Fabiano Vieira Vilhena

Teeth with molar-incisor hypomineralization (MIH) present demarcated opacities, which are structural alterations in the enamel, making them more porous and often resulting in dentin hypersensitivity (DH). New technologies have been developed for the management of MIH-affected teeth, including bioactive silicon materials, which could form new silicon-enriched hydroxyapatite crystals, reinforcing the structure, and acting as an obliterating agent. The aim of this study was to evaluate the formation of a mineral layer and changes in the demarcated opacities’ color employing an intraoral Trios 4 scanner after using a new silicon-based bioactive clinical system plus calcium in 11 children with MIH. DH was assessed with the VAS and SCASS scales at baseline, 15, and 30 days. Intraoral scanning revealed the formation of a mineral layer after 30 days, and significant DH reduction was observed (mean reductions: VAS 65% at 15 days and 83% at 30 days; SCASS 76% at 15 days and 94% at 30 days). Moreover, Cox regression analysis identified baseline pain severity as an independent predictor of a faster reduction in DH (adjusted HR = 0.06, p < 0.05). Color analysis suggested a lightening of the demarcated opacities. These results indicate that the new silicon-based bioactive clinical system plus calcium may effectively reduce DH and modify both enamel structure and opacity coloration in MIH-affected teeth. Longitudinal studies with larger samples are needed to assess the long-term effects.

The use of adjunct chemical substances in the early postoperative period of periodontal surgical procedures is recommended due to the potential risk of trauma in the operated area. Chlorhexidine digluconate mouthwash is widely used but can cause adverse effects. Phthalocyanine derivatives are being studied as an alternative, demonstrating good antimicrobial activity, especially in the self-activated form, which does not require additional light or chemicals. The objective of this study is to compare the cytotoxicity of different concentrations of a phthalocyanine (PHY) with chlorhexidine (CHX) and assess their influence on fibroblast cell migration. Different concentrations of CHX and PHY (0.0075%–0.12%) were evaluated using NIH 3T3 fibroblasts. Cell viability was assessed by the MTT and crystal violet (CV) assay; CHX and PHY (0.0075% and 0.12%) were also evaluated by in vitro wound healing assay. PHY was less cytotoxic compared to CHX, based on cell viability assays. PHY did not interfere with experimental healing, allowing cell migration similar to the positive control with both concentrations (PHY 0.0075% and 0.12%) and only 0.0075% CHX allowed cell migration. In a comparative analysis, PHY showed less cytotoxicity than CHX and PHY concentrations of 0.0075% and 0.015% was non-toxic even after 48 h of contact with the cells. This in vitro evaluation demonstrated that PHY was less cytotoxic to NIH 3T3 fibroblasts compared to CHX. Furthermore, the different concentrations of PHY did not interfere negatively in the healing of experimental wounds.

This in vitro study evaluated the protective effect of an Si-containing toothpaste associated with different fluoride concentrations by reducing the depth of the demineralized lesions in dentin after cariogenic pH cycling. Methods: Sixty bovine dentin blocks (4 × 4 × 2 mm) were randomly assigned into five groups (n = twelve/group): RGS₁ (Si toothpaste with 1450 ppm F), RGS₂ (Si toothpaste with 1100 ppm F), RGS₃ (fluoride-free Si toothpaste), negative control (NC) (fluoride-free toothpaste), and positive control (PC) (1450 ppm F toothpaste). The specimens underwent a three-day pH cycling model simulating the oral environment with twice-daily brushing. The mineral loss (ΔF) and lesion depth (ΔF_max) were assessed using quantitative light-induced fluorescence (QLF), and scanning electron microscopy (SEM) provided a morphological analysis. Elemental analyses were performed with an energy-dispersive X-ray spectrometer (EDS). ANOVA and Tukey’s test were used for the data analysis (α = 5%). Results: EDS confirmed the Si in the toothpaste formulations. The groups treated with fluoride silicon toothpastes (RGS₁, RGS₂) had significantly reduced mineral loss and lesion depth compared to the PC group. The NC group exhibited the greatest mineral loss and lesion depth. SEM images revealed occluded superficial dentin tubules and a protective mineral layer in the groups treated with Si toothpaste, whereas no deposition (NC group) or limited mineral deposition (PC group) was observed in the control groups. Conclusions: The findings suggest that the Si toothpastes favored protection against dentin demineralization, even at a lower concentration or free of fluoride, with dentin tubule occlusion, thus representing a promising oral care product over traditional fluoride toothpastes.

