Salleh, A.
    Ann Dent, 2003;10(1):-.
    MyJurnal
    Decalcified permanent teeth were sectioned and stained with Van Gieson and Gomori trichome dyes. Sections dyed with the Van Gieson dye did not produce any zones in dentine but with the Gomori trichome dye, four different zones of dentine were produced. Zone 1 begins at the predentine-dentine junction while zone 4 ends at the enamel - dentine junction. In zone 1, the intertubular dentine was stained clearly while in zone 3 intense staining of the peritubular dentine was observed. The result of this study supports the previous findings reported by other workers that the formation of intertubular dentine takes place in zone 1 while peritubular dentine occurs in zone 3.
    Matched MeSH terms: Tooth Demineralization
  4. Shoaib L, Deery C, Ricketts DN, Nugent ZJ
    Caries Res, 2009;43(6):442-8.
    PMID: 19907175 DOI: 10.1159/000258551
    The aim of this in vitro study was to assess the validity and reproducibility of the ICDAS II (International Caries Detection and Assessment System) criteria in primary teeth. Three trained examiners independently examined 112 extracted primary molars, ranging from clinically sound to cavitated, set up in groups of 4 to mimic their anatomical positions. The most advanced caries on the occlusal and approximal surfaces was recorded. Subsequently the teeth were serially sectioned and histological validation was undertaken using the Downer and Ekstrand-Ricketts-Kidd (ERK) scoring systems. For occlusal surfaces at the D(1)/ERK(1) threshold, the mean specificity was 90.0%, with a sensitivity of 75.4%. For approximal surfaces, the specificity and sensitivity were 85.4 and 66.4%, respectively. For occlusal surfaces at ICDAS code > or =3 (ERK(3) threshold), the mean specificity and sensitivity were 87.0 and 78.1%, respectively. For approximal surfaces, the equivalent values were 90.6 and 75.3%. At the D(3) threshold for occlusal surfaces, the mean specificity and sensitivity were 92.8 and 63.1%, and for approximal surfaces 94.2 and 58.3%, respectively. Mean intraexaminer reproducibility (Cohen's kappa) ranged from 0.78 to 0.81 at the ICDAS code > or =1 cut-off and at the ICDAS code > or =3 cut-off from 0.74 to 0.76. Interexaminer reproducibility was lower, ranging from 0.68 to 0.70 at the ICDAS code > or =1 cut-off and from 0.66 to 0.73 at the ICDAS code > or =3 cut-off. In conclusion, the validity and reproducibility of the ICDAS II criteria were acceptable when applied to primary molar teeth.
    Matched MeSH terms: Tooth Demineralization/diagnosis; Tooth Demineralization/pathology
  5. Chew HP, Zakian CM, Pretty IA, Ellwood RP
    Caries Res, 2014;48(3):254-62.
    PMID: 24481141 DOI: 10.1159/000354411
    BACKGROUND: Measurement of initial enamel erosion is currently limited to in vitro methods. Optical coherence tomography (OCT) and quantitative light-induced fluorescence (QLF) have been used clinically to study advanced erosion. Little is known about their potential on initial enamel erosion.

    OBJECTIVES: To evaluate the sensitivity of QLF and OCT in detecting initial dental erosion in vitro.

    METHODS: 12 human incisors were embedded in resin except for a window on the buccal surface. Bonding agent was applied to half of the window, creating an exposed and non-exposed area. Baseline measurements were taken with QLF, OCT and surface microhardness. Samples were immersed in orange juice for 60 min and measurements taken stepwise every 10 min. QLF was used to compare the loss of fluorescence between the two areas. The OCT system, OCS1300SS (Thorlabs Ltd.), was used to record the intensity of backscattered light of both areas. Multiple linear regression and paired t test were used to compare the change of the outcome measures.

    RESULTS: All 3 instruments demonstrated significant dose responses with the erosive challenge interval (p < 0.05) and a detection threshold of 10 min from baseline. Thereafter, surface microhardness demonstrated significant changes after every 10 min of erosion, QLF at 4 erosive intervals (20, 40, 50 and 60 min) while OCT at only 2 (50 and 60 min).

    CONCLUSION: It can be concluded that OCT and QLF were able to detect demineralization after 10 min of erosive challenge and could be used to monitor the progression of demineralization of initial enamel erosion in vitro.

