The aim of this vitro-study is to evaluate the effects of fluoride on remineralization of artificial dentine caries. 10 sound permanent premolars, which were extracted for orthodontic reason within 1 week, were used for this study. Artificial dentine caries was created by using a partially saturated buffer solution for 2 days with grounded thin specimens and fractured whole-body specimens. Remineralization solutions with three different fluoride concentration (1 ppm, 2 ppm and 4 ppm) were used on demineralized-specimens for 7 days. Polarizing microscope and scanning electron microscope were used for the evaluation of the mineral distribution profile and morphology of crystallites of hydroxyapatite.
The results were as follows :
When treated with the fluoride solutions, the demineralized dentine specimens showed remineralization of the upper part and demineralization of the lower part of the lesion body simultaneously. As the concentration of fluoride increased, the mineral precipitation in the caries dentine increased. The mineral precipitation mainly occurred in the surface layer in 1 and 2 ppm-specimens and in the whole lesion body in 4 ppm-specimens. When treated with the fluoride solution, the hydroxyapatite crystals grew. This crystal growth was even observed in the lower part of the lesion body which had shown the loss of mineral.
Dental caries is the most common disease in the oral cavity. However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial.
In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss of inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase, the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM.
The results were as follows;
In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly. As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p < 0.05). In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size.
In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.
The purpose of this study is to compare and to evaluate the effect of pH and lactic acid concentration on the progression of artificial root caries lesion using polarizing microscope, and to evaluate the morphological changes of hydroxyapatite crystals of the demineralized area and to investigate the process of demineralization using scanning electron microscope.
Artificial root caries lesion was created by dividing specimens into 3 pH groups (pH 4.3, 5.0, 5.5), and each pH group was divided into 3 lactic acid concentration groups (25 mM, 50 mM, 100 mM). Each group was immersed in acid buffer solution for 5 days and examined. The results were as follows:
1. Under polarized microscope, the depth of lesion was more effected by the lactic acid concentration rather than the pH.
2. Under scanning electron microscope, dissolution of hydroxyapatite crystals were increased as the lactic acid concentration increased and the pH decreased.
3. Demineralized hydroxyapatite crystals showed peripheral dissolution and decreased size and number within cluster of hydroxyapatite crystals and widening of intercluster and intercrystal spaces as the pH decreased and the lactic acid concentration increased.
4. Under scanning electron microscope evaluation of the surface zone, clusters of hydroxyapatite crystals were dissolved, and dissolution and reattachment of crystals on the surface of collagen fibrils were observed as the lactic acid concentration increased.
5. Under scanning electron microscope, demineralization of dentin occurred not only independently but also with remineralization simultaneously.
In conclusion, the study showed that pH and lactic acid concentration influenced the rate of progression of the lesion in artificial root caries. Demineralization process was progressed from the surface of the cluster of hydroxyapatite crystals and the morphology of hydroxyapatite crystals changed from round or elliptical shape into irregular shape as time elapsed.