Browsing by Author "Al Dehailan, Laila"
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Item Effect of Bottled Water and Fluoride Toothpaste Usage on Caries Lesion Remineralization(2023) Qaw, Masoumah Samir; Lippert, Frank; Al Dehailan, Laila; Hara, Anderson T; Cook, N. BlaineBackground: The importance of fluoride in the prevention of dental caries has been well documented in the literature, as it inhibits demineralization of the tooth structure and enhances remineralization. One of the major public health policies to prevent caries is to provide the population with an adequate amount of fluoride through community water fluoridation. Nowadays many people drink bottled water instead of tap water due to its easy access, convenience, and low cost. Besides fluoride, other minerals present in tap and bottled water, such as calcium and magnesium, are also important in decreasing dental caries prevalence. However, our knowledge of the role of bottled water in caries prevention and especially when combined with fluoride toothpaste usage is still poor. Objectives: The aim of this in-vitro study was to evaluate the effects of some bottled waters on fluoride toothpaste efficacy in enhancing caries lesion remineralization. Methodology: Early caries lesions were created in bovine enamel specimens and stratified into treatment groups based on Vickers surface microhardness (VHN). The present study followed a two (fluoride and fluoride-free toothpaste) by five (four bottled waters and tap water) factorial design. The treatment groups were bottled water with the following attributes: a) 309.9 ppm Ca/1.20 ppm F; b) 118.4 ppm Ca/0.16 ppm F; c) 1.00 ppm Ca/1.01 ppm F; d) 0.1 ppm Ca/0.04 ppm F, and tap water (48.7 ppm Ca/0.7 ppm F). The five water groups were paired either with 1100 ppm fluoride or fluoride-free toothpaste, yielding 10 groups. Specimens were pH-cycled for 10 days with the daily regimen comprised of twice daily toothpaste slurry, with four exposures to water in between. VHN was measured, again, and the difference calculated (ΔVHN). Data were analyzed using two-way ANOVA at a 5-percent significance level. Results: The two-way interaction between water and toothpaste was significant (p < 0.001). All groups except fluoride-free toothpaste/bottled water with 0.1 ppm Ca/0.04 ppm F (p = 0.411) had significant increases in VHN after pH cycling (p ≤ 0.023). Fluoridated toothpaste resulted in a higher rate of remineralization compared to fluoridefree toothpaste (all p < 0.001). Bottled water with 1.20 ppm F/309.9 ppm Ca exhibited the greatest extent of remineralization within fluoride toothpaste groups (p < 0.001) and higher remineralization than lower fluoride water in fluoride-free toothpaste groups (p ≤ 0.006). Within the fluoridated toothpaste group, tap water exhibited significantly less remineralization compared to all bottled waters (all p < 0.001). Conclusion: Within the limitation of this study, bottled water with higher fluoride and calcium concentrations might improve fluoridated toothpaste efficacy by enhancing remineralization of early enamel caries-like lesions.Item The effect of filler on the mechanical properties of a novel resin-based calcium phosphate cement(2010) Al Dehailan, Laila; Chu, Tien-Min Gabriel; Lund, Melvin R, 1922-; Cochran, Michael A. (Michael Alan), 1944-; Martinez Mier, Esperanza de los A. (Esperanza de los Angeles), 1967-; Cook, Norman Blaine, 1954-Several studies have found that resin-based amorphous calcium phosphate (ACP) composites can function well for applications that do not require high mechanical demand. Milled tricalcium phosphate (TCP), a new calcium-phosphate-releasing material, is crystalline in nature, suggesting it to be strong. In the present study, we investigated the use of a TCP-filled composite resin as a possible tooth restorative-material. An experimental TCP-based composite was prepared using monomer with a mixture of 34.3 percent by mass of EBPADMA, 34.2 percent by mass of HmDMA, and 30.5 percent by mass of HEMA. TCP fillers were added to the monomer mixture at different levels (30 percent, 40 percent, 50 percent, and 60 percent by weight). A universal testing machine (Sintech Renew 1121; Instron Engineering Corp., Canton, MA) was used to measure the compressive strength and modulus. FTIR was used to measure the degree of conversion. The depth of cure was determined according to the ISO standards for dental resin 4049 using the scrapping technique. Knoop hardness numbers were obtained by a microhardness