In-Vitro Tooth Cleaning Efficacy and Filament End Rounding of Different Manual Children's Toothbrushes.

PURPOSE: This in-vitro study aimed to investigate the cleaning efficacy of 18 different manual children's toothbrushes applying horizontal, vertical, and rotational movements, as well as to evaluate the rounding of their filament ends. MATERIALS AND METHODS: Models equipped with artificial teeth (coated with titanium dioxide) were brushed using a brushing machine with clamped manual children's toothbrushes. The machine carried out horizontal, vertical, and rotational movements for 1 min with a constant contact pressure of 100 g. The percentage of the area of titanium dioxide removed from the buccal, mesial, distal and total surfaces of the artificial teeth corresponded to the cleaning efficacy. To assess the filament design, a scanning electron microscope was used to check the morphology of the filaments which was scored with Silverstone and Featherstone scale. SPSS 22 was used for data analysis. RESULTS: The rotational and the vertical movements achieved the best cleaning efficacy with all tested toothbrushes. The vast majority of the tested toothbrushes had their poorest cleaning efficacy in the horizontal movement. Only a small part of the children's toothbrushes (3 out of 18) had a correct and acceptable proportion of rounded bristle ends. CONCLUSIONS: Based on the present results, it could be concluded that the cleaning efficacy of different manual children's toothbrushes varied considerably. The best cleaning efficacy was almost always observed for rotational and vertical movements.

Cleaning performance of electric toothbrushes around brackets applying different brushing forces: an in-vitro study.

Throughout treatment with fixed orthodontic appliances, effective plaque control is crucial to maintaining dental health. This in-vitro study evaluated the cleaning performance of eleven different brush heads of seven electric toothbrushes (oscillating-rotating and sonic motions) and varying brushing forces around orthodontic brackets. Six Mini Diamond® Twin brackets were placed on black-stained front teeth. Teeth were coated with white titanium oxide and brushed in a machine six times for one minute with two different brushing forces (1 N and 1.5 N). Eleven different brush heads were evaluated (either oscillating-rotating or sonic movements). The teeth were scanned and planimetrically evaluated after brushing. Three detailed plaque areas (DPAs) were created: proximal (< 1 mm to bracket), mid-tier (1-2 mm to bracket), and distant (> 2 mm to bracket). The proportion of contaminated proximal, mid-tier, and distant surfaces (white regions) in relation to the respective DPA was calculated. Independent of brushing forces, places with a higher distance (> 2 mm) to the orthodontic bracket had the least amount of residual contamination, followed by areas with a minor (1-2 mm) and proximal distance (< 1 mm). In all of the brushes tested and for both estimated brushing forces, the region with the highest residual contamination was the proximal area. The brush heads of the Paro® Sonic toothbrush left the least amount of residual contamination. The cleaning performance of electric toothbrushes around brackets on upper incisors varied across the brushes examined. The proximal area has the most residual contamination. Furthermore, 9 out of 11 toothbrushes cleaned more successfully with 1.5 N than with 1 N brushing force.

Is there a rise of prevalence for Molar Incisor Hypomineralization? A meta-analysis of published data.

Since Molar Incisor Hypomineralization was first described as a pathologic entity, public perception often suggests a considerable rise in prevalence of the respective disease. Since there are still considerable doubts regarding the etiology and-accordingly-prevention of MIH and respective therapeutic approaches are difficult this question is of considerable clinical and public interest. Accordingly, a systematic literature search in accordance with the PRISMA guidelines for systematic reviews on Medline, Cochrane Database, EMBASE, LILACS, Web of Science, Google scholar, Scopus was performed to retrieve original articles reporting the prevalence of MIH as defined by the European Academy of Pediatric Dentistry (EAPD). From initially 2360 retrieved titles, 344 full texts were assessed for possible inclusion and finally 167 articles of mainly moderate to high quality and based on data of 46'613 individuals were included in the meta-analysis. All studies published before 2001 had to be excluded since it was not possible to align the findings with the EAPD classification. Studies varied considerably regarding cohort size (25 to 23'320, mean 1'235)) and age (5.6-19 y, mean 9.8 y). Over all studies, the weighted mean for the prevalence for MIH was 12.8% (95% CI 11.5%-14.1%) and no significant changes with respect to either publication year or birthyear were found. A sub-analysis of eleven studies reporting on the prevalence in different age groups, however, revealed strong evidence for an increasing prevalence between the years 1992 (3%) and 2013 (13%).Therefore, based on data from cross-sectional studies a possible rise in prevalence of MIH remains unclear. Future prospective large-scale studies under standardized examination conditions with an emphasis on examiner calibration are needed to gain better understanding in the evolution of the prevalence of MIH.

