Age effect on presence, susceptibility and treatment of erosive tooth wear

Indiana University-Purdue University Indianapolis (IUPUI)Erosive tooth wear (ETW) is a growing dental condition often associated with aging. This in-vitro project comprised three studies aiming to investigate the impact of tooth age on ETW susceptibility and prevention. In the first study, un-identified extracted premolars were collected and had their ages estimated using validated dental forensic methods. The premolars were examined to investigate the relationship between age and presence and severity of ETW, as well as other main dental-hard tissues conditions. ETW, dental caries, fluorosis, extrinsic staining and tooth color were evaluated using established clinical indices. In the second study, the tooth age impact on ETW susceptibility and response to preventive treatments (Sn+F, NaF, and de-ionized water control) were evaluated using representative samples from the initial study. Enamel and dentin specimens were prepared and subjected to daily erosion-treatmentremineralization cycling procedure. Surface loss (SL) was determined during and after the cycling, by optical profilometry. Similar protocol was adopted in the third study with the addition of toothbrushing abrasion to the model, in order to explore the interplay between age and toothpaste abrasivity on erosion-abrasion development. SL was measured during and after the erosion-toothbrushing-remineralization cycling. The relationships between age and the investigated variables were assessed using linear regression models. In conclusion: 1. The presence and severity of ETW, dental caries, and extrinsic staining increased with age, while of enamel fluorosis decreased. Tooth also showed to be darker with age. 2. Susceptibility of enamel and dentin to demineralization increased with age. Sn+F showed the highest anti-erosive efficacy, and was not affected by age. NaF showed lower efficacy on dentin, which increased with age. 3. Enamel and dentin SL increased with toothpaste abrasivity level. Dentin SL also increased with age. Age effect on enamel SL was observed only with low abrasive toothpaste. Age-related changes on enamel and dentin affected ETW development.2020-05-1

Efficacy of stannous, fluoride and their their combination in dentin erosion prevention in vitro

The aim of this study was to compare the protective effects of solutions containing stannous (Sn), fluoride (F) and their combination in the prevention of dentin erosion. Forty bovine root dentin specimens (4’4’2 mm3) were prepared and randomly assigned to 4 groups (n = 10): SnCl2 (800 ppm/6.7 mM Sn), NaF (250 ppm/13 mM F), NaF/SnCl2 (800 ppm/6.7 mM Sn; 250 ppm/13 mM F), and deionized water (DIW) as a negative control. An acquired pellicle was formed on dentin samples by incubation in clarified, pooled, stimulated human saliva for 24 hours. The specimens were subjected to 5 daily cycles, each consisting of 5 of min demineralization (0.3%/15.6 mM citric acid, pH 2.6, 6’/day) and 60 min of re-mineralization in clarified human saliva. Thirty minutes after the 1st, 3rd and 5th demineralization episodes of each day, the specimens were treated with one of the test solutions for 2 min. Surface loss was measured via optical profilometry. Mixed-model ANOVA followed by Tukey’s test were used for the statistical analysis. Sn, F, and their combination significantly reduced the dentin surface loss by 23%, 36%, and 60% compared with DIW, respectively. All groups were significantly different (p < 0.05). The combination of Sn and F significantly reduced the amount of dentin surface loss compared with all other groups. The F group also significantly reduced surface loss compared with Sn and DIW, followed by the Sn group, which showed significantly greater protection compared with the DIW control. The daily use of a combined fluoride and stannous solution is promising for preventing dentin erosion

Interaction between tin/flouride-containing solutions and artificially created dental pellicles on erosion prevetion in vitro