tester (M-400; Leco Co., St. Joseph, MI). The viscosities of the experimental resin were determined in a viscometer (DV-II+ Viscometer; Brookfield, Middleboro, MA). The data were analyzed using a one-way analysis of variance (ANOVA). A 5-percent significance level was used for all the tests. Resin composites with 30-percent TCP filler showed the highest compressive strength and hardness values. Also, this group showed the lowest degree of conversion. Resin composites with 60-percent TCP filler showed the highest degree of conversion. However, this group showed the lowest compressive strength, depth of cure, and hardness. Resin composites with 50-percent filler showed the highest compressive modulus. Resin composites with 40-percent filler showed higher viscosity values than resin composites with 30-percent filler. In conclusion, increasing the filler level significantly reduced the compressive strength, hardness, and depth of cure, but increased the degree of conversion. Also, resin composites with the lowest filler level (30 percent) had the highest compressive strength, depth of cure, and hardness. From these results, it can be concluded that the experimental TCP-filled resin used in this study cannot be used as restorative material.Item THE EFFECT OF NANO-FILLED RESIN COATING ON FLUORIDE RELEASE IN A NEW CONVENTIONAL GLASS IONOMER CEMENT(Office of the Vice Chancellor for Research, 2012-04-13) Al Dehailan, Laila; Eckert, George; Platt, JeffreyThe objective of this study was to evaluate fluoride release amounts and patterns from high strength tooth filling material (EQUIA™) which is a con-ventional Glass Ionomer Cement, and investigate whether the application of nano-filled resin-based coating with different thicknesses has any effect on fluoride release from this new material. A total of 120 disc shaped specimens (10 x 2 mm) of EQUIA™ were fabricated according to manufacturer’s in-structions. Samples were subsequently divided into three groups: no resin coating; coated with nano-filled resin-based coat; coated with nano-filled resin-based coat then subjected to abrasion using a mechanical tooth brush-ing machine. Each specimen was soaked individually into a polyethylene container with 20 ml of distilled water and stored at 37ºC. Samples from each group were soaked for four time points; 1 day, 7 days, 14 days and 21 days. Fluoride content was then measured using a fluoride-specific ion elec-trode (Model 9609BNWP, Orion Research, Boston MA, USA). The effects of time and coating on fluoride release were analyzed using two-way analysis of variance (ANOVA), with multiple comparisons performed using the Sidak method at an overall 5% significance level. The distribution of the fluoride release measurements was examined and a natural logarithm transformation of the data was necessary to satisfy the ANOVA assumptions. The time-by-coating interaction was significant (p<0.0001). We can conclude that fluo-ride level significantly increased with time for non-coated and coated then abraded samples only. Application of resin coat significantly reduced fluoride release. Also, subjecting coated samples to tooth brush abrasion increased the fluoride release when compared to coated specimens but was still signifi-cantly less than uncoated samples.Item The Effect of Silver Diamine Fluoride on Caries Lesion Remineralization as a Function of Lesion Baseline Mineral Distribution(2022) AlMady, Fahad; Lippert, Frank; Hara, Anderson; Al Dehailan, Laila; Capin, OrianaPurpose: The primary objective of this laboratory study was to investigate whether the ability of SDF to remineralize caries lesion is modulated by their baseline mineral distribution. The exploratory objective was to determine whether the staining caused by SDF is modulated by lesion mineral distribution. Materials and methods: This in vitro study utilized bovine permanent enamel specimens. SDF was compared to the clinical reference standard, 5% sodium fluoride varnish (FV), and deionized water (DIW) was the negative control. By utilizing three lesion creation protocols (methylcellulose [MeC], hydroxyethylcellulose [HEC], Carbopol [C907]), artificial caries lesions with different mineral distributions (n=20 per subgroup) were created in the enamel specimens Interventions were applied and the lesions remineralized using artificial saliva. Changes in mineral loss, lesion depth, mineral density of the surface zone, and lesion mineral distribution were determined using transverse microradiography. Throughout