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Browsing by Author "Lynch, R. J. M."
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Item Characteristics of Methylcellulose Acid Gel Lesions Created in Human and Bovine Enamel(Karger, 2013-01) Lippert, Frank; Butler, A.; Lynch, R. J. M.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryAcid gel caries lesions were created in 3,100 human and bovine enamel specimens and studied with transverse microradiography. Small, significant differences were found. Human enamel lesions were found to be less demineralized, shallower, had a higher ratio of integrated mineral loss (ΔZ) to lesion depth (L), a lower degree of surface zone mineralization (SZmax) and showed less variability than those in bovine enamel. SZmax showed the highest variability. Between tissues, L differed the most, ΔZ the least. Biological variation within bovine enamel is perhaps not only bigger than previously assumed, it may also overshadow any structural and chemical differences between tissues.Item Comparison of Knoop and Vickers Surface Microhardness and Transverse Microradiography for the Study of Early Caries Lesion Formation in Human and Bovine Enamel(Elsevier, 2014-07) Lippert, Frank; Lynch, R. J. M.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjective The aims of the present laboratory study were twofold: a) to investigate the suitability of Knoop and Vickers surface microhardness (SMH) in comparison to transverse microradiography (TMR) to investigate early enamel caries lesion formation; b) to compare the kinetics of caries lesion initiation and progression between human and bovine enamel. Design Specimens (90 × bovine and 90 × human enamel) were divided into six groups (demineralization times of 8/16/24/32/40/48 h) of 15 per enamel type and demineralized using a partially saturated lactic acid solution. SMH was measured before and after demineralization and changes in indentation length (ΔIL) calculated. Lesions were characterized using TMR. Data were analyzed (two-way ANOVA) and Pearson correlation coefficients calculated. Results ΔIL increased with increasing demineralization times but plateaued after 40 h, whereas lesion depth (L) and integrated mineral loss (ΔZ) increased almost linearly throughout. No differences between Knoop and Vickers SMH in their ability to measure enamel demineralization were observed as both correlated strongly. Overall, ΔIL correlated strongly with ΔZ and L but only moderately with the degree of surface zone mineralization, whereas ΔZ and L correlated strongly. Bovine demineralized faster than human enamel (all techniques). Conclusions Lesions in bovine formed faster than in human enamel, although the resulting lesions were almost indistinguishable in their mineral distribution characteristics. Early caries lesion demineralization can be sufficiently studied by SMH, but its limitations on the assessment of the mineral status of more demineralized lesions must be considered. Ideally, complementary techniques to assess changes in both physical and chemical lesion characteristics would be employed.Item Effect of Fluoride, Lesion Baseline Severity and Mineral Distribution on Lesion Progression(Karger, 2012) Lippert, Frank; Butler, A.; Lynch, R. J. M.; Hara, Anderson T.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryThe present study investigated the effects of fluoride (F) concentration, lesion baseline severity (ΔZbase) and mineral distribution on lesion progression. Artificial caries lesions were created using three protocols [methylcellulose acid gel (MeC), hydroxyethylcellulose acid gel (HEC), carboxymethylcellulose acid solution (CMC)] and with low and high ΔZbase groups by varying demineralization times within protocols. Subsequently, lesions were immersed in a demineralizing solution for 24 h in the presence of 0, 1, 2 or 5 ppm F. Changes in mineral distribution characteristics of caries lesions were studied using transverse microradiography. At baseline, the protocols yielded lesions with three distinctly different mineral distributions. Secondary demineralization revealed differences in F response between and within lesion types. In general, lowΔZ lesions were more responsive to F than highΔZ lesions. LowΔZ MeC lesions showed the greatest range of response among all lesions, whereas highΔZ HEC lesions were almost unaffected by F. Laminations were observed in the presence of F in all but highΔZ HEC and CMC lesions. Changes in mineral distribution effected by F were most pronounced in MeC lesions, with remineralization/mineral redeposition in the original lesion body at the expense of sound enamel beyond the original lesion in a dose-response manner. Both ΔZbase and lesion mineral distribution directly impact the F response and the extent of secondary demineralization of caries lesions. Further studies – in situ and on natural white spot lesions – are required to better mimic in vivo caries under laboratory conditions.Item Effect of toothbrushing duration and dentifrice quantity on enamel remineralisation: An in situ randomized clinical trial(Elsevier, 2016-12) Creeth, J. E.; Kelly, Sue A.; González-Cabezas, Carlos; Karwal, R.; Martinez-Mier, Esperanza A.; Lynch, R. J. M.; Bosma, M.; Zero, Domenick T.