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Browsing by Author "Alkattan, Rana"
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Item The influence of baseline hardness and chemical composition on enamel demineralization and subsequent remineralization(2017-05-09) Alkattan, Rana; Ando, Masatoshi; Lippert, Frank; Cook, Norman BlaineBACKGROUND Several studies have reported that harder enamel with higher contents of calcium (Ca), phosphorus (P) and fluorine (F) coupled with lower contents of carbonate (C), magnesium (Mg) and nitrate (N) was found to be more resistant to demineralization. Additionally, the hardness of dental enamel was found to have a strong correlation with its chemical content. However, yet to be established is the relation between the physical and chemical structure of enamel and its response to de- and remineralizing conditions. OBJECTIVES The aims of this laboratory study were: 1) To investigate the hardness and chemical content of sound enamel and their influence on demineralization; 2) To investigate these properties in demineralized enamel and their influence on remineralization; and 3) To investigate these properties in sound enamel and their influence on remineralization. MATERIALS AND METHODS Incipient subsurface caries lesions were created in 94 bovine enamel specimens using Carbopol C907 using three demineralization times. The specimens were then pH-cycled and treated using either 367 ppm F sodium fluoride or a placebo. Knoop surface microhardness (SMH), Energy dispersive X-ray spectroscopy (EDS) and Transverse microradiography (TMR) were performed on the specimens at all stages and compared between them. TMR variables included integrated mineral loss (ΔZ), Lesion depth (L) and maximum mineral density of the surface zone (SZmax). Data were analyzed using three- and four-way ANOVA and Pearson correlation coefficients were calculated. RESULTS SMH, ΔZ, L and SZmax were significantly different among stages, demineralization times and treatment. The weight% of F at the surface was significantly affected by treatment, irrespective of demineralization time. A statistically significant moderate correlation was found between SZmax and ΔZ and SZmax and L after pH cycling. SMH also correlated weakly to moderately with TMR data. CONCLUSIONS SMH and SZmax decreased while ΔZ and L increased with increased demineralization time. Both fluoride and non-fluoride specimens were able to remineralize, which emphasizes the role of saliva in mineralization. The Ca:P ratio remained stable at various stages, indicating the stoichiometric dissolution and redeposition of minerals. The greatest deposition of F was at the surface and its increase led to an increase in SMH and SZmax. SMH values showed that harder specimens at baseline and after demineralization remained hard after demineralization and pH-cycling, respectively, although this correlation was weak. Additionally, harder lesions showed less L and ΔZ and greater SZmax. RELEVANCE This in-vitro study will help better understand the caries process and the impact of physical and chemical characteristics of enamel on de- and remineralization challenges.Item The influence of hardness and chemical composition on enamel demineralization and subsequent remineralization(Elsevier, 2018-08) Alkattan, Rana; Lippert, Frank; Tang, Qing; Eckert, George J.; Ando, Masatoshi; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjectives The objectives were to investigate the hardness and chemical composition of sound, demineralized and pH-cycled bovine enamel and determine their influence on demineralization and remineralization behavior. Methods Ninety-four, 5 × 5 × 2-mm bovine enamel specimens were demineralized using three different times [(24 h (n = 33), 48 h (n = 30), 96 h (n = 31)]. The specimens were then pH-cycled using either 367 ppm F sodium fluoride or deionized water. Knoop hardness (HK) and energy-dispersive X-ray spectroscopy (measured elements: Ca, P, F, C, Mg, N) were performed at three stages (sound, after demineralization, after pH-cycling) and transverse microradiography was performed after demineralization and pH-cycling. Comparisons were determined by ANOVA. Results Results showed that HK, integrated mineral loss and lesion depth were significantly different between stages, demineralization times and treatments. The weight% of F at the surface was significantly affected by treatment, irrespective of demineralization time, while the Ca:P ratio of the enamel remained stable even after de- and remineralization protocols. The F in fluoride groups and the artificial saliva in non-fluoride groups were both able to induce enamel remineralization, indicating the protective effect of salivary pellicle against demineralization even in the absence of fluoride. Conclusions Harder specimens and those with greater surface F weight% were less susceptible to demineralization and were more likely to remineralize. However, the amount of surface Ca and P did not influence de- or remineralization behavior.