Indiana University-Purdue University Indianapolis (IUPUI)School of dentistryBACKGROUND: Fluoride and stannous ions have been reported to be relevant for dental erosion prevention. However, their interaction with the acquired dental pellicle (ADP), a clinically relevant erosion protective factor, is not well known and needs to be investigated. OBJECTIVES: To investigate the anti-erosive properties of fluoride-containing solutions and stannous solutions on enamel and dentin surfaces with a previously formed ADP. To characterize the protein profile of the ADP treated with the test solutions. METHODS: Phase I tested four solutions: SnCl2/NaF, NaF, SnCl2 and deionized water (DIW) (as negative control). Forty bovine enamel and dentin specimens 104 (4x4x2 mm3) were prepared and randomly distributed into 4 groups (n = 10). The specimens were incubated in clarified human saliva (CHS) for 24 h for pellicle formation and then they were subjected to a cycling procedure that included a 5-min erosive challenge (0.3-percent citric acid, pH 2.6); a 2-min treatment with the solution (between 1st, 3rd and 6th cycles); a 2-h immersion in CHS, and overnight immersion in CHS. Cycles were repeated 6x/day for 5 days. The outcome measure was surface loss (SL) using profilometry. Phase II: Thirty-two (32) bovine enamel specimens (882 mm3) (n = 8) were similarly prepared and incubated in saliva for 24 h and then treated with the solutions for 2 min followed by CHS immersion for 2 h. This cycle was repeated 3x for one day. The pellicles formed and treated with the test rinse solutions were collected, digested, and analyzed for specific protein content using liquid chromatography electrospray ionization tandem mass spectrometry (LCESI-MS/MS). RESULTS: Phase I: for enamel, SnCl2/NaF, SnCl2, NaF solutions provided 89 percent, 67 percent, and 42 percent SL reduction respectively compared with the control, while in dentin they provided 60 percent, 23 percent, and 36 percent, respectively, all significant at p < 0.05. Phase II: Seventy-two (72) common proteins were identified in all groups, 30 exclusive to DIW, 20 to SnCl2/NaF, 19 to NaF, and 13 to SnCl2. SnCl2/NaF increased the abundance of pellicle proteins than each one alone. CONCLUSION: SnCl2/NaF showed the best anti-erosive effect on both enamel and dentin. The findings suggest that the composition of acquired pellicle changes with different solutions, which may be related to their anti-erosive effect

Odnosi između dentalne topografije, ukupne istrošenosti cakline, Bang i Ramm/Liversidge te Mollesonov procjena starosti za uzorak ljudskih pretkutnjaka

Objectives: Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation. Material and methods: Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample. Results: Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters. Conclusion: The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear through-out the lifecourse.Svrha: Trošenje zubne krune kutnjaka često se koristi u bioarheološkim istraživanjima za procjenu dobi u trenutku smrti. No u nekoliko takvih analiza upotrijebljeni su pretkutnjaci ili se uspoređivala primjena različitih metoda procjene relativne dobi. Materijal i metode: Koristeći se uzorkom od 197 izvađenih prvih maksilarnih pretkutnjaka stomatoloških pacijenata iz SAD-a, u radu razmatramo tri protokola za procjenu dobi – prema Bangu i Ramm/Liversidgeu te Mollesonu (BRLM), okluzalnu topografsku analizu i Smithovu metodu za sustav bodovanja makroistrošenosti. U prethodnoj studiji koja se koristila metodom Banga i Ramma dobiven je raspon procijenjene dobi od 9,4 do 10,8 godina za uzorak. Rezultati: Naše analize nisu pokazale povezanost između parametara okluzalne topografije (okluzalni nagib, reljef ili faseta) i procjene starosti BRLM-a, i određenu podudarnost između Smithova bodovanja i procjena starosti BRLM-a te između Smithova bodovanja i parametara okluzalne topografije. Zaključak: Dobiveni rezultati sugeriraju da su odnosi između gruboga trošenja zuba, njihova oblika i procjene starosti složeni, a dostupne metode treba razmotriti zajedno kako bi se steklo sveobuhvatnije razumijevanje o tome kako zubi tijekom života trošenjem mijenjaju oblik

Trend-analysis of dental hard-tissue conditions as function of tooth age

Objective This retrospective in-vitro study investigated tooth age effect on dental hard-tissue conditions. Methods Unidentified extracted premolars (n = 1500) were collected and their individual age was estimated (10–100 (±10) years old (yo)) using established dental forensic methods Dental caries, fluorosis and tooth wear (TW) were assessed using the International Caries Detection and Assessment System (ICDAS; 0–5 for crown and 0–2 for root), Thylstrup-Fejerskov (TFI; 0–9) and Basic Erosive Wear Examination (BEWE; 0–3) indices, respectively. Staining and color were assessed using the modified-Lobene (MLI) (0–3) and VITA shade (B1-C4) indices, respectively. Relationships between indices and age were tested using regression models. Results Starting at age ∼10yo, presence of caries increased from 35% to 90% at ∼50yo (coronal), and from 0% to 35% at ∼80yo (root). Caries severity increased from ICDAS 0.5 to 2 at ∼40yo and from ICDAS 0 to 0.5 at ∼60yo for coronal and root caries, respectively. Presence of TW increased from 25% (occlusal) and 15% (smooth-surfaces) to 100% at ∼80yo. TW severity increased from BEWE 0.5 to 2 at ∼50yo (occlusal) and ∼0.3 to 1.5 at ∼50yo (smooth-surfaces). Percentage and severity of fluorosis decreased from 70% to 10% at ∼80yo, and from TFI 1 to 0 at ∼90yo, respectively. Percentage of extrinsic staining increased from 0% to 85% at ∼80yo and its severity increased from MLI 0 to 2 at ∼70yo. Color changed from A3 to B3 at ∼50yo (crown), and from C2 to A4 at ∼85yo (root). Conclusions Aging is proportionally related to the severity of caries, TW, staining, and inversely to dental fluorosis. Teeth become darker with ag

