Caries Research

Original Paper

Higher Fluorosis Severity Makes Enamel Less Resistant to Demineralization

Marín L.M.a, c · Cury J.A.c · Tenuta L.M.A.c · Castellanos J.E.b · Martignon S.a

Author affiliations

aUNICA Caries Research Unit, Research Vice-Rectory, Universidad El Bosque, and bResearch Vice-Rectory, Universidad El Bosque, Bogotá, Colombia; cPiracicaba Dental School, UNICAMP, Piracicaba, Brazil

Keywords: HypomineralizationDental caries resistanceDental enamelDental fluorosisFluorideHardness

Related Articles for ""
Caries Res 2016;50:407-413
https://doi.org/10.1159/000447270

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 28, 2015
Accepted: May 27, 2016
Published online: July 27, 2016
Issue release date: September 2016

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 0008-6568 (Print)
eISSN: 1421-976X (Online)

For additional information: https://www.karger.com/CRE

Abstract

Fluorotic teeth could either be more resistant or more susceptible to the caries process than sound ones due to their higher enamel fluoride concentration and higher porosity (subsurface hypomineralization), respectively; however, there is no consensus on this subject. In this study, a total of 49 human unerupted third molars presenting Thylstrup and Fejerskov (TF) fluorosis scores 0-4 were used. Two enamel slabs were obtained from each tooth. The rest of the tooth crown was powdered, and the enamel was separated from the dentine. In purified powdered enamel, the calcium (Ca), inorganic phosphate (Pi), and fluoride (F) concentrations were determined. The F concentration gradient throughout the enamel and in the enamel volume was determined in one slab. The other enamel slab was isolated with acid-resistant varnish, subjecting the exposed enamel surface half to a pH-cycling model to evaluate its demineralization resistance and to calculate the demineralization area. The nonexposed surface was used to determine the natural hypomineralization area found in fluorotic enamel and normalize the demineralization data. The hypomineralization and demineralization areas were assessed by cross-sectional microhardness. For statistical analyses, the data for TF1 and 2, and for TF3 and 4 were pooled. Concentrations of powered enamel Ca and Pi were not significantly different (p > 0.05) among groups TF0, TF1-2 and TF3-4, but a higher F concentration was found in fluorotic enamel (p < 0.05). Highly fluorotic teeth (TF3-4) presented a greater hypomineralization subsurface area and demonstrated lower demineralization resistance than sound enamel (p < 0.05). The findings suggest that a higher severity of fluorosis makes enamel less resistant to the caries process due to its greater subsurface mineral area exposed to demineralization and deeper acid diffusion through the enamel.