Supplementation of Energy Drinks with Green Tea Extract: Effect on In Vitro Abrasive/Erosive Dentin Wear.

PURPOSE: To investigate the effect of the supplementation of energy drinks with green tea extract on abrasive and erosive dentin wear. MATERIALS AND METHODS: Six groups, each comprising 15 bovine dentin samples, were prepared, yielding a total of 90 samples. Erosion was performed by immersing the samples in Red Bull and Red Bull light with and without green tea extract. Tap water with and without green tea extract was used as the control groups. The samples were subjected to abrasive/erosive cycling for five days. The following cycling was performed daily: toothbrush abrasion (20 brushstrokes; 2.5 N); eight erosive cycles (2 min storage in the respective solutions); in between the erosive cycles, storage in artificial saliva (60 min) and again toothbrush abrasion (20 brushstrokes; 2.5 N). During the night, samples were again stored in artificial saliva. Abrasive/erosive dentin wear was measured using a stylus profilometer (µm, accuracy = 40 nm). The measured dentin loss results from the vertical position shift on the y-axis from base to final profile after the wear process in 2D. Pairwise comparisons between the groups were carried out using Wilcoxon signed-rank test. RESULTS: The following dentin wear (median [IQR]) was measured: Red Bull: 1.9 µm (0.5); Red Bull Light: 1.3 µm (0.3); Red Bull with green tea extract: 0.8 µm (0.3); Red Bull Light with green tea extract: 0.3 µm (0.5); Tap water with green tea extract: -0.2 µm (0.7); Tap water: -1.0 µm (1.2). The comparison of all tested groups to each other proved to be statistically significant (p < 0.05). CONCLUSION: The supplementation of energy drinks with green tea extract provide a protective effect against erosive/abrasive wear in vitro.

A laboratory pilot study on voids in flowable bulk-fill composite restorations in bovine Class-II and endodontic access cavities after sonic vibration.

This pilot study investigated whether sonic-powered application of a bulk-fill resin-based composite (RBC) in Class-II or endodontic access cavities reduces void formation. The crowns and roots of 60 bovine teeth with Class-II cavities (C) and endodontic access cavities (E) respectively, were assigned to ten groups (C1-C5, E1-E5). Cavities were filled with RBC (SDR flow + , one increment) using different application techniques: no adaptation (C1 + E1), spreading of RBC on the cavity surfaces with a dental explorer tip (C2 + E2), low (C3 + E3) or high frequency (C4 + E4) direct activation by inserting a sonic-powered tip into RBC and high frequency indirect activation with an ultrasonic insertion tip (C5 + E5). The restorations were light-cured and investigated for voids using microtomography. The number of voids and percentage of voids related to the volume were statistically analysed (α < 0.05). While most voids in Class-II restorations were observed in C4 (p ≤ 0.0031), no significant differences were found between the other groups (p > 0.05). The percentage of voids showed no differences in E1-E5 (p > 0.05). C4 showed a significantly higher percentage of voids compared to C2 (p < 0.001). There is no benefit in applying sonic vibration when filling Class-II or endodontic access cavities.

Effect of Toothbrush Bristle Stiffness and Brushing Force on Cleaning Efficacy.

PURPOSE: This study investigated the effect of toothbrush bristle stiffness and brushing force on the cleaning efficacy in vitro. MATERIALS AND METHODS: Eighty bovine dentin samples were allocated to eight groups (n=10). Two custom-made toothbrushes of different bristle stiffness (soft and medium) were tested at four different brushing forces (1, 2, 3 and 4 N). Dentin samples were stained in black tea and brushed (60 strokes/min) for a total of 25 min in a brushing machine with an abrasive solution (RDA 67). Photographs were taken after 2 and 25 min of brushing time. Cleaning efficacy was measured planimetrically. RESULTS: After 2 min of brushing, the soft-bristle toothbrush did not cause statistically significantly different cleaning efficacy at different brushing forces, while the medium-bristle toothbrush cleaned statistically significantly less efficaceously only at 1 N. Comparing the two different toothbrushes, higher cleaning efficacy was observed only at 1 N for the soft-bristle brush. At 25 min brushing time, the soft-bristle cleaned statistically significantly better at 4 N compared to 1 N and 2 N and at 3 N compared to 1 N. Using the medium-bristle, cleaning efficacy increased with increasing brushing force. After 25 min of brushing, no statistically significant difference was observed between the two different toothbrushes. CONCLUSION: Irrespective the brushing force, the use of a soft or medium toothbrush results in comparable cleaning efficacy. At 2 min brushing time, increasing the brushing force does not increase the cleaning efficacy.

