Remineralizing agents: effects on acid-softened enamel

Self-Instruction Exercise No. 372
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Exercise No. 372
Subject Code: 011
Cariology

The 15 questions for this exercise are based on the article, Remineralizing agents: effects on acid-softened enamel, on pages 73-76. This exercise was developed by Riki Gottlieb, DMD, MS, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • describe the effects of 4 dentifrices on acid-softened enamel;
  • understand the mechanism of action of remineralizing agents; and
  • learn which dentifrices can decrease or prevent the progression of erosive lesions.

Answers for this exercise must be received by June 30, 2016.
  1. All of the following statements about enamel erosion are correct except one. Which is the exception?

    A. It is caused by frequent consumption of acidic foods and drinks.
    B. The eroded tooth surface is highly susceptible to abrasion and mechanical impacts.
    C. It can lead to irreversible loss of ultraperipheral enamel layers.
    D. It is caused by calcium ions present in the oral fluid.

  2. The term pH cycling refers to alternating periods of acid exposure and use of dentifrices. In a pH cycling study, the use of amorphous calcium phosphate and calcium products offered no advantage over conventional fluoride toothpaste.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  3. All of the following statements about nanoparticles are correct except one. Which is the exception?

    A. Desensitizing pastes and toothpastes include hydroxyapatite nanoparticles.
    B. Nanoparticles have higher bioactivity than conventional particles.
    C. Nanoparticles have increased surface area compared to conventional particles.
    D. Nanoparticles increase in size in contact with saliva.

  4. The study was performed on 50 ______ teeth.

    A. canine
    B. equine
    C. bovine
    D. porcine

  5. Erosion-like lesions were induced by incubating enamel slabs in 20 mL of 0.3% _____ acid aqueous solution (pH 3.2) at room temperature.

    A. malic
    B. citric
    C. acetic
    D. lactic

  6. What medium was used for remineralization of erosion-like lesions?

    A. Knoop solution
    B. saline
    C. bovine saliva
    D. artificial saliva

  7. All of the following dentifrices were tested in this study except one. Which is the exception?

    A. Sensodyne ProNamel
    B. Colgate Sensitive Pro-Relief
    C. XyliWhite Sodium Bicarbonate
    D. Dio Nano-HAp Toothfoam

  8. The mixed dentifrice–aqueous solution slurry was applied to the specimen’s surface for _____ minute(s).

    A. 1
    B. 2
    C. 3
    D. 4

  9. Following the dentifrice treatments, specimens were immersed in the remineralization solution for ______ hours.

    A. 2
    B. 3
    C. 4
    D. 5

  10. How many dentifrice and erosion-remineralization cycles were performed in this study?

    A. 4
    B. 5
    C. 6
    D. 7

  11. All of the following statistical analyses were performed in this study except one. Which is the exception?

    A. ANOVA
    B. Tukey test
    C. paired t test
    D. Mann-Whitney test

  12. The greatest remineralization of erosive lesions was due to all of the following processes except one. Which is the exception?

    A. release of calcium ions from the dentifrice
    B. release of potassium ions from the dentifrice
    C. formation of an amorphous surface layer
    D. crystallization of the surface layer

  13. In this study, the dentifrice with high fluoride availability (KNO3 + F) did not cause a statistically significant increase in posttreatment hardness values. Previous studies have shown that high F content dentifrices added to precipitation of fluoridated hydroxyapatite.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  14. Which of the following dentifrices showed a statistically significant difference between post-erosion and posttreatment hardness values?

    A. nanoHAp
    B. arginine and CaCO3
    C. KNO3 and F
    D. POH and Na

  15. The dentifrice that exhibited the greatest increase in Knoop surface hardness values (KHN) post-remineralization was ______.

    A. DIO Nano-HAp Toothfoam
    B. Colgate Sensitive Pro-Relief
    C. Sensodyne ProNamel
    D. Sensodyne Cool Gel

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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