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryObjectives The influence of toothbrushing duration and dentifrice quantity on fluoride efficacy against dental caries is poorly understood. This study investigated effects of these two oral hygiene factors on enamel remineralisation (measured as surface microhardness recovery [SMHR]), enamel fluoride uptake (EFU), and net acid resistance (NAR) post-remineralisation in a randomized clinical study using an in situ caries model. Methods Subjects (n = 63) wore their partial dentures holding partially demineralised human enamel specimens and brushed twice-daily for two weeks, following each of five regimens: brushing for 120 or 45 s with 1.5 g of 1150 ppm F (as NaF) dentifrice; for 120 or 45 s with 0.5 g of this dentifrice; and for 120 s with 1.5 g of 250 ppm F (NaF) dentifrice. Results Comparing brushing for 120 s against brushing for 45 s, SMHR and EFU increased by 20.0% and 26.9% respectively when 1.5 g dentifrice was used; and by 22.8% and 19.9% respectively when 0.5 g dentifrice was used. Comparing brushing with 1.5 g against brushing with 0.5 g dentifrice, SMHR and EFU increased by 35.3% and 51.3% respectively when brushing for 120 s, and by 38.4% and 43.0% respectively when brushing for 45 s. Increasing brushing duration and dentifrice quantity also increased the NAR value. The effects of these two oral hygiene factors on SMHR, EFU, and NAR were statistically significant (p < 0.05 in all cases). Conclusion Brushing duration and dentifrice quantity have the potential to influence the anti-caries effectiveness of fluoride dentifrices. Study NCT01563172 on ClinicalTrials.gov. Clinical significance The effect of two key oral hygiene regimen factors – toothbrushing duration and dentifrice quantity – on fluoride’s anticaries effectiveness is unclear. This 2-week home-use in situ remineralisation clinical study showed both these factors can influence fluoride bioactivity, and so can potentially affect fluoride’s ability to protect against caries.Item Enamel demineralization and remineralization under plaque fluid-like conditions – a QLF study(Karger, 2011) Lippert, Frank; Butler, A.; Lynch, R. J. M.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryThe present study investigated de- and remineralization in enamel lesions under plaque fluid (PF)-like conditions using quantitative light-induced fluorescence (QLF). Preformed lesions were exposed to partially saturated lactic acid solutions, varying in pH and fluoride concentration ([F]) based on a 5 × 3 factorial study design (0/0.1/0.5/1.5/4 ppm F; pH 4.9/5.2/5.5). Average fluorescence loss (ΔF) was monitored for 11 days. Subsequently, lesions were demineralized in a partially saturated acetic acid solution for two 24-hour periods. Data were analyzed using repeated measures analysis of covariance. Lesions exposed to PF at 4 ppm F and pH 5.5 showed not only the most remineralization (ΔΔF = 28.2 ± 14.0%) for all groups after 11 days, but also the most demineralization (ΔΔF = –19.3 ± 13.5%) after subsequent acetic acid exposure. Increased [F] resulted in more remineralization, regardless of pH. Higher pH values resulted in more remineralization. No remineralization was observed in lesions exposed to F-free solutions, regardless of pH. Remineralization was noticeable under the following conditions: pH 4.9 – [F] = 4 ppm, pH 5.2 – [F] ≧ 1.5 ppm, and pH 5.5 – [F] ≧ 0.5 ppm. Overall, [F] had a stronger effect on remineralization than pH. Subsequent demineralization showed that little protection was offered by PF-like solutions, and further demineralization compared with baseline was observed on lesions not remineralized initially. [F] had a stronger effect on net mineral change than pH. The present study has shown that QLF is a valuable tool in studying lesion de- and remineralization under PF-like conditions, where [F] was shown to be more important than pH.Item In situ Fluoride Response of Caries Lesions with Different Mineral Distributions at Baseline(Karger, 2011) Lippert, Frank; Lynch, R. J. M.; Eckert, George; Kelly, S. A.; Hara, Anderson T.; Zero, Domenick T.; Department of Cariology, Operative Dentistry and Dental Public Health, School of DentistryThe present in situ study investigated the fluoride response of caries lesions with similar mineral loss but two distinct mineral distributions (low- and high-‘R’, calculated as the ratio of mineral loss to lesion depth). Sixteen subjects wore eight gauze-covered enamel specimens with preformed lesions placed buccally on their mandibular partial dentures for periods up to 4 weeks. The participants brushed twice daily for 1 min with an 1,100 ppm F (as NaF) dentifrice. After 3 and 4 weeks, specimens were retrieved and analyzed microradiographically (TMR) and by quantitative light fluorescence (QLF). TMR results revealed that low- and high-R lesions showed opposite behaviors – low-R lesions further demineralized, whereas high-R lesions exhibited some remineralization. In comparison, lesion depth increased in low-R, but remained unchanged in high-R lesions; R decreased in both, but more in high-R lesions; mineral density at the lesion surface remained unchanged in low-R, but increased in high-R lesions. Differences in mineral loss between lesion types increased further between 3 and 4 weeks. QLF did not mirror TMR results as low-R lesions were found to remineralize, whereas high-R lesions remained unchanged. It is likely that low-R lesions differ from high-R lesions chemically and microstructurally; therefore rendering low-R lesion more susceptible to further dissolution. During lesion formation, low-R in contrast to high-R lesions may not lose all of the solubility-determining impurities such as magnesium and carbonate, which can reprecipitate again in different mineral phases within the lesion. In conclusion, mineral distribution at baseline directly impacts in situ lesion response to fluoride.