Inhibitory effect of gels loaded with a low concentration of antibiotics against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis

We explored longitudinally the inhibitory effect of gels loaded with 1 mg/mL modified triple antibiotic paste (MTAP) or double antibiotic paste (DAP) against biofilm formation by Enterococcus faecalis and Porphyromonas gingivalis. Methylcellulose-based antibiotic gels of MTAP (ciprofloxacin, metronidazole and clindamycin) and DAP (ciprofloxacin and metronidazole) were prepared at a concentration of 1 mg/mL. Individually cultured E. faecalis and P. gingivalis bacterial suspensions were treated with MTAP, DAP, or placebo (vehicle only) gels at different dilutions and allowed to grow in 96-well microtiter plates. Untreated bacterial suspensions served as a negative control. Crystal violet assays were used to evaluate biofilm formation after 48 h. The ability of the gels to inhibit biofilm formation was determined immediately, and at 1 month and 3 months after the gels had been prepared. Data were analyzed using a mixed-model ANOVA. The MTAP and DAP gels significantly reduced biofilm formation by both bacterial species at all time points, regardless of the tested dilution. No-significant differences in biofilm-inhibitory effects between MTAP and DAP gels were observed at the majority of the tested dilutions through various time points. Gels loaded with 1 mg/mL MTAP and DAP demonstrated a significant antibiofilm effect against E.faecalis and P. gingivalis

Original research Efficacy of stannous, fluoride and their their combination in dentin erosion prevention in vitro

Abstract: The aim of this study was to compare the protective effects of solutions containing stannous (Sn), fluoride (F) and their combination in the prevention of dentin erosion. Forty bovine root dentin specimens (4&apos;4&apos;2 mm 3 ) were prepared and randomly assigned to 4 groups (n = 10): SnCl 2 (800 ppm/6.7 mM Sn), NaF (250 ppm/13 mM F), NaF/SnCl 2 (800 ppm/6.7 mM Sn; 250 ppm/13 mM F), and deionized water (DIW) as a negative control. An acquired pellicle was formed on dentin samples by incubation in clarified, pooled, stimulated human saliva for 24 hours. The specimens were subjected to 5 daily cycles, each consisting of 5 of min demineralization (0.3%/15.6 mM citric acid, pH 2.6, 6&apos; /day) and 60 min of re-mineralization in clarified human saliva. Thirty minutes after the 1 st , 3 rd and 5 th demineralization episodes of each day, the specimens were treated with one of the test solutions for 2 min. Surface loss was measured via optical profilometry. Mixedmodel ANOVA followed by Tukey&apos;s test were used for the statistical analysis. Sn, F, and their combination significantly reduced the dentin surface loss by 23%, 36%, and 60% compared with DIW, respectively. All groups were significantly different (p &lt; 0.05). The combination of Sn and F significantly reduced the amount of dentin surface loss compared with all other groups. The F group also significantly reduced surface loss compared with Sn and DIW, followed by the Sn group, which showed significantly greater protection compared with the DIW control. The daily use of a combined fluoride and stannous solution is promising for preventing dentin erosion

Relationships between Dental Topography, Gross Wear, and Bang and Ramm/Liversidge and Molleson Age Estimates for a Sample of Human Premolar Teeth

Objectives: Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation. Material and methods: Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample. Results: Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters. Conclusion: The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear through-out the lifecourse

Knowledge and attitude of dentists toward minimally invasive caries management in Almadinah Almunawwarah province, KSA

