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Câmara JVF, Schestakow A, Hannig M. Impact of modifications on the characteristics of salivary pellicle on dental hard tissue: a scoping review. J Dent 2025; 157:105779. [PMID: 40274218 DOI: 10.1016/j.jdent.2025.105779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2025] [Revised: 04/20/2025] [Accepted: 04/21/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVES The salivary pellicle regulates interfacial events on dental surfaces and is a promising target for modification to improve dental health. This scoping review systematically examines substances that modify the pellicle, evaluating their potential and identifying knowledge gaps. DATA This review followed the PRISMA-ScR guidelines. Studies investigating how substances applied during pellicle formation on enamel or dentin affect its structure, composition, or protective function were included. SOURCES A systematic search of Medline was conducted up to March 2024 using predefined terms. Only English-language research articles were included. No hand-searching was performed. STUDY SELECTION A total of 864 records were identified. After title and abstract screening, 110 articles were assessed in full, resulting in 85 eligible studies for data charting. These studies investigated human saliva-derived pellicles on enamel or dentin, comparing their composition, structure, or protective properties with and without modification. Most studies, conducted equally in vitro and in situ, focused on fluorides and metals (n = 28), peptides and proteins (n = 21), and polyphenols (n = 18), while other substances were less frequently examined (n = 17). Modifications affected the pellicle's ultrastructure, altered its proteome, or enhanced its protective role against erosion, abrasion, and bacterial adherence. CONCLUSIONS Despite numerous studies and distinct substance classes, findings remain inconclusive and must be interpreted within the context of individual study designs. CLINICAL SIGNIFICANCE Modifying the pellicle can improve its protective function, presenting a promising approach for preventive dentistry. However, the long-term effects of these substances within the dynamic oral environment remain unclear. This review underscores the need for further research to close existing knowledge gaps and confirm clinical relevance.
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Affiliation(s)
- João Victor Frazão Câmara
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421 Homburg, Saar, Germany
| | - Anton Schestakow
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421 Homburg, Saar, Germany.
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421 Homburg, Saar, Germany
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Baltaci E, Bilmenoglu C, Ozgur O, Ozveren N. Effect of three different remineralising agents on prevention against acidic erosion of primary teeth: an in vitro study. Eur Arch Paediatr Dent 2023; 24:651-659. [PMID: 37646903 DOI: 10.1007/s40368-023-00834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/15/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE This study aimed to evaluate and compare the protective effect of fluoride varnish (Enamelast™, Ultradent Inc., Cologne, Germany), casein phosphopeptide-amorphous calcium phosphate fluoride/CPP-ACPF (MI Paste Plus, GC Corp., Tokyo, Japan) and self-assembling P11-4 peptide (Curodont™ Protect, Credentis AG, Windisch, Switzerland), against acidic erosion of primary teeth. METHODS Forty primary anterior teeth were randomly assigned to four groups (n = 10): group 1: control, group 2: fluoride varnish, group 3: CPP-ACPF and group 4: self-assembling P11-4 peptide. After applying remineralising agents, except for the control group, all specimens underwent an erosive challenge of carbonated soft drink and artificial saliva for 15 cycles of 6 s each at 6-h intervals for a day. Groups were compared in terms of surface microhardness, roughness readings, and surface scanning with an extra-oral scanner (D800; 3Shape A/S) before and after the erosive process. RESULTS All experimental groups showed superior results than the control group regarding microhardness, surface roughness, and substance loss. The fluoride varnish group showed significantly favourable results in microhardness change. There was no significant difference between the experimental groups regarding surface roughness and enamel loss measurements. CONCLUSION 5% NaF fluoride varnish, CPP-ACPF and self-assembling P11-4 peptide protect the enamel of primary teeth against erosion compared to artificial saliva alone.
