Objective: To assess literature for the effectiveness and impact of femtosecond (fs) laser irradiation for surface processing of enamel and dentine. Materials and methods: This systematic review followed PRISMA guidelines. Criteria for inclusion and exclusion were established, and searches undertaken in the PubMed/MEDLINE, Embase and, Scopus databases for articles published in English over a period of the last 25 years. In-vivo studies were excluded. Analysis explored the effects of varying laser parameters including the ablation threshold, ablation rate, relative ablation efficiency and the influence of laser processing parameters, such as the laser scanning speed, on purported surface changes and presumed thermal effects on dental enamel and dentin that arise directly as a result of fs laser irradiation. Results: Eleven articles that met the inclusion criteria reported that fs laser pulses can progressively remove (i.e., ablate) dental enamel and dentin with an acceptable precision and accuracy, with little or no observed thermal effects. These reported the use of an ultra-fast fs lasers employing different wavelengths, pulse durations and irradiation parameters, such as the output power and the pulse repetition rates. The chemical composition of enamel and dentin was found not to be significantly altered by an fs laser treatment. Conclusion: Significant efforts are still required to optimisefs laser parameters for precise and selective ablation of dental tissue and dentine to enable minimally invasive restorative procedures.

AbstractNicotine replacement therapy (NRT) products are used extensively for assisting users in achieving cessation goals through the substitution of pure nicotine with tobacco-less products. Awareness of the adverse oral effects of nicotine replacement products is important for health practitioners. This review highlights the potential effects of NRT products on the oral tissues and management of these adverse effects. Cochrane, PubMed, and MEDLINE electronic databases were utilized in search of the relevant literature related to NRT. The review highlights various adverse effects on oral health status from NRT products, with the underlying mechanisms for these effects remaining inconclusive. There is a need for more education of health professionals in oral health promotion and maintenance in these cases. NRT products have many potential adverse effects on oral health, and it is the responsibility of dental professionals to consider these in the management of patients to optimize a beneficial clinical outcome.

BACKGROUND:Calcium phosphate and fluoride (F) delivery systems claim to facilitate enamel remineralization.AIM:To evaluate and compare (i) the remineralizing potential of Clinpro® Tooth Crème(CTC) and Tooth Mousse Plus®(TMP) on artificial carious lesions, and (ii) the benefit of 1000ppm F dentifrice prior to the application of CTC and TMP.STUDY DESIGN:Carious lesions, 200-300μm deep were produced by placing molars in demineralizing solution for 96h, sections 100-150μm thick were then randomly assigned to six groups(n=150). Specimens were treated thrice daily with a non-fluoridated(Group A), or fluoridated dentifrice[1000ppm, (Group B)], or CTC(Group C), TMP(Group D), fluoridated dentifrice followed by CTC(Group E), or a fluoridated dentifrice followed by TMP(Group F), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography.RESULTS:Posttreatment maximum mineral content at the surface zone(Vmax) was significantly increased in Groups B, C, and D compared to the other groups. The lesion depth(LD) decreased in Group D>Group C>Group E, and the net mineral content gain(ΔZ) in Group C>Group D, which did not reach statistical significance.CONCLUSIONS:CTC and TMP exhibited similar efficacy in remineralizing artificial carious lesions. Nevertheless, the net mineral gain or lesion consolidation following CTC use was higher than TMP.

BACKGROUND:No published studies exist on the remineralizing potential of Tooth Mousse Plus® (TMP) when applied for less than 3 min.AIM:To evaluate (i) the remineralizing potential of TMP on artificial carious lesions, when applied thrice daily for 60 s, and (ii) the benefit of using a fluoridated dentifrice prior to TMP application.DESIGN:Carious lesions, 120-200 μm deep, were produced by placing molars in demineralizing solution for 96 h, and sections 100-150 μm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or 1000 ppm F dentifrice (Group B), or TMP (Group C), or a 1000 ppm F dentifrice followed by TMP application (Group D), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography.RESULTS:Post-treatment maximum mineral content at the surface zone (Vmax ) was significantly increased and lesion depth (LD) significantly decreased in Group C, while only the Vmax increased in Group D. Increase in LD was observed in Group B; however, no significant differences were noted in percentage LD changes between groups B, C, and D (P > 0.05).CONCLUSIONS:TMP applied for 60 s significantly remineralized the artificial carious lesions. No additional benefit was evident when TMP was preceded by treatment with 1000 ppm F dentifrice.

To evaluate (1) the remineralizing potential of Tooth Mousse® (TM) on artificial carious lesions, when applied for 1 min, and (2) the benefit of a fluoridated dentifrice prior to TM application.