This in vitro study evaluated the protective effect of a Si-containing toothpaste associated with different fluoride concentrations by reducing the depth of demineralized lesions in dentin after cariogenic pH cycling. Methods: Sixty bovine dentin blocks (4x4x2mm) were randomly assigned into five groups (n = 12/group): RGS1 (Si-toothpaste with 1450 ppm F), RGS2 (Si-toothpaste with 1100 ppm F), RGS3 (fluoride-free Si-toothpaste), negative control-NC (fluoride-free toothpaste), and positive control-PC (1450 ppm F toothpaste). The specimens underwent a three-day pH cycling model simulating the oral environment with twice-daily brushing. Mineral loss (ΔF) and lesion depth (ΔFmax) were assessed using quantitative light-induced fluorescence (QLF), and scanning electron microscopy (SEM) provided morphological analysis. Elemental analyses were determined with an energy-dispersive X-ray spectrometer (EDS). ANOVA/Tukey's test were used for data analysis (α = 5%). Results: The groups treated with fluoride silicon-toothpastes (RGS1, RGS2) significantly reduced the mineral loss and lesion depth compared to the PC group. The NC group exhibited the greatest mineral loss and lesion depth. SEM images revealed occluded superficial dentin tubules and a protective mineral layer in groups treated with Si-toothpaste, whereas no deposition (NC group) or a limited mineral deposition (PC group) was observed in the control groups. EDS confirmed Si in the toothpaste formulations. Conclusions: Findings suggest that Si-toothpastes favored protection against dentin demineralization even at a lower concentration or free of fluoride, with dentin tubule occlusion, thus consisting of a promising oral care product over traditional fluoride toothpastes.

Objective: The purpose of this scoping review was to identify gaps in the literature and summarize findings from studies examining the use of silicon-, silica-, and silicate-based toothpastes for the remineralization and repair of mineralized tooth tissues. Methods: A 10-year literature search was conducted using PubMed and Scopus, adhering to PRISMA 2020 guidelines. A total of 331 studies were initially identified, with 56 full-text review articles. After selecting the manuscripts, 27 studies were qualitatively analyzed by four reviewers, focusing on the results of both in vivo and in vitro methods. Results: The findings suggest that toothpastes containing silicon, silica, and silicate demonstrate promising results for remineralization and enamel repair, with evidence of mineral layer formation and/or deep enamel surface remineralization under various conditions. Additionally, the use of these toothpastes can lead to the obliteration of dentinal tubules within a few days. The results collectively support the efficacy of these toothpastes in enamel repair. Most of the clinical studies focused on dentine hypersensitivity, followed by white spot lesions. Conclusions: Silicon-, silica-, and silicate-based toothpastes (bioactive Si-toothpastes) can be considered effective based mostly on laboratory studies. There remains a need for more in vivo research studies on enamel and dentin mineral repair. Existing studies provide strong evidence that these technologies can reduce dentin hypersensitivity and promote enamel–dentin repair.

