Faculty Bibliography

The purpose of this investigation was to study the intra-oral rehardening of acid-softened enamel and fluoride uptake from SnF2 gel. Bovine enamel slabs were softened with 0.1 mol/L lactate buffer at pH 4.0 for 14 hrs and then mounted in a mandibular removable Hawley appliance. Control slabs were worn for 96 hrs by seven adult males whose teeth were brushed daily with a fluoride-free dentifrice. Test slabs were exposed once/day to 0.4% SnF2 gel. The gel was swabbed onto the slabs for one minute before being replaced in the mouth unrinsed. The natural dentition was brushed 4 X /day with a fluoride-free dentifrice. Microhardness testing was performed after intra-oral exposure (IOE) and after acid-resistance-testing (ART) following immersion in 0.01 mol/L lactate buffer for 24 hrs at pH of 4.0. Fluoride uptake was measured on separate controls, test slabs, and test slabs after ART, with 0.5 mol/L HClO4 etches of from 15 to 60 sec. The F content was measured with a F-ion-specific electrode and the phosphate content by spectrophotometry. Following IOE, microhardness recovery was 35.6% for control and 37.9% for test slabs, and control slabs retained 1.4% resistance to acid, as compared with 18.6% for the test slabs. The F content of control slabs was significantly less than that of SnF2-treated slabs from 5 to 60 micron in depth, and the F content of SnF2-treated slabs after ART was significantly less at depths of from 5 to 35 micron than that of SnF2-treated slabs not exposed to ART. Both control and SnF2 enamel slabs demonstrated rehardening after IOE, but only SnF2-treated enamel retained a significant fraction of that rehardening after ART

Among the anticaries benefits of fluorides is the remineralization of incipient carious lesions. There is increasingly convincing evidence that low-potency fluoride agents applied frequently are effective in remineralizing early carious lesions. This study of in vivo remineralization used an intraoral appliance with demineralized enamel slabs mounted in the appliance and an innovative method of fluoride delivery, the fluoride-releasing device, which releases a controlled amount of fluoride (0.3 mg fluoride every 24 hours) on exposure to saliva. After control and treatment periods of 7 and 30 days, the enamel specimens were removed from the appliance and evaluated for microhardness, acid resistance, and fluoride uptake. The treated specimens significantly exceeded the values of their corresponding controls in all parameters measured, indicating that considerable remineralization of the treated enamel had occurred at both 7 and 30 days. Although the longer period of treatment produced greater results, considerable effects were observed after 7 days. This model system provided for an in vivo environment to study the effects of treatment of the FRD and allowed for subsequent recovery of the enamel specimens for evaluation. The results of this study are encouraging with respect to the efficacy of a fluoride-releasing device but indicate that subsequent clinical testing of the effects of FRDs on incipient carious lesions in the natural dentition of human subjects is necessary

This study analyzes the clinical effectiveness of a sealant (Delton) and its requirements for retreatment to maintain the optimum protection from pit and fissure caries. One hundred paired occlusal surfaces were treated in 29 patients. Two contralateral, partially erupted, noncarious molars with deep occlusal fissures were randomly selected to receive a sealant; one had a rubber dam and the other, cotton rolls for isolation. Each tooth received a prophylaxis with a rubber cup and a pumice slurry. The dryness of the field was evaluated. Each tooth was etched with 37% phosphoric acid for 60 seconds, rinsed for 15 seconds, and dried for 30 seconds. Sealant (Delton Tinted) was applied with a syringe according to manufacturer's instructions. Sealants were evaluated and reapplied where indicated at 6-month intervals. The average 6-month retention rate over 36 months was 95%, regardless of the method of isolation used when the sealant was applied initially. No tooth under treatment with a sealant became carious. The retreatment rate was highest at baseline (8%) and at 6 months (11.3%). Of the total number of retreated sealants, 61% were from the mandibular arch. During the 36 months of this study, 31% of the treated teeth required at least one retreatment