UNLABELLED:Orofacial viral infections may be less common but appear in different clinical forms. Often these infections get initially treated by antibiotics which obviously will have limited or no effect. The authors review the current concepts of orofacial viral infections, causative agents, their classification and clinical manifestations and a basis for treatment.CLINICAL RELEVANCE:Most viral infections do not require any specific treatment except in patients who are immunosuppressed or immunodeficient. Appropriate diagnosis and timely management of orofacial viral lesions are important irrespective of whether it is localized or a manifestation of a systemic infection.

Objectives. Milk is a universal dietary component and it is now recognized as an effective medium for the delivery of fluoride (F). This study sought (i) to evaluate fluoridated milk (2.5 ppm, 5 ppm, 10 ppm) for remineralizing carious lesions and (ii) to determine the optimum frequency for treating carious lesions with fluoridated milk. Materials and methods. Artificial carious lesions, 90-180 mu m deep, were created on extracted third molar teeth that were sectioned to produce specimens of 100-120 mu m thickness. Specimens were randomly divided into 13 groups (n = 20) for treatment with deionized water, plain milk or fluoridated milk (2.5 ppm, 5 ppm, 10 ppm); once daily, twice daily or on alternate days as part of a 20-day pH cycling model. Lesion depth (LD) and mineral content were evaluated before and after pH cycling. Paired t-test, ANOVA and Student-Newman-Keuls tests were employed to make comparisons within and between the different groups. Results. Fluoridated milk significantly reduced LD and increased the mineral content of the lesions compared to plain milk and deionized water (p < 0.05). The greatest reduction in LD was with 2.5 ppm F milk used twice daily (p < 0.05). Conclusions. Milk with 2.5 ppm F used twice daily demonstrated the greatest remineralization of artificial enamel carious lesions in vitro.

OBJECTIVE:To investigate the relationship between concentration of fluoride in milk and its re-mineralizing efficacy, and to test whether increasing the volume of fluoridated milk has any effect on its re-mineralizing efficacy.METHODS:Third molars were painted leaving a 1 mm window on the buccal and/or lingual surfaces. Artificial carious lesions were induced using a de-mineralizing solution. The teeth were then sectioned longitudinally. Specimens were randomly assigned to 15 groups according to different concentrations and volume; i.e., 2.5 ppm, 5 ppm, 7.5 ppm, 10 ppm, 15 ppm, 20 ppm, and 250 ppm of fluoride with 25 ml/section and 50 ml/section. De-ionized water and plain milk were used as controls. Sections were subjected to pH cycling for 20 days. Polarized light microscopy and micro-radiography were utilized to record the lesion characteristics before and after pH cycling.RESULTS:Mean lesion depths decreased significantly in all the fluoride groups, and increased significantly in the control groups. There were no differences in percentage of lesion depth decrease when the volume was doubled for the same fluoride concentration. There were also no statistically significant differences between percentages of decrease in lesion depth when the concentration of fluoride in milk was increased.CONCLUSION:Fluoridated milk demonstrated a remineralization efficacy on early enamel carious lesions. A 2.5 ppm fluoride milk concentration provided similar remineralization potential to that of higher fluoride concentration in milk.

BACKGROUND:Although child formula fluoridated dentifrices can be used safely by young children their remineralizing capability remains questionable.AIMS:To evaluate the remineralizing potential of child formula dentifrices on primary teeth.DESIGN:In vitro single-section technique utilizing a 7 days pH-cycling model.METHODS:Primary teeth were placed in demineralizing solution for 96 h to produce artificial carious lesions 100 μm deep, and then cut longitudinally into 50 sections 100-150 μm thick and randomly assigned to five groups. Sections in Groups A to D were treated with dentifrices containing 500 ppm AmF, 500 ppm MFP, 500 ppm MFP and xylitol, or 500 ppm NaF, respectively. Group E sections were treated with a nonfluoridated dentifrice.OUTCOME MEASUREMENTS:Lesions were evaluated using polarized light microscopy and microradiography.RESULTS:Group D (500 ppm NaF) sections exhibited a significant decrease in lesion depth, whereas those in Group E (nonF) showed a significant increase in depth (P<0.05, paired t-test). Decrease in lesion progression was observed in Groups A, B and C.CONCLUSIONS:The 500 ppm NaF dentifrice demonstrated remineralization of carious lesions by virtue of a significant decrease in lesion depth; whereas dentifrices that contained AmF, MFP and MFP with xylitol decelerated the progression of demineralization.

