Correlation with Caries Lesion Depth of The Canary System, DIAGNOdent and ICDAS II.

INTRODUCTION: The aim of this study was to correlate lesion depth of natural caries, measured with Polarized Light Microscopy (PLM), to Canary Numbers (CN) derived from The Canary System™ (CS), numerical readings from DIAGNOdent (DD), and lesion scores from ICDAS II. METHODS: A total of 20 examination sites on extracted human molars and premolars were selected. The selected examination sites consisted of healthy and enamel caries on smooth and occlusal surfaces of each tooth. Two blinded dentists ranked each examination site using ICDAS II and the consensus score for each examined site was recorded. The same examination sites were scanned with CS and DD, and the CN and DD readings were recorded. After all the measurements were completed, the readings of the three caries detection methods were validated with a histological method, Polarized Light Microscopy (PLM). PLM performed by blinded examiners was used as the 'gold standard' to confirm the presence or absence of a caries lesion within each examined site and to determine caries lesion depth. RESULTS: Pearson's coefficients of correlation with caries lesion depth of CNs, DD readings and ICDAS scores were 0.84, 0.21 and 0.77, respectively. Mean ± SD CN for sound sites (n=3), caries lesion depths <800 µm (n=11), and caries lesion depths >800 µm (n=6) were 11±1, 55±15, and 75±22, respectively. Mean ± SD DD readings for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 1±1, 7±11, and 8±9, respectively. Mean ± SD ICDAS II scores for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 0±0, 2±1, and 2±1, respectively. The intra-operator repeatability for the Canary System was .953 (0.913, 0.978). CONCLUSION: This study demonstrated that the CS exhibits much higher correlation with caries lesion depth compared to ICDAS II and DD. CS may provide the clinician with more information about the size and position of the lesion which might help in monitoring or treating the lesion.The present extracted tooth study found that The Canary System correlates with caries lesion depth more accurately that ICDAS II and DIAGNOdent.

Evaluation of nanohydroxyapatite-containing toothpaste for occluding dentin tubules.

PURPOSE: To compare dentin tubule occlusion by dentifrices containing either nanohydroxyapatite (10%nHAP and 15%nHAP), sodium monofluorophosphate (Na-MFP) or NovaMin (NovaMin). METHODS: All 80 participants wore four intraoral appliances bearing dentin blocks while using one of the four test dentifrices (n = 20/dentifrice) twice daily for 14 days. The four appliances were removed in pairs after 7 and 14 days. One treated block from each of the test periods (7 and 14 days) and their untreated controls were examined with SEM to determine the level of tubule occlusion. The remaining two treated blocks and their controls were used to determine tubule permeability to dye solution. Effectiveness was compared statistically (ANOVA/Tukey's) based on % area covered by deposited precipitate layer (%DPL), % dye penetration inhibition (%DPI) and percentage of fully-open (%FOT), partially-occluded (%POT) and completely-occluded (%COT) tubules in each block calculated relative to the number of tubules in their control blocks. RESULTS: SEM showed increased %COT and %DPL overtime. After 7 and 14 days, %COT, %POT, %DPL and %DPI were significantly lower with Na-MFP when compared to 10%nHAP (P < 0.01), NovaMin (P < 0.05) and 15%nHAP (P < 0.001), the three of which were not significantly different from each other in those four variables. A reverse trend was observed with %FOT (P < 0.001). Within the same dentifrice, no difference in %COT, %POT, %FOT, %DPI and %DPL after 7 and 14 days, except with Na-MFP in which %DPL significantly (P< 0.05) increased with usage. In conclusion, nanohydroxyapatite-containing and NovaMin-containing toothpastes showed equal and more effectiveness in occluding dentin tubules than Na-MFP toothpaste.

Effect of theobromine-containing toothpaste on dentin tubule occlusion in situ.

OBJECTIVES: Dentin hypersensitivity (DH) is treated by either occlusion of dentin tubules or nerve desensitization. This in situ study compared dentin tubules occlusion by theobromine-containing dentifrices with (Theodent-classic-F®, TCF) and without (Theodent-classic®, TC) fluoride with 1,500 ppm fluoride toothpaste, Colgate®-Regular (Fluoride) and Novamin®-containing toothpaste, Sensodyne®-5000-Nupro (Novamin®). METHODS: Each subject wore four intraoral appliances bearing dentin blocks while using one of four test dentifrices (n = 20/dentifrice) twice daily for 7 days. The four appliances were removed successively after 1, 2, 3, and 7 days. Treated blocks and their control (untreated) blocks were examined with scanning electron microscopy (SEM). Effects were compared statistically (ANOVA/Tukey's) based on percentage of surface area covered by deposited precipitate layer (%DPL) and percentage of fully open (%FOT), partially occluded (%POT), and completely occluded (%COT) tubules in each block calculated relative to the number of tubules in their control blocks. RESULTS: SEM observation indicated an increased %COT and %DPL over time. After 1 and 2 days, %COT was comparable with TC and TCF, and significantly (p < 0.05) higher compared with Novamin® and Fluoride. Following 3 and 7 days, %COT was comparable among TC, TCF, and Novamin®, but remained significantly lower in Fluoride. At any time, %DPL was significantly (p < 0.05) higher in TC, TCF, and Novamin® compared with Fluoride. CONCLUSIONS: Theobromine-containing toothpastes with and without fluoride have equal potential in occluding dentin tubules within a shorter time period than Novamin®-containing toothpaste; however, the three demonstrated equal potential after 1 week, but not the fluoride toothpaste. CLINICAL RELEVANCE: Theobromine-containing toothpaste promoted dentin tubule occlusion thus shows potential to relief DH.