الملخص: أهداف البحث: يتم تحويل إدارة تسوس الأسنان نحو طب الأسنان طفيف التوغل، واستراتيجيات أكثر تحفظا وقائمة على الأدلة. على الرغم من أن معظم مدارس طب الأسنان تبدأ في دمج استراتيجيات إدارة تسوس الأسنان طفيفة التوغل في مناهجها الدراسية؛ ليس معروفا جيدا ما إذا كان يتم تنفيذها في الممارسة اليومية. هدفت هذه الدراسة إلى تقييم معرفة وموقف أطباء الأسنان العاملين في منطقة المدينة المنورة في المملكة العربية السعودية فيما يتعلق بتطبيق طب الأسنان طفيف التوغل في إدارة تسوس الأسنان. طريقة البحث: أجريت دراسة مقطعية باستخدام استبانة إلكترونية بين أطباء الأسنان الممارسين في كل من العيادات الخاصة والعامة في المدينة المنورة، المملكة العربية السعودية. تتكون الاستبانة من 4 أقسام بما في ذلك البيانات الديموغرافية وتعليم الأسنان والخبرة السريرية والمعرفة والموقف فيما يتعلق بطب الأسنان طفيف التوغل وإدارة تسوس الأسنان. بالنسبة للتحليل الإحصائي، تم حساب إحصائيات وصفية بسيطة مثل التوزيعات المتوسطة والترددية؛ بينما تم إجراء المقارنات باستخدام اختبار كاي سكوير. النتائج: شارك في الدراسة ما مجموعه 130 طبيب أسنان، غالبيتهم من أطباء الأسنان السعوديين العامين العاملين في عيادات الأسنان الخاصة مع توزيع مماثل بين الذكور والإناث الذين تتراوح أعمارهم بين 25 و 35 سنة. فيما يتعلق بمعرفة إزالة التسوس الانتقائي، اختار 20 ٪ فقط أن إزالة التسوس الانتقائي يعتمد على عمق الآفة، بينما أجاب 74.6 ٪ أن تناسق الأسنان الملتهب مهم لإزالة التسوس الانتقائي. على الرغم من أن 60٪ كشفوا أنهم سيقيمون مخاطر تسوس المريض قبل بدء العلاج، إلا أن 11.5٪ فقط سيقومون بتقييم المخاطر والعلاج غير الجراحي في الزيارة الأولى لإدارة التسوس. يستخدم 4.6٪ فقط معايير النظام الدولي للكشف عن التسوس وتقييمه 2 في تشخيص تسوس الأسنان، بينما يستخدم 46.2٪ معايير ''جي في بلاك''. بالإضافة إلى ذلك، وافق 53.8٪ من المشاركين على أنه يجب إزالة التسوس بالكامل لوقف تقدم التسوس. الاستنتاجات: حصل أطباء الأسنان في المدينة المنورة على معرفة معقولة فيما يتعلق بأهمية طب الأسنان طفيف التوغل في إدارة تسوس الأسنان، لكنهم لا يطبقون بشكل كامل مفاهيم مثل تقييم مخاطر التسوس ومعايير تشخيص تسوس الأسنان الموصى بها مؤخرا في الممارسة السريرية اليومية. Abstract: Objective: Over time, the management of dental caries has shifted towards minimally invasive dentistry (MID) and more conservative and evidence-based strategies. Although most dental schools have begun to incorporate MID caries management strategies in their curriculum; it has yet to be established whether these strategies are being implemented in everyday practice. In this study, we aimed to evaluate the knowledge and attitude of dentists working in Almadinah Almunawwarah province in KSA with regards to the implementation of MID in caries management. Methods: This was a cross-sectional study which involved sending a self-administered and anonymous questionnaire to dentists practicing in both private and public clinics in Almadinah Almunawwarah, KSA. The questionnaire consisted of four sections: demographic data, dental education, clinical experience, and knowledge and attitude with regards to MID and the management of caries. For statistical analysis, we calculated simple descriptive statistics, including mean and frequency distributions; comparisons were performed using the Chi-squared test. Results: A total of 130 dentists participated in the study; the majority of respondents were Saudi general dentists working in private dental clinics; there was a similar distribution of males and females and the age of the dentists ranged from 25 to 35 years. With regards to knowledge relating to selective caries removal (SCR), only 20% of subjects responded that SCR is based on lesion depth, while 74.6% reported that carious dentin consistency is important for SCR. Although 60% of respondents reported that they would assess a patient's risk of caries before commencing treatment, only 11.5% would perform risk assessment and non-surgical treatment in the first visit for caries management. Only 4.6% reported that they used the International Caries Detection and Assessment System (ICDAS) II criteria for the diagnosis of caries while 46.2% used the G.V. Black criteria. In addition, 53.8% of participants agreed that caries must be completely removed to prevent the progression of caries. Conclusion: Dentists in Almadinah Almunawwarah province had reasonable levels of knowledge regarding the importance of MID in caries management. However, they did not fully implement certain concepts, such as caries risk assessment and the recently recommended criteria for the diagnosis of caries, in their everyday clinical practice