B.I. Kim

Effect of dentinal tubule occlusion by dentifrice containing nano-carbonate apatite.

This study evaluated the effects of the short-term use of a dentifrice containing nano-sized carbonate apatite (n-CAP) on the occlusion of the dentinal tubules using a scanning electron microscope (SEM) and an image analyser in vitro. One hundred human dentine specimens were wet ground with a silicone carbide papers and etched with 6% citric acid for 1 min to allow complete opening of the dentinal tubule. Specimens showing complete opening tubules were used as the baseline. The specimens were divided randomly into five groups: G1: 0% n-CAP, G2: 5% n-CAP, G3: 10% n-CAP, G4: 20% n-CAP and G5: 10%strontium chloride (SrCl(2)). Five specimens from each group were brushed by applying 50, 100, 250 and 500 strokes, respectively. All the specimens were evaluated by a SEM (x3000), and the degree of occlusion of the dentinal tubules was quantified using an image analyser. The results were analysed by one-way anova and a Tukeys test using the spss 12.0 statistical package program. The dentifrice containing 20% n-CAP for 50 strokes, which indicated 2-day use, showed the highest tubular occlusion than the other groups (P < 0.05). Moreover, this group showed 79.5% and 77.4% less open tubular area than the baseline and 0% n-CAP group, respectively. The groups containing various concentrations of n-CAP showed significant differences in the SrCl(2) group after tooth-brushing for 500 strokes, which indicated 17-day use. According to this examination of the short-term use of desensitizing dentifrices in vitro, the dentifrice containing 20% n-CAP was the most effective in occluding the dentinal tubules.

The addition of nano-sized hydroxyapatite to a sports drink to inhibit dental erosion—In vitro study using bovine enamel

OBJECTIVESnThis study examined the dental erosion and demineralization potential of a sports drink containing nano-sized hydroxyapatite (nano-HA) as an additive.nnnMETHODSnThe experimental solutions were Powerade (PA) alone and PA with 0.05%, 0.10%, and 0.25% nano-HA. The pH, titratable acidity, and calcium and phosphate content of each solution were analysed, and the degree of saturation with respect to the dental enamel (DS(En)) was obtained. Twelve sound bovine enamel specimens for each group were treated in accordance with the pH-cycling schedule which had 60min treatment with experimental solution per day for 7 days. The erosion potential was determined from the changes in surface micro hardness (SMH), the depths of erosion and demineralized layer using confocal laser scanning microscopy (CLSM), and the morphological changes to the tooth surface were examined with scanning electron microscopy (SEM) after pH-cycling.nnnRESULTSnpH and DS(En) increased with increasing nano-HA concentration in the drinks, whereas the titratable acidity decreased. There were significant differences in the SMH between the PA alone and >0.10% nano-HA groups (p<0.001). Although the PA alone group showed a pronounced erosion depth, CLSM showed no erosion depth in 0.25% nano-HA group. SEM showed an intact surface with increasing nano-HA concentration in the drinks. In conclusion, dental erosion was effectively prevented with increase of adding concentration of nano-HA, and a sports drink containing 0.25% nano-HA might prevent dental erosion.

Subjective food intake ability in relation to maximal bite force among Korean adults.

This study examined the relationship between the subjective food intake of 30 food types and their objective bite force to identify the key food items within the 30 food types to achieve a greater depth of masticatory function in Korean adults. A sample of 308 (112 males and 196 females) adults over the age of 20 (average age, 48.6) was selected among patients who visited four dental hospitals in Seoul, Korea. The subjective masticatory ability was evaluated through an interview with food intake ability questionnaires consisting of 30 food types ranging from hard to soft using a five-step Likert scale. The objective maximal bite force was measured using pressure-sensitive films. The relationship between the food intake ability and bite force was analysed and stratified according to age, gender, number of post-canine teeth lost and several clinical oral health indicators. The key foods were selected using correlation and factor analysis. The subjective food intake ability between the 30 foods and key foods were tested by cluster and one-way anova analysis. The Pearsons correlation coefficient between food intake ability and bite force was 0.45 (P < 0.01). The five key food items selected were dried cuttlefish, raw carrot, dried peanut, cubed white radish kimchi and caramel. The correlation coefficient between the food intake ability and bite force of these items was 0.51 (P < 0.01). These results suggest that the subjective food intake ability using the 30 and five key foods can be used to evaluate the masticatory function in Korean adults.

