Four topical fluoride agents were evaluated in vitro for their ability to form permanently bound fluoride. APF, NH4F, and Na2SnF6 formed soluble reaction products, while TiF4 did not. Surface coatings were present on those samples that showed higher levels of fluoride after washing.
The aim of this study was to assess the effect of milk with 0, 2.5 or 5 ppm F on progression and remineralization of caries-like root surface lesions using a pH cycling model. The root surface lesions were created utilizing a partially saturated lactic acid buffer at pH 4.6. Longitudinal sections were cut through the lesion and analyzed using polarized light microscopy (PLM) and microradiography (MRG). The sections were then coated with an acid resistant varnish, except the outer natural surface that would be exposed to water, milk or fluoridated milk and cycled in a de- and remineralizing system for 2 weeks. The lesions were characterized again by PLM and MRG after treatment. A significant reduction in lesion progression was found by PLM and MRG after treatment with either non-fluoridated or fluoridated milk when compared to the control group. Using quantitative MRG, mineral change and distribution in the lesions were recorded. A possible protective effect of fluoridated milk on root surface caries was supported by a reduction in the progression of the lesions and an increase in the mineral within the lesion.
An intra-oral model system has been developed which uses a single-section technique for before-and-after measurements on the same tissue. This model allows for placement of sections of enamel at both buccal and approximal sites. These sections may be sound or possess white-spot lesions. This allows for the evaluation of lesion initiation, lesion progression, and/or lesion remineralization. The sections are appropriate for measurement by polarized light microscopy, and, although not included in this study, they are also suitable for microradiographic evaluation. With ten human volunteers, the model system was evaluated by means of three rinse regimens in a cross-over design. The distilled water rinse showed the whole range of possible changes (e.g., demineralization, no change, and remineralization). More consistent remineralization was observed when a fluoride rinse or a remineralizing fluid was used. This model system should prove to be quite useful in evaluation of demineralization and remineralization phenomena in the oral environment.
This work compared lesions produced by three artificial caries systems with natural white spot lesions using both polarized light microscopy and microradiography. The three systems employed were the acidified gelatin gel, diphosphonate surface dissolution inhibitor, and a partially saturated buffer system. When we compared the natural white spot lesions with the artificial caries-like lesions, we found that the acidified gel system reproduced the classical histological zones most frequently. All systems showed a radiopaque surface layer overlying a radiolucent body of the lesion. This radiopaque layer could not be equated with the negatively birefringent surface zone seen in polarized light.
Dicalcium phosphate dihydrate (DCPD) may play a significant role in the caries lesion since it is a stable calcium phosphate phase under acidic conditions. The reaction of DCPD and fluoride, forming fluorapatite (FAP), may provide a potentially promising treatment regimen for remineralization of caries lesions in vivo. The purpose of this study was to determine whether a two-step DCPD and inorganic wash with fluoride can remineralize artificial caries-like lesions in vitro. We used the single-section technique to facilitate quantitation of the same tissue before and after the experimental regimen. The two-step remineralizing treatment was repeated three times and consisted of a two-minute saturated DCPD treatment (pH 2.1) followed by a 24-hour inorganic wash. Lesion parameters were recorded before and after treatment by the taking of polarized light photomicrographs of each section after imbibition in several media. The changes in the tissue following treatment were expressed as a percent change in the area of the initial pre-treatment lesion. Significant reductions (p< 0.02) in lesion pore volume were observed in all aqueous media examined. In the lesions after imbibition in quinoline, remineralization was also apparent from the significant increase in the area of the dark zone following treatment. This two-step DCPD treatment appears to remineralize artificial caries-like lesions effectively, but additional work is needed to determine whether it affords any protection against subsequent cariogenic challenges.
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