Anti-caries evaluation of a nano-hydroxyapatite dental lotion for use after toothbrushing: An in situ study.

OBJECTIVES: The aim of this randomized, double-blind, two-arm crossover in situ study was to investigate whether nano-hydroxyapatite (nanoHAP) dental lotion (Apagard Deep Care) applied immediately after tooth-brushing with nanoHAP toothpaste (Apagard M-plus) enhances the remineralization promotion and the demineralization inhibition efficacies of nanoHAP toothpastes. METHODS: 64 sound enamel blocks and 64 blocks bearing artificially-produced initial caries were produced from human permanent molar teeth. During each treatment period, lasting 14 days per arm, two blocks, one sound and one lesion-bearing, were exposed to either 5% nanoHAP-containing or placebo dental lotion after tooth-brushing with 5% nanoHAP toothpaste, via an intra-oral appliance worn by 30 adults in each of the study groups. Baseline and post-test mineral loss were quantified using transverse microradiography (TMR). One-sided t-test of one group mean was used for intragroup comparison, while two-sided t-test of two independent means was used to compare the two dental lotions. RESULTS: Pairwise comparison (baseline vs. post-test) indicated significant (p<.001) remineralization by nanoHAP toothpaste in both groups. However, when compared against each other, there was a significantly (p<.001) greater percentage of remineralization with nanoHAP lotion [58.4(±1.8)%] than with placebo lotion [37.7(±2.2)%]. TMR examination showed absolute demineralization inhibition in sound enamel blocks exposed to either lotions. CONCLUSIONS: Toothpaste containing 5% nanoHAP effectively remineralized initial caries and inhibited demineralization of healthy enamel; however, the application of a dental lotion containing 5% nanoHAP after brushing resulted in superior remineralization compared to a placebo lotion. CLINICAL SIGNIFICANCE: Dental lotion containing 5% nanohydroxyapatite used immediately after toothbrushing with 5% nanohydroxyapatite toothpaste can serve as an adjunct to enhance the clinical benefits of the toothpaste.

Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children.

OBJECTIVE: This in situ study compared the effectiveness of two toothpastes containing hydroxyapatite or 500 ppm fluoride in promoting remineralization and inhibiting caries development. MATERIALS AND METHODS: Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, were exposed to toothpaste containing either 10% hydroxyapatite or 500 ppm F- (amine fluoride) via intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs. post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups. RESULTS: Pairwise comparison (baseline vs. test) indicated significant (p < 0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. No demineralization could be observed in sound enamel blocks exposed to either toothpaste. While F- induced lesion surface lamination, HAP produced a more homogenous lesion remineralization. CONCLUSIONS: 10% hydroxyapatite achieved comparable efficacy with 500 ppm F- in remineralizing initial caries and preventing demineralization. Thus the HAP toothpaste is confirmed to be equal to the fluoride toothpaste in this study.

Effectiveness of Two Desensitizer Materials, Potassium Nitrate and Fluoride Varnish in Relieving Hypersensitivity After Crown Preparation.

AIM: The aim of this clinical investigation was to compare the efficacy of fluoride varnish and potassium nitrate on the reduction of hypersensitivity of prepared teeth both pre and post cementation. MATERIALS AND METHODS: In this randomized clinical trial, patients who needed at least three single crowns fixed partial prosthesis were included. Two desensitizing agents including fluoride varnish and potassium nitrate were used in this study and compared to the control group (sterile saline). In each patient, each prepared tooth was randomly assigned to one group. The desensitizing agent was applied on prepared teeth immediately after tooth preparation. The sensitivity of the teeth was measured by means of an air sensitivity test based on the visual analog scale at five different time points: baseline (2 hours after preparation), 7 days after preparation, before cementation, after cementation and one-week post cementation. Data were analyzed by Kruskal-Wallis and Friedman tests with a significant level of 0.05. RESULTS: Overall 300 vital abutment teeth needed full crown coverage in 100 patients were included. Both desensitizers' agents decreased the sensitivity of vital abutment teeth compared to the control group at every time intervals except at baseline (p = 0.089). There was no significant difference between fluoride varnish and potassium nitrate in the reduction of pre-cementation sensitivity while one week after cementation, sensitivity was more relieved by potassium nitrate compared to fluoride varnish (p = 0.023). CONCLUSION: The application of both desensitizers is effective in sensitivity reduction of vital abutment teeth. Potassium nitrate, however, is more eligible one week after cementation compared to fluoride varnish. CLINICAL SIGNIFICANCE: Both potassium nitrate and fluoride varnish are capable of desensitizing prepared tooth for the fixed partial denture.

Effectiveness of S-PRG Filler-Containing Toothpaste in Inhibiting Demineralization of Human Tooth Surface.

OBJECTIVES: Using an established pH-cycling caries model, the authors evaluated the effectiveness of toothpastes containing Surface Pre-reacted Glass-ionomer filler (S-PRG) in preventing tooth surface demineralization. MATERIALS AND METHODS: 210 tooth blocks were randomly assigned to seven experimental groups (30 blocks/group): no treatment (A), and toothpaste containing either NaF (B), 0 wt% S-PRG (C), 1 wt% S-PRG (D), 5 wt% S-PRG (E), 20 wt% S-PRG (F) or 30 wt% S-PRG (G). Groups were subjected to 14-day demineralization for development of early caries lesions using a pH-cycling caries model. Demineralization was assessed using Quantitative Light-induced Fluorescence (QLF) and Transverse Microradiography (TMR). All pairwise contrasts (between treatments) were tested using Analysis of Variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if <0.05. RESULTS: With QLF, there was a significant (ANOVA; p<0.001) difference in mean percent fluorescence loss (∆F) observed among the groups. Relative to control, all S-PRG-containing toothpastes significantly (Tukey's; p<0.0001) inhibited demineralization at varying percentages (48.6%, 61.3%, 67.4% and 69.8% reduction with S-PRG 1%, 5%, 20% and 30% respectively). Demineralization reduction was not significant with either NaF (15.6% reduction) or 0% S-PRG (-2.5% reduction i.e. 2.5% more demineralization than the Control) when compared to control group. Mineral loss assessed using TMR followed a similar trend as fluorescence loss. CONCLUSION: Toothpaste containing S-PRG filler can serve as an effective caries control tool. S-PRG filler-containing dentifrice to be more effective in preventing tooth demineralization than 1100 ppm fluoride provided as sodium fluoride.

Omental torsion after repeated abdominal blunt trauma.

Omental torsion is caused by the rotation of the greater omentum on its axis which may lead to tissue infarction and necrosis. It is a rare cause of acute abdomen. Signs, symptoms and paraclinical data are not specific. The patients usually undergo laparotomy for acute abdomen of poorly defined origin. High index of suspicious is required for the diagnosis of this entity. The diagnosis is usually confirmed after an explorative laparotomy. We present clinical characteristics and imaging findings of omental torsion in a young man following repeated blunt abdominal trauma.