the study, color of the lesion and changes thereof were measured using a spectrophotometer. Data were analyzed by using two-way ANOVA. Pair-wise comparisons were performed using Fisher’s Protected Least Significant Differences to control the overall significance level at 5%. Results: For changes in mineral loss, DIW in MeC showed significantly greater change (more remineralization) than both SDF (p<0.01) and FV (p=0.01), which were not different from one another (p=0.13). There were no statistically significant differences between SDF and FV in the other lesions (C907 – p=0.18; HEC – p=0.56). For changes in lesion depth, there was no statistically significant interaction between study factors lesion protocol and treatments (p=0.23) as well as the individual factors lesion protocols (p=0.08) and treatments (p=0.82). For changes in surface zone mineral density, SDF showed significant change in mineral density compared to FV (p=0.02); however, SDF was not different from with DIW (p=0.25). For lesion mineral distribution, MeC exhibited the greater mineral loss in the lesion body and lowest mineral density at the surface zone. HEC lesions were the deepest but exhibited modest differences in mineral loss between the lesion body and the surface zone. C907 lesions were somewhat between MeC and HEC. SDF in MeC had the highest mineral gain in the surface zone, while DIW resulted in the highest mineral gain in the lesion body. SDF in HEC showed the highest mineral gain in the surface area compared to FV and DIW, with all treatments resulting in the largest mineral gain to a similar extent in the lesion body. In C907, SDF showed the most mineral gain in the lesion body compared to DIW and FV, while differences in the surface zone between treatments were less pronounced. For color changes post intervention, SDF showed more darkening in C907 and HEC lesions compared to MeC (p<0.01) and compared to FV and DIW. For post remineralization, SDF treated C907 lesions became significantly whiter (p<0.01) compared to SDF in MeC and HEC which continued to get darker. Conclusion: SDF did exhibit different remineralization abilities and behaviors and the modulation was based on lesion baseline mineral distribution. Staining resulting from SDF treatment varied significantly based on lesion mineral distribution.Item Effects of air-abrasion pressure on the resin bond strength to zirconia: a combined cyclic loading and thermocycling aging study(XMLink, 2017-08) Al-Shehri, Eman Z.; Al-Zain, Afnan O.; Sabrah, Alaa H.; Al-Angari, Sarah S.; Al Dehailan, Laila; Eckert, George J.; Özcan, Mutlu; Platt, Jeffrey A.; Bottino, Marco C.; Biomedical and Applied Sciences, School of DentistryObjectives To determine the combined effect of fatigue cyclic loading and thermocycling (CLTC) on the shear bond strength (SBS) of a resin cement to zirconia surfaces that were previously air-abraded with aluminum oxide (Al2O3) particles at different pressures. Materials and Methods Seventy-two cuboid zirconia specimens were prepared and randomly assigned to 3 groups according to the air-abrasion pressures (1, 2, and 2.8 bar), and each group was further divided into 2 groups depending on aging parameters (n = 12). Panavia F 2.0 was placed on pre-conditioned zirconia surfaces, and SBS testing was performed either after 24 hours or 10,000 fatigue cycles (cyclic loading) and 5,000 thermocycles. Non-contact profilometry was used to measure surface roughness. Failure modes were evaluated under optical and scanning electron microscopy. The data were analyzed using 2-way analysis of variance and χ2 tests (α = 0.05). Results The 2.8 bar group showed significantly higher surface roughness compared to the 1 bar group (p < 0.05). The interaction between pressure and time/cycling was not significant on SBS, and pressure did not have a significant effect either. SBS was significantly higher (p = 0.006) for 24 hours storage compared to CLTC. The 2 bar-CLTC group presented significantly higher percentage of pre-test failure during fatigue compared to the other groups. Mixed-failure mode was more frequent than adhesive failure. Conclusions CLTC significantly decreased the SBS values regardless of the air-abrasion pressure used.Item Enhancing predicted fluoride varnish efficacy and post-treatment compliance by means of calcium-containing gummy bears(Elsevier, 2018) Lippert, Frank; Al Dehailan, Laila; Castiblanco, Gina A.; Tagelsir, Azza; Buckley, Christine; Eckert, George J.