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Assessment of the remineralisation induced by contemporary ion-releasing materials in mineral-depleted dentine

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Abstract

Objectives

Evaluate the ability of current ion-releasing materials to remineralise bacteria-driven artificial caries lesions.

Materials and methods

Standardised class I cavities were obtained in 60 extracted human molars. Specimens underwent a microbiological cariogenic protocol (28 days) to generate artificial caries lesions and then were randomly divided into four restorative groups: adhesive + composite (negative control); glass ionomer cement (GIC); calcium silicate cement (MTA); and resin-modified calcium silicate cement (RMTA). Microhardness analysis (ΔKHN) was performed on 40 specimens (10/group, t = 30 days, 45 days, 60 days in artificial saliva, AS). Micro-CT scans were acquired (3/group, t = 0 days, 30 days, and 90 days in AS). Confocal microscopy was employed for interfacial ultra-morphology analysis (2/group, t = 0 days and 60 days in AS). Additional specimens were prepared and processed for scanning electron microscopy (SEM) and FTIR (n = 3/group + control) to analyse the ability of the tested materials to induce apatite formation on totally demineralised dentine discs (60 days in AS). Statistical analyses were performed with a significance level of 5%.

Results

Adhesive + composite specimens showed the lowest ΔKHN values and the presence of gaps at the interface when assessed through micro-CT even after storage in AS. Conversely, all the tested ion-releasing materials presented an increase in ΔKHN after storage (p < 0.05), while MTA best reduced the demineralised artificial carious lesions gap at the interface. MTA and RMTA also showed apatite deposition on totally demineralised dentine surfaces (SEM and FTIR).

Conclusions

All tested ion-releasing materials expressed mineral precipitation in demineralised dentine. Additionally, calcium silicate-based materials induced apatite precipitation and hardness recovery of artificial carious dentine lesions over time.

Clinical relevance

Current ion-releasing materials can induce remineralisation of carious dentine. MTA shows enhanced ability of nucleation/precipitation of hydroxyapatite compared to RMTA and GIC, which may be more appropriate to recover severe mineral-depleted dentine.

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Funding

Research facilities were supported by grants “Ministerio de Ciencia, Innovación y Universidades (PID2020-120346 GB-I00)” (PI: SS). Paula Maciel Pires undertook a PhD exchange programme at Cardenal Herrera University during part of the experimental assay and was supported by a CAPES grant from Brazil (grant numbers 88882.424807/2018–01 and 88881.188518/2018–01).

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Authors and Affiliations

  1. Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil

    Paula Maciel Pires & Aline de Almeida Neves

  2. Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain

    Paula Maciel Pires & Salvatore Sauro

  3. Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy

    Andrei Cristian Ionescu & Eugenio Brambilla

  4. Microbiology, Departamento de Farmacia, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain

    Maria Teresa Pérez-Gracia

  5. Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy

    Elena Vezzoli

  6. Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University UNESP, Araraquara, Brazil

    Igor Paulino Mendes Soares

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  1. Paula Maciel Pires
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  2. Andrei Cristian Ionescu
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  3. Maria Teresa Pérez-Gracia
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  4. Elena Vezzoli
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  5. Igor Paulino Mendes Soares
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  6. Eugenio Brambilla
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  7. Aline de Almeida Neves
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  8. Salvatore Sauro
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Contributions

All authors gave their final approval and agreed to be accountable for all aspects of the work. Paula Maciel Pires1: Investigation, Formal Analysis, Data curation, Writing-Original Draft. Andrei Cristian Ionescu: Formal Analysis, Data curation, Writing-Review & Editing. Salvatore Sauro: Funding Acquisition, Conceptualization, Formal analysis, Methodology, Writing-Review & Editing, Project administration. Maria Teresa Pérez-Gracia: Investigation. Elena Vezzoli: Investigation, Data curation, Formal analysis. Igor Paulino Mendes Soares: Investigation, Data curation. Eugenio Brambilla: Writing-Review & Editing. Aline de Almeida Neves: Conceptualization, Methodology, Writing -Review & Editing, Project administration.

Corresponding author

Correspondence to Salvatore Sauro.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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For this type of study, formal consent is not required. Human molars used in this study were collected according to the guidelines of the local Ethics Committee (Universidade Federal Do Rio de Janeiro, 54941416.9.0000.5257).

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The authors declare no competing interests.

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Maciel Pires, P., Ionescu, A.C., Pérez-Gracia, M.T. et al. Assessment of the remineralisation induced by contemporary ion-releasing materials in mineral-depleted dentine. Clin Oral Invest 26, 6195–6207 (2022). https://doi.org/10.1007/s00784-022-04569-9

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