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Affiliation(s)
- E Baltaci
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, 22030, Edirne, Turkey.
| | - C Bilmenoglu
- Department of Prosthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - O Ozgur
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, 22030, Edirne, Turkey
| | - N Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University, 22030, Edirne, Turkey
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Velagala D, Reddy VN, Achanta A, Snehika G, Ramavath BN, Mareddy RA. Enamel Erosion: A Possible Preventive Approach by Casein Phosphopeptide Amorphous Calcium Phosphate-An In Vitro Study. Int J Clin Pediatr Dent 2021; 13:486-492. [PMID: 33623334 PMCID: PMC7887166 DOI: 10.5005/jp-journals-10005-1827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Context Several efforts were made in order to alter the compositions of acidic food items concerning their properties to be able to reduce their erosivity potential. The addition of combinations of calcium and phosphate salts to these food products has grabbed great interest. Aim In vitro evaluation of the effect of the addition of 0.2% w/v casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) to four commonly available beverages (of which two were carbonated) on enamel erosion. Materials and methods Sound-extracted human third molar teeth were taken, and enamel sections (n = 270) were made and polished. Acid-resistant nail varnish was painted to create an exposed enamel window of 1 mm2, followed by testing of the four soft drinks and distilled deionized water (DDW). Every drink was evaluated with and without the addition of 0.2% w/v CPP–ACP. The enamel specimens were kept in 50 mL solution at 37°C for 30 minutes, rinsed, and then varnish was removed. All samples were then profiled using white-light profilometer, and erosive depths were recorded. Statistical analysis One-way analysis of variance test and post hoc Tukey test. Results Enamel erosion was created by all the soft drinks tested, but the addition of 0.2% w/v CPP–ACP has remarkably reduced (p value < 0.05) erosive depths in all test solutions compared to solutions without CPP–ACP. The erosive depths for solutions with DDW did not vary much from those with 0.2% CPP–ACP. Conclusion Addition of 0.2% w/v CPP–ACP to the soft drinks has remarkably reduced their erosivity potential. How to cite this article Velagala D, Reddy VN, Achanta A, et al. Enamel Erosion: A Possible Preventive Approach by Casein Phosphopeptide Amorphous Calcium Phosphate—An In Vitro Study. Int J Clin Pediatr Dent 2020;13(5):486–492.
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Affiliation(s)
- Daneswari Velagala
- Department of Pedodontics and Preventive Dentistry, Mamata Dental College, Khammam, Telangana, India
| | - Venugopal N Reddy
- Department of Pedodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
| | - Alekhya Achanta
- Department of Pedodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
| | - Ghanta Snehika
- Department of Pedodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
| | | | - Reddy Ajay Mareddy
- Department of Pedodontics, Mamata Dental College, Khammam, Andhra Pradesh, India
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Yu H, Jiang NW, Ye XY, Zheng HY, Attin T, Cheng H. In situ effect of Tooth Mousse containing CPP-ACP on human enamel subjected to in vivo acid attacks. J Dent 2018; 76:40-45. [PMID: 29857075 DOI: 10.1016/j.jdent.2018.05.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/27/2018] [Accepted: 05/28/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This in situ study aimed to evaluate the protective effect of Tooth Mousse (GC) containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on human enamel erosion and to compare the difference in erosion between the anteriorly and posteriorly positioned human enamel. METHODS This study used a 2-treatment (7 days each) crossover design with 12 healthy volunteers wearing intraoral appliances. Each appliance contained 4 human enamel specimens positioned on the buccal surfaces of the volunteers' maxillary central incisors and first molars. The specimens were intraorally treated withTooth Mousse (CPP-ACP group) or deionized water (control group) for 3 min and then exposed to in vivo acid attacks by rinsing with 150 ml of a cola drink (4 × 5 min/day). The surface microhardness (SMH) of the specimens was measured and used to calculate the percentage of SMH loss (%SMHl). Erosion effect on enamel was also investigated by scanning electron microscopy (n = 4) at the end of study. The data were statistically analysed using two-way analysis of variance (ANOVA) and Tukey's test at a level of P < 0.05. RESULTS A significant decrease in %SMHl was observed for the specimens of CPP-ACP group compared to that for the controls (P = 0.007). The specimens positioned posteriorly exhibited a significantly lower %SMHl than those positioned anteriorly (P = 0.033). Samples of CPP-ACP group showed fewer etching patterns than those of the control group. CONCLUSIONS In this in situ model, application of Tooth Mousse containing CPP-ACP before erosion reduced the %SMHl of human enamel. Enamel located in different positions showed different patterns of erosion. CLINICAL SIGNIFICANCE Application of Tooth Mousse containing CPP-ACP could be considered as a suitable preventive strategy against enamel erosion. ClinicalTrials.gov Identifier: NCT03426150.