The ADA recommends the use of fluoridated dentifrices as soon as the primary teeth erupt, so as to reduce the incidence of dental caries. However, young children can ingest a significant amount of dentifrice during normal toothbrushing; this is a potential problem because the permanent teeth are at risk from fluorosis for the first seven years of life. Aims: the objective of this paper was to review the literature on the role of fluoride dentifrices in causing dental fluorosis. Methods: Search strategy: a search for literature was performed using MEDLINE, OVID with the key words fluorosis, dentifrice, ingestion, and children. The search was limited to English language publications. Subsequently, 31 articles were retrieved, additional relevant articles were collected from the references cited in the initially identified papers. Ultimately, 96 articles were retrieved for review. Conclusions: Fluoride, should be used with caution so that the benefits out-way the adverse affects. Oral health care providers need to systematically assess individual tooth brushing habits and emphasize the advantages of early use of a fluoridated dentifrice whilst still meeting the need for the prudent use of small quantities of dentifrice. Dentifrices with a low concentration of fluoride may be appropriate for young children who are considered to be at low caries risk and the risk of fluorosis is minimal for children who ingest this dentifrice; nevertheless, it appears that more research is still required on the therapeutic effects of fluoride dentifrices which contain fluoride at a low concentration.

ABSTRACT Objectives. To test whether the modified in-vitro pH-cycling model would work successfully as a means of investigating the de-/re-mineralization effects of nanoparticle hydroxyapatite toothpaste, and to compare such effects with those of sodium fluoride toothpaste. Methods. Sound extracted molars were painted, leaving a 1-mm wide window, and placed in a demineralizing solution for 96 hours to produce 100 to 120 孍 deep artificial carious lesions. The teeth were sectioned longitudinally (100 to 150 孍 thick) and divided into three groups (n=10 in each). Group A specimens were treated with a non-fluoride toothpaste containing 10% hydroxyapatite; group B (negative control) specimens were treated with a non-fluoride toothpaste containing 0% hydroxyapatite; while group C (positive control) specimens were treated with a fluoride (950 ppm sodium fluoride) toothpaste with 0% hydroxyapatite. The pH-cycling model was utilized for a period of 10 days. Results. For groups A and C, the mean depth (P<0.01) and the mineral content (P<0.05) of the lesions after treatment decreased significantly compared with baseline (paired t test), while the corresponding values for group B were significantly higher (P<0.001, paired t test). Furthermore, the maximum mineral content of the surface zone decreased significantly in group B but not in groups A and C. Conclusions. The modified in-vitro pH-cycling model successfully revealed progression and mineral changes in initial enamel lesions. Application of both the 10% hydroxyapatite and the 950 ppm sodium fluoride toothpastes reduced the rate of lesion progression when compared with application of toothpaste without either active ingredient.

Objective: To investigate the effectiveness of two treatment methods, namely topical applications of silver diamine fluoride (SDF) solution and a high fluoride releasing glass ionomer, in arresting dentine caries in primary teeth. Methods: 212 preschool children, aged 3-4 years, in a rural area in Southern China were randomly allocated to one of three groups for treatment of the carious cavities in their primary teeth: Gp1-annual application of SDF, Gp2-semi-annual application of SDF, and Gp3-annual application of a high fluoride releasing glass ionomer. Treatments were provided in the kindergartens. Information on the children's demographic background, oral hygiene and snacking habit was collected by questionnaires. Follow-up examinations were carried out every six months by an independent examiner. Intra-oral LED light, mouth-mirrors and sharp probes were used. Treatment success was recorded when the glass ionomer covered the whole lesion or the caries lesion was arrested, i.e. hard to probing with a light force. Generalized Estimating Equation (GEE) approach was used to account for the within-subject clustering effect when assessing the effects of treatment group, tooth position, surface and other background factors on the outcome. Results: After 24 months, 178 (84%) children were examined. The success rates were 79.2%, 90.7% and 81.8% for Gp1, Gp2 and Gp3, respectively (Chi-square test, p=0.007). Children's background and behavioral factors had no significant effects on the treatment outcome. The lesions in Gp2 were more likely to become arrested compared to those in Gp1 (OR=2.98, p=0.007) or Gp3 (OR=2.65, p=0.001). Success rates were also higher for lesions in the anterior teeth (OR=5.55, p<0.001) or in buccal/lingual smooth surfaces (OR=15.6, p=0.004). Conclusion: The 24-month success rates of the two treatment methods are high in this study population, with that of semi-annual application of SDF being the highest. Success of caries arrest treatment varies with tooth position and the surface involved.