Dentin Loss and Surface Alteration Through Chemical and Chemomechanical Challenge after Initial Root Instrumentation.

PURPOSE: To assess the root surface roughness and substance loss induced by chemical and chemomechanical challenges on root surfaces pretreated with ultrasonic instrumentation, a hand scaler, or erythritol airflow. MATERIALS AND METHODS: One hundred twenty (120) bovine dentin specimens were used in this study. Specimens were divided into eight groups and treated as follows: groups 1 and 2: polished with 2000- and 4000-grit carborundum papers but not instrumented ('untreated'); groups 3 and 4: hand scaler; groups 5 and 6: ultrasonic instrumentation; groups 7 and 8: erythritol airflow. Samples from groups 1, 3, 5, and 7 then underwent a chemical challenge (5 x 2 min HCl [pH 2.7]), whereas samples from groups 2, 4, 6, and 8 were subjected to a chemomechanical challenge (5 x 2 min HCl [pH 2.7] + 2 min brushing). Surface roughness and substance loss were measured profilometrically. RESULTS: The least substance loss through chemomechanical challenge was noted after erythritol airflow treatment (4.65 ± 0.93 µm), followed by ultrasonic instrumentation (7.30 ± 1.42 µm) and the hand scaler (8.30 ± 1.38 µm); the last two (hand scaler and ultrasonic tip) did not differ statistically significantly. The highest roughness after chemomechanical challenge was observed on ultrasonically treated specimens (1.25 ± 0.85 µm), followed by hand-scaled specimens (0.24 ± 0.16 µm) and those subject to erythritol airflow (0.18 ± 0.09 µm); there was no statistically signficant difference between the latter two, but they both differed statistically significantly from the ultrasonically treated specimens. No statistically significant difference in substance loss through the chemical challenge was observed between specimens pretreated by the hand scaler (0.75 ± 0.15 µm), ultrasonic tip (0.65 ± 0.15 µm), and erythritol airflow (0.75 ± 0.15 µm). The chemical challenge smoothed the surfaces treated with the hand scaler, ultrasonic tip, and erythritol airflow. CONCLUSION: Dentin pretreatment with erythritol powder airflow resulted in a higher resistance to chemomechanical challenge than did dentin treated ultrasonically or with the hand scaler.

Abrasive Enamel and Dentin Wear Resulting from Brushing with Toothpastes with Highly Discrepant Relative Enamel Abrasivity (REA) and Relative Dentin Abrasivity (RDA) Values.

PURPOSE: To investigate the absolute wear caused by toothpastes with highly discrepant REA (Relative Enamel Abrasivity) and RDA (Relative Dentin Abrasivity) values on both enamel and dentin: Candida Peppermint (CP; REA: 1; RDA: 42), Colgate Total Original (CTO; REA: 4; RDA: 100), Signal White System (SWS; REA: 8; RDA: 143), and Candida White Diamond (CWD; REA 244; RDA: 12). MATERIALS AND METHODS: Eighty (80) bovine enamel samples and 80 dentin samples were divided into four groups each (n = 20) and investigated after a 6-h brushing procedure (21,600 cycles, 60 cycles/min, load of 2.5 N) with the four toothpastes. The abrasive enamel and dentin wear were registered using a contact profilometer. The median and interquartile range (IQR) of the abrasive enamel and dentin wear were calculated for each group. Pairwise comparisons were conducted using the Wilcoxon signed-rank exact test, and the p-value was adjusted according to Holm (statistical significance set at 0.05). RESULTS: CWD led to the highest abrasive enamel wear (9.86 µm [5.77]). CTO caused the highest abrasive dentin wear (166.70 µm [69.90]), being statistically significantly higher than the wear for CP (54.20 µm [24.00]) and CWD (17.00 µm [7.80]) (p = 0.00001). The abrasive dentin wear for CWD was statistically significantly lower in comparison to all other groups (p = 0.00001). CONCLUSION: Toothpastes with highly discrepant REA and RDA values presented statistically significantly different absolute wear on enamel and dentin. REA and RDA values should both be declared for every toothpaste.

