Browsing by Author "Hara, Anderson T."
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Item Ability of Caries Detection Methods to Determine Caries Lesion Activity(2019-12) Aldawood, Fatma; Ando, Masatoshi; Hara, Anderson T.; Diefenderfer, Kim E.Background: Non-cavitated caries lesions form due to acid diffusion and demineralization of enamel subsurface with an intact surface layer (SL). Caries lesions progress when the outcome of demineralization and remineralization processes over time is net mineral loss. Lesions that continue to demineralize are called active, while those that display no evidence of further demineralization are called inactive. Micro-computed-tomography (µCT) analysis provides objective non-destructive measurements of the thickness of the surface layer (SL) and severity of caries lesions. Aims: 1) To investigate if visual/tactile suspected active non-cavitated early white spot lesions present a thinner surface layer than inactive ones; 2) To investigate if there is an association between the thickness of the surface layer (SLT) and caries activity, as determined by QLF during dehydration (△QD); 3) To determine lesion severity by comparing lesion volume and maximum depth correlation with △Q value at 15 s from QLF during dehydration. Materials and Methods: Thirty extracted human premolars exhibiting non-cavitated approximal white spot early lesions stored in 0.1.-percent thymol/4C and treated with 5.0-percent NaOCl/30 min were included in the study. Fifteen active and 15 inactive lesions were determined by visual/tactile examinations by consensus of two experienced examiners. Roughness measurements (Ra) were acquired using non-contact optical profilometry. Two-dimensional minimum (2D-min), maximum (2D-max), average (2D-avg) SL and three-dimensional (3D) analyses, volume and depth of lesions were determined from µCT image analysis. A series of fluorescence images were acquired at baseline (hydrated), at 1 s, at 5 s, at 10 s and at 15 s by QLF. During image acquisition, surfaces were dehydrated with continuous-compressed-air. △Q and △Q/s (△QD) were calculated. Data were analyzed using two-sample t-tests and Pearson correlation coefficients (p < 0.05). Results: Surface roughness of active and inactive lesions was not significantly different (p > 0.08). Overall lesion volume and depth in dentin were significantly larger in active lesions (p = 0.022, p = 0.009). SL thickness of active and inactive lesions was not significantly different (2D = 0.121, 3D = 0.080, 2D-avg = 0.446, 2D-min = 0.197, 2D-max = 0.122). △QD at 1s was significantly larger for active lesions (p = 0.046). ΔQ at 15 s of dehydration had a moderate positive association with lesion volume (r = 0.56). △QD had a weak negative association with SL thickness (2D-avg) and (2D-min). Conclusions: 1) Active and inactive non-cavitated lesions show no difference in SL thickness; 2) QLF during dehydration (△QD) does not correlate well with SL thickness; 3) ΔQ at 15 s of dehydration correlates moderately well with lesion volume and is consistent with caries activity assessed by visual/tactile examination.Item Age effect on presence, susceptibility and treatment of erosive tooth wear(2018) Algarni, Amnah Abdullah; Hara, Anderson T.; Lippert, Frank; Platt, Jeffrey A.; González-Cabezas, Carlos; Ungar, PeterErosive tooth wear (ETW) is a growing dental condition often associated with aging. This in-vitro project comprised three studies aiming to investigate the impact of tooth age on ETW susceptibility and prevention. In the first study, un-identified extracted premolars were collected and had their ages estimated using validated dental forensic methods. The premolars were examined to investigate the relationship between age and presence and severity of ETW, as well as other main dental-hard tissues conditions. ETW, dental caries, fluorosis, extrinsic staining and tooth color were evaluated using established clinical indices. In the second study, the tooth age impact on ETW susceptibility and response to preventive treatments (Sn+F, NaF, and de-ionized water control) were evaluated using representative samples from the initial study. Enamel and dentin specimens were prepared and subjected to daily erosion-treatmentremineralization cycling procedure. Surface loss (SL) was determined during and after the cycling, by optical profilometry. Similar protocol was adopted in the third study with the addition of toothbrushing abrasion to the model, in order to explore the interplay between age and toothpaste abrasivity on erosion-abrasion development. SL was measured during and after the erosion-toothbrushing-remineralization