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Affiliation(s)
- Hao Yu
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fujian, China; Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| | - Neng-Wu Jiang
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fujian, China
| | - Xin-Yi Ye
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fujian, China
| | - Hai-Yan Zheng
- Department of Prosthodontics, School and Hospital of Stomatology, Zhejiang University, Zhejiang, China
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University Zurich, Zurich, Switzerland
| | - Hui Cheng
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fujian, China.
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Buzalaf MAR, Magalhães AC, Rios D. Prevention of erosive tooth wear: targeting nutritional and patient-related risks factors. Br Dent J 2018; 224:371-378. [PMID: 29495031 DOI: 10.1038/sj.bdj.2018.173] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 02/07/2023]
Abstract
This article provides an overview of the nutritional and patient-related risk factors involved in the aetiology of erosive tooth wear (ETW) and the preventive strategies to counteract them. The first step is to diagnose clinical signs of ETW and to recognise causal factors. Low pH and high buffer capacity of foods/drinks are the major risk factors, while the calcium concentration is the main protective factor. Reduction of frequency of consumption and contact time of erosive foods/drinks with the teeth, use of straws appropriately positioned and consumption of dairy products are advisable. Oral hygiene has a role in the development of ETW, however, postponing toothbrushing is not clinically advisable. In cases of drug abuse, chronic alcoholism, GERD or bulimia, the patient must be referred to a doctor. Immediately after vomiting, patients might be advised to rinse the mouth. Saliva has an important protective role and patients with reduced salivary flow can benefit from the use of chewing gum. Recent studies have focused on improving the protective capacity of the acquired pellicle as well as on the role of protease inhibitors on dentine erosion. However, the degree of evidence for these preventive measures is low. Clinical trials are necessary before these measures can be recommended.
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Affiliation(s)
- M A R Buzalaf
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
| | - A C Magalhães
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
| | - D Rios
- Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brazil 17,012-901
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Alencar CRBD, Oliveira GCD, Magalhães AC, Buzalaf MAR, Machado MADAM, Honório HM, Rios D. In situ effect of CPP-ACP chewing gum upon erosive enamel loss. J Appl Oral Sci 2017; 25:258-264. [PMID: 28678944 PMCID: PMC5482248 DOI: 10.1590/1678-7757-2016-0304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/15/2016] [Indexed: 11/22/2022] Open
Abstract
Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is able to increase salivary calcium and phosphate levels at an acidic pH. Previous studies demonstrated that a CPP-ACP chewing gum was able to enhance the re-hardening of erosion lesions, but could not diminish enamel hardness loss. Therefore, there is no consensus regarding the effectiveness of CPP-ACP on dental erosion.
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Affiliation(s)
| | - Gabriela Cristina de Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, SP, Brasil
| | - Ana Carolina Magalhães
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | - Marília Afonso Rabelo Buzalaf
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Bauru, SP, Brasil
| | | | - Heitor Marques Honório
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, SP, Brasil
| | - Daniela Rios
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, SP, Brasil
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Abstract
AIM To investigate in situ/ex vivo the effect of remineralizing agents in the prevention of dental erosion in permanent and primary teeth. STUDY DESIGN A randomized, controlled, double-blind study with crossover design with three treatment phases: Control, ProNamel® and Tooth Mousse™. Twenty adults and children wore removable palatal appliances containing two insets of permanent and primary human enamel and used the corresponding assigned toothpaste twice daily for 10 days. The enamel samples were then removed, mounted on acrylic bases and acid-challenged in demineralizing solution. Enamel surface microhardness (SμH) was measured pre and post acid challenge. Data were analyzed using two-way ANOVA and Tukey's post hoc test (P < 0.05). RESULTS The mean SμH values (Vicker's unit) prior to acid challenge were: Permanent teeth (Control 366.16 ± 12.28, ProNamel® 372.18 ± 14.75, Tooth Mousse™ 370.19 ± 11.88) and Primary teeth (Control 325.31± 11.90, ProNamel® 327.34 ± 9.90, Tooth Mousse™ 331.63 ± 10.55). Following the acid challenge, the mean %ΔSμH (±SD) were: Permanent (79.72 ± 1.59, 66.52 ± 2.45, 60.13 ± 4.98) and Primary (81.09 ± 2.90, 76.50 ± 3.13, 69.02 ± 4.23). CONCLUSION The application of remineralizing agents reduced the significantly softening by acidic attack of enamel especially in the permanent dentition.
