BACKGROUND:In recent literatures, much attention has been given to natural products for their health benefits. AIMS:In this study, the objective was to measure the efficacy of the ginger-honey-chocolate mixture as the remineralization effect has been shown in the literature previously and to evaluate the individual contributions of this mixture; ginger, natural honey, bitter chocolate separately on remineralization of initial enamel caries lesion. MATERIALS AND METHODS:All specimens were divided into eight groups as: Ginger (Arifoglu®, Turkey) in powder form, (n = 8); Ginger-Honey-Chocolate (n = 8); Natural honey (Balparmak Plateau Blossom Honey®, Turkey) (n = 9); Bitter chocolate (Nestlé®, Switzerland) (n = 8); MI Paste (GC, Japan) (n = 8); Paradontax (Sensodyne, Glaxosmithklein, USA) (n = 9); Pronamel (Sensodyne, Glaxosmithklein, USA) (n = 9); Control (n = 9) groups. Samples were carried out five pH cycles along 7 days at 37°C for each group. During pH cycling, blocks were put in a demineralization (6 h) and a remineralization solution (18 h). The treatment consisted of 1 min. interaction of enamel surfaces with agent/deionized slurries (1:3 w/w) on a daily basis. The surface microhardness (SMH) was determined before and after pH cycling with a Digital Micro-Vickers Hardness Tester (Wilson Wolpert; Europe BV, 401 MVD, Netherlands). Mineral changes were determined by using FluoreCam® and recovery values were calculated as SMHR% and FΔ%, respectively. RESULTS:All groups showed an enhanced remineralization. There was no significant difference in terms of FΔ% (F = 1.223, P = 0.304) and SMHR% (F = 0.709, P = 0.664) between all groups. CONCLUSION:The herbals (ginger, honey, and bitter chocolate) examined in this study gave promising results with a high remineralization potential.

Remineralization Potential of Different Agents and Assessment by a Abstract Objectives: The aim of this study was to evaluate the effectiveness of casein and hydroxyapatite on remineralization of white spot enamel lesion and assessment by a new caries detection device, FluoreCam System (Thereametric Co., Indianapolis, USA). Study Design: Demineralized human enamel specimens were measured for baseline surface by the following methods; micro hardness, Quantitative Light Induced Fluorescence (QLF) (Inspektor Pro, Inspektor Research Systems, Amsterdam, Holland) and FluoreCam System (There a metric Co., Indianapolis, USA). Ten specimens in each of four groups were used in this in vitro recycling study with the following treatments applied three times daily for 1 min: 1) Sodium fluoride (NaF) dentifrice, Ipana, (Procter&Gamble,

Background/Aims: Currently available techniques for fluoride analysis are not standardized. Therefore, this study was designed to develop standardized methods for analyzing fluoride in biological and nonbiological samples used for dental research. Methods: A group of nine laboratories analyzed a set of standardized samples for fluoride concentration using their own methods. The group then reviewed existing analytical techniques for fluoride analysis, identified inconsistencies in the use of these techniques and conducted testing to resolve differences. Based on the results of the testing undertaken to define the best approaches for the analysis, the group developed recommendations for direct and microdiffusion methods using the fluoride ion-selective electrode. Results: Initial results demonstrated that there was no consensus regarding the choice of analytical techniques for different types of samples. Although for several types of samples, the results of the fluoride analyses were similar among some laboratories, greater differences were observed for saliva, food and beverage samples. In spite of these initial differences, precise and true values of fluoride concentration, as well as smaller differences between laboratories, were obtained once the standardized methodologies were used. Intraclass correlation coefficients ranged from 0.90 to 0.93, for the analysis of a certified reference material, using the standardized methodologies. Conclusion: The results of this study demonstrate that the development and use of standardized protocols for F analysis significantly decreased differences among laboratories and resulted in more precise and true values.

