• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.20-29
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• 2009

The purpose of this study is to observe and compare the dynamic change of artificially demineralized enamel by remineralization solutions of different degrees of saturation at pH 4.3. In this study, 30 enamel specimens were demineralized artificially by lactic acid buffered solution. Each of 10 specimens was immersed in pH 4.3 remineralization solution of three different degrees of saturation (0.22, 0.30, 0.35) for 10 days. After demineralization and remineralization, images were taken by a polarizing microscope (${\times}100$). The density of lesion were determined from images taken after demineralization and remineralization. During remineralization process, mineral deposition and mineral loss occurred at the same time. After remineralization, total mineral amount and width of surface lesion increased in all groups. The higher degree of saturation was, the more mineral deposition occurred in surface lesion and the amount of mineral deposition was not much in subsurface lesion. Total demineralized depth increased in all groups.

• Restorative Dentistry and Endodontics
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• v.35 no.2
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• pp.96-105
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• 2010

The purpose of this study is to observe and compare the remineralization tendencies of artificial enamel caries lesion by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 48 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 2 days in order to produce artificial dental caries that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffering remineralization solution of four different degrees of saturation (0.507, 0.394, 0.301, and 0.251) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope (${\times}100$). The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were est mated. While the group with the lowest degree of saturation (0.251) showed total remineralization feature from the surface to the subsurface of the lesion, the group with the highest degree of saturation (0.507) showed demineralization mainly on the surface of the lesion at the constant organic acid concentration 0.01 M and pH 5.5.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.381-390
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• 2004

The purpose of this in vitro study was to investigate the effects of Nd:YAG laser irradiation and fluorides on acid drink demineralized enamel. The materials were 30 freshly extracted permanent premolars with intact smooth enamel surfaces. They were demineralized with Coca-cola at $37^{\circ}C$ for 12hours and then irradiated by Nd:YAG laser with 6W power, $50mJ/cm^2$ energy density, and 20Hz pulse repetition. After laser irradiation, teeth were treated by three kinds of fluorides; (1)0.05% NaF fluoride solution (2)1.23% APF gel and (3)0.1%F fluoride varnish, microhardness(VHN) and Diagnodent scores were measured and the surfaces of each treated specimens were also observed with SEM under 1500 magnification. The results were as follows: 1. In the change of microhardness(VHN), it decreased to 34.68% from the initial micrhardness, increased to 78.37% after laser irradiation and increased to 82.62% after fluoride treatment, there were significant differences except when it was irradiated and treated with fluoride(P<0.05). 2. In the change of Diagnodent scores, it was decreased to 28.08% from the initial scores after demineralization, and then increased to 59.81% after laser irradiation, and increased to 82.17% after fluoride treatment. Scores were different significantly between the scores of initial, demineralization, laser irradiation and fluoride treatment(P<0.05). All the scores were not different significantly between fluoride types. 3. SEM observation showed that the lased enamel surfaces after demineralization were thermally degenerated and showed molten lava-like appearance and crater with cracks and many microholes.

• The korean journal of orthodontics
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• v.40 no.4
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• pp.212-226
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• 2010

Objective: The aim of this study was to evaluate the effect of remineralization and inhibition to demineralization after fluoride gel (acidulated phosphate fluoride, APF) or hydroxyapatite (HAp) paste application on interdentally stripped teeth. Methods: After interdental stripping, 1.23% APF or 5%, 10% HAp paste were applied for 7 days for remineralization. Afterwards, teeth were exposed to lactate carbopol buffer solution for demineralization. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to compare change in surface contents and crystal structures after remineralization, and then after demineralization. Results: EDS analysis indicated that calcium (p < 0.001) and phosphate (p < 0.01) contents were increased after 10% HAp paste application on stripped enamel, calcium (p < 0.05) and phosphate (p < 0.01) contents were increased after 5% HAp paste application, and fluoride (p < 0.01) contents were increased after 1.23% APF application. SEM image showed that enamel surfaces became smoother and crystal structures became small and compact after APF or HAp application. After demineralization, calcium (p < 0.05) and phosphate (p < 0.05) contents remained increased on the enamel remineralized with 10% HAp paste, and phosphate (p < 0.05) contents remained increased on the enamel remineralized with 5% HAp paste. After demineralization, surfaces looked less destroyed in the enamel remineralized beforehand than those of the control, and small pores between crystal structures, formed by remineralization were remained. Conclusions: Hydroxyapatite paste and fluoride gel were helpful to remineralize and inhibit deminerlization on stripped enamel.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.278-286
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• 2008