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Colombo M, Beltrami R, Rattalino D, Mirando M, Chiesa M, Poggio C. Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study. ANNALI DI STOMATOLOGIA 2017; 7:38-45. [PMID: 28149449 DOI: 10.11138/ads/2016.7.3.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste against an erosive challenge produced by a soft drink (Coca-Cola) using Scanning Electron Microscopy (SEM). METHODS Forty specimens were assigned to 4 groups of 10 specimens each (group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, group 3: erosive challenge, fluoride toothpaste treatment, group 4: erosive challenge, zinc-hydroxyapatite toothpaste treatment). The surface of each specimen was imaged by SEM. A visual rating system was used to evaluate the condition of the enamel surface; results were analyzed by nonparametric statistical methods. RESULTS Statistically significant differences were found between the samples untreated and those immersed in Coca-Cola (group 1, 2); the highest grade of damage was found in group 2, while the lowest grade was recorded in the samples of group 4. Comparing the groups, the two analyzed toothpaste tended to protect in different extend. CONCLUSIONS In this study treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. This was greater than the effect observed for a normal fluoride toothpaste and confirmed the potential benefit the Zn-HAP technology can provide in protecting enamel from erosive acid challenges.
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Affiliation(s)
- Marco Colombo
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Riccardo Beltrami
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Davide Rattalino
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Maria Mirando
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Marco Chiesa
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
| | - Claudio Poggio
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, Section of Dentistry, University of Pavia, Italy
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Bayrak S, Tuloglu N, Bicer H, Sen Tunc E. Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion. SCANNING 2017; 2017:1897825. [PMID: 29109803 PMCID: PMC5661827 DOI: 10.1155/2017/1897825] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/14/2016] [Indexed: 06/07/2023]
Abstract
This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n = 10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey's tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p < 0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.
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Affiliation(s)
- Sule Bayrak
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Nuray Tuloglu
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Huseyin Bicer
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - Emine Sen Tunc
- Department of Pediatric Dentistry, Faculty of Dentistry, University of Ondokuz Mayıs, Samsun, Turkey
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Influence of Calcium Phosphate and Apatite Containing Products on Enamel Erosion. ScientificWorldJournal 2016; 2016:7959273. [PMID: 27430013 PMCID: PMC4939184 DOI: 10.1155/2016/7959273] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/16/2016] [Indexed: 11/18/2022] Open
Abstract
For the purpose of erosion prevention the present study aimed to compare the efficacy of two biomimetic products and a fluoride solution to optimize the protective properties of the pellicle. After 1 min of in situ pellicle formation on bovine enamel slabs, 8 subjects adopted CPP-ACP (GC Tooth Mousse), a mouthwash with hydroxyapatite microclusters (Biorepair), or a fluoride based mouthwash (elmex Kariesschutz) for 1 min each. Afterwards, samples were exposed in the oral cavity for 28 min. Native enamel slabs and slabs exposed to the oral cavity for 30 min without any rinse served as controls. After oral exposure, slabs were incubated in HCl (pH values 2, 2.3, and 3) for 120 s and kinetics of calcium and phosphate release were measured photometrically; representative samples were evaluated by SEM and TEM. The physiological pellicle reduced demineralization at all pH values; the protective effect was enhanced by fluoride. The biomimetic materials also reduced ion release but their effect was less pronounced. SEM indicated no layer formation after use of the different products. However, TEM confirmed the potential accumulation of mineral components at the pellicle surface. The tested products improve the protective properties of the in situ pellicle but not as effectively as fluorides.