Effect of brushing force on the abrasive dentin wear using slurries with different abrasivity values.

OBJECTIVE: The aim of this study was to investigate the resulting abrasive dentin wear using abrasive slurries with different RDA values and applying increasing brushing forces. METHODS: Forty-five bovine incisors were randomly allocated in three groups (A, B, C, n = 15). One hundred and eighty dentin samples were prepared from these incisors and allocated to twelve groups (A1-A4, B1-B4, C1-C4; n = 15). The groups were subjected to a brushing cycle (120 strokes/min, 25 min) as follows: groups A1 to A4 with an abrasive slurry (RDA = 71) applying increasing brushing forces (1, 2, 3 and 4 N). Groups B1 to B4 were brushed using an abrasive slurry (RDA = 85) and C1 to C4 (RDA = 133) applying the same above-mentioned brushing forces. Abrasive dentin wear was recorded using a stylus profilometer and compared amongst the groups using robust models. Pairwise comparisons in each model were tested and corrected after Tukey's method (α = 0.05). RESULTS: Applying 1-N brushing force resulted in the same amount of abrasive dentin wear in all groups regardless of the abrasivity of the used slurry. Increasing the brushing force to 2 N resulted in statistically significantly higher abrasive wear in all groups. This increase in abrasive wear was much higher when the slurry with high abrasivity was used (RDA = 133) compared with the lower abrasive slurry (RDA = 71). CONCLUSION: The abrasivity of the used slurry does not add to the resulting abrasive wear when the brushing force is kept at 1 N. It seems better to advise and help the patients (showing signs of non-carious cervical lesions) calibrating their brushing force to 1 N, than only to advise them to use toothpastes with lower abrasivities.

Relative dentin and enamel abrasivity of charcoal toothpastes.

OBJECTIVES: Very little data are known about charcoal toothpastes. The aim of this study was to counteract the missing data by determining the relative dentin abrasivity (RDA) and relative enamel abrasivity (REA) values of charcoal toothpastes. METHODS: Radioactively charged dentin and enamel samples were randomly divided into groups of eight specimens. Each group was brushed with two of total 12 charcoal toothpaste slurries and with a standard abrasive with a known RDA and REA value. The measured radioactivity in counts per minute within the slurries corresponds to the amount of dentin or enamel abraded. RDA and REA values of the charcoal toothpastes were expressed relative to the known value of the standard slurry. RESULTS: The RDA and REA values of the charcoal toothpastes have a broad range of 24-166 and 0-14, respectively. CONCLUSIONS: The RDA and REA values do not differ significantly from previously tested commercially available toothpastes. However, the lack of fluoride compounds in many of the investigated charcoal toothpastes can have a less beneficial effect for the consumers. It is very important to educate patients accordingly.

Interplay Between the In-Vitro Cleaning Performance and Wear of Manual Toothbrushes.

PURPOSE: This in-vitro study deals with the question of whether the wear and tear of the manual toothbrush over a simulated timeframe up to 24 months has an effect on its cleaning performance. The purpose was to find indications as to whether and when a toothbrush needs to be replaced based on its cleaning performance. MATERIALS AND METHODS: Models equipped with artificial teeth (coated with titanium dioxide) were brushed in-vitro using a brushing machine with clamped manual toothbrushes. The machine carried out even, horizontal brush strokes (120 brush strokes/min) for 1 min with a constant contact pressure of 2.5 N. The percentage of the area of titanium dioxide removed from the buccal, mesial and distal surfaces of the artificial teeth corresponded to the cleaning performance. The manual toothbrushes were used on bovine roots to simulate the wear and tear after 2, 4, 6, 12, 18, 24 months of use. The cleaning performance was re-evaluated after each simulated timepoint of wear. In addition, the brushes were photographed after each cycle. RESULTS: An increase in the in-vitro cleaning performance of the toothbrush was observed up to 6 months of wear compared to the starting point. After that, the cleaning performance decreased somewhat, but always remained above the initial cleaning performance. CONCLUSION: Based on the in-vitro cleaning performance after 24 months, the toothbrush would not have to be replaced. However, this in-vitro study cannot determine when a toothbrush should be replaced, because in-vivo it is also dependent on a variety of other factors such as fraying and microbial colonisation. Direct transfer of results from this study to everyday clinical practice is therefore difficult.