Many studies regarding Casein phosphopeptides-amorphous calcium phosphate(CPP-ACP) have demonstrated the remineralization ability on the demineralized enamel surface. A question is still remained that how deep can the calcium (Ca) and phosphorus (P) ions supplied by the CPP-ACP paste penetrate into the enamel subsurface. The aims of this study were to measure the penetrating depth of Ca and P ions in the demineralized human enamel in vitro, and were to determine the amount and depth of Ca and P ions according to the duration. The amount and depth of Ca and P ions were measured by microscopic observation with Field Emission Scanning Electron Microscopy (FE-SEM; LEO SUPRA 55, Carl Zeiss, Germany) and Energy Dispersive X-ray Spectrometer (EDS; GENESIS 2000, EDAX, USA: Linescan of Calcium and Phosphorus). Freshly extracted four human 1st premolars were obtained from the Dept. of Pediatric Dent., Kyung Hee Univ. Buccal surfaces of the 1st premolars were covered with nail varnish to form a window on the middle third of buccal surface. All of the teeth with enamel windows were immersed in a solution of 0.1 M lactic acid, Carbopol C907 (carboxypolymethylene BF Goodrich, Cleveland, OH, USA) at pH 4.8, and then incubated for 7 days. Each tooth crown was sawn in half through the midline of buccal window along the long axis of premolar. The four blocks of premolars were immersed in a 10-times diluted solution of CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan) for 1, 2, 3 and 5 weeks while the rests were immersed in a placebo solution (distilled water) for the same duration. Each specimen was embedded in epoxy resin, and was sectioned perpendicular to the window, using a water-cooled diamond blade saw. The spectrum density indices of Ca and P were measured in the sound, de- and remineralized enamels by FE-SEM and EDS. The Student's t test was performed to compare the Spectrum Density Indices (SDI) of sound, re-and demineralized enamels, and to compare the differences among the durations. Followings are the conclusion : 1. The penetration depth of the remineralizing ions (Ca & P) of CPP-ACP paste is related to the depth of demineralized enamel (approximately $1050{\sim}1350{\mu}m$). It is revealed that the penetration depth of both ions reaches full thickness of decalcification and even slightly into the sound enamel. 2. The Ca & P levels of remineralized enamels in 1, 2 weeks were significantly higher than those of the sound enamels (p<0.05). 3. No statistically significant difference of Ca & P levels was found in relation with the increasing duration of remineralization (p>0.05).

• Restorative Dentistry and Endodontics
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• v.33 no.5
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• pp.481-492
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• 2008

The purpose of this study is to observe and compare the remineralization tendencies of artificially demineralized enamel by remineralization solutions of different degree of saturations at pH 5.5, using a polarizing microscope and computer programs (Photoshop, Image pro plus, Scion Image, Excel). For this study, 36 sound permanent teeth with no signs of demineralization, cracks, or dental restorations were used. The specimens were immersed in lactic acid demineralization solution for 3 days in order to produce dental caries artificially that consist of surface and subsurface lesions. Each of 9 or 10 specimens was immersed in pH 5.5 lactic acid buffered remineralization solution of three different degrees of saturation (0.25, 0.30, 0.35) for 12 days. After the demineralization and remineralization, images were taken by a polarizing microscope $({\times}100)$. The results were obtained by observing images of the specimens, and using computer programs, the density of caries lesions were determined. In conclusion, in the group with the lowest degree of saturation, remineralization occurred thoroughly from the surface to the subsurface lesion, whereas in the groups with greater degree of saturation showed no significant change in the subsurface lesion, although there was corresponding increase in the remineralization width on the surface zones.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.266-276
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• 2020

