IADR Abstract Archives
Remineralizing Agents Differentially Affect Amelogenesis Imperfecta Enamel Microhardness
Objectives: Autosomal dominant hypocalcified amelogenesis imperfecta (ADHCAI) caused by FAM83H mutation is the most severe form of AI. The tooth enamel is cheesy soft, porous, and irregular; while dentin is mildly disturbed. Currently, the dental management of ADHCAI is unresolved. The aim of this study was to investigate the ultrastructure and how remineralizing agents affect ADHCAI tooth microhardness.
Methods: Five ADHCAI teeth were obtained from patients identified with FAM83H mutation. The phenotypic properties of each tooth evaluated were compared with 3 normal control teeth. Microhardness was measured with a Vickers indenter at baseline versus after applying a remineralizing agent and pH cycling (treated group). NaF varnish, APF gel, Neutral NaF gel, Silver diamine fluoride (SDF), and Tooth mousse were used. One half of each tooth served as its own control (untreated group). Tooth ultrastructure was examined using scanning electron microscopy (SEM).
Results: The SEM images demonstrated irregular and broken enamel rods in ADHCAI tooth enamel. At baseline, ADHCAI enamel showed a significantly lower microhardness than normal controls. ADHCAI enamel treated with NaF varnish or SDF exhibited a significantly decreased percent microhardness compared with its untreated half, suggesting the superior effects of NaF varnish and SDF on maintaining enamel hardness in ADHCAI. A significant difference between treated and untreated ADHCAI dentin microhardness was not observed. Among the different remineralizing agent types, the percent microhardness decrease in ADHCAI enamel treated with SDF was significantly lower compared with tooth mousse.
Conclusions: This study demonstrates severe abnormalities in enamel prisms and decreased enamel microhardness in ADHCAI tooth enamel, indicating a weakness that results in rapid destruction. Here, we propose for the first time that NaF varnish and SDF could be effective remineralizing agents to preserve ADHCAI enamel integrity and minimize ADHCAI tooth deterioration.
Methods: Five ADHCAI teeth were obtained from patients identified with FAM83H mutation. The phenotypic properties of each tooth evaluated were compared with 3 normal control teeth. Microhardness was measured with a Vickers indenter at baseline versus after applying a remineralizing agent and pH cycling (treated group). NaF varnish, APF gel, Neutral NaF gel, Silver diamine fluoride (SDF), and Tooth mousse were used. One half of each tooth served as its own control (untreated group). Tooth ultrastructure was examined using scanning electron microscopy (SEM).
Results: The SEM images demonstrated irregular and broken enamel rods in ADHCAI tooth enamel. At baseline, ADHCAI enamel showed a significantly lower microhardness than normal controls. ADHCAI enamel treated with NaF varnish or SDF exhibited a significantly decreased percent microhardness compared with its untreated half, suggesting the superior effects of NaF varnish and SDF on maintaining enamel hardness in ADHCAI. A significant difference between treated and untreated ADHCAI dentin microhardness was not observed. Among the different remineralizing agent types, the percent microhardness decrease in ADHCAI enamel treated with SDF was significantly lower compared with tooth mousse.
Conclusions: This study demonstrates severe abnormalities in enamel prisms and decreased enamel microhardness in ADHCAI tooth enamel, indicating a weakness that results in rapid destruction. Here, we propose for the first time that NaF varnish and SDF could be effective remineralizing agents to preserve ADHCAI enamel integrity and minimize ADHCAI tooth deterioration.