Combined Effects of Nano-Hydroxyapatite and NaF on Remineralization of Early Caries Lesion

A previous study reported that many supplements have been added to NaF mouthrinses to improve the remineralization potential. Nano-hydroxyapatite (nano-HA) might also be suitable to this purpose because these nano-size particles can penetrate the enamel pores. Moreover, hydroxyapatite is similar to the inorganic component of teeth and is both bioactive and biocompatible. The aim of this study was to evaluate the combined effects of a nano-HA and fluoride mouthrinse on an early caries lesion in human enamel using an in vitro cycle remineralization and treatment model. Forty-eight human enamel specimens, which had a Vickers Hardness Number (VHN) of 25~45 were artificially demineralized for 48h. There were 8 treatment groups (0%, 1%, 5%, 10% nano-HA in distilled water and the same concentrations of nano-HA in a 0.05% NaF solution). The specimens were incubated in an in vitro remineralization model. After immersing the specimens into the treatment and remineralization solution for 12 hours each, the VHN of each specimen was evaluated for total 24 hours. This step was repeated once again for total 48 hours. The enamel surfaces of all specimens were examined by Confocal Laser Scanning Microscopy (CLSM) and SEM. The statistical significance of the data was identified by one-way ANOVA followed by a Duncan’s studentized range test. A p value < 0.05 was considered significant. The results showed that the degree of remineralization, as revealed by the VHN values, was higher in the NaF groups than in the distilled water groups. The VHNs of the remineralized enamel specimens for 48 hours were higher than after the 24 hours treatment. In addition, the level of remineralization increased with increasing concentration of nano-HA and was more pronounced in the NaF groups than the distilled water groups (p<0.05). The CLSM and SEM images nano-sized particles attached to the enamel in the nano-HA treated groups. Nano-HA might play a synergistic role in remineralization with a fluoride mouthrinse. However, more study will be needed to determine the optimal condition of nano-HA and NaF mouthrinse for human use. In conclusion, nano-HA in a 0.05% NaF mouthrinse can help remineralize an early caries lesion.

Objective and subjective assessment of masticatory function for patients with temporomandibular disorder in Korea.

This study examined the differences in the masticatory function of patients with temporomandibular disorder (TMD) in Korea. The experimental groups were as follows: 23 patients with painful arthralgia classified as pain group according to the research diagnostic criteria for temporomandibular disorder (RDC/TMC) and 28 patients with pain-free disc displacement and reduction classified as clicking group. The subjects were obtained from those who had visited Yonsei University Dental Hospital from 2007 to 2008. Twenty dental students without TMD symptoms were enroled as the normal control group. The Mixing Ability Index (MAI) was used as the objective index, and the Food Intake Ability (FIA) Index, Visual Analogue Scale (VAS) and oral health impact profile (OHIP) were used as the subjective indices. The MAI, FIA and VAS were significantly lower in the pain group than in the normal and clicking groups (P<0·05). The pain group showed a MAI, FIA and VAS of 16%, 81% and 67%, respectively, compared to that of the normal group. However, there were no significant differences in the MAI, FIA and VAS between the clicking and normal groups. The pain and clicking groups showed a 1·7 and 1·4 times higher OHIP value than the normal group (P<0·05). The MAI and subjective indices, such as the FIA (r=0·40) and VAS (r=0·48), showed a moderate correlation (P<0·01). In conclusion, pain is the main factor for the reduced masticatory function in patients with TMD in Korea, and the joint sound, not the masticatory function, affects the declining OHIP.