The purpose of this study was to compare the remineralization effect of 38% silver diamine fluoride (SDF) and 5% sodium fluoride (NaF) varnish on artificially induced enamel caries. The present study standardized the physiochemical characteristics of the tooth structure using bovine teeth, realized the wash-off action of agents using a saliva, reproduced an environment similar to mouth through pH-cycling, and comparatively assessed the remineralization effect of 38% SDF and 5% NaF varnish in a non-destructive method using micro-CT. And the remineralized enamel surface structure was analyzed by scanning electron microscopy (SEM) and energy dispersive X-Ray spectroscopy (EDS). In both SDF and NaF varnish, mineral density (△Hounsfield unit value) and the volume of enamel restored to normal mineral density through remineralization gradually increased with time. And the SDF showed a much higher level of increase in mineral density at all depths and remineralized volume than NaF varnish. According to SEM analysis, the surface roughness decreased in the order of artificial saliva, NaF varnish and SDF. In addition, EDS analysis showed that silver ion was precipitated on the enamel surface in SDF group. In conclusion, SDF had a greater remineralization effect than NaF varnish on demineralized enamel.

• Restorative Dentistry and Endodontics
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• v.33 no.6
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• pp.507-517
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• 2008

There are considerable in vitro and in vivo evidences for remineralization and demineralization occurring simultaneously in incipient enamel caries. In order to "heal" the incipient dental caries, many experiments have been carried out to determine the optimal conditions for remineralization. It was shown that remineralization is affected by different pH, lactic acid concentrations, chemical composition of the enamel, fluoride concentrations, etc. Eighty specimens from sound permanent teeth without demineralization or cracks, 0.15 mm in thickness, were immersed in lactic acid buffered demineralization solutions for 3 days. Dental caries with a surface zone and subsurface lesion were artificially produced. Groups of 10 specimens were immersed for 10 or 12 days in lactic acid buffered remineralization solutions consisting of pH 4.3 or pH 6.0, and 100, 50, 25, or 10 mM lactic acid. After demineralization and remineralization, images were taken by polarizing microscopy (${\times}100$) and micro-computed tomography. The results were obtained by observing images of the specimens and the density of the caries lesions was determined. 1.As the lactic acid concentration of the remineralization solutions with pH 4.3 was higher, the surface zone of the carious enamel increased and an isotropic zone of the subsurface lesion was found. However, the total decalcification depth increased at the same time. 2.In the remineralization solutions with pH 6.0, only the surface zone increased slightly but there was no significant change in the total decalcification depth and subsurface zone. In the lactic acid buffer solutions with the lower pH and higher lactic acid concentration, there were dynamic changes at the deep area of the dental carious lesion.

• Restorative Dentistry and Endodontics
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• v.32 no.2
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• pp.151-161
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• 2007

Dental caries is the most common disease in the oral cavity However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss or inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM. The results were as follows, 1. In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p<0.05). 2. In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 3. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size. In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.159-166
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• 2008

The dental caries can be recovered or worse depending on the velocity of de- and remineralization of tooth. It is possible to remineralize the lesions by fluoride agent, but the results can be distinguished according to one's salivary flow rate, quantity of ion contents, and pH of the saliva. This article presents good results after applying the CPP-ACP paste for the patients who have incipient enamel caries. We instructed the patients to apply the paste everyday in the customed tray. We observed the white spot lesions without getting worse and reducing the size of lesions. After applying the CPP-ACP paste for 6 weeks, we concluded that; 1. It was possible to remineralize the incipient caries without preparation of the teeth. 2. CPP-ACP paste was successful for recovery of the demineralized lesions, especially for mild and moderate caries lesions, not for the severe developemental defects or chronic lesions. 3. CPP-ACP paste was efficient for pediatric patients, and the custumed tray was very useful for patients to apply the paste. 4. The ability of the patients for caring their oral hygiene was improved by routine check up and instructions.