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Jordão M, Alencar C, Mesquita I, Buzalaf M, Magalhães A, Machado M, Honório H, Rios D. In situ Effect of Chewing Gum with and without CPP-ACP on Enamel Surface Hardness Subsequent to ex vivo Acid Challenge. Caries Res 2016; 50:325-30. [DOI: 10.1159/000444718] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 02/14/2016] [Indexed: 11/19/2022] Open
Abstract
The erosion-protective effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is controversial. This study aimed to investigate the ability of CPP-ACP chewing gum to prevent a single event of erosive demineralization in situ. Bovine enamel blocks (n = 120) were randomly assigned to 3 phases according to the baseline surface hardness: phase I (PI) - chewing gum with CPP-ACP, phase II (PII) - chewing gum without CPP-ACP, and control phase (PIII) - salivary effect without stimulation (no gum). Nineteen volunteers participated in this study during 3 crossover phases of 2 h. In PI and PII, the volunteers wore intraoral palatal appliances for 120 min and chewed a unit of the corresponding chewing gum for the final 30 min. In the control phase the volunteers wore the appliance for 2 h, without chewing gum. Immediately after intraoral use, the appliances were extraorally immersed in a cola drink for 5 min to promote erosive demineralization. The percentage of surface hardness loss was calculated. The data were analyzed by ANOVA models and Tukey's test. Lower enamel hardness loss was found after the use of chewing gum with CPP-ACP (PI: 32.7%) and without CPP-ACP (PII: 33.5%) compared to the salivary effect without stimulation (PIII: 39.8%) (p < 0.05). There was no difference between PI and PII (p > 0.05). The results suggest that the use of chewing gum immediately before an erosive demineralization can diminish enamel hardness loss. However, the presence of CPP-ACP in the chewing gum cannot enhance this protective effect.
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Melcher M, Facey SJ, Henkes TM, Subkowski T, Hauer B. Accelerated Nucleation of Hydroxyapatite Using an Engineered Hydrophobin Fusion Protein. Biomacromolecules 2016; 17:1716-26. [PMID: 27010648 DOI: 10.1021/acs.biomac.6b00135] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Calcium phosphate mineralization is of particular interest in dental repair. A biomimetic approach using proteins or peptides is a highly promising way to reconstruct eroded teeth. In this study, the screening of several proteins is described for their binding and nucleating activities toward hydroxyapatite. Out of 27 tested candidates, only two hydrophobin fusion proteins showed binding abilities to hydroxyapatite in a mouthwash formulation and an increased nucleation in artificial saliva. Using a semirational approach, one of the two candidates (DEWA_5), a fusion protein consisting of a truncated section of the Bacillus subtilis synthase YaaD, the Aspergillus nidulans hydrophobin DEWA, and the rationally designed peptide P11-4 described in the literature, could be further engineered toward a faster mineral formation. The variants DEWA_5a (40aaYaaD-SDSDSD-DEWA) and DEWA_5b (40aaYaaD-RDRDRD-DEWA) were able to enhance the nucleation activity without losing the ability to form hydroxyapatite. In the case of variant DEWA_5b, an additional increase in the binding toward hydroxyapatite could be achieved. Especially with the variant DEWA_5a, the protein engineering of the rationally designed peptide sequence resulted in a resemblance of an amino acid motif that is found in nature. The engineered peptide resembles the amino acid motif in dentin phosphoprotein, one of the major proteins involved in dentinogenesis.
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Affiliation(s)
- Melanie Melcher
- Institute of Technical Biochemistry, University of Stuttgart , Allmandring 31, 70569 Stuttgart, Germany
| | - Sandra J Facey
- Institute of Technical Biochemistry, University of Stuttgart , Allmandring 31, 70569 Stuttgart, Germany
| | - Thorsten M Henkes
- Institute of Technical Biochemistry, University of Stuttgart , Allmandring 31, 70569 Stuttgart, Germany
| | | | - Bernhard Hauer
- Institute of Technical Biochemistry, University of Stuttgart , Allmandring 31, 70569 Stuttgart, Germany
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Erdemir U, Yildiz E, Saygi G, Altay NI, Eren MM, Yucel T. Effects of energy and sports drinks on tooth structures and restorative materials. World J Stomatol 2016; 5:1-7. [DOI: 10.5321/wjs.v5.i1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/21/2015] [Accepted: 01/19/2016] [Indexed: 02/06/2023] Open
Abstract
Sports and energy drinks are consumed by more people than ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their over-consumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The over-consumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.