cycling. The relationships between age and the investigated variables were assessed using linear regression models. In conclusion: 1. The presence and severity of ETW, dental caries, and extrinsic staining increased with age, while of enamel fluorosis decreased. Tooth also showed to be darker with age. 2. Susceptibility of enamel and dentin to demineralization increased with age. Sn+F showed the highest anti-erosive efficacy, and was not affected by age. NaF showed lower efficacy on dentin, which increased with age. 3. Enamel and dentin SL increased with toothpaste abrasivity level. Dentin SL also increased with age. Age effect on enamel SL was observed only with low abrasive toothpaste. Age-related changes on enamel and dentin affected ETW development.Item Anticaries Potential of a Sodium Monofluorophosphate Dentifrice Containing Calcium Sodium Phosphosilicate: Exploratory in situ Randomized Trial(Karger, 2017-03) Parkinson, C. R.; Siddiqi, M.; Mason, S.; Lippert, Frank; Hara, Anderson T.; Zero, Domenick T.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryCalcium sodium phosphosilicate (CSPS) is a bioactive glass material that alleviates dentin hypersensitivity and is postulated to confer remineralization of caries lesions. This single-centre, randomized, single (investigator)-blind, placebo-controlled, crossover, in situ study explored whether the addition of 5% CSPS to a nonaqueous fluoride (F) such as sodium monofluorophosphate (SMFP)-containing dentifrice affects its cariostatic ability. Seventy-seven subjects wore 4 gauze-covered enamel specimens with preformed lesions (2 surface-softened and 2 subsurface) placed buccally on their mandibular bilateral dentures for up to 4 weeks. Subjects brushed twice daily with 1 of the 5 study dentifrices: 927 ppm F/5% CSPS, 927 ppm F/0% CSPS, 250 ppm F/0% CSPS, 0 ppm F/5% CSPS, or 0 ppm F/0% CSPS. Specimens were retrieved after either 21 (surface-softened lesions; analyzed by Knoop surface microhardness [SMH]) or 28 days (subsurface lesions; analyzed by transverse microradiography). The enamel fluoride uptake was determined for all specimens using a microbiopsy technique. The concentrations of fluoride and calcium in gauze-retrieved plaque were also evaluated. Higher dentifrice fluoride concentrations led to greater remineralization and fluoridation of both lesion types and increased plaque fluoride concentrations. CSPS did not improve the cariostatic properties of SMFP; there were no statistically significant differences between 927 ppm F/5% CSPS and 927 ppm F/0% CSPS in percent SMH recovery (p = 0.6788), change in integrated mineral loss (p = 0.5908), or lesion depth (p = 0.6622). Likewise, 0 ppm F/5% CSPS did not provide any benefits in comparison to 0 ppm F/0% CSPS. In conclusion, CSPS does not negatively impact nor does it improve the ability of an SMFP dentifrice to affect remineralization of caries lesions.Item Beam profile characterization of light-emitting-diode curing units and its effect on polymerization of a resin-matrix composite(2017) AlZain, Afnan Omar; Platt, Jeffrey A.; Chu, Tien-Min G.; Bottino, Marco C.; Hara, Anderson T.; Goodpaster, John V.; Roulet, Jean-FrancoisThe general aim of this study was to investigate the influence of the localized irradiance beam profiles from multiple light-emitting-diode (LED) light-curing units (LCUs) on the polymerization pattern within a resin-matrix composite (RMC). Irradiance beam profiles were generated from one quartz-tungsten-halogen and various single and multiple emission peak LED LCUs using a camera-based beam profiler system combined with LCU power measurements obtained using an integrating sphere/spectrometer assembly. The influence of distance on irradiance, radiant exposure (RE) and degree of conversion (DC) on the top and bottom surfaces of a RMC increment, using various LCUs, at two clinically relevant distances was investigated. Molar absorptivity of the photoinitiators present in the nano-hybrid RMC (Tetric EvoCeram bleaching shade-XL) assessed was using UV-spectrophotometry. The correlation among irradiance, RE and DC was explored. A mapping approach was used to investigate DC, microhardness and cross-link density (CLD) within 5×5×2 mm specimens at various depths; top, 0.5, 0.7, 0.9, 1.1, 1.3,1.5 mm and bottom. The localized irradiance correlation with its corresponding DC, microhardness and CLD was explored, and localized DC correlation with microhardness was assessed. The DC was measured using micro-Raman spectroscopy, and CLD was assessed by an ethanol-softening method (%KHN reduction) using an automated microhardness tester. Molar absorptivity of diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide was 20-fold higher than camphorquinone. Non-uniform LCU beam profiles caused localized polymerization discrepancies that were significant at specific depths and points within the specimens with respect to DC, microhardness and CLD, which did not follow a specific pattern regardless of the LCU or curing distance assessed. A moderate correlation was displayed among irradiance, RE and DC. The localized irradiance from the LCUs was weakly correlated with the corresponding DC, microhardness and CLD on the top surface of a RMC at both curing distances. The localized microhardness was moderately correlated with DC. In conclusion, polymerization within the RMC investigated was non-uniform and did not reflect the LCU irradiance pattern at the area assessed. Also, a mapping approach within the specimens provided a detailed polymerization pattern assessment occurring within a RMC increment. Therefore, the LCUs explored may potentially increase the risk of RMC fracture.Item Effect of phytate and zinc ions on fluoride toothpaste efficacy using an in situ caries model(Elsevier, 2018) Parkinson, Charles; Burnett, Gary R.; Creeth, Jon; Lynch, Richard; Budhawant, Chandrashekhar; Lippert, Frank; Hara, Anderson T.; Zero, Domenick T.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjectives To compare and explore the dose-response of phytate-containing 1150 ppm fluoride toothpastes on model caries lesions and to determine the impact of zinc ions. Methods This was a single-centre, randomised, blinded (examiner/laboratory analyst), six-treatment, four-period crossover, in situ study in adults with a removable bilateral maxillary partial denture. Study treatments were toothpastes containing: 0.425% phytate/F; 0.85% phytate/F; 0.85% phytate/Zn/F; F-only; Zn/F and a 0% F placebo. Where present, F was 1150 ppm as NaF; Zn was 0.3% as ZnCl2. Human enamel specimens containing early-stage, surface-softened (A-lesions) or more advanced, subsurface (B-lesions) caries lesions were placed into the buccal flanges of participants’ modified partial denture (one of each lesion type per side). A-lesions were removed after 14 days of twice-daily treatment use; B-lesions were removed after a further 14 days. A-lesions were analysed for surface microhardness recovery. Both lesion types were analysed by transverse microradiography and for enamel fluoride uptake, with B-lesions additionally analysed by quantitative light-induced fluorescence. Comparison was carried out using an analysis of covariance model. Results Statistically significant differences between 1150 ppm F and the placebo toothpastes (p < 0.05) were shown for all measures, validating the model. No differences between fluoride toothpastes were observed for any measure with little evidence of a dose-response for phytate. Study treatments were generally well-tolerated. Conclusions Results suggest phytate has little impact on fluoride’s ability to promote early-stage lesion remineralisation or prevent more advanced lesion demineralisation in this in situ caries model. Similarly, results suggest zinc ions do not impair fluoride efficacy.Item The effect of polymerization methods and fiber types on the mechanical behavior of fiber-reinforced composite resin(2015) Huang, Nan-Chieh; Chu, Tien-Min Gabriel; Hara, Anderson T.; Brown, David T.; Bottino, Marco C.; Levon, John A.Background: Interim restoration for a lost anterior tooth is often needed for temporary esthetic and functional purposes. Materials for interim restorations usually have less strength than ceramic or gold and can suffer from fracture. Several approaches have been proposed to reinforce interim restorations, among which fiber reinforcement has been regarded as one of the most effective methods. However, some studies have found that the limitation of this method is the poor polymerization between the fibers and the composite resin, which can cause debonding and failure. 