• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.2
• /
• pp.278-286
• /
• 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
• /
• v.26 no.5
• /
• pp.372-378
• /
• 2001

The aim of this in vitro study was to analyze the composition of human tooth enamel in terms of three components, Ca, P, and F after demineralization and remineralization in acid buffer solution. A total of 8 human premolars without any defects and cracks were selected and buccal and lingual sides of the teeth were cleaned with an ultrasonic device and pumice without fluoride 5$\times$5mm windows were opened, and other areas were completely covered with 3-coats of nail varnish to prevent from being in contact with demineralized and remineralized solutions. After demineralization process, each tooth was sectioned into two slices, highly polished one of them with$\gamma$-alumina, and then analyzed the composition of the demineralized tooth with EPMA(electron probe micro-analyzer). The other slices were put into the remineralized solution for 10 days, polished, and analyzed in the same manner. These data were statistically analyzed with one sample t-test(p<0.05). The results were as follows. 1. Normal tooth enamel consists of 49.76% Ca, 39.80% P, and 0.28% F. 2. After demineralization, percentage of Ca and P ratio were decreased by about 5.57 and 5.07% respectively. Percentage of F ratio was also decreased by about 0.01%, which was not statistically significant. 3. After remineralization, percentage of Ca, P increased about by 4.47 and 4.35% respectively Percentage of F decreased by about 0.01%, which was not statistically significant. In conclusion, remineralized solution used in our study has the potential to induce the uptake the Ca and P into the pore sites of the demineralized enamel. But, in the oral cavity. there were rapid temperature change, organic matrix that inhibits the movement of the ions, and limitation of continuous contact with this remineralized solution. Therefore, further in vivo study is necessary.

• The korean journal of orthodontics
• /
• v.38 no.6
• /
• pp.407-415
• /
• 2008

Objective: The aim of this study was to evaluate the remineralization of interdentally stripped teeth after fluoride gel or hydroxyapatite paste application. Methods: After interdental stripping, 1.23% fluoride gel or 10% hydroxyapatite paste was applied three times a day, with a duration of four minutes, for a week. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) were used to compare the change of surface contents and crystal structures before and after the application of fluoride gel or hydroxyapatite paste. Results: EDS analysis indicated that calcium contents were increased after 10% HAp paste application on stripped enamel (p < 0.01). SEM view showed that enamel surfaces in groups of 1.23% APF gel or 10% HAp paste application were smoother than those of control group, which was regarded as filling of the pore structure. And pores between crystal structures in groups treated with 1.23%, APF gel or 10% HAp paste were smaller than those of control group. Conclusions: Application of APF or HAp on stripped enamel could positively influence on the surface contents or crystal structure.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.4
• /
• pp.391-400
• /
• 2016

The purpose of this study was to evaluate the difference of remineralization effects of various anti-cariogenic toothpastes on artificial carious lesions in primary and permanent teeth using quantitative light-induced fluorescence-digital (QLF-D) system. Sound human primary (n = 48) and permanent teeth (n = 48) were randomly divided into following groups : control group (Group 1), fluoride toothpaste (Group 2), functionalized tricalcium phosphate (fTCP) + fluoride toothpaste (Group 3), and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) toothpaste (Group 4). Specimens were prepared by exposure in a demineralizing solution and then treated using the different toothpastes twice daily during 14 days. All specimens were analyzed with the QLF-D system. QLF data analysis indicated three different toothpastes showed significant remineralizing effects compared to Group 1 in both primary and permanent teeth. Also, the remineralizing effects in Group 3 and 4 were significantly higher than in Group 2. This study suggested that the toothpastes containing fTCP + fluoride and CPP-ACP have the significant anti-cariogenic effects on enamel demineralization in both primary and permanent teeth, and QLF-D is an useful device to assess the incipient carious lesion and remineralization effects of the anti-cariogenic materials quantitatively. Therefore, clinicians can consider the QLF-D system for the evaluation of demineralization and remineralization in primary and permanent teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.2
• /
• pp.312-322
• /
• 1998

