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Item The effect of acid etching on remineralization of incipient caries lesions : a micro-ct study(2009) Yeslam, Hanin E.; Ando, Masatoshi; Gonzalez-Cabezas, Carlos, 1966-; Chu, Tien-Min Gabriel; Lund, Melvin; Cochran, MichaelEtching of enamel caries lesions has been demonstrated to enhance remineralization. However, this effect reaches a plateau after a period of time. This study aimed at investigating the effectiveness of additional acid etching on remineralization. Forty 1 mm × 2 mm human enamel blocks with chemically induced artificial incipient lesions were used. Ten specimens were randomly selected at the end of demineralization for transverse microradiography (TMR) analysis. The remaining specimens were then divided into three groups (n = 10). Group A was remineralized by a pH cycling system with 1100 ppm sodium fluoride for 20 days. In group B, the specimens were etched with 35-percent phosphoric acid for 30 s and then remineralized. Group C was remineralized by same procedure as group B plus and given an additional acid etch after 10 days of remineralization. Mineral density was measured by x-ray microtomography (µ-CT). The volumetric mineral content [VM (µm3×105)] was determined between 91 and 0-wt%. The µ-CT % mineral recovery (%) was calculated using the formula 100×(remineralize VM - demineralization VM) / (sound VM - demineralization VM). One-hundred-μm sections of demineralized and remineralized specimens were used to assess the mineral loss (IML: vol%×µm) and lesion depth (µm) using TMR. The three groups showed no significant difference in mineral change or mineral content for µ-CT or TMR lesion depth. The TMR IML showed a significant difference between the demineralized specimens and the three remineralized groups. The correlation between TMR IML and TMR lesion depth was 0.66 (p < 0.0001). The µ-CT percent mineral recovery from demineralization was correlated with neither TMR IML nor TMR lesion depth. When evaluated with µ-CT, the twice-acid-etched group presented lower mineral gain values than the group etched only once with acid. Also, the twice-etched group presented lower mineral gain and greater TMR IML compared with the non-acid etch group. TMR images revealed reduction of surface layer in the acid-etched groups, especially in the twice-etched group, in which significant reduction or loss of surface layer occurred. Based on these results, we conclude that additional acid etching with 35-percent phosphoric acid does not enhance remineralization compared with a single application of acid etching. We believe that the viable existence of the surface layer is essential for remineralization of the lesion. Further investigations into the accuracy of µ-CT to detect minute mineral changes in incipient caries lesions are probably needed.Item Enhancing Root Caries Lesion Prevention By Combining Two American Dental Association-Recommended Preventive Agents(2022) Almudahi, Abdulellah; Duarte, Simone; Hara, Anderson; Cook, N.BlainePurpose: This in vitro study aims to analyze the effect of combining two ADA-recommended professionally applied 1:1 Chlorhexidine/Thymol varnish ((Cervitec Plus)) and professionally prescribed 5,000 ppm fluoride toothpaste ((PreviDent 5000 Plus)) on reducing lesion depth and increasing mineral content Materials & Methods: Forty-eight dentin specimens were randomly distributed into four treatment groups (n=12 per treatment). Biofilms of Streptococcus mutans and Candida albicans were created on the polished surfaces of bovine root dentin specimens (n=12 per treatment). 1:1 Chlorhexidine/Thymol varnish was applied once then the tested 5,000 ppm fluoride toothpaste was applied for 120 seconds twice daily over the course of 2 days. Tested groups were: (1) 1:1 Chlorhexidine/Thymol varnish ((Cervitec Plus)) (C/T). (2) 5,000 ppm F toothpaste ((PreviDent 5000 Plus)) (F). (3) Combination of 1:1 Chlorhexidine/Thymol varnish ((Cervitec Plus)) & 5000 ppm F toothpaste ((PreviDent 5000 Plus)) (C/T+F). (4) Deionized water (DIW) as control group. Biofilms were analyzed for biofilm dry weight. Dentin specimens were analyzed using transversal microradiography (TMR) for mineral content change and lesion depth. PH data was analyzed using two-way ANOVA. Total biofilm dry weight data was analyzed using one-way ANOVA. Integrated mineral loss and lesion depth data was analyzed using two-way ANOVA All pair-wise comparisons from ANOVA analysis were made using Fisher’s Protected Least Significant Differences to control the overall significance level at 5%. Results: Treatment with (C/T+F) resulted in higher mean pH values compared to the control group (DIW) and (F) group. The average pH values of group (C/T) were not statistically different than group (C/T+F). the biomass of the combined S. mutans & C. albicans biofilm among all the groups were not significantly different. (DIW) presented significantly deeper lesions for both surfaces (sound &demineralized) when compared to (F) (P=0.0118), (C/T) (P=0.0002), and (C/T+F) (P<.0001). The sound surfaces for the specimens for group (C/T) and Group (F) showed superficial lesion depth. However, the sound surfaces of specimens treated with (C/T+F) showed the most superficial depth. Due to mineral gain, the demineralized surfaces of the specimens of both (C/T) & (C/T+F) showed a decrease in the lesion depth. Conclusion: Within the limitations of our study. The combination of 5,000 ppm fluoride toothpaste and CHX/Thymol had no significant effect on mineral content. However, the combination had a considerable effect on lesion depth reduction.