Chemical kinetics of silver diammine fluoride in demineralization and remineralization solutions—an in vitro study

Introduction: Silver Diammine Fluoride (SDF) is a clinical minimal intervention to manage dentin caries. Its chemistry in demineralization conditions has been investigated widely, but far less in remineralization conditions. The aim was to investigate and compare the chemical reactions when SDF is added to remineralization and demineralization solutions. Methods: 0.01 ml SDF (Riva Star) was added to deionized water (DW); demineralization (DS = pH4) and remineralization (RS = pH7.0) solutions. The time sequence of concentrations of NH4+, F−, and Ag+ were measured using ion selective electrodes (ISEs) every 2 min. The pH was also measured. Precipitates were characterized using x-ray Diffraction (XRD) and, 31P and 19F nuclear magnetic resonance spectroscopy (NMR). Results: The concentrations of NH4+ and Ag+ showed decreasing trends in DW (−0.12 and −0.08 mM/h respectively), and in DS (−1.06 and −0.5 mM/h respectively); with corresponding increase in F− concentration (0.04 and 0.7 mM/h respectively). However, in RS, NH4+ concentration showed little change (0.001 mM/h), and Ag+ and F− concentrations were negligible. XRD results showed that precipitates (in RS only) contained AgCl, and metallic Ag. NMR showed that fluorapatite/carbonated fluorapatite (FAP/CFAP) were formed. The pH increased after SDF addition in all three solutions. Discussion: SDF dissolved to release NH4+, F− and Ag + . In DW and DS, NH4+ combined with Ag+ to form diamminesilver, causing an increase of F− and pH. In RS, F− reacted with Ca2+ and (PO)43− to form FAP/CFAP, and Ag+ reacted with Cl− to form AgCl/Ag. These suggests why SDF is effective in managing dentin caries

Characterization of chemical reactions of silver diammine fluoride and hydroxyapatite under remineralization conditions.

INTRODUCTION: Silver Diammine Fluoride (SDF) is a clinically used topical agent to arrest dental caries. However, the kinetics of its chemical interactions with hydroxyapatite (HA), the principal inorganic component of dental enamel, are not known. The aim was to characterize the step-wise chemical interactions between SDF and HA powder during the clinically important process of remineralization. METHODS: Two grams of HA powder were immersed in 10 ml acetic acid pH = 4.0 for 2 h to mimic carious demineralization. The powder was then washed and dried for 24 h and mixed with 1.5 ml SDF (Riva Star) for 1 min. The treated powder was then air-dried for 3 min, and 0.2 g was removed and stored in individual tubes each containing 10 ml remineralizing solution. Powder was taken from each tube at various times of exposure to remineralization solution (0 min, 10 min, 2 h, 4 h, 8 h, 24 h, and 10 days), and characterized using Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR) spectroscopy. RESULTS AND DISCUSSION: 19F MAS-NMR spectra showed that calcium fluoride (CaF2) started to form almost immediately after HA was in contact with SDF. After 24 h, the peak shifted to -104.5 ppm suggesting that fluoride substituted hydroxyapatite (FSHA) was formed with time at the expense of CaF2. The 31P MAS-NMR spectra showed a single peak at 2.7 ppm at all time points showing that the only phosphate species present was crystalline apatite. The 35Cl MAS-NMR spectra showed formation of silver chloride (AgCl) at 24 h. It was observed that after the scan, the whitish HA powder changed to black color. In conclusion, this time sequence study showed that under remineralization conditions, SDF initially reacted with HA to form CaF2 which is then transformed to FSHA over time. In the presence of chloride, AgCl is formed which is subsequently photo-reduced to black metallic silver

Bioactive glass composite for orthodontic adhesives - Formation and characterisation of apatites using MAS-NMR and SEM.