There are many concerns about the erosive effect of acidic beverage. In this study, the erosive effect of bovine enamel caused by $Pepsi-Cola^{(R)}$(pH 2.41) and rehardening effect by intraoral exposure were determined by microhardness test and SEM. The bovine enamel specimen was imbedded in 100ml $Pepsi-Cola^{(R)}$ during 5 minutes and exposed to the intraoral environment with removable resin plate. The microhardness test was performed after 1 hr, 24 hrs, and 48 hrs. The results obtained from this study can be summarized as follows ; 1. The microhardness value was significantly (p<0.05) reduced by cola beverage, and significantly (p<0.05) increased after 1 hr and 24 hrs respectively. 2. The difference in the microhardness between 24 hrs group and 48 hrs group was not significant (p>0.05) and microhardness value of 48 hrs group was significantly less than that of initial group (p<0.05). 3. The erosive effect of cola beverage and remineralization effect by intraoral exposure were visualized by the SEM photo. But, the enamel surfaces did not return to their original state.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.51 no.1
• /
• pp.80-87
• /
• 2024

Silver diamine fluoride, which can arrest dental caries, is alkaline and may cause mild soft tissue irritation. Water-based silver fluoride has a neutral pH, which is closer to the physiological range, and is biocompatible for use in the oral environment. This study aimed to evaluate the effect of water-based silver fluoride on remineralizing early enamel lesions by comparing it with other fluoride agents through microhardness and quantitative light-induced fluorescence measurements. An in vitro study with intact bovine incisors was performed. Artificial enamel lesions were induced and subjected to microhardness and quantitative light-induced fluorescence testing. Specimens were randomly divided into 4 groups for treatment. The specimens in group I were treated with water-based silver fluoride and potassium iodide, group II with silver diamine fluoride and potassium iodide, group III with sodium fluoride varnish, and group IV with distilled water. After 8 days of pH cycling, the specimens were subjected to microhardness and quantitative light-induced fluorescence testing. Water-based silver fluoride and silver diamine fluoride showed the greatest increases in microhardness and quantitative light-induced fluorescence, with no significant differences between the two. Sodium fluoride varnish also exhibited a significant increase in microhardness and quantitative light-induced fluorescence, but the differences were smaller than those for water-based silver fluoride and silver diamine fluoride. Water-based silver fluoride is considered useful in a clinical setting for remineralizing enamel lesions, with the advantages of no risk of tissue burn and improved taste and smell.

• Restorative Dentistry and Endodontics
• /
• v.32 no.6
• /
• pp.498-513
• /
• 2007

Since it was reported that incipient enamel caries can be recovered, previous studies have quantitatively evaluated that enamel artificial caries have been, remineralized with fluoride showing simultaneously the increase of width of surface layer and the decrease of width of the body of legion. There is, however, little report which showed that remineralization could occur without fluoride. In addition, the observations on the change of hydroxyapatite crystals also have been scarcely seen. In this study, enamel caries in intact premolars or molars was induced by using lactic acidulated buffering solutions over 2 days. Then decalcified specimens were remineralized by seven groups of solutions using different degree of saturation(0.212, 0.239, 0.301, 0.355) and different pH(5.0, 5.5, 6.0) over 10 days. A qualitative comparison to changes of hydroxyapatite crystals after fracturing teeth was made under SEM(scanning electron microscopy) and AFM(atomic force microscopy). The results were as follows: 1. The size of hydroxyapatite crystals in demineralized area was smaller than the normal ones. While the space among crystals was expanded, it was observed that crystals are arranged irregularly. 2. In remineralized enamel area, the enlarged crystals with various shape were observed when the crystals were fused and new small crystals in intercrystalline spaces were deposited. 3. Group 3 and 4 with higher degree of saturation at same pH showed the formation of large clusters by aggregation of small crystals from the surface layer to the lesion body than group 1 and 2 with relatively low degree of saturation at same pH did. Especially group 4 showed complete remineralization to the body of lesions. Group 5 and 6 with lower pH at similar degree of saturation showed remineralization to the body of lesions while group 7 didn't show it. Unlike in Group 3 and 4, Group 5 and 6 showed that each particle was densely distributed with clear appearance rather than crystals form clusters together.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.35 no.1
• /
• pp.57-64
• /
• 2008