The purpose of this study was to identify risk factors to predict caries progression in toddlers in primary-healthcare settings for the cost-effective targeting of preventive and referral strategies. We examined 329 children (26 ± 6 mos old) twice, one year apart, in Indiana, USA. A 107-item structured interview was used to collect information from the primary caregiver and child on factors/beliefs/perceptions/behaviors that could affect caries development, transmission of bacteria, medical-dental health, and access to care. Bacterial levels, gingivitis, dental plaque, and caries experience were assessed. Multiple-variable logistic regression models of caries progression toward cavitation included family caries experience, transmission-related behaviors, dietary factors, health beliefs, and lower income, but differed in selected predictors/predictive power by race/ethnicity. Addition of clinical variables did not significantly improve the prediction.

This study aimed to evaluate the effectiveness of an ultrasonic system for in vitro measurement of cusp tips of human teeth. Each worn cusp of 12 molar teeth was measured with an industrial ultrasonic system. The teeth were sectioned and measured by polarized light microscopy. The ultrasonic measurements and histological readings were moderately correlated (r = 0.601, p < 0.01). The ultrasonic system used in this study seemed a promising method for measuring thickness of worn cusp tips of extracted human molar teeth.

The objective of this research was to evaluate the anticaries effectiveness of a low-dose (500 ppm F, low-NaF) sodium fluoride dentifrice, a high-dose (2,800 ppm F, high-NaF) sodium fluoride dentifrice and an experimental 0.454% stabilized stannous fluoride (1,100 ppm F) with sodium hexametaphosphate (SnF2-HMP) dentifrice, each relative to a standard 1,100 ppm F sodium fluoride positive control dentifrice. Subjects (n = 955, with approximately 239 per group) with a mean age of 10.6 (approximately 9-12 years) were randomly assigned to one of four dentifrice treatments. Two calibrated examiners independently measured visual-tactile caries as DMFS that was supplemented with a radiographic examination at baseline, 12 months and 24 months for each subject. Generally similar results were independently observed by both examiners at the conclusion of the 2-year study period. Considering all subjects that attended at least 60% of the supervised brushing sessions, statistically significantly less caries was observed in the high-NaF group compared to the control group. Similarly, statistically significantly less caries was observed in the SnF2-HMP group as compared to the control group. Differences in caries increments between the low-NaF and control groups were not statistically significant. One of the examiners observed these same statistically significant differences after 1 year. In conclusion, the results of this clinical trial indicated that while no difference in caries increments was observed between the low-NaF and control groups, both the high-NaF and the SnF2-HMP groups experienced significantly fewer lesions than the control group.

The objective of this study was to determine the ability of several techniques to detect natural secondary caries adjacent to proximal class II amalgam restorations. Two sites were selected and marked on each of 50 human extracted posterior teeth. Three examiners visually characterized each site independently for signs of demineralization (VI), ditching presence (VD), and color change, and utilized light-induced fluorescence (QLF), and infrared laser fluorescence (LF) techniques. The teeth were sectioned through the selected sites, and the severity of each lesion was determined by confocal laser scanning microscopy (CLSM) as the ‘gold standard’. Agreement among examiners was assessed using weighted kappa statistics and showed fair to moderate correlation with all techniques. Sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy were determined by utilizing three arbitrary CLSM thresholds. Higher sensitivity was indicated by the QLF and LF than by VI. For PPV and accuracy, QLF and LF showed values higher or similar to VI. Low sensitivity was found for VD. The results obtained in this study suggest that LF and QLF may improve the ability to detect early secondary caries around amalgam restorations.