In situ remineralization of white-spot enamel lesions by 500 and 1,100 ppm F dentifrices.

The aim of this study was to evaluate the remineralization potential of three silica-containing NaF dentifrice systems in an intraoral model. Subjects (N = 30) in this randomized, three-phase, 28-day, crossover study served as their own control. Each participant wore a customized orthodontic appliance attached to a mandibular molar and contained one tooth block with caries-like lesion. For each phase, participants engaged in twice-daily brushing for 2 min with one of the following dentifrices: 500 ppm F, 500 ppm F plus functionalized ß-tricalcium phosphate (fTCP), and a clinically proven 1,100 ppm F. After each phase, appliances were removed, and specimens were analyzed using surface microhardness (SMH), transverse microradiography (TMR), and cross-sectional microhardness (CSMH). Statistically significant (p < 0.05) remineralization of white-spot lesions relative to baseline occurred for each dentifrice as determined with SMH and TMR. No significant differences (p > 0.05) in SMH were found among the three groups, but trending revealed the 500 ppm F plus fTCP produced 26% and 27% greater SMH recovery relative to 500 and 1,100 ppm F, respectively. Similarly, no significant differences (p > 0.05) in TMR were found among the groups. However, the 500 ppm F plus fTCP dentifrice produced 10% and 38% greater mineral recovery relative to 500 and 1,100 ppm F, respectively, while reducing the lesion depth 30% and 52%, respectively. Significant differences (p < 0.05) in CSMH existed among the three dentifice groups at different enamel depths, but statistical differences (p < 0.05) in relative lesion size were only found between 500 ppm F plus fTCP and 500 ppm F. The combination of fTCP and fluoride in a single-compartment, water-based dentifrice can cooperate with fluoride to produce significant remineralization. These results suggest that the combination of 500 ppm F with fTCP may provide comparable anticaries benefits relative to a 1,100 ppm F dentifrice.

Remineralization of eroded enamel by a NaF rinse containing a novel calcium phosphate agent in an in situ model: a pilot study.

PURPOSE: An in situ study evaluated the remineralization potential of 225 ppm fluoride (F) rinses with and without a calcium phosphate agent (TCP-Si-Ur) on eroded enamel. METHODS: 20 human patients participated in this IRB approved study. Enamel blocks extracted from 20 human molars were assigned to each of the three study phases (G1, G2, G3). Each block was eroded using 1% citric acid (pH = 2.5), with a slice cut from each block to establish baseline lesion parameters (ie, integrated mineral loss ΔZ, and lesion depth LD) using transverse microradiography (TMR). Participants and assigned blocks were randomly divided into three 28-day phases. The blocks were mounted into modified orthodontic brackets and bonded to the buccal surface of one of the subject's mandibular molars. The appliance remained in the subject's mouth for 28 days. Prior to each study phase, participants observed a one-week-washout period using a fluoride-free dentifrice. In each phase, participants brushed with the fluoride-free dentifrice for 1 min, followed by one of the following coded treatments: G1: 225 ppm F + 40 ppm TCP-Si-Ur rinse (1 min); G2: 225 ppm F rinse (1 min); G3: no rinse (saliva-only). After each phase, appliances were removed and specimens were analyzed using TMR. RESULTS: TMR data (ie, ΔZ and LD) revealed all three groups significantly remineralized eroded enamel (paired t-tests, P < 0.001). Net mineralization (% change in ΔZ, LD) were as follows (mean (std.dev): G1: 44.1 (22.6), 30.5 (27.0); G2: 30.0 (7.4), 29.4 (10.5); G3: 23.8 (16.4), 25.7 (15.5). Furthermore, G1 was found to cause significantly more remineralization than G2 (P = 0.039) and G3, (P = 0.002). CONCLUSION: Mouthrinse containing 225 ppm F plus TCP-Si-Ur provided significantly greater remineralization relative to 225 ppm F only or saliva alone.