It is well established that fluoride products play an important role in the prevention and remineralization of carious lesion. Fluoride varnish is a concentrated topical fluoride and varnishes adhere to tooth surface, permitting prolonged fluoride exposure and uptake. In this study, the artificial initial enamel caries was caused on the sound human enamel and divided 60 specimens into three groups. Group 1 and group 2 were treated with the topical application of fluoride varnish and stored in artificial saliva for 1 and 2 weeks. Group 3 was stored in artificial saliva for 2 weeks, which acted as control group. Changes in mineral contents were analysed with the confocal laser scanning microscope. The following results were obtained: 1. In group 1 and group 2, the total fluorescence of the lesion(TFL) was reduced in remineralized area compared to in demineralized area(p<0.05). 2. The total fluorescence of the lesion of remineralized area was more reduced in group 2 than in group 1(p<0.05). 3. The total fluorescence of the lesion was more reduced in group 2 than in control group(p<0.05). 4. Confocal laser scanning microscope can be used in quantitative analysis of remineralization by fluoride varnish.

• Restorative Dentistry and Endodontics
• /
• v.41 no.2
• /
• pp.121-129
• /
• 2016

Objectives: The purpose of this study was to assess the effect of single and combined applications of fluoride on the amount of fluoride release, and the remineralization and physical properties of enamel. Materials and Methods: Each of four fluoride varnish and gel products (Fluor Protector, FP, Ivoclar Vivadent; Tooth Mousse Plus, TM, GC; 60 Second Gel, A, Germiphene; CavityShield, CS, 3M ESPE) and two fluoride solutions (2% sodium fluoride, N; 8% tin(ii) fluoride, S) were applied on bovine teeth using single and combined methods (10 per group), and then the amount of fluoride release was measured for 4 wk. The electron probe microanalysis and the Vickers microhardness measurements were conducted to assess the effect of fluoride application on the surface properties of bovine teeth. Results: The amount of fluoride release was higher in combined applications than in single application (p < 0.05). Microhardness values were higher after combined applications of N with FP, TM, and CS than single application of them, and these values were also higher after combined applications of S than single application of A (p < 0.05). Ca and P values were higher in combined applications of N with TM and CS than single application of them (p < 0.05). They were also increased after combined applications of the S with A than after single application (p < 0.05). Conclusions: Combined applications of fluoride could be used as a basis to design more effective methods of fluoride application to provide enhanced remineralization.

• The Journal of the Korean dental association
• /
• v.55 no.2
• /
• pp.156-164
• /
• 2017

Purpose: The aim of this in vitro study was to assess changes in remineralization by stimulated human saliva over a short period of 48 hours with quantitative light-induced fluorescence (QLF) technology. Materials and Methods: Bovine incisor surfaces were demineralized for 10 days. Two types of stimulated saliva were collected from 7 healthy persons. 24 hours after tooth brushing (Stimulated saliva group) and immediately after tooth brushing with 1,000 ppm NaF dentifrice (Dentifrice saliva group). The specimens were immersed in saliva and fluorescence images were obtained by QLF-digital (QLF-D $biluminator^{TM}$,) at 2, 4, 6, 12, 24, and 48 hours fluorescence loss (${\Delta}F%$) of the lesions. A paired t-test was performed to assess fluorescence differences between before (${\Delta}F_{baseline}$) and after (${\Delta}F_{treatment\;time}$) the remineralization process. Results: Before the remineralization, the mean ${\Delta}F_{baseline}$ of the initial demineralized specimens was $-18.42{\pm}0.15$ (%). In both groups, the ${\Delta}F$ values obtained at baseline and after 2 hours were statistically significant (P < 0.001), indicating recovery of the lesions by approximately 40% after 2 hours. After 48 hours, remineralization rates were slightly higher (49%) for the stimulated saliva group than for the dentifrice saliva group (41%), but the difference was not statistically significant. Conclusions: With QLF minute degrees of remineralization by saliva can be measured in periods as short as 2 hours. Additionally no significantly higher effects of remineralization were observed in the dentifrice saliva group when compared to the stimulated saliva group.