ObjectiveThis study investigates the effects of nano-hydroxyapatite (NHA) gel and Clinpro (CP) on remineralization potential of enamel and cementum at the cavosurface area of computer-aided design and computer-aided manufacturing ceramic restoration.Materials and methodsThirty extracted human mandibular third molars were sectioned at 1 mm above and below the cemento–enamel junction to remove the cemento–enamel junction portions and replaced them with zirconia ceramic disks by bonding them to the crown and root portions with resin cement. The enamel and cementum with an area of 4×4 mm2 surrounding the ceramic disk was demineralized with carbopol. The demineralized surfaces were treated with either NHA or CP, while 1 group was left with no treatment. Vickers microhardness of enamel and cementum were determined before demineralization, after demineralization, and after remineralization. Analysis of variance and Tukey multiple comparisons were used to determine statistically significant differences at 95% level of confidence. Scanning electron microscopy and X-ray diffraction were used to evaluate for surface alterations.ResultsThe mean ± SD of Vickers microhardness for before demineralization, after demineralization, and after remineralization for enamel and cementum were 377.37±22.99, 161.95±10.54, 161.70±5.92 and 60.37±3.81, 17.65±0.91, 17.04±1.00 for the no treatment group; 378.20±18.76, 160.72±8.38, 200.08±8.29 and 62.58±3.37, 18.38±1.33, 27.99±2.68 for the NHA groups; and 380.53±25.14, 161.94±5.66, 193.16±7.54 and 62.78±4.75, 19.07±1.30, 24.46±2.02 for the CP groups. Analysis of variance indicated significant increase in microhardness of demineralized enamel and cementum upon the application of either NHA or CP (p<0.05). Post hoc multiple comparisons indicated significantly higher remineralization capability of NHA for both enamel and cementum than CP (p<0.05), as evidenced by scanning electron microscopy, indicating NHA particle deposition in the area of remineralization, and crystallinity accumulation, as indicated by X-ray diffraction.ConclusionNHA gel and CP were capable of remineralization of the enamel and cementum. NHA was more capable in the remineralization process than CP. NHA was extremely capable in the remineralization process for enamel and cementum surrounding the margin of the computer-aided design and computer-aided manufacturing ceramic.

Introduction. Nanohydroxyapatite (nano-HA) has been utilized as an alternative agent for dental enamel remineralization. This study compared remineralization potential of nano-HA toothpaste (NHT), functionalized tricalcium phosphate toothpaste (TCPT), and fluoride toothpaste (FT) on carious lesions. Materials and Methods. Sixty extracted human premolars were prepared for artificial carious lesions with synthetic polymer gel. Samples were divided into four groups according to testing agents: NHT, TCPT, FT, and one group with no treatment (NT). Each group was subjected to pH-cycling with the application of toothpaste in slurry form twice a day (2-min each) for 10 days. Surface microhardness was measured before demineralization, after demineralization, and after pH-cycling. Hardness at different periods, percentage of hardness recovery (% HR), and percentage of remineralization potential (%RP) were determined and statistically analyzed with ANOVA and Tukey comparisons (α = 0.05). Polarized light microscopy (PLM) was utilized to assess lesion depth. Results. Significant remineralization of carious lesions was observed among different toothpastes compared to NT ( p < 0.05 ). No significant difference in remineralization potential was found among NHT, TCPT, and FT ( p > 0.05 ). No significant difference in % HR and % RP was seen among NHT, TCPT, and FT ( p > 0.05 ). PLM indicated a greater decrease in carious depth upon using NHT compared to TCPT and FT, with minimal increase in depth for NT. Conclusions. NHT has comparable capability to TCPT and FT in hardness recovery. However, decrease in carious depth was evidenced with PLM for NHT more than TCPT and FT. Thus, NHT was suggested as a potential remineralization product for treating initial carious lesions. Clinical Significance. The study showed that NHT had the potential to remineralize artificial carious lesion. It was confirmed in potential in the lesion depth reduction and forming a new enamel layer. NHT showed its capability as an alternative for dental caries therapeutic.

This study demonstrates the clinical significance of sLea expression in vascular invasion, and an unfavorable outcome in CCA. The role of sLea in vascular invasion which may lead to poor prognosis is supported by the in vitro adhesion and transmigration studies.