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FREITAS ARD, AZNAR FDDC, SILVA ALD, SALES-PERES A, SALES-PERES SHDC. Assessment of the effects of decontamination and storage methods on the structural integrity of human enamel. REVISTA DE ODONTOLOGIA DA UNESP 2016. [DOI: 10.1590/1807-2577.05915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction The storage of teeth for use in research is a controversial issue with no consensus on the most appropriate treatment method for this purpose. Objective The aim of this study was analyze the effectiveness and the influence of different methods of decontamination and storage of human enamel samples, in order to maintain their integrity. Material and method The sample consisted of 124 molars distributed randomly into three groups according to the method: control - distilled water, 0.1% thymol and 0.02% sodium azide. The tests performed were laser fluorescence, surface microhardness and profilometry analysis (0, 15 and 30 days) and Microbiological test (7, 15 and 30 days). Data were analyzed by the ANOVA and Tukey tests (P <0.05). Result In the laser fluorescence test, thymol proved to be more feasible for maintaining the integrity of the dental organ, since it did not show significant variations in values among the analyzed periods (P> 0.05). The surface microhardness analysis showed loss of tooth structure in all methods, and sodium azide led to a lower level of tooth loss. Profilometry analysis showed loss of mass in all groups whereas sodium azide showed the greatest loss. None of the methods was able to inhibit bacterial growth. Conclusion Among the processing methods analyzed none was able to combine effective decontamination and storage with maintenance of the structural integrity of the human enamel.
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Effect on oral pH changes and taste perception in 10-14-year-old children, after calcium fortification of a fruit juice. Eur Arch Paediatr Dent 2015; 16:483-9. [PMID: 26420264 DOI: 10.1007/s40368-015-0198-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022]
Abstract
AIM The aim was to determine the effect of calcium fortification of a commercially available mixed-fruit juice on oral pH changes and taste perception in a group of 10 to 14 year-old Indian children. METHOD A controlled, blinded, non-randomised clinical trial was adopted, consisting of a sample of 100 healthy children (DMFT <3; age 10-14 years), who were exposed to three test juices one by one [Group A: original fruit juice (control group); Group B: calcium-fortified fruit juice and Group C: calcium + vitamin D fortified fruit juice]. Oral pH, collection of saliva and plaque sampling was undertaken, before and after the juice exposure by each subject at 0, 1, 5, 15, 30 and 45 min. The respective pH was measured with a digital pH meter. For taste perception, a scoring system was used after exposure of the juices to the subjects in a blind manner. The statistical evaluation was done using one-way ANOVA for salivary and plaque pH and Kruskal-Wallis test for buffer capacity and taste perception. RESULTS There was a smaller drop in salivary and plaque pH (p < 0.5) and a significant reduction in perceived taste (p < 0.001) by the subjects after calcium modification of fruit juice. CONCLUSION The calcium-modified mixed fruit juices was less acidogenic compared with the unfortified juice, and hence will be less cariogenic and erosive towards teeth.
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Stefański T, Postek-Stefańska L. Possible ways of reducing dental erosive potential of acidic beverages. Aust Dent J 2014; 59:280-8. [PMID: 24912931 DOI: 10.1111/adj.12201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 11/30/2022]
Abstract
Frequent consumption of acidic beverages is related to excessive tooth wear, namely dental erosion. Preventive measures may involve reduction or elimination of acidic drink consumption. However, the success of this approach is difficult to achieve as it is highly dependent on patient compliance. Therefore, a practical way of minimizing the erosive potential of popular acidic drinks may be their chemical modification. The aim of this article was to review the different methods of modification and their shortcomings. The available literature demonstrates that the erosive potential of most acidic beverages could be reduced. To date, the effectiveness of soluble calcium salts supplementation is the best established. However, modification can reduce the sensorial quality of the drink and shorten its shelf-life. There is also a need to evaluate the lowest effective and safe dose of the additive.