Objectives: To compare the detection of changes before and after remineralization of artificial enamel and dentin caries by microCT scanning, polarized light microscopy (PLM) and transverse microradiography (TMR).Methods: Fourteen extracted premolars were cut into tooth blocks and painted with an acid-resistant varnish leaving one enamel and one dentin surface exposed. The tooth blocks were immersed into demineralizing solution for 4 days to produce artificial caries-like lesions and scanned by microCT. Then the 14 tooth blocks were randomly allocated into two groups. Seven tooth blocks in Group I were cut longitudinally through the exposed surface into 100150 mu m thick sections and microradiographs were taken. The other seven tooth blocks in Group H were left intact. All the tooth blocks and sections were then immersed into remineralizing solution for 5 days. PLM and TMR of the tooth sections in Group I were taken again. Depth of the lesion on the TMR was measured. Tooth blocks in Group II were scanned by microCT.Results: Mean lesion depth in Group I reduced by 13.0% and 8.2% after remineralization for enamel and dentin, respectively (paired t-test, P < 0.001). In Group II, linear attenuation coefficient (LAC) of the region of interest (ROI) increased by 11.1% and 23.8% after remineralization for enamel and dentin lesions, respectively (paired t-test, P < 0.001).Conclusion: Both microCT and microradiography are able to detect a change of similar magnitude in the artificial caries lesions after remineralization. MicroCT may be used to substitute TMR and PLM in in vitro studies about caries. (C) 2010 Elsevier Ltd. All rights reserved.

Objectives. To consider the eects of chewing gum on dental plaque and saliva, and to discuss the value of chewing gum as a means of delivering anticariogenic agents. Methods. Literature and data from 1940 to 2007 related to chewing gum and anticariogenic therapeutic agents were sourced using PubMed and hand searches. Results. Chewing of gum increases salivary production and salivary #ow rate. With the increase in salivary #ow, the concentration of bicarbonate and phosphate is higher in stimulated saliva. The resultant increase in plaque pH and salivary buering capacity prevents demineralization of tooth structure. The chewing action also results in the physical removal of plaque and food debris, which assists in cleansing the occlusal surfaces of the teeth. Because gum is repetitively chewed it has a longer period of exposure to the surfaces of teeth than a dentifrice or mouthrinse; thus, it can be a useful adjunct in maintaining oral health, especially if it contains a therapeutic agent that is eective topically. Agents that have been added to chewing gum to speci$cally prevent dental caries include: polyols such as xylitol and sorbitol, #uoride, calcium phosphate, carbamide (urea), enzymes, and granules. Conclusions. There is insu!cient published evidence, especially for carbamide, enzymes, and granules, to support the notion that these addictives have a therapeutic role when added to chewing gum. Further investigations are required to justify the anticariogenic claims when chewing gum is the medium of delivery.

International Journal of Paediatric DentistryVolume 19, Issue s1 p. 9-11 Free Access Oral Session O04/Cariology 4 First published: 15 May 2009 https://doi.org/10.1111/j.1365-263X.2009.00992_5.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume19, Issues1Special Issue: Abstracts of the 22nd Congress of the International Association of Paediatric Dentistry, Munich, Germany, 17-20 June 2009June 2009Pages 9-11 RelatedInformation

Objectives: Oral mucositis and their correlation with oral infections, pro-inflammation agents and deficiency of proteins such as mannose binding lectin in haematopoietic stem cell transplantation (HSCT) have been part of an ongoing study at the Haematology and Oncology, Queen Mary Hospital in Hong Kong. Methods: A cohort of randomly selected adult patients with hematological disorders who underwent HSCT during 2005-07 was screened from the day of admission until discharged. Confounding variables include the type of donor, conditioning regimens, immunosuppressants and opioid analgesics used, disease state, hematological values and, febrile episodes. Oral mucositis scoring system (OMS) was adopted with modifications (WHO). The assessment and sampling of specimens was conducted by dental specialists and/or transplantation specialty nurses. Inter-examiner cross validations were done prior to actual assessment period. Mouth mirrors and bedside lighting were used to evaluate the oral conditions. Results: A total of 65 adult patients were participated in this study. They included 39 males and 26 females with an age range of 17-65 years with diseases such as myeloma, lymphomas, acute leukaemia and, pre-leukaemia. Forty-eight (74%) had chemotherapy alone and 17 (26%) had combined chemotherapy and radiation as conditioning regimen. Donors included autologus (20, 30.7%), allogenic (16, 24.6%) and syngenic/sibling match (29, 44.6%). The total OMS ranged between 10 and 25 (normal total score = 9) with no significant difference between the variable scores amongst autologus, allogenic and sibling-match. Hospital stay was highest in the allogenic group (mean, 35 days) compared with sibling-match (mean, 30 days) and autologus (mean, 25 days). OMS correlated well with neutropenia (p=0.0004), high pain score (p=0.005) and thrombocytopenia (p<0.0001; ANOVA). Conclusions: OMS significantly correlated with the causative events of oral complications such as neutropenia and thrombocytopenia and positively correlated with pain visual analogous score. Type of donor cells was correlated well with duration of hospital stay.