Dental caries prevention products available on the market contain only remineralizing agents or antibacterial agents. This study aimed to develop adhesive pastes containing calcium phosphate and α-mangostin for dental caries prevention using the optimization technique. Calcium phosphate was used as a remineralizing agent, and extracted α-mangostin was used as an antibacterial agent. The effect of the independent variables, which were fumed silica, Eudragit EPO, polyethylene glycol, and ethyl alcohol, on the responses was investigated. The drying time, erosion rate, calcium release rate, and α-mangostin release rate were established as the measured responses. An equation and a model of the relationship were constructed. An optimal formulation was obtained, and its effect on dental caries prevention was investigated using the pH-cycling model. The quadratic equation revealed that the drying time, calcium release rate, and α-mangostin release rate tended to decrease when increasing the fumed silica and decreasing other factors. The erosion rate tended to increase when decreasing Eudragit EPO and increasing other factors. The observed responses of the optimal adhesive pastes were not significantly different from the predicted responses. This result demonstrated that optimization is an efficient technique in the formulation development of the adhesive pastes. In addition, the optimal adhesive pastes could enhance acid resistance activity to the tooth enamel.

Background: New approaches for chemomechanical caries removal require effective materials with antibacterial properties for removal of infected dentin. Apacaries gel is a newly developed material comprised polyphenol from mangosteen extracts and papain mixed in gel preparation.Aim: This study evaluated the antibacterial effects of Apacaries gel on Streptococcus mutans in vitro.Materials and methods: Mangosteen pericarp powder was extracted. The amount of phenolic compounds was determined using the Folin-Ciocalteu method. The time-kill kinetics were investigated. Mangosteen extract and papain were mixed with gel base to develop Apacaries gel. The inhibition zone of the Apacaries gel was determined using agar well diffusion methods.Results: The mangosteen pericarp extract, which contains α-mangostin, was active against S. mutans strain ATCC25175. The time-kill kinetics curve showed that applying 1 mg/ml of mangosteen extract can reduce S. mutans by 50% within approximately 5 seconds; after this reduction, the bacterial count rapidly dropped to 0 within 60 seconds. Using mangosteen extract and papain mixture gel preparation resulted in a larger inhibition zone than using the mangosteen extract gel or papain gel separately.Conclusion: Apacaries gel can effectively inhibit S. mutans strain ATCC25175. Apacaries is capable of S. mutans inhibition better than both mangosteen extract or papain separately.How to cite this article: Juntavee A, Peerapattana J, Ratanathongkam A, Nualkaew N, Chatchiwiwattana S, Treesuwan P.The Antibacterial Effects of Apacaries Gel on Streptococcus mutans: An in vitro Study. Int J Clin Pediatr Dent 2014;7(2):77-81.

BackgroundThis study evaluated the effect of ceramic surface treatments on bond strength of ceramic brackets to machine-able ceramics and ceramic veneering metal.Material and MethodsMachined ceramic specimens (10x10x1.5 mm) were prepared from Empress® CAD (EP), and e.max® CAD (EM). Ceramic veneering metal specimens (PF) were fabricated from sintered d.Sign® porcelain (1.27 mm thickness) over d.Sign®10 metal (0.23 mm thickness). Each ceramic was divided into 3-groups and treated surface by Er-YAG laser (LE) or etching with 9.6% HF acid for 5 seconds (A5) or 15 seconds (A15). Resin adhesive (Transbond™-XT) was used for attaching ceramic brackets for each group (n=15) and cured with LED (Bluephase®) for 50 seconds. Specimens were immersed in distilled water for 24 hours before testing for shear bond at crosshead speed of 1.0 mm/min. The data were analyzed for the differences in bond strength with ANOVA and Tukey’s multiple comparisons (α = 0.05). De-bond surfaces were microscopically examined.ResultsBond strength (MPa) were 12.65±1.14 for EMA5, 14.50±2.21 for EMA15, 13.97±1.17 for EMLE, 12.40±1.95 for PFA5, 15.85±3.13 for PFA15, 14.06±2.17 for PFLE, 12.12±1.54 for EPA5, 15.65±1.57 for EPA15, 12.89±1.17 for EPLE. Significant differences in bond strength among groups were found related to surface treatment (p<0.05), but not significant difference upon type of ceramics (p>0.05). A15 provided higher bond strength than LE and A5 (P<0.05). No damage of ceramic surface upon de-bonding was indicated except for A15 tends to exhibit ditching. LE showed more uniform treated surface for bonding and no surface destruction upon de-bond compared to others.ConclusionsBond strength was affected by surface treatment. Both LE and A15 treated surface provided higher bond strength than A5. Considering possibly inducing defect on ceramic surface, LE seems to provide better favorable surface preparation than others. Treated ceramic surface with Er-YAG prior to bracket bonding is recommended. Key words:Ceramic, ceramic bracket, Er-YAG, laser, shear bond strength, surface treatment.