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjectives This study determined whether consumption of calcium-containing gummies prior to fluoride varnish application enhances plaque fluoride retention and compliance with post-varnish application instructions. Methods The present study followed a multi-center, parallel, randomized, and laboratory analyst-blind design. Following IRB approval, parent consent and child assent, 44 subjects (7–12 years), were randomized to either gummy or no-gummy study groups. A baseline plaque sample was obtained after a wash-out period. Fluoride varnish (5% NaF) was applied; subjects in the gummy group received two calcium-containing gummies prior to varnish application. Subjects were given two questionnaires to complete (subject and parent) to investigate adherence to post-treatment instructions. Three days later, a second plaque sample was obtained. Plaque was analyzed for plaque fluid and solid fluoride concentrations. Fluoride data were analyzed using Wilcoxon Rank Sum tests, questionnaire data using Pearson chi-square tests. Results Plaque fluid fluoride did not change pre- to post-treatment in the gummy group (mean ± sd: 8.8 ± 5.7 μmol/l vs. 10.0 ± 6.3 μmol/l; p = 0.265) or in the no-gummy group (8.1 ± 4.4 μmol/l vs. 16.1 ± 20.0 μmol/l; p = 0.058). Groups were not different for plaque fluid fluoride pre-treatment (p = 1.000), post-treatment (p = 0.904), or change (p = 0.904). Plaque solid fluoride did not change pre- to post-treatment in the gummy group (0.89 ± 1.10 μmol/g vs. 1.37 ± 1.77 μmol/g; p = 0.073) or in the no-gummy group (0.68 ± 0.77 μmol/g vs. 2.01 ± 5.00 μmol/g; p = 0.190). Groups were not different for plaque solid fluoride pre-treatment (p = 1.000), post-treatment (p = 0.466), or change (p = 0.874). No significant differences were found between groups for questionnaire responses. Conclusion This study failed to demonstrate an effect of calcium-containing gummies in enhancing plaque fluoride retention.Item Fluoride concentration in saliva and biofilm fluid following the application of three fluoride varnishes(Elsevier, 2017-05) Al Dehailan, Laila; Lippert, Frank; González-Cabezas, C.; Eckert, George J.; Martinez-Mier, E. Angeles; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjective Most of the commercially available fluoride varnishes (FV) have not been evaluated for their cariostatic properties. Consequently, the aim of this in vivo study was to investigate intra-oral fluoride retention and clearance patterns from three different FV. Methods Eighteen subjects (7–11 years) participated in a laboratory analyst-blinded, randomized, crossover study comparing the ability of 5% sodium fluoride varnishes (CavityShield-CS, Enamel Pro-EP, Vanish-V) to enhance fluoride concentrations in biofilm fluid, centrifuged and whole saliva over a period of 48 h after a single FV application. Results Similar fluoride concentration × time patterns were noted for all investigated FV and studied variables, with the highest fluoride concentrations observed for the first biological sample collected after FV application (30 min). Mean ± SE (area under fluoride clearance curve) values were (μg F/g or ml × min): biofilm fluid − CS (472 ± 191), EP (423 ± 75), V (1264 ± 279); centrifuged saliva − CS (42 ± 7), EP (19 ± 3), V (41 ± 8); whole saliva − CS (68 ± 11), EP (64 ± 10), V (60 ± 7). V delivered more fluoride to biofilm fluid than CS (p = 0.0116) and EP (p = 0.0065), which did not differ (p = 0.27). For centrifuged saliva, CS and V were not significantly different (p = 0.86), but resulted in higher fluoride retention than EP (p < 0.0008). No significant differences among FV were observed for whole saliva (p = 0.79). Conclusion The present study has shown that FV vary in their ability to deliver fluoride intra-orally potentially related to formulation differences. To what extent the present findings relate to clinical efficacy remains, however, to be determined. Clinical significance Clinical research that investigates fluoride release patterns into saliva and biofilm fluid from different FV products is insufficient. More research is needed to investigate different FV formulations for their efficacy in order to help clinicians make better evidence based treatment choices.Item Impact of Toothbrush Head Configuration and Dentifrice Abrasivity on Non-Carious Cervical Lesions Development In-Vitro(2022) Alzahrani, Lina; Hara, Anderson T.; Lippert, Frank; Al Dehailan, LailaBackground: Non-carious cervical lesions (NCCLs) result from the loss of tooth structure at