Evaluation of the Changes in Physical Properties and Mineral Content of Enamel Exposed to Radiation After Treating with Remineralization Agent

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2022 May 13

PMID 35552532

Authors

Merve Pelin Dur

Neslihan Celik

Nilgun Seven

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to investigate the effect of different remineralization agents on the physical properties and elemental content of enamel exposed to radiation.

Material And Method: The enamel surfaces of impacted third molar teeth were prepared, and six study groups were created (n = 6). Next, 60 Gy radiation was applied to each group. Between applications, each group except for the control group was treated with a different remineralization agent (sodium fluoride, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium phosphate with fluorite (CPP-ACFP), bioactive glass, or chitosan). The results were evaluated in terms of pre- and post-radiation values and the difference between the two. The paired-samples t test and analysis of variance test were used in the analysis of normally distributed hardness and roughness values, while Wilcoxon's signed ranks test, and the Kruskal Wallis and Mann-Whitney U tests were used in the analysis of elemental content without normal distribution.

Results: A statistically significant decrease was observed in microhardness measurements in all groups. Intragroup evaluation revealed a statistically significant difference between the NaF and bioactive glass groups (p < 0.05). No significant difference was observed between the groups' roughness measurements (p < 0.05). Intergroup evaluation of surface roughness revealed a significant difference in the CPP-ACFP and chitosan groups (p < 0.05). Pre- and post-radiation oxygen, magnesium, and potassium levels and Ca/P ratios also differed significantly (p < 0.05).

Conclusion: Radiation caused a statistically significant difference in the microhardness and elemental content of enamel. However, no significant difference was observed in enamel roughness. The applied remineralizing agents have a partial ameliorating effect on the adverse impacts of radiation.

Clinical Relevance: Radiation causes changes in the mechanical properties and elemental content of tooth enamel. Remineralizing agent application is a promising option in reducing the adverse effects of irradiation.

Citing Articles

Effect of different protocols in preventing demineralization in irradiated human enamel, in vitro study.

Suwannapong N, Chantarangsu S, Kamnoedboon P, Srinivasan M, Pianmee C, Bunsong C BMC Oral Health. 2025; 25(1):46.

PMID: 39780133 PMC: 11714816. DOI: 10.1186/s12903-024-05404-1.

Efficacy of different remineralizing agents on primary teeth exposed to therapeutic gamma radiation: An in vitro randomized control study.

Morad Y, El Shishiny S, Hindi R, El Sheshiny A, Samy A Saudi Dent J. 2024; 36(2):315-320.

PMID: 38420007 PMC: 10897604. DOI: 10.1016/j.sdentj.2023.11.009.

References

Faustino I, Palmier N, Fernandes P, Ribeiro A, Brandao T, Santos-Silva A . Morphological patterns of circumpulpal dentin affected by radiation-related caries. J Clin Exp Dent. 2020; 12(5):e501-e508. PMC: 7263775. DOI: 10.4317/jced.56584. View

Vissink A, Jansma J, Spijkervet F, Burlage F, Coppes R . Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003; 14(3):199-212. DOI: 10.1177/154411130301400305. View

Kielbassa A, Wrbas K, Schulte-Monting J, Hellwig E . Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. Arch Oral Biol. 1999; 44(3):243-51. DOI: 10.1016/s0003-9969(98)00123-x. View

Kielbassa A, Beetz I, Schendera A, Hellwig E . Irradiation effects on microhardness of fluoridated and non-fluoridated bovine dentin. Eur J Oral Sci. 1997; 105(5 Pt 1):444-7. DOI: 10.1111/j.1600-0722.1997.tb02142.x. View

Naves L, Novais V, Armstrong S, Correr-Sobrinho L, Soares C . Effect of gamma radiation on bonding to human enamel and dentin. Support Care Cancer. 2012; 20(11):2873-8. DOI: 10.1007/s00520-012-1414-y. View

Gupta N, Pal M, Rawat S, Grewal M, Garg H, Chauhan D . Radiation-induced dental caries, prevention and treatment - A systematic review. Natl J Maxillofac Surg. 2016; 6(2):160-6. PMC: 4922225. DOI: 10.4103/0975-5950.183870. View

Li X, Wang J, Joiner A, Chang J . The remineralisation of enamel: a review of the literature. J Dent. 2014; 42 Suppl 1:S12-20. DOI: 10.1016/S0300-5712(14)50003-6. View

Ten Cate J, Featherstone J . Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med. 1991; 2(3):283-96. DOI: 10.1177/10454411910020030101. View

10.

Lynch R, Mony U, Ten Cate J . The effect of fluoride at plaque fluid concentrations on enamel de- and remineralisation at low pH. Caries Res. 2006; 40(6):522-9. DOI: 10.1159/000095652. View

11.

Hellwig E, Lussi A . What is the optimum fluoride concentration needed for the remineralization process?. Caries Res. 2001; 35 Suppl 1:57-9. DOI: 10.1159/000049112. View

12.

Reynolds E, Cain C, Webber F, Black C, Riley P, Johnson I . Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res. 1995; 74(6):1272-9. DOI: 10.1177/00220345950740060601. View

13.

Reynolds E . Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Spec Care Dentist. 1998; 18(1):8-16. DOI: 10.1111/j.1754-4505.1998.tb01353.x. View

14.

Reynolds E, Cai F, Cochrane N, Shen P, Walker G, Morgan M . Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008; 87(4):344-8. DOI: 10.1177/154405910808700420. View

15.

Burwell A, Litkowski L, Greenspan D . Calcium sodium phosphosilicate (NovaMin): remineralization potential. Adv Dent Res. 2009; 21(1):35-9. DOI: 10.1177/0895937409335621. View

16.

Andersson O, Kangasniemi I . Calcium phosphate formation at the surface of bioactive glass in vitro. J Biomed Mater Res. 1991; 25(8):1019-30. DOI: 10.1002/jbm.820250808. View

17.

Pasquantonio G, Greco C, Prenna M, Ripa C, Vitali L, Petrelli D . Antibacterial activity and anti-biofilm effect of chitosan against strains of Streptococcus mutans isolated in dental plaque. Int J Immunopathol Pharmacol. 2009; 21(4):993-7. DOI: 10.1177/039463200802100424. View

18.

Kielbassa A, Schendera A, Schulte-Monting J . Microradiographic and microscopic studies on in situ induced initial caries in irradiated and nonirradiated dental enamel. Caries Res. 1999; 34(1):41-7. DOI: 10.1159/000016568. View

19.

Jansma J, Borggreven J, Driessens F . Effect of X-ray irradiation on the permeability of bovine dental enamel. Caries Res. 1990; 24(3):164-8. DOI: 10.1159/000261260. View

20.

Akyol O, Dirican B, Toklu T, Eren H, Olgar T . Investigating the effect of dental implant materials with different densities on radiotherapy dose distribution using Monte-Carlo simulation and pencil beam convolution algorithm. Dentomaxillofac Radiol. 2019; 48(4):20180267. PMC: 6592586. DOI: 10.1259/dmfr.20180267. View

21.

Mitra S, Wolff J, Garrett R . Calibration of a prototype in vivo total body composition analyser using 14 MeV neutron activation and the associated particle technique. Appl Radiat Isot. 1998; 49(5-6):537-9. DOI: 10.1016/s0969-8043(97)00070-5. View