OBJECTIVE:To evaluate the effectiveness of ultrasound on measuring the thickness of enamel in abrasion.STUDY DESIGN:Flat areas on occlusal surfaces of 20 premolar teeth were marked. Two initial ultrasonic measurements on marked areas were obtained by the first researcher. Then the tooth was measured in the axial direction with a compass. The cusp tips were abraded by an abrasive paper, then the second and third ultrasonic measurements were taken. The second researcher repeated the third ultrasonic measurement to evaluate the interobserver variation. All specimens were sectioned and the remaining enamel thickness was measured under polarized light microscope.RESULTS:Pearson's correlation analysis showed a high level of intraobserver agreement for the ultrasonic measurements of the first researcher (r = .891, P < .000 initial; r = .690, P < .001 first abrasion; r = .885, P < .000 second abrasion). Third ultrasonic measurements of the first and second researchers were positively and significantly correlated with histological readings (r = .966, P < .000; r = .466, P = .039).CONCLUSIONS:The ultrasonic system used in this study was reliable in measuring enamel thickness.

Considerable research during the past two decades has focused upon the development of new technologies for the detection of dental caries. Of these technologies, the method that has been most extensively studied is based upon the indirectly assessed changes in the fluorescence of enamel associated with the loss of mineral. The purpose of this presentation was to review the available information regarding the use of this technology, commonly known as quantitative light fluorescence, for caries detection, particularly early caries detection, and the potential for the routine use of this technology in clinical caries trials. This technology is unique in its ability to measure small changes in the mineral content of enamel lesions quantitatively. The results of recent small-scale clinical trials have indicated that the impact of caries-preventive measures can be determined within a six-month period. With current hardware and software refinements and the results of long-term clinical validation studies that are in progress, it may be that this technology will be the future method of choice for caries clinical trials.

The objective of this study was to determine the effect of imaging geometry on evaluating natural white-spot lesions with quantitative light-induced fluorescence (QLF). A total of 34 specimens were prepared from extracted human premolars and permanent molars with white spots on the interproximal surface. The specimens were each adjusted to a final thickness of 3.0 mm. Images were acquired with the QLF system perpendicular to the white spots and at 5 degrees intervals up to 30 degrees above and below the perpendicular. The specimens were rotated around the buccolingual axis of the tooth (pitch angle) and around the long axis of the tooth (roll angle). The averages of fluorescence loss (DeltaF, %) and lesion size (mm2) were determined with QLF. Another variable, DeltaQ, which was defined as the fluorescence loss integrated over the lesion size (% x mm2), was also calculated. DeltaF was smaller when lesions were viewed from the cervical direction (angles less than 90 degrees ), and became bigger when viewed from the coronal direction. Roll angle did not significantly affect DeltaF. Apparent lesion size diminished with deviations from 90 degrees in both directions for pitch and roll angles. DeltaQ was affected by pitch and roll angles with the largest value at 90 degrees and values decreasing in both directions from 90 degrees. In general, there were significant differences for angles larger than 20 degrees from the perpendicular for all three QLF variables. This study suggests that angle is an important factor to control when performing QLF studies; however, small changes (deviations within 20 degrees ) have a minimal effect on QLF variables.

The objective of this study was to evaluate the effect of enamel thickness on the quantification of white-spot lesions with laser fluorescence. One hundred and twenty 3-mm-diameter human ground and polished enamel specimens were used. Specimens were illuminated by a 488-nm argon laser, images were acquired through a 540-nm high-pass filter and stored on the Quantitative Light-Induced Fluorescence (QLF) program. Specimens were divided into two groups and demineralized for 48 or 96 h and QLF images were again acquired. Fluorescence radiance (FR) of both sound (FR(s)) and demineralized (FR(d)) enamel was determined using the QLF program. Change in fluorescence radiance (Delta FR, %) was determined as follows: Delta FR = FR(d)/FR(s) x 100. One thin section was obtained for transverse microradiography analysis. Enamel and dentin thickness of the thin sections were measured. There was a good correlation between QLF parameters and enamel thickness. It can be concluded that the FR observed for similar lesions depends on the actual enamel thickness.