64 Purpose: The purpose of this study was to investigate the effects of different polymerization methods as well as fiber types on the mechanical behavior of fiberreinforced composite resin. Material and Methods: A 0.2-mm thick fiber layer from strip fibers or mesh fibers embedded in uncured monomers w as fabricated with polymerization (two-step method) or without polymerization (one-step method), on top of which a 1.8-mm composite layer was added to make a bar-shape sample, followed by a final polymerization. Seventy-five specimens were fabricated and divided into one control group and four experimental groups (n=15), according to the type of glass fiber (strip or mesh) and polymerization methods (one-step or two-step). Specimens were tested for flexural strength, flexural modulus, and microhardness. The failure modes of specimens were observed by scanning electron microscopy (SEM). Results: The fiber types showed significant effect on the flexural strength of test specimens (F = 469.48; p < 0.05), but the polymerization methods had no significant effect (F = 0.05; p = 0.82). The interaction between these two variables was not significant (F = 1.73; p = 0.19). In addition, both fiber types and polymerization steps affected the flexural modulus of test specimens (F = 9.71; p < 0.05 for fiber type, and F = 12.17; p < 0.05 for polymerization method). However, the interaction between these two variables was not significant (F = 0.40; p = 0.53). Both fiber types and polymerization steps affected the Knoop hardness number of test specimens (F = 5.73; p < 0.05 for polymerization method. and F = 349.99; p < 0.05 for fiber type) and the interaction between these two variables was also significant (F = 5.73; p < 0.05). SEM images revealed the failure mode tended to become repairable while fiber reinforcement was 65 existed. However, different polymerization methods did not change the failure mode. Conclusion: The strip fibers showed better mechanical behavior than mesh fibers and were suggested for use in composite resin reinforcement. However, different polymerization methods did not have significant effect on the strength and the failure mode of fiber-reinforced compositeItem In vitro caries lesion rehardening and enamel fluoride uptake from fluoride varnishes as a function of application mode(2013) Lippert, Frank; Hara, Anderson T.; Martinez-Mier, Esperanza A.; Zero, Domenick T.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryPURPOSE: To study the laboratory predicted anticaries efficacy of five commercially available fluoride varnishes (FV) by determining their ability to reharden and to deliver fluoride to an early caries lesion when applied directly or in close vicinity to the lesion (halo effect). METHODS: Early caries lesions were created in 80 polished bovine enamel specimens. Specimens were allocated to five FV groups (n = 16) based on Knoop surface microhardness (KHN) after lesion creation. All tested FV claimed to contain 5% sodium fluoride and were: CavityShield, Enamel Pro, MI Varnish, Prevident and Vanish. FV were applied (10 +/- 2 mg per lesion) to eight specimens per FV group (direct application); the remaining eight specimens received no FV but were later exposed to fluoride released from specimens which received a FV treatment (indirect application). Specimens were paired again and placed into containers (one per FV). Artificial saliva was added and containers placed into an incubator (27 hours at 37 degrees C). Subsequently, FV was carefully removed using chloroform. Specimens were exposed to fresh artificial saliva again (67 hours at 37 degrees C). KHN was measured and differences to baseline values calculated. Enamel fluoride uptake (EFU) was determined using the acid etch technique. Data were analyzed using two-way ANOVA. RESULTS: The two-way ANOVA highlighted significant interactions between FV vs. application mode, for both deltaKHN and EFU (P < 0.001). All FV were able to reharden and deliver fluoride to caries lesions, but to different degrees. Furthermore, considerable differences were found for both variables between FV when applied either directly or in close vicinity to the lesion: MI Varnish and Enamel Pro exhibited greater fluoride efficacy when applied in vicinity rather than directly to the lesion, whereas CavityShield and Vanish did not differ. Prevident exhibited a higher EFU when applied directly, but little difference in rehardening.Item Laboratory Investigations Into the Potential Anticaries Efficacy of Fluoride Varnishes(2014-07) Lippert, Frank; Hara, Anderson T.; Martinez-Mier, Esperanza A.; Zero, Domenick T.