the cemento-enamel junction for reasons unrelated to dental caries.1 NCCLs have been attributed to processes of dental abrasion, erosion and/or abfraction.7 In this study, we focused on the effects of excessive toothbrushing abrasion, resulting from the mechanical interaction between the tooth, toothbrush, and toothpaste. Purpose: The aim of this in vitro study was to investigate the effect of toothbrush head configuration and toothpaste abrasivity combinations on the development and progression of simulated NCCLs, evaluated by 3D optical profilometry. Hypotheses: The study hypotheses were: a) the abrasive level of the dentifrice and toothbrush bristle configuration have a significant influence on the initiation and progression of NCCLs independently; and b) the association between the abrasive level and toothbrush head configuration does affect the initiation and the progression of NCCLs. Materials and Methods: A total of 240 extracted human upper first premolars, free of any dental caries, restorations, stains, or enamel and root defects were selected. The teeth were cleaned with a hand periodontal scaler and randomly allocated into 15 groups (n = 16), generated by the association between toothbrushes of different head configurations (ordinary/flat-trimmed, rippled, cross-angled/multileveled/rubber, cross-angled/multileveled/flex head and feathered) and toothpaste abrasivity (low, medium, and high, simulated using different silica abrasives) in a factorial design. The dental specimens were mounted on custom-made acrylic blocks, and their root surfaces were partially covered with acrylic resin to simulate the gingiva, leaving a 2-mm area in length apical to the cemento-enamel junction exposed to toothbrushing. The specimens were brushed with the tested toothbrushes and abrasive slurries for a total of 35,000 and 65,000 double strokes. Specimens were analyzed by optical profilometry at baseline and after each brushing cycle. The outcome variable was dentin volume loss (mm3), calculated by image subtraction. Data were analyzed using mixed-model analysis of variance (ANOVA). Significance of the Results: Oral health maintenance and effective plaque control depend on the combined usage of a toothbrush and a toothpaste. Specific combinations of toothbrush and toothpaste associated with excessive toothbrushing may lead to tooth wear. Results obtained from this study will showed how different combinations of toothbrush head configuration and toothpaste abrasivity affect NCCL development and progression. Results: A significant interaction among the experimental factors (toothbrush type abrasive level brushing cycles) was observed (p = 0.05). All toothbrushes caused significantly more tooth wear when associated with the high-abrasivity slurry, as compared to medium- and low-abrasivity slurries. The medium-abrasivity slurry caused significantly more tooth wear than the low-abrasivity slurry. At both testing points and when associated with the low abrasivity slurry, the Feathered toothbrush was the least abrasive. At 35,000 brushing cycles, the flat-trimmed toothbrush was the most abrasive. At 65,000 brushing cycles, the flat-trimmed toothbrush was the most abrasive only when associated with the high-abrasivity slurry, and the multileveled/rubber bristles was the most abrasive when associated with the medium- and high-abrasivity slurries. Overall, 35,000 brushing cycles resulted in significantly less tooth wear than 65,000 brushing cycles. Conclusion: Considering the limitations of this study, it can be suggested that for patients at higher risk of developing NCCLs, ordinary/flat-trimmed toothbrushes are not favorable options. According to the abrasive level of the toothpaste, either feathered or multileveled/flex head may be more suitable to prevent the development of NCCLs.Item An In-Vitro Study to Determine Anti-Caries Efficacy of Fluoride Varnishes(Office of the Vice Chancellor for Research, 2013-04-05) Al Dehailan, Laila; Mier, E. Angeles Martinez; Lippert, FrankFundamental research on fluoride varnishes (FV) and how different formulations affect adherence to teeth, fluoride release into saliva and uptake by teeth is virtually non-existent. The objective of this in vitro study was to investigate the anti-caries efficacy of five commercially available FV: Enamel Pro® Varnish Clear, Flor-Opal® Varnish White, MI Varnish™, PreviDent® and Vanish™. Ninety bovine enamel specimens (4x4mm) were prepared and assigned to five groups (n=18). Early caries lesions were