Salivary Flow Rate During Toothbrushing.

PURPOSE: To determine the salivary flow rate and subsequent dilution of toothpaste and assess the pH of oral fluids during toothbrushing with toothpastes of various pHs. MATERIALS AND METHODS: The study was conducted as an in-vivo trial involving 30 healthy volunteers. The participants took part in a series of trials distributed over four appointments. After a screening check, in which the participants' stimulated and unstimulated salivary flow rate and buffering capacities were determined, four test series involving toothbrushing were conducted. Participants brushed their teeth using a manual toothbrush for 2 min: once without toothpaste and three times using toothpastes of varying pHs. The salivary flow rate and subsequent dilution of the toothpaste was determined. Additionally, the pH of the collected oral fluid was analysed. RESULTS: Brushing teeth with toothpaste caused a statistically significant increase in salivary flow rate (median/IQR in ml/min) (Elmex Kariesschutz 3.29/1.36, Colgate Total Original 3.23/1.08, Elmex Sensitive Professional 3.18/1.39) when compared to brushing teeth using a manual toothbrush without toothpaste (1.85/0.78) (p < 0.05). The variation in pH of the oral fluid samples was dictated primarily by the pH of the toothpaste used. CONCLUSION: The salivary flow rate when brushing using toothpaste was similar across all tested toothpastes, independent of pH, and had an average median of 3.23 ml/min. The dilution of 1 g of toothpaste during a standard toothbrushing procedure of 2 min is therefore approximately at a ratio of one part toothpaste to 6.5 parts saliva.

Diamond particles in toothpastes: in-vitro effect on the abrasive enamel wear.

BACKGROUND: Diamond particles have recently been used as abrasives in toothpastes, which raises questions about its abrasive behaviour towards enamel. This study was carried out to investigate the abrasive enamel wear caused by three diamond-loaded toothpastes (Candida White Diamond: CWD, Swiss Smile Diamond Glow: SSDG, Emoform F Diamond: EFD) and to compare it with a traditional toothpaste with silica abrasive (Colgate Total Original CTO). METHODS: Eighty bovine enamel samples were divided into four groups (n = 20) and brushed for 21,600 cycles (60 cycles/min) for 6 h at 2.5-N brushing force. The abrasive enamel wear was recorded with a contact profilometer. The median and interquartile range (IQR) of the abrasive enamel wear was calculated in each group. Pairwise comparisons were conducted using Wilcoxon signed rank exact test and the p value was adjusted according to Holm. Significance level was set at 0.05. RESULTS: Diamond-loaded toothpastes caused statistically significantly higher abrasive wear than the traditional toothpaste (p < 0.0001). SSDG caused statistically significantly higher enamel wear (19.0 µm (11.2)) than CWD (8.4 µm (4.6)) and EFD (7.3 µm (3.9)) (p < 0.0001). CONCLUSIONS: Diamond-loaded toothpastes cause higher enamel wear than toothpastes with traditional abrasives and also exhibit different abrasivity behaviour compared to each other.

Species-specific enamel differences in hardness and abrasion resistance between the permanent incisors of cattle (Bos primigenius taurus) and the ever-growing incisors of nutria (Myocastor coypus).

Hypselodont (ever-growing) teeth of lagomorphs or rodents have higher wear rates (of a magnitude of mm/week), with compensating growth rates, compared to the non-ever-growing teeth of ungulates (with a magnitude of mm/year). Whether this is due to a fundamental difference in enamel hardness has not been investigated so far. We prepared enamel samples (n = 120 per species) from incisors of cattle (Bos primigenius taurus) and nutria (Myocastor coypus, hypselodont incisors) taken at slaughterhouses, and submitted them to indentation hardness testing. Subsequently, samples were split into 4 groups per species (n = 24 per species and group) that were assessed for abrasion susceptibility by a standardized brush test with a control (no added abrasives) and three treatment groups (using fine silt at 4 ±1 µm particle size, volcanic ash at 96 ±9 µm, or fine sand at 166 ±15 µm as abrasives), in which enamel abrasion was quantified as height loss by before-and-after profilometry. The difference in enamel hardness between the species was highly significant, with nutria enamel achieving 78% of the hardness of cattle enamel. In the control and the fine sand group, no enamel height loss was evident, which was attributed to the in vitro system in the latter group, where the sand particles were brushed out of the test slurry by the brushes' bristles. For fine silt and volcanic ash, nutria enamel significantly lost 3.65 and 3.52 times more height than cattle. These results suggest a relationship between enamel hardness and susceptibility to abrasion. However, neither the pattern within the species nor across the species indicated a monotonous relationship between hardness and height loss; rather, the difference was due to qualitative step related to species. Hence, additional factors not measured in this study must be responsible for the differences in the enamel's susceptibility to abrasion. While the in vitro brush system cannot be used to rank abrasive test substances in terms of their abrasiveness, it can differentiate abrasion susceptibility in dental tissue of different animal species. The results caution against considering enamel wear as a similar process across mammals.