Introduction. Nano-hydroxyapatite gel (NHG) has never been investigated for enamel remineralization. This study evaluated the effects of two concentrations of NHG on remineralization of an artificial carious lesion in comparison with nano-HA toothpaste (NHT) and fluoride varnish (FV). Materials and Methods. Carious lesions were prepared on 100 enamel samples and divided into 5 groups: FV, NHT, 20% NHG, and 30% NHG. One untreated (NT) group was left as control. The hardness of the surface was evaluated before, during, and after remineralization. Microhardness at various phases and the percent recovery of hardness (%HR) were determined and analyzed with ANOVA. Polarized-light micrographs (PLM) were evaluated for depth of the carious lesion. Results. Significantly different remineralization capability was indicated for tested agents ( p < 0.05 ). NHT was significantly capable of remineralization greater than NHG, FV, and NT ( p < 0.05 ). No noticeable difference in %HR between 20% NHG and 30% NHG ( p > 0.05 ) was found. Decreasing in the depth of caries lesion was notified by PLM as applying either NHT or NHG as greater than FV, with no reduction in the depth for NT. Conclusions. Nano-HA both in toothpaste and gel form was capable of remineralization better than fluoride varnish. Comparable remineralization of 20% versus 30% NHG was evidenced. NHG for both concentrations was recommended as a capable remineralizing agent for caries remineralization. Clinical Significance: This study indicated that an application of nano-HA gel is an attractive route to deliver the material and can be more effective and less toxic than conventional formulations and provide its effectiveness directly at the site of action, especially for a noncooperative young child and medicinally intimidated patients who may face with inconvenience in using toothbrush and toothpaste for hygiene control.

Background: It is important to emphasize that the aspects of pretreatment techniques, as well as the composition and mechanism of adhesion, may decisively influence the effectiveness of the restorative materials in sealing cavity margins and preventing marginal leakage.Aims: This study assessed the in vitro influence of surface preparation techniques on the microleakage of glass ionomer restorations in primary teeth.Materials and methods: The study groups were divided into three different techniques: (1) The chemomechanical caries removal (CMCR) method using the Apacaries gel, (2) the erbium:yttrium aluminum-garnet (Er:YAG) laser method and (3) the atraumatic restorative technique (ART). The teeth restored with a glass ionomer restorative material (Fuji IX GP capsule, GC Corporation, Tokyo, Japan). The dye penetration was measured in micrometers using a polarized light microscope and specific computer software.Results: The results showed that the mean microleakage level after was lowest with the CMCR method using Apacaries gel and highest with the Er:YAG laser. There was a statistically significant difference regarding the mean microleakage level between the group with the CMCR method using Apacaries gel and the Er:YAG laser.Conclusion: Marginal leakage was significantly higher with preparations made using the Er:YAG laser than with the CMCR method using Apacaries gel and spoon excavator (p < 0.05).How to cite this article: Juntavee A, Juntavee N, Peerapattana J, Nualkaew N, Sutthisawat S. Comparison of Marginal Microleakage of Glass Ionomer Restorations in Primary Molars Prepared by Chemomechanical Caries Removal (CMCR), Erbium: Yttrium Aluminum-Garnet (Er:YAG) Laser and Atraumatic Restorative Technique (ART). Int J Clin Pediatr Dent 2013;6(2):75-79.