created in the specimens and characterized using Vickers microhardness (VHN). FV was applied to each group of specimens. Immediately afterwards, 7.5ml of artificial saliva (AS) were pipetted over each group, collected and renewed every 15min for 6h. AS samples were analyzed for fluoride using a ion-specific electrode and meter. FV was removed using chloroform and part of the specimens protected to determine enamel fluoride uptake (EFU) using the acid etch technique. Each group was then subjected to pH cycling consisting of a 4h/day acid challenge and two, one-minute treatments with Crest Cavity Protection. Post-pH cycling microhardness was measured and compared to baseline values to determine the ability of the FV to enhance remineralization/prevent demineralization. One-way ANOVA was used for data analysis (p<0.05). Specimens treated with Enamel Pro® revealed an increase in VHN that was significantly higher than all other groups. There was no significant difference in ΔVHN for Flor-Opal® compared to MI Varnish™, PreviDent® and Vanish™. Specimens treated with MI Varnish™ showed significantly higher ΔVHN than Vanish™ only. No significant difference in EFU was found among groups. Total fluoride release over 6h was MI Varnish™(303μg/ml) > Enamel Pro® (217μg/ml) > Flor-Opal® (153μg/ml) > PreviDent® (84μg/ml) > Vanish(28μg/ml). In conclusion, anti-caries efficacy (measured through EFU, fluoride release and VHN) differs among FV products and this difference may be attributed to different composition, fluoride source and other active ingredients.Item Longitudinal In Vitro Effects of Silver Diamine Fluoride on Early Enamel Caries Lesions(2020) Thompson Alcorn, Alice-Anne; Lippert, Frank; Al Dehailan, Laila; Cook, N. BlaineObjective: This study aimed to evaluate surface microhardness changes in early, incipient, non-cavitated white-spot, enamel caries lesions treated with silver diamine fluoride (SDF) longitudinally. The utilization of silver nitrate and potassium fluoride test groups served as additional controls to assist in evaluating if the remineralization effects were due to the silver or fluoride component in SDF. Hypotheses: 1. SDF treatment will result in increased surface microhardness of early, incipient, non-cavitated white-spot, enamel caries lesions compared to all other tested interventions. 2. Specimen storage for 2-weeks in artificial saliva will result in greater surface rehardening in lesions treated with SDF compared to other tested interventions. Design: This laboratory study had 5 intervention groups (SDF, silver nitrate (AgNO3), potassium fluoride (KF), 5.0-percent sodium fluoride varnish (FV), deionized water (DI)) × 2-time intervals after intervention (immediate & delayed pH-cycling), resulting in 10 groups (n = 18). Early, incipient, non-cavitated white-spot, enamel caries lesions were created in bovine enamel and extent of demineralization was determined using Vickers surface microhardness (VHNlesion). Intervention treatments were applied. Half the specimens from each group underwent immediate 5-day pH-cycling and half were stored in an incubator with artificial saliva for two weeks before undergoing 5-day pH-cycling. After pH-cycling, lesion hardness was evaluated using VHNpost. Specimens were then exposed to a second demineralization challenge and lesion softening was evaluated using VHNsecdem. Surface rehardening was calculated: ΔVHN =VHNpost - VHNlesion. Surface softening was calculated: ΔVHNsecdem =VHNsecdem – VHNpost. Data was analyzed using two-way ANOVA. Results: Immediately cycled, SDF had significantly (p < .0001) greater remineralization than DI, AgNO3, and FV. All delayed cycling groups had significantly (p < .0001) greater remineralization than FV. Significantly greater remineralization was noted in delayed AgNO3 (p < .0001), DI (p = .0003), and FV (p = .0006) compared to immediately cycled. After the second demineralization challenge, FV had significantly less surface softening than AgNO3 (p = 0.0002), DI (p = 0.0003), KF (p = 0.0225), and SDF (p = 0.0388) intervention groups. No significant difference was found between the pH-cycle timings. Conclusion: Based on our findings, FV maybe better suitable than SDF to treat early, incipient, non-cavitated white-spot, enamel caries lesions. Longitudinally, SDF exhibited greater remineralization than both FV and DI groups, though not statistically significant. However, upon a second demineralization challenge, FV significantly outperformed SDF in preventing surface softening.