The authors hypothesize that the arrestment and remineralization of these lesions could be improved if secondary caries could be detected and monitored at earlier stages. Traditional diagnostic techniques detect secondary caries when it is relatively advanced and when significant tissue has been lost. This in vitro study evaluated the Quantitative Light-induced Fluorescence QLF) system for detecting and monitoring demineralization surrounding tooth-colored restorations. This investigation was divided into three studies. The first study evaluated QLF for the detection and measurement of chemically induced lesions surrounding resin composite restorations. The second study evaluated QLF for the detection of demineralization around different tooth-colored restorations (glass ionomer, resin composite, compomer and smart material) created in a microbial caries model. Finally, the third study tested whether QLF was effective at detecting early wall lesions adjacent to resin composite restorations. Data from Study 1 demonstrated the potential for QLF to detect very early secondary caries and to distinguish between the different stages of early demineralization. Study 2 confirmed the potential for QLF to detect early secondary caries created by cariogenic bacteria and concluded that the four types of materials differed in their ability to prevent secondary caries in this model, with the glass ionomer being the most effective and the non-fluoride releasing composite performing the worst, which allowed for the development of larger lesions. The results of Study 3 suggest a potential application of the QLF system to detect early wall lesions. Data from this investigation strongly suggest that QLF is a potentially viable technology to detect and monitor early secondary caries.

The purpose of this study was to determine the efficacy of fluoride varnish (FV) in inhibiting progression of secondary caries (SC). In a first experiment, human teeth, restored either with amalgam or resin composite, were exposed for 4 days to a microbial caries model. Half of each specimen was then painted with an acid-resistant nail varnish to maintain the baseline SC lesion. Specimens were then either treated with a FV (removed after 24 h) or not treated (control groups) prior to being exposed for 4 more days to the caries model. A second experiment was conducted to compare the effect that the varnish (with and without fluoride) had on SC development around amalgam. Confocal laser scanning microscopy data from these experiments suggested that the application of a FV to early, active SC lesions significantly slowed down their progression. Furthermore, the application of a placebo varnish showed a trend towards slowing down lesion progression, suggesting that the effect of FV on SC is not only due to its fluoride release.

Concurrent with the decline in dental caries has been an increase in the prevalence of dental fluorosis, a side-effect of exposure to greater than optimal levels of fluoride during amelogenesis. The mechanisms that underlie the pathogenesis of dental fluorosis are not known. We hypothesize that genetic determinants influence an individual's susceptibility or resistance to develop dental fluorosis. We tested this hypothesis using a mouse model system (continuous eruption of the incisors) where genotype, age, gender, food, housing, and drinking water fluoride level can be rigorously controlled. Examination of 12 inbred strains of mice showed differences in dental fluorosis susceptibility/resistance. The A/J mouse strain is highly susceptible, with a rapid onset and severe development of dental fluorosis compared with that in the other strains tested, whereas the 129P3/J mouse strain is least affected, with minimal dental fluorosis. These observations support the contribution of a genetic component in the pathogenesis of dental fluorosis.

Quantitative light-induced fluorescence (QLF) is based on the dark appearance of a white spot in otherwise highly fluorescent enamel. This can be explained by the increased scattering coefficient in the white spot compared with that of sound enamel. The aim of this study was to estimate the effect of different sound enamel scattering coefficients (sSE) and enamel thickness d, caused by developmental enamel differences, on the fluorescence appearance of white-spot lesions. We ran a Monte Carlo simulation of a 4 × 4 mm2 illuminated enamel slab on a highly fluorescent background. The slab had a 0.7 × 0.7 mm2, 100-µm-deep, white spot in the center. Fluorescent and back-scattered photons re-emitted from the central 2 × 2 mm2 were recorded. We found that the fluorescence photon excitance from the white spot (FWS) was less than that of sound enamel (FSE), with an optimum difference for SSE between 20 and 80/mm. For sSE <20/mm, both FSE and FWS decreased with d. We found no relation with d for sSE >20/mm. The results indicate that for small sSE, we are suffering from edge losses, which explains why the optimum for lesion visibility is not found at sSE = 0/mm, as would be expected.