Effect of tapered-end and round-end bristles on the abrasive dentine wear applying increasing brushing forces.

OBJECTIVE: To investigate the effect of toothbrush bristles end configuration on the abrasive dentine wear at different brushing forces. MATERIAL AND METHODS: One hundred and sixty bovine dentine samples were randomized into eight groups (n = 20). Groups (1 to 4) were brushed with tapered-end bristles at 1-, 2-, 3-, and 4-N brushing forces, respectively. Groups (5 to 8) were brushed with round-end bristles with the same brushing forces. The brushing sequence was carried out using an abrasive slurry (RDA = 121) for 25 min. Profiles were recorded using a contact profilometer. Mean and standard deviation were calculated for the abrasive dentine wear in each group. Two-way ANOVA was used to locate any significance. The significance values were corrected after Tukey (α = 0.05). RESULTS: Brushing with tapered-end bristles resulted in statistically significantly less abrasive dentine wear than round-end bristles regardless of the applied brushing force (1 N: 4.4 ± 1.5 vs. 7.7 ± 2.0 µm; 2 N: 7.7 ± 2.1 vs. 12.2 ± 2.7 µm; 3 N: 11.3 ± 2.6 vs. 19.4 ± 3.7 µm; 4 N: 11.2 ± 2.1 vs. 25.3 ± 4.8 µm). The interaction between bristle configuration and brushing force was statistically significantly (p < 0.001). CONCLUSION: Tapered-end toothbrushes might be a safer choice for patients, especially when showing signs of non-carious cervical lesion. However, other toothbrush properties should also be considered.

Effect of the toothbrush tuft arrangement and bristle stiffness on the abrasive dentin wear.

The geometrical properties of toothbrushes play a role in developing abrasive tooth wear and non-carious cervical lesions. This study investigated the interplay between the toothbrush tuft arrangement (crossed vs. parallel) and bristle stiffness (soft vs. medium) on the abrasive dentin wear using three slurries with different levels of abrasivity (RDA: 67, 121 and 174). Twelve groups of bovine dentin samples (n = 20) were brushed with a combination of the aforementioned variables. Abrasive dentin wear was recorded with a profilometer and the resulting abrasive wear of each group was calculated and compared with each other using two-way ANOVA and pairwise tests. Toothbrushes with parallel tuft arrangement caused statistically significantly higher dentin wear compared to crossed tuft arrangement, regardless of the abrasivity level of the used slurry and the bristle stiffness. Soft crossed tuft toothbrushes caused statistically significantly higher abrasive dentin wear than medium crossed tuft toothbrushes, while soft and medium parallel tuft toothbrushes caused the same amounts of dentin wear, regardless of the RDA value of the used slurry. These results could be helpful for dentists and dental hygienists when advising patients. Crossed tuft toothbrushes could be a less-abrasive choice in comparison to parallel tuft toothbrushes.

Enamel Softening Can Be Reduced by Rinsing with a Fluoride Mouthwash Before Dental Erosion but Not with a Calcium Solution.