Application of fluoride iontophoresis to improve remineralization.

Iontophoresis is generally used to maximize the therapeutic action of drugs in medicine. This technique can be used to improve the remineralization effect of topical fluoride applications in dentistry. The aim of this study was to compare the remineralization effect of fluoride iontophoresis (FI) with the conventional fluoride application (CFA) method in vitro. Sixty bovine enamel specimens were divided into three groups: no fluoride treatment, CFA and FI. Fluoride was applied to the demineralized specimens for 4 min in each experimental group. The types of fluoride system used for application were 1.23% acidulated phosphate fluoride gel (12 300 p.p.m. F, pH 3.5) and 2% sodium fluoride solution (9050 p.p.m. F, pH 7) in the experimental groups. All the specimens were then placed in a remineralizing solution for 24 h. This cycle was repeated five times. An iontophoresis device (0.4 mA, 12 V) was used in the FI groups. The efficacy of this technique was evaluated by measuring changes in the surface microhardness and lesion depth of the specimens using confocal laser scanning microscope (CLSM). Data were analysed using anova and Tukeys post hoc test (P < 0.05). Although the FI groups showed higher DeltaVHN than the CFA groups, there were no significant differences between these fluoride application methods (P > 0.05). When the lesion depth was measured using CLSM imaging, there was also no significant difference between the FI and CFA groups (P > 0.05). In conclusion, FI was not significantly superior to CFA in terms of the remineralization effect.

Subjective food intake ability in relation to the Mixing Ability Index in Korean adults

This study examined the association between the subjective food intake ability (FIA) using a questionnaire with 30 types of foods and the objective Mixing Ability Index (MAI) using a two-coloured wax cube. A total of 147 subjects (32 males, 115 females, mean age: 54.9 +/- 20.7) were enrolled in this study. The FIA for 30 food types and the key food intake ability (KFIA) for five key food types were obtained using a self-assessed questionnaire to evaluate the subjective chewing ability. The objective chewing ability was evaluated by asking the subjects to chew a wax cube for 10 strokes. The MAI was calculated by image analysis of the chewed wax cube. The Pearsons correlation between the subjective FIA and objective MAI was analysed according to age and number of post-canine teeth lost. The FIA for the 30 foods and five key food types showed a moderate correlation with the MAI (r = 0.51, 0.55, respectively, P < 0.01). The KFIA of the denture wearing group (r = 0.44, P < 0.01) and over 60-year-old group (r = 0.49, P < 0.01) showed a significantly higher correlation with the MAI than the other groups. In conclusion, there was a moderate correlation between the subjective FIA and objective MAI in Korean adults.

Remineralization Potential of Sports Drink Containing Nano-Sized Hydroxyapatite

Several studies have reported the on dental erosive potential of sports drinks with a low pH. Therefore, there is a need for new components that can reduce the erosive potential of a sports drink. Hydroxyapatites (HA) are the major components of dental enamel and bone mineral as biological apatites. In addition, HA contains a significant amount of calcium and phosphate, which can promote remineralization. Hence, some remineralization of the enamel surface can be expected if nano-sized hydroxyapatite (nano-HA) is added to a sports drink. The aim of this study was to evaluate the remineralization effects of sports drinks containing nano-HA in vitro. The crowns of extracted human molars were embedded in acrylic resin and then ground flat and polished. A commercially available sports drink (Powerade, Coca-Cola, South Korea) was purchased from a local supermarket. Nano-HA was added at a concentration of 0.05%, 0.25%, and 0.5%. Deionized water (DW) was used as the negative control. The pH of each solution was measured by a pH-meter at room temperature. The enamel specimens were immersed in each solution for 15 and 30 minutes at 37°C. In order to evaluate remineralization effect, the VHN of the enamel surface was measured at every step by microhardness test (JTTOSHI INC, Japan). CLSM and SEM were utilized to identify the change of enamel surface. The pH of test solutions and VHN of enamel surface increased in proportion to the nano-HA concentrations (P<0.05). The nano-HA could reduce the erosive potential of a sports drink in a concentration dependent manner. These effects were confirmed by the CLSM and SEM images, which showed the remineralization effect of nano-HA. However, more study will be needed to examine the optimal concentration and remineralization mechanism of the nano-HA in sports drinks. In conclusion, the addition of nano-HA to a sports drink can promote enamel remineralization.