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryPurpose: The purpose of this study was to investigate the potential anticaries efficacy of fluoride varnishes (FVs) by studying their ability to reharden and deliver fluoride to carious lesions and to release fluoride into saliva. Methods: Enamel carious lesions were created and allocated to 24 groups (11 FVs with two FV incubation times and two control groups) based on Knoop microhardness test values. FVs were applied to lesions, which were incubated in artificial saliva for two or six hours, with saliva being renewed hourly. FV was removed and lesions were remineralized in artificial saliva for 22 hours. Microhardness was measured and enamel fluoride uptake (EFU) was determined. Saliva samples (six-hour groups) were analyzed to determine fluoride release characteristics. Data were analyzed using analysis of variance. Results: FVs differed considerably in their ability to reharden and deliver fluoride to carious lesions and in their fluoride release characteristics. Little consistency was found between investigated study variables for virtually all tested FVs. For example, a particular FV showed the highest EFU and fluoride release values but the lowest rehardening value. A longer FV contact time led to increased EFU for five of the 11 FVs. Some FVs delivered more fluoride to lesions in two hours than others did in six hours. Conclusion: Fluoride varnishes differ greatly in their in vitro anticaries efficacy.Item Mechanical properties of a new zinc-reinforced glass ionomer restorative material(2012) Al-Angari, Sarah Sultan; Cook, Norman Blaine; Lund, Melvin R., 1922; Cochran, Michael A. (Michael Alan), 1944-; Chu, Tien-Min Gabriel; Platt, Jeffrey A., 1958-; Hara, Anderson T.Objective: Zinc-reinforced glass ionomer restorative material (ZRGIC) has been proposed as an improved restorative material. The study compared the mechanical properties of a ZRGIC restorative material (ChemFil Rock, (Dentsply)), with three commercially available glass ionomers (GICs); Fuji IX GP Extra (GC America), Ketac Molar (3M ESPE) and EQUIA Fil (GC America). A resin composite, Premise (Kerr), was included as a control group except for fracture toughness. Methods: Fracture toughness (KIC) testing was done according to ISO 13586, using single edge notched-beam specimens (n=10), loaded until failure in a three-point bending test device. Specimens (n=9) for the hardness, roughness and abrasive wear testing were made by mixing and inserting the restorative materials into individual stainless steel molds followed by flattening and polishing. Knoop microhardness (KHN) was performed (25 g, 30 s),on pre-determined areas of the polished surfaces. For toothbrushing wear resistance and roughness, specimens were brushed in an automated brushing machine (200 g) with a suspension of dentifrice and water (1:1, w/v) for 20,000 strokes. Specimen surfaces were scanned in an optical profilometer before and after brushing to obtain surface roughness (Ra) and mean height (surface) loss using image subtraction and dedicated software. Data were analyzed using Wilcoxon Rank Sum tests (α=0.05). Results: ChemFil Rock had the highest change in surface roughness (Ra)(0.79±0.14; p<0.001) and the lowest microhardness (KHN) values (52.39±2.67; p<0.05) among all GICs. Its wear resistance was comparable to other GICs (p>0.05). ChemFil Rock had lower fracture toughness (0.99±0.07, KIC) compared to Equia Fil (p<0.01) and higher compared to the other GICs (p<0.01). Conclusion: The new ZRGIC restorative material showed intermediate fracture toughness, high change in surface roughness, and low microhardness compared to three other commercial GICs. All materials were supplied by respective manufacturers.Item Topical ferumoxytol nanoparticles disrupt biofilms and prevent tooth decay in vivo via intrinsic catalytic activity(Springer Nature, 2018-07-31) Liu, Yuan; Naha, Pratap C.; Hwang, Geelsu; Kim, Dongyeop; Huang, Yue; Simon-Soro, Aurea; Jung, Hoi-In; Ren, Zhi; Li, Yong; Gubara, Sarah; Alawi, Faizan; Zero, Domenick; Hara, Anderson T.; Cormode, David P.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryFerumoxytol is a nanoparticle formulation approved by the U.S. Food and Drug Administration for systemic use to treat iron deficiency. Here, we show that, in addition, ferumoxytol disrupts intractable oral biofilms and prevents tooth decay (dental caries) via intrinsic peroxidase-like activity. Ferumoxytol binds within the biofilm ultrastructure and generates free radicals from hydrogen peroxide (H2O2), causing in situ bacterial death via cell membrane disruption and extracellular polymeric substances matrix degradation. In combination with low concentrations of H2O2, ferumoxytol inhibits biofilm accumulation on natural teeth in a human-derived ex vivo biofilm model, and prevents acid damage of the mineralized tissue. Topical oral treatment with ferumoxytol and H2O2 suppresses the development of dental caries in vivo, preventing the onset of severe tooth decay (cavities) in a rodent model of the disease. Microbiome and histological analyses show no adverse effects on oral microbiota diversity, and gingival and mucosal tissues. Our results reveal a new biomedical application for ferumoxytol as topical treatment of a prevalent and costly biofilm-induced oral disease.