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Affiliation(s)
- T Stefański
- Academic Centre for Dentistry, Bytom, Poland
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Franklin S, Masih S, Thomas AM. An in-vitro assessment of erosive potential of a calcium-fortified fruit juice. Eur Arch Paediatr Dent 2014; 15:407-11. [PMID: 24986231 DOI: 10.1007/s40368-014-0130-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/06/2014] [Indexed: 12/01/2022]
Abstract
AIM To evaluate and compare the in vitro pH, buffer capacity and calcium loss from tooth enamel before and after calcium fortification of a packaged fruit juice. METHODS An approved brand of packaged mixed fruit juice was selected as a test drink on the basis of a pilot questionnaire. The test drink was fortified with 1,000 mg/l (0.1% w/v) of calcium citrate malate to obtain two test groups: Group 1: original beverage (serving as control) and Group 2: calcium-fortified drink. The pH and buffering capacity for the test drinks were measured before and after calcium fortification; 90 prepared enamel samples were divided and immersed into three test subgroups: (1) buffer solution pH 7 (positive control), (2) original fruit juice (negative control) and (3) calcium-fortified fruit juice for 3 min. Calcium loss from the enamel of immersed teeth was measured as a quantitative estimate of tooth mineral loss. RESULTS After calcium fortification of the fruit juice the mean pH raised from 3.4 to 4.0 (p = 0.029), the mean buffer capacity decreased from 9.73 to 9.16 (p < 0.001) and the mean calcium loss from enamel specimens decreased from 3.5 to 0.26 mg/dl (p < 0.001). STATISTICS To compare the change in mean pH and buffering capacity between the subject groups, t test was used, and to compare the calcium loss from enamel specimens, among the three subgroups, ANOVA was used. CONCLUSION Calcium fortification of packaged fruit juice in vitro, improves its pH and buffering capacity. Consequently, the fortified juice causes significantly less mineral loss from human enamel. Fortifying juice with calcium may exert a significant protective potential against dental erosion particularly due to frequent exposure of acidic drinks.
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Affiliation(s)
- S Franklin
- Department of Pediatric and Preventive Dentistry, Christian Dental College, Ludhiana, 141008, Punjab, India,
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Acquired pellicle as a modulator for dental erosion. Arch Oral Biol 2014; 59:631-8. [DOI: 10.1016/j.archoralbio.2014.02.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 11/11/2013] [Accepted: 02/04/2014] [Indexed: 11/19/2022]
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Inhibition of tooth erosion by milk containing different fluoride concentrations: An in vitro study. J Dent 2014; 42:498-502. [DOI: 10.1016/j.jdent.2013.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 12/12/2013] [Accepted: 12/17/2013] [Indexed: 11/17/2022] Open
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Lei Y, Wang T, Mitchell JW, Zaidel L, Qiu J, Kilpatrick-Liverman L. Bioinspired amphiphilic phosphate block copolymers as non-fluoride materials to prevent dental erosion. RSC Adv 2014; 4:49053-49060. [PMID: 25419457 PMCID: PMC4235796 DOI: 10.1039/c4ra08377f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Inspired by the fact that certain natural proteins, e.g. casein phosphopeptide or amelogenin, are able to prevent tooth erosion (mineral loss) and to enhance tooth remineralization, a synthetic amphiphilic diblock copolymer, containing a hydrophilic methacryloyloxyethyl phosphate block (MOEP) and a hydrophobic methyl methacrylate block (MMA), was designed as a novel non-fluoride agent to prevent tooth erosion under acidic conditions. The structure of the polymer, synthesized by reversible addition-fragment transfer (RAFT) polymerization, was confirmed by gel permeation chromatography (GPC), Fourier transform infrared spectroscopy (FTIR), and nuclear magnetic resonance spectroscopy (NMR). While the hydrophilic PMOEP block within the amphiphilic block copolymer strongly binds to the enamel surface, the PMMA block forms a hydrophobic shell to prevent acid attack on tooth enamel, thus preventing/reducing acid erosion. The polymer treatment not only effectively decreased the mineral loss of hydroxyapatite (HAP) by 36-46% compared to the untreated control, but also protected the surface morphology of the enamel specimen following exposure to acid. Additionally, experimental results confirmed that low pH values and high polymer concentrations facilitate polymer binding. Thus, the preliminary data suggests that this new amphiphilic diblock copolymer has the potential to be used as a non-fluoride ingredient for mouth-rinse or toothpaste to prevent/reduce tooth erosion.