Evaluation of penetration effect of resin infiltrant using optical coherence tomography

OBJECTIVEnThe aims of this in vitro study were to investigate whether optical coherence tomography (OCT) could analyze infiltration of resin infiltrant (RI) into early dental caries (EC), and to confirm the correlation between the results of OCT and confocal laser scanning microscopy (CLSM) for evaluation of RI infiltration into EC.nnnMETHODSnSound bovine permanent teeth were used to produce sixty specimens by making two windows on the teeth. Each 20 specimens were demineralized for 20, 30, and 40 days, and the RI was treated on one of the windows. As a result, the images of the fifty-two specimens were taken by OCT and CLSM. The demineralized lesion depth (LDOCT and LDCLSM) and the infiltrated depth of RI into lesion (IDOCT and IDCLSM) obtained from the OCT and the CLSM were analyzed. The correlations between the LDOCT and the LDCLSM, and between the IDOCT and the IDCLSM, were analyzed by Pearson correlation and intra-class correlation. Also, Bland-Altman plot was constructed to assess the agreement between the IDOCT and the IDCLSM, and the IDOCT divided by refractive index of RI and the IDCLSM.nnnRESULTSnThe Pearson correlation coefficient and intra-class correlation of 0.75 and 0.83 (95% CI: 0.71-0.91) respectively were confirmed between the LDOCT and the LDCLSM (p<0.001), and 0.59 and 0.71 (95% CI: 0.50-0.84) respectively were observed between the IDOCT and the IDCLSM (p<0.001). The lower bias was confirmed in Bland-Altman plot between adjusted IDOCT and the IDCLSM than between the IDOCT and the IDCLSM.nnnCONCLUSIONnThe OCT was the promising quantitative evaluation method for RI penetrated into EC.nnnCLINICAL SIGNIFICANCEnThe OCT would be used as a nondestructive and real-time evaluation method for RI penetrated into EC on clinical procedure.

Effect of New Dentifrice Containing Nano-Sized Carbonated Apatite on Enamel Remineralization

The process of dental caries is dynamic and continuous, with periods of de- and remineralization of the tooth structure occurring over time. When the remineralization potential is superior to demineralization, the caries process can be stopped and early caries lesions can recover. Moreover, the remineralization potential will be increased if active components are added to a dentifrice. Therefore, the aim of this study was to re-evaluate the remineralizaton potential of a dentifrice containing nano-sized carbonated apatite using pH cycling, which simulates the oral environment. Artificial incipient caries was induced on bovine tooth specimens, which were treated with 4 dentifrices containing several concentrations of nano carbonated apatites with pH cycling. The remineralization effect was evaluated at each step by measuring the Vickers Hardness Number, and obtaining SEM and CLSM images of the enamel surface. The micro hardness of the enamel surface increased after the pH cycling treatment of the dentifrices. The dentifrice containing 5% n-CAPs showed the highest level of remineralization followed by 0%, 15% and 30%. One-way ANOVA indicated a significant difference in remineralization between the dentifrice containing 5% and 30% n-CAPs. SEM and CLSM also demonstrated observable differences in each step. From this study, the fluoride dentifrice containing 5% n-CAPs was effective in remineralizing an artificial incipient caries lesion. In conclusion, the dentifrice containing 5% nano carbonated apatites and 25% silica was the most effective in remineralizing early caries lesion.