    Matched MeSH terms: Tooth Demineralization/diagnosis; Tooth Demineralization/pathology
  6. Ab-Ghani Z, Ngo H, McIntyre J
    Aust Dent J, 2007 Dec;52(4):276-81.
    PMID: 18265682
    BACKGROUND: There have been cononcerns about the dissolution of conventional glass ionomer cement (GIC) and its possible degradation when exposed to an acidic environment over time. The objective of this study was to investigate the effects of exposure of Fuji IX Fast to the simulated acidic aspects of the oral environment in terms of any change in the elemental composition of strontium (Sr), phosphorus (P), calcium (Ca) and fluorine (F) which resulted at the surface of this material.

    METHODS: Sixty-five cylindrical block of Fuji IX Fast were prepared using split moulds. The demineralizing solution was an acetate buffered demineralizing solution at pH 403. The remineralizing solution was a buffered solution containing 1.5 mM Ca, 0.9 mM P and 10 ppm F at pH 7. The blocks of Fuji IX Fast were subjected either to two-day alternating cycles of remineralization and demineralization for up to 24 days (test); 6 two-day cycles of demineralizing or remineralizing solution separately, or deionized distilled water alone (controls) or were left untreated (base line control). Mineral profiles of Ca, P, Sr and F within 100 microm of the material surface were assessed following 8, 16 and 24 days of treatment (test); 4, 8 or 12 days (controls) or for baseline control samples, using electron probe microanalysis (EPMA).

    RESULTS: There were significant changes in mineral profile in the test specimens in terms of Sr and Ca concentrations. A molecule for molecule exchange of these elements resulted between GIC and eluant solutions. Fluoride loss from the GIC occurredto the level comparable with uptake levels recorded in eluant solutions from previous studies. The ionic exchanges appeared to be the result of dissolution followed by an equilibrium-driven diffusion. These exchanges were superficial though substantial.

    CONCLUSIONS: Simulated exposure of Fuji IX to the oral environment resulted in an exchange of Ca from the bathing solutions into Fuji IX to replace any Sr which was lost to the GIC. Fluorine loss from the GIC followed previously described patterns. The possible clinical significance of this exchange was discussed.

    Matched MeSH terms: Tooth Demineralization
  7. Qamar Z, Haji Abdul Rahim ZB, Neon GS, Chew HP, Zeeshan T
    Arch Oral Biol, 2019 Oct;106:104482.
    PMID: 31325718 DOI: 10.1016/j.archoralbio.2019.104482
    OBJECTIVE: The aim of the study was to determine demineralisation inhibition and remineralisation potential of poly-γ-glutamic acid with its possible mechanism of action on human dental enamel.

    METHODOLOGY: Three sodium-fluoride(NaF) concentration(0.01%w/v,0.1%w/v and 0.5%w/v respectively)and two poly-γ-glutamic acid(PGGA)concentration(1%w/v and 2%w/v respectively)were prepared in 0.1 M acetic acid(pH4.0)and deionized distilled water.For de/re-mineralisation study, tooth samples (18 teeth varnished, leaving a 2 mm2 window on the mid-buccal surfaces) were immersed in respective acidified NaF and PGGA solutions. The Ca2+ release/uptake was monitored with ISE over 72-hr with increasing pH every 24-h from 4.0 to 6.0.These teeth were later subjected to cross-sectional microhardness to determine integrated mineral recovery of enamel on increasing pH of respective acidified solution.In order to determine mechanism of PGGA,two concentrations of PGGA in deionized-water-solutions were used for tooth samples immersion followed by overnight drying then later subjected to Fourier Transform Infra-Red(FT-IR) analysis.The FT-IR analysis was also carried out on PGGA powder.For control,the experiment was repeated using hydroxyapatite(HAp)pellets.The density of PGGA solutions(1%and2%)was also measured to determine their dynamic viscosities.

    RESULTS: The ISE and microhardness testing revealed statistically significant (ρ ≤ 0.05) dissolution inhibition and remineralisation potential for tooth sample treated with acidified 2%PGGA. From the FT-IR spectra, it was observed that the profiles of the enamel and HAp surfaces treated with 1%-and 2%-PGGA solutions were similar to those of PGGA powder.It was found that the viscosity of PGGA increases with increasing concentration.

    CONCLUSION: The study implies that 2% PGGA is more effective than NaF as forms a coating layer to protect from demineralisation and promote remineralisation of the tooth surface.

    Matched MeSH terms: Tooth Demineralization
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