PURPOSE: This in-situ-study investigated if rinsing the oral cavity with a calcium containing solution or a fluoride containing mouthwash immediately before an erosive attack leads to reduced enamel softening. MATERIALS AND METHODS: Bovine enamel samples (n = 240) with measured baseline surface microhardness (KHN) were assigned to five series (S1-5). Twelve participants carried out each series as follows: Four enamel samples of the associated test series were placed in an intraoral appliance and carried in each participants' mouth. After 30 min, the participants either rinsed the oral cavity for 60 s with 30 ml of a solution prepared from a 1,000 mg calcium effervescent tablet dissolved in 100 ml water (S2), an 800 mg calcium containing mineral supplement powder (5 g) dissolved in 200 ml water (S3), a fluoride (500 ppm) mouthwash (S4), a fluoride (500 ppm) and stannous chloride (800 ppm) containing mouthwash (S5), or did not rinse with any test solution before the erosive attack (S1, negative control). The participants subsequently rinsed the oral cavity with 100 ml of a soft drink (Sprite Zero) for 60 s to simulate the erosive attack and immediately afterwards with water to stop the erosive process. As final step, surface microhardness was measured a second time and hardness loss (∆KHN) calculated. Differences of ∆KHN between the series were investigated by fitting a mixed effect model to the data set. RESULTS: The highest loss of microhardness and thus softening of enamel (mean of ∆KHN; lower/upper confidence level) was observed in the negative control (S1: 60.2; 67.6/52.8). While no statistically significant difference (P > 0.05) compared to S1 could be found in S2 (50.0; 57.4/42.5) and S3 (54.6; 62.1/47.2), statistically significantly less softening of enamel (P < 0.001) was discovered in S5 (33.8; 41.2/26.4) and S4 (41.8.2; 49.3/34.4). S5 showed the overall lowest values for ∆KHN and thus best protection from enamel softening. CONCLUSION: Rinsing with a fluoride mouthwash or a fluoride and stannous chloride containing mouthwash immediately before an erosive attack reduces the softening of enamel. None of the investigated calcium-containing solutions was able to reduce erosion induced softening of enamel.

OralDisk: A Chair-Side Compatible Molecular Platform Using Whole Saliva for Monitoring Oral Health at the Dental Practice.

Periodontitis and dental caries are two major bacterially induced, non-communicable diseases that cause the deterioration of oral health, with implications in patients' general health. Early, precise diagnosis and personalized monitoring are essential for the efficient prevention and management of these diseases. Here, we present a disk-shaped microfluidic platform (OralDisk) compatible with chair-side use that enables analysis of non-invasively collected whole saliva samples and molecular-based detection of ten bacteria: seven periodontitis-associated (Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) and three caries-associated (oral Lactobacilli, Streptococcus mutans, Streptococcus sobrinus). Each OralDisk test required 400 µL of homogenized whole saliva. The automated workflow included bacterial DNA extraction, purification and hydrolysis probe real-time PCR detection of the target pathogens. All reagents were pre-stored within the disk and sample-to-answer processing took < 3 h using a compact, customized processing device. A technical feasibility study (25 OralDisks) was conducted using samples from healthy, periodontitis and caries patients. The comparison of the OralDisk with a lab-based reference method revealed a ~90% agreement amongst targets detected as positive and negative. This shows the OralDisk's potential and suitability for inclusion in larger prospective implementation studies in dental care settings.

Wear of conventional and pre-polymerized composite materials under erosive/abrasive conditions.

The aim of this study was to examine the wear of three different composite materials usable for vertical bite reconstruction under erosive/abrasive conditions and to compare them with the bovine dental hard tissues enamel and dentin in-vitro. The composite materials Filtek Supreme XTE, CeraSmart and Brilliant Crios and bovine enamel and dentin specimens were evenly allocated to five groups (n=10). Samples were firstly exposed to hydrochloric acid for 1 min, then stored for 30 min in artificial saliva. In the second step, the samples were brushed for 1 min with 100 brushing strokes each and an applied force of 2.5 N in an automated brushing device. After 60 of these erosive/abrasive cycles, wear of the samples was determined by contact profilometry. Filtek Supreme XTE showed significantly less wear (mean ± standard deviation; 0.15 ± 0.11 µm) compared to the other two composite materials (p < 0.05). No significant difference (p > 0.05) could be found between CeraSmart (0.25 ± 0.03 µm) and Brilliant Crios (0.24 ± 0.04 µm). The two bovine dental hard tissues, enamel (13.70 ± 0.94 µm) and dentin (50.08 ± 4.46 µm), each showed a significantly higher amount of wear than the three restorative materials (p <0.05). In conclusion, this study exhibited that the three composite materials, Filtek Supreme XTE, CeraSmart and Brilliant Crios, were more resistant under erosive/abrasive conditions compared to bovine enamel and bovine dentin, respectively.

Erosive tooth wear among athletes.

The following article deals with various considerations concerning the frequently observed occurrence of dental erosion in athletes. It summarizes the basics of erosive tooth wear development as well as special etiologic factors for groups of athletes with increased prevalence of dental erosion and concludes with preventive advice. (Originally published (in German) in Quintessenz Zahnmed 2021;72:1008-1017).