© 2016 S. Karger AG, Basel



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References

  1. Alhawij H, Lippert F, Martinez-Mier EA: Relative fluoride response of caries lesions created in fluorotic and sound teeth studied under remineralizing conditions. J Dent 2015;43:103-109.
    External Resources
  2. Argenta RM, Tabchoury CP, Cury JA: A modified pH-cycling model to evaluate fluoride effect on enamel demineralization. Pesqui Odontol Bras 2003;17:241-246.
    External Resources
  3. Baelum V, Manji F, Fejerskov O: Post-eruptive tooth age and severity of fluorosis. Scand J Dent Res 1986;94:405-410.
    External Resources
  4. Benelli EM, Serra MC, Rodrigues AL Jr, Cury JA: In situ anticariogenic potential of glass ionomer cement. Caries Res 1993;27:280-284.
    External Resources
  5. Brudevold F, Gardner DE, Smith FA: The distribution of fluoride in human enamel. J Dent Res 1956;35:420-429.
    External Resources
  6. Chankanka O, Levy SM, Warren JJ, Chalmers JM: A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol 2010;38:97-109.
    External Resources
  7. Cury JA, do Amaral RC, Tenuta LM, Del Bel Cury AA, Tabchoury CP: Low-fluoride toothpaste and deciduous enamel demineralization under biofilm accumulation and sucrose exposure. Eur J Oral Sci 2010;118:370-375.
    External Resources
  8. Cury JA, Rebelo MAB, Del Bel Cury AA, Derbyshire MTVC, Tabchoury CPM: Biochemical composition and cariogenicity of dental plaque formed in the presence of sucrose or glucose and fructose. Caries Res 2000;34:491-497.
    External Resources
  9. Cury JA, Tenuta LM: How to maintain a cariostatic fluoride concentration in the oral environment. Adv Dent Res 2008;20:13-16.
    External Resources
  10. Driscoll WS, Horowitz HS, Meyers RJ, Heifetz SB, Kingman A, Zimmerman ER: Prevalence of dental caries and dental fluorosis in areas with negligible, optimal, and above-optimal fluoride concentrations in drinking water. J Am Dent Assoc 1986;113:29-33.
    External Resources
  11. Featherstone JDB, ten Cate JM, Shariati M, Arends J: Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profiles. Caries Res 1983;17:385-391.
    External Resources
  12. Fejerskov O, Cury JA, Tenuta LM, Marinho VC: Fluorides in caries control; in Fejerskov O, Nyvad B, Kidd E (eds): Dental Caries - The Disease and Its Clinical Management, ed 3. Oxford, Blackwell Munksgaard, 2015, pp 245-276.
  13. Fejerskov O, Thylstrup A, Larsen MJ: Clinical and structural features and possible pathogenic mechanisms of dental fluorosis. Scand J Dent Res 1977;85:510-534.
    External Resources
  14. Fiske CH, Subbarow Y: The colorimetric determination of phosphorus. J Biol Chem 1925;66:375-400.
  15. García-Pérez A, Irigoyen-Camacho ME, Borges-Yáñez A: Fluorosis and dental caries in Mexican schoolchildren residing in areas with different water fluoride concentrations and receiving fluoridated salt. Caries Res 2013;47:299-308.
    External Resources
  16. Isaac S, Brudevold F, Smith FA, Gardner DE: The relation of fluoride in the drinking water to the distribution of fluoride in enamel. J Dent Res 1958;37:318-325.
    External Resources
  17. Kidd EAM, Thylstrup A, Fejerskov O, Bruun C: Influence of fluoride in surface enamel and degree of dental fluorosis on caries development in vitro. Caries Res 1980;14:196-202.
    External Resources
  18. Kidd EAM, Thylstrup A, Fejerskov O, Silverstone LM: Histopathology of caries-like lesions created in vitro in fluorosed and sound enamel. Caries Res 1978;12:268-274.
    External Resources
  19. Kielbassa AM, Wrbas KT, Schulte-Mönting J, Hellwig E: Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. Arch Oral Biol 1998;44:243-251.
    External Resources
  20. Lida H, Kumar JV: The association between enamel fluorosis and dental caries in U.S. schoolchildren. J Am Dent Assoc 2009;140:855-862.
    External Resources
  21. Manly RS, Hodge HC: Density and refractive index studies of hard tissues: I. Methods for separation and determination of purity. J Dent Res 1939;18:133-141.
    External Resources
  22. Onoriobe U, Rozier RG, Cantrell J, King RS: Effects of enamel fluorosis and dental caries on quality of life. J Dent Res 2014;93:972-979.
    External Resources
  23. Petersen PE, Lennon MA: Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol 2004;32:319-321.
    External Resources
  24. Poulsen S, Larsen MJ: Dental caries in relation to fluoride content of enamel in the primary dentition. Caries Res 1975;9:59-65.
    External Resources
  25. Richards A, Fejerskov O, Baelum V: Enamel fluoride in relation to severity of human dental fluorosis. Adv Dent Res 1989;3:147-153.
    External Resources
  26. Richards A, Likimani S, Baelum V, Fejerskov O: Fluoride concentrations in unerupted fluorotic human enamel. Caries Res 1992;26:328-332.
    External Resources
  27. Sapov K, Gedalia I, Grobler S, Lewinstein I, Roman I, Shapira L, Hirschfeld Z, Teotia S: A laboratory assessment of enamel hypoplasia of teeth with varying severities of dental fluorosis. J Oral Rehabil 1999;26:672-677.
    External Resources
  28. Shellis RP, Ganss C, Ren Y, Zero DT, Lussi A: Methodology and models in erosion research: discussion and conclusions. Caries Res 2011;45:69-77.
    External Resources
  29. Suma R, Shashibhushan KK, Shashikiran ND, Subba RV: Progression of artificial caries in fluorotic and nonfluorotic enamel: an in vitro study. J Clin Pediatr Dent 2008;33:127-130.
    External Resources
  30. Takagi S, Liao H, Chow LC: Effect of tooth-bound fluoride on enamel demineralization/ remineralization in vitro. Caries Res 2000;34:281-288.
    External Resources
  31. ten Cate JM, Featherstone JDB: Physicochemical aspects of fluoride-enamel interactions; in Fejerskov O, Ekstrand J, Burt BA (eds): Fluoride in Dentistry, ed 2. Copenhagen, Munksgaard, 1996, pp 252-272.
  32. Thylstrup A, Fejerskov O: Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes. Community Dent Oral Epidemiol 1978;6:315-328.
    External Resources
  33. Waidyasekera PG, Nikaido T, Weerasinghe DD, Wettasinghe KA, Tagami J: Caries susceptibility of human fluorotic enamel and dentine. J Dent 2007;35:343-349.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 28, 2015
Accepted: May 27, 2016
Published online: July 27, 2016
Issue release date: September 2016

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2

ISSN: 0008-6568 (Print)
eISSN: 1421-976X (Online)

For additional information: https://www.karger.com/CRE

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2016, Vol.50, No. 4

September 2016

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