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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 Effect of intracanal medicaments used in endodontic regeneration procedures on microhardness and chemical structure of dentin(Synapse, 2015-05) Hamdon, Ghaeth Yassen; George, Joseph Eckert; Platt, Jeffrey Allen; Department of Restorative Dentistry, School of DentistryOBJECTIVES: This study was performed to investigate the effects of different intracanal medicaments on chemical structure and microhardness of dentin. MATERIALS AND METHODS: Fifty human dentin discs were obtained from intact third molars and randomly assigned into two control groups and three treatment groups. The first control group received no treatment. The second control group (no medicament group) was irrigated with sodium hypochlorite (NaOCl), stored in humid environment for four weeks and then irrigated with ethylenediaminetetraacetic acid (EDTA). The three treatment groups were irrigated with NaOCl, treated for four weeks with either 1 g/mL triple antibiotic paste (TAP), 1 mg/mL methylcellulose-based triple antibiotic paste (DTAP), or calcium hydroxide [Ca(OH)2] and finally irrigated with EDTA. After treatment, one half of each dentin disc was subjected to Vickers microhardness (n = 10 per group) and the other half was used to evaluate the chemical structure (phosphate/amide I ratio) of treated dentin utilizing attenuated total reflection Fourier transform infrared spectroscopy (n = 5 per group). One-way ANOVA followed by Fisher's least significant difference were used for statistical analyses. RESULTS: Dentin discs treated with different intracanal medicaments and those treated with NaOCl + EDTA showed significant reduction in microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.05) compared to no treatment control dentin. Furthermore, dentin discs treated with TAP had significantly lower microhardness (p < 0.0001) and phosphate/amide I ratio (p < 0.0001) compared to all other groups. CONCLUSIONS: The use of DTAP or Ca(OH)2 medicaments during endodontic regeneration may cause significantly less microhardness reduction and superficial demineralization of dentin compared to the use of TAP.Item Investigations of the anti-caries potential of fluoride varnishes(2015-11-12) Al Dehailan, Laila Adel; Martinez-Mier, Esperanza Angeles; Lippert, Frank; Soto-Rojas, Armando E.; González-Cabezas, Carlos; Stelzner, SarahThe majority of currently marketed fluoride varnishes (FV) have not been evaluated for their effectiveness in preventing dental caries. Fundamental research on FVs and how different formulations affect adherence to teeth, fluoride release into saliva and uptake by teeth is virtually non-existent. The objective of this work was to investigate the anti-caries potential, measured as fluoride release into saliva, change in surface microhardness of early enamel caries lesions, and enamel fluoride uptake, of multiple commercially available FVs. We have found that FVs differed in their release characteristics, rehardening capability, and ability to deliver fluoride to demineralized lesions. In addition to our in vitro work, we have conducted a clinical study that aimed to compare saliva and plaque fluid fluoride concentrations following the application of three commercially available FV treatments at predetermined post application time points. We also investigated the change in fluoride concentration in saliva and plaque fluid fluoride from baseline to each post application predetermined time point. We found that FVs varied in their release of fluoride into saliva and plaque fluid but shared common trends in release characteristics. The outcomes of our in vitro and in vivo investigations demonstrate a great variation in anti-caries potential of FVs. This may be attributed to different compositions and physical properties of the tested FVs.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.Item Performance of Multiple Emission Peak Light Emitting Diode Light Curing Unit: Degree of Conversion and Microhardness of Resin-Based Pit and Fissure Sealant(2022-07) Ba Armah, Ibrahim; Soto, Armando E.; Platt, Jeffrey A.; Al Dehailan, Laila A.Background: The light-cured resin-based pit and fissure sealants success and longevity are enhanced by sufficient curing. Multiple emission peak Light Emitting Diode Light Curing Units offer a wider range of wavelengths and different levels of irradiances to ensure sufficient curing.The irradiance is considered a main curing factor that can affect the material properties. Purpose: The aim of this study was to assess the effect of different settings of a multiwave LED LCU on the degree of conversion and microhardness of a pit and fissure sealant comparing the irradiance of 1000 mW/cm2 to 1400 mW/cm2 and 3200 mW/cm2 irradiances of the LCU using manufacturer’s guidelines for curing times at 2, 4 and, 6 mm distances. Methods: A multiwave LED light curing unit was evaluated on three different irradiance levels 1000 mW/cm2 (S), 1400 mW/cm2 (H), and 3200 mW/cm2 (X). A total of 90 samples made from the fissure sealant were fabricated and divided into eighteen groups (n=5/group). Samples were cured following manufacturer’s guidelines of curing times for each curing mode at 2, 4, or 6 mm distance between the light tip and top of samples. The DC was measured using (ATR-FTIR) spectroscopy. The KHN test was performed on five different locations of each specimen using a hardness tester (Leco LM247AT, MI, USA, software; Confident V 2.5.2). Results: The top DC for H-8 was significantly higher than S-10 at 2 and 4mm, H-20 DC was significantly lower than S-30 at only 2mm. The bottom DC for H-8 was significantly higher than S-10 at 2mm only, H-20 DC was significantly lower than S-30 at 4 and 6mm only. H-8 KHN at top surface was significantly lower than S-10 at 2mm only, H-20 was significantly lower than S-30 at 2 and 6mm only. H-8 KHN at bottom surface was significantly lower than S-10 at 4 and 6mm but significantly higher at 2mm. H-20 was significantly lower than S-30 at 2mm but significantly higher at 4 and 6mm. The top DC for X-3 was significantly lower than S-10 at all curing distances with no significant difference at all curing distances between X-9 and S-30. The bottom DC for X-3 was significantly higher than S-10 at all curing distances with no significant difference between X-9 and S-30. X-3 KHN at top surface was significantly lower than S-10s at all curing distances. X-9 was significantly lower than S-30 at 6mm only. X-3 KHN at bottom surface was significantly lower than S-10 at 2 and 4mm only with no significant difference at all curing distances between X-9 and S-30. Conclusions: Using a multiwave LED LCU to polymerize Delton Opaque resin-based fissure sealants will result in an optimal DC and KHN values for any irradiance level if the curing distance is kept at 4 mm or less and with at least two cycles of the shortest curing time recommended by the manufacturer. Using a multiwave LED LCU with 1000, 1400 or 3200 mW/cm2 irradiance levels with shortest curing times recommended resulted in unsatisfactory DC and KHN levels. LED LCU with high and extra high irradiance levels (1400 and 3200 mW/cm2) can result in high DC and KHN levels when used adequately. Xtra Power mode (3200 mW/cm2) used on shortest curing time (3 seconds) resulted in significantly lower mechanical properties and for that reason it is not recommended to be used.