OBJECTIVES: To study the dissolution and fluoroapatite (FAP) formation of a new bioactive glass (BAG)-resin adhesive in an acidic solution in reference to neutral solutions, using the magic angle spinning-nuclear magnetic resonance (MAS-NMR) and the scanning electron microscopy (SEM). METHODS: BAG composite disks (n = 90) were prepared from, novel fluoride-containing BAG-resin. Three sample groups (n = 30) of the disks were immersed in Tris buffer pH = 7.3 (TB), neutral artificial saliva pH = 7 (AS7) and acidic artificial saliva pH = 4 (AS4) at ten time points (from 6 h to 6 months). Half of the immersed disks at each time point were crushed into a powder and investigated by the solid state MAS-NMR. SEM studies were undertaken by embedding the other half of the immersed disk in a self-cure acrylic where the fracture surface was imaged. RESULTS: MAS-NMR results show that the BAG composite degraded significantly faster in AS4 compared to TB and AS7. At the end of the immersion period (6 months), around 80% of the glass particles in AS4 had reacted to form an apatite, evidenced by the sharp peak at 2.82 ppm in 31P signals compared to a broader peak in TB and AS7. It also shows evidence of fluorapatite (FAP) formation, indicated by 19F signal at -103 ppm, while signal around -108 ppm indicated the formation of calcium fluoride, from the excess Ca2+ and F- especially on longer immersion. SEM images confirm higher degradation rate of the BAG composite in AS4 and reveal the impact of time on the dissolution of more glass particles. The images also indicate apatite formation around the glass particles in TB and AS4, while it forms predominantly over the disk surface in AS7. SIGNIFICANCE: BAG composite demonstrate smart reactivity in response to pH change which has a potential clinical benefit against demineralization and promoting remineralisation to form more stable fluorapatites

Pten (phosphatase and tensin homologue gene) haploinsufficiency promotes insulin hypersensitivity

AIMS/HYPOTHESIS: Insulin controls glucose metabolism via multiple signalling pathways, including the phosphatidylinositol 3-kinase (PI3K) pathway in muscle and adipose tissue. The protein/lipid phosphatase Pten (phosphatase and tensin homologue deleted on chromosome 10) attenuates PI3K signalling by dephosphorylating the phosphatidylinositol 3,4,5-trisphosphate generated by PI3K. The current study was aimed at investigating the effect of haploinsufficiency for Pten on insulin-stimulated glucose uptake. MATERIALS AND METHODS: Insulin sensitivity in Pten heterozygous (Pten(+/−)) mice was investigated in i.p. insulin challenge and glucose tolerance tests. Glucose uptake was monitored in vitro in primary cultures of myocytes from Pten(+/−) mice, and in vivo by positron emission tomography. The phosphorylation status of protein kinase B (PKB/Akt), a downstream signalling protein in the PI3K pathway, and glycogen synthase kinase 3β (GSK3β), a substrate of PKB/Akt, was determined by western immunoblotting. RESULTS: Following i.p. insulin challenge, blood glucose levels in Pten(+/−) mice remained depressed for up to 120 min, whereas glucose levels in wild-type mice began to recover after approximately 30 min. After glucose challenge, blood glucose returned to normal about twice as rapidly in Pten(+/−) mice. Enhanced glucose uptake was observed both in Pten(+/−) myocytes and in skeletal muscle of Pten(+/−) mice by PET. PKB and GSK3β phosphorylation was enhanced and prolonged in Pten(+/−) myocytes. CONCLUSIONS/INTERPRETATION: Pten is a key negative regulator of insulin-stimulated glucose uptake in vitro and in vivo. The partial reduction of Pten due to Pten haploinsufficiency is enough to elicit enhanced insulin sensitivity and glucose tolerance in Pten(+/−) mice

Effect of Dental Operatory Light on the Flow and Penetration of Fissure Sealant

What can be done to prevent premature polymerisation

A novel frameshift MSX1 mutation in a Saudi family with autosomal dominant premolar and third molar agenesis

OBJECTIVES: In this study, the aim was to investigate a consanguineous Saudi family with non-syndromic premolars and third molars agenesis and to identify the causal mutation(s) using whole exome sequencing. DESIGN: Family phenotype and family pedigree were constructed from clinical and radiographic examinations. Whole exome sequencing was performed in two affected members of the Saudi family using the SureSelect Human all Exon 50 Mb kit (Agilent Technologies, Inc., Santa Clara, CA) and then sequenced on an Illumina HiSeq. SNP and indel calling were performed using samtools version 0.18 and were annotated using the software ANNOVAR. RESULTS: The family pedigree showed that the inheritance was autosomal dominant. Whole exome sequencing revealed that the affected members in this family were heterozygous with a novel frameshift mutation in exon 2 of the MSX1 gene, (NM_002448:c.750_751insACCGGCTGCC, p.F251PfsX92). CONCLUSIONS: The novel MSX1 frameshift mutation was linked to a family with moderate to severe tooth agenesis phenotype affecting second premolars and third molars in both arches. This expands the genotype-phenotype of MSX1 associated conditions