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Affiliation(s)
- Yanda Lei
- College of Dentistry, Howard University, Washington, DC 20059, USA
- CREST Center for Nanomaterials, College of Engineering, Howard University, Washington, DC 20059, USA
| | - Tongxin Wang
- College of Dentistry, Howard University, Washington, DC 20059, USA
- CREST Center for Nanomaterials, College of Engineering, Howard University, Washington, DC 20059, USA
| | - James W. Mitchell
- CREST Center for Nanomaterials, College of Engineering, Howard University, Washington, DC 20059, USA
| | | | - Jianhong Qiu
- Colgate-Palmolive Company, Piscataway, NJ 08855, USA
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In situ effect of chewing gum containing CPP–ACP on the mineral precipitation of eroded bovine enamel—A surface hardness analysis. J Dent 2013; 41:747-51. [DOI: 10.1016/j.jdent.2013.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 11/20/2022] Open
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MITA H, KITASAKO Y, TAKAGAKI T, SADR A, TAGAMI J. Development and evaluation of a low-erosive apple juice drink with Phosphoryl-Oligosaccharides of Calcium. Dent Mater J 2013; 32:212-8. [DOI: 10.4012/dmj.2012-256] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cochrane NJ, Yuan Y, Walker GD, Shen P, Chang CH, Reynolds C, Reynolds EC. Erosive potential of sports beverages. Aust Dent J 2012; 57:359-64; quiz 398. [DOI: 10.1111/j.1834-7819.2012.01708.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nongonierma AB, Fitzgerald RJ. Biofunctional properties of caseinophosphopeptides in the oral cavity. Caries Res 2012; 46:234-67. [PMID: 22572605 DOI: 10.1159/000338381] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 03/14/2012] [Indexed: 11/19/2022] Open
Abstract
Caseinophosphopeptides (CPPs), bioactive peptides released from caseins, have the ability to enhance bivalent mineral solubility. This is relevant to numerous biological functions in the oral cavity (promotion of tooth enamel remineralisation, prevention of demineralisation and buffering of plaque pH). Therefore, CPPs may play a positive role as prophylactic agents for caries, enamel erosion and regression of white spot lesions. Most in vitro and in situ studies demonstrate strong evidence for the bioactivity of CPPs in the oral cavity. Nevertheless, relatively little is known concerning their use as adjuvants for oral health and more particularly regarding their long-term effects on oral health.
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Affiliation(s)
- A B Nongonierma
- Department of Life Sciences and Food for Health Ireland (FHI), University of Limerick, Limerick, Ireland
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Barbosa CS, Kato MT, Buzalaf MAR. Effect of supplementation of soft drinks with green tea extract on their erosive potential against dentine. Aust Dent J 2011; 56:317-21. [DOI: 10.1111/j.1834-7819.2011.01338.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
In Australia, caries experience of 6-year-old and 12-year-old children has increased since the mid to late 1990s. Previously, caries rates had declined, attributable to community water fluoridation. The recent caries increase has been attributed speculatively to changes in fluid intake, including increased consumption of sweet drinks and bottled waters. Increasing urbanization and globalization have altered children's diets worldwide, promoting availability and access to processed foods and sweet drinks. Studies in Australia and internationally have demonstrated significant associations between sweet drink intake and caries experience. Despite widespread fluoride availability in contemporary Australian society, the relationship between sugar consumption and caries development continues and restricting sugar intake remains key to caries prevention. Caries risk assessment should be included in treatment planning for all children; parents should be advised of their child's risk level and given information on oral health promotion. Readily-implemented caries risk assessment tools applicable to parents and clinicians are now available. Public health information should increase awareness that consuming sweet drinks can have deleterious effects on the dentition as well as the potential for promoting systemic disease. Restricting sales of sweet drinks and sweet foods and providing healthy food and drinks for purchase in schools is paramount.
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Affiliation(s)
- J G Lee
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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PAROLIA A. Soft Drink Erosion and Cpp-Acp. Aust Dent J 2011; 56:108; author reply 108. [DOI: 10.1111/j.1834-7819.2010.01311_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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