The purpose of this scoping review was to identify gaps in the literature and summarize findings from studies examining the use of silicon-, silica-, and silicate-based toothpastes for the remineralization and repair of mineralized tooth tissues. A 10-year literature search was conducted using PubMed and Scopus, adhering to PRISMA 2020 guidelines. A total of 331 studies were initially identified, with 56 full-text review articles. After selecting the manuscripts, 27 studies were qualitatively analyzed by four reviewers, focusing on the results of both in vivo and in vitro methods. The findings suggest that toothpastes containing silicon, silica, and silicate demonstrate promising results for remineralization and enamel repair, with evidence of mineral layer formation and/or deep enamel surface remineralization under various conditions. Additionally, the use of these toothpastes can lead to the obliteration of dentinal tubules within a few days. The results collectively support the efficacy of these toothpastes in enamel repair. Most of the clinical studies focused on dentine hypersensitivity, followed by white spot lesions. In conclusion, silicon-, silica-, and silicate-based toothpastes (bioactive-Si-toothpastes) can be considered effective based mostly on laboratory studies. There remains a need for more in vivo research studies on enamel and dentin mineral repair. Existing studies provide strong evidence that these technologies can reduce dentin hypersensitivity and promote enamel-dentin repair.

The objective of this study was to investigate and compare the effectiveness of toothpastes containing bioactives to relieve dentin hypersensitivity with that of a commercial desensitizing toothpaste containing REFIX technology, associated or not with a calcium booster. In this double-blind, randomized, parallel-group, multi-center clinical trial, thirty-two volunteers diagnosed with dentin hypersensitivity and qualified to participate were randomized into four groups: (1) Colgate Sensitive Pro-Relief; (2) Sensodyne Repair & Relief; (3) Regenerador Sensitive; and (4) Regenerador Sensitive, associated with a calcium booster. Evaporative and tactile tests were used to check for dentin hypersensitivity in the test subjects. The participants brushed their teeth with one of the toothpastes, and dentin hypersensitivity was immediately tested using a visual analogue scale (VAS), in which the pain was rated on a scale of 0 to 10. Dentin hypersensitivity was measured after one week and after one month of the subjects continuing to use the toothpaste three times per day. Data were statistically analyzed with a non-parametric Friedman test for dependent data (α = 0.05). All toothpastes reduced dentin hypersensitivity. In the evaporative test, Sensodyne Protect & Repair and Regenerador Sensitive, associated with the calcium booster, exhibited faster and more effective results in reducing pain caused by dentin hypersensitivity, even after the first use. Colgate Sensitive Pro-Relief was effective only after one week of use. All toothpastes performed well in the tactile test for treating dentin hypersensitivity, and their performance improved over time. Sensodyne Repair & Protect presented the highest overall pain remission after one month (84.6%). The bioactive toothpastes reduced, to a different extent, the tooth hypersensitivity reported by the volunteers. Sensodyne Repair & Relief and Regenerador Sensitive, associated or not with a calcium booster, presented faster and more effective results in reducing pain caused by dentin hypersensitivity.

Calcium boosters have been used as a supplement for fluoride toothpastes to repair the dental tissues and reduce dentin permeability. This in vitro study aimed to characterize the regenerative and protective effects of the treatment of dental tissues with a fluoride–silicon-rich toothpaste associated with a calcium booster. Bovine enamel and dentin blocks (n = 5) were obtained (4 × 4 × 6 mm). A fluoride–silicon-rich toothpaste and a calcium booster were used to brush the enamel and dentin both immediately and five days afterwards. The outcomes were then compared to those of the untreated control group. After that, the specimens were cross-sectioned. SEM was used to evaluate the micromorphology of the surface and cross-section. Energy-dispersive X-ray spectroscopy (EDS) was used to determine the elemental analyses (weight%). After treatment for 5 days with a booster/silicon-rich toothpaste, EDS analysis demonstrated that it induced a significant mineral change. It was also able to form a protective silicon-enriched mineral layer on both enamel and dentin surfaces. It was demonstrated in vitro that a fluoride–silicon-rich toothpaste associated with a calcium booster regenerates the dental tissues, remineralizing the enamel structure and occluding the dentin tubules.