Remineralization with Saliva and Fluoride Flashcards
Case study:
In class Dr. fernando explains the process of net remineralistion when fluoride ions intercept calcium ions in the subsurface enamel, forming FA. Dr. fernando then explains how some toothpastes cause deposition of minerals onto the enamel surface. Mid lecture, a female student yells out, you’re wrong, since the deposition of minerals onto the enamel surface should be net remineralization as you’re increasing the mineral content on teeth. Amro, sitting in the back of the class, silently raises his hand and then explains, that both Dr. Fernando and the girl are conceptually confused.
If you were amro, what would you say? What is net remineralization?
Net remineralization is deposition of calcium and phosphate ions into the subsurface levels of enamel from an external source.
Dr.F’s explanation of flouride is remineralization or deposition, not net re remineralization
The girl is wrong because deposition onto enamel surfaces is not consider net remineralization due to not being into the subsurface layer
Where do minerals redeposit during remineralisation of enamel?
Redeposit into damaged crystallites
What mineral crystals can redeposit into enamel?
Hydroxyapatite
Fluorapatite
Fluorhydroxyapatite
Sahaij presents to Dr.Alami’s dental clinic. Upon examination Dr. Alami notices sahaij has an active white spot lesion on the 37. Moreover, Sahaij has a frank cavitated lesion on the 46.
What is required for net remineralization to occur?
Use that knowledge to explain treatment plans.
Required:
Bioavailbale calcium ions, phosphate ions, hydroxide ions/fluoride ions
crystal template
water
37 use CPP ACP and modify diet to arrest lesion
46, cannot fix due to lack of template. Depending on scenario, either restore teeth or attempt to modify lifestyle to arrest lesion then restore.
You travel to an alien planet where chemistry is unique and novel. In this planet there exists two crystals: thoriumapatite and xenonapatite. The Ksp of thoriumapatite is 10^-17 and the Ksp of xenonapatite is 10^-24.
In a solution, which with equal amounts of thorium and xenon ions, which apatite do you think forms faster or do they form at the same rate? Explain.
Since DS >1 = super sat = crystal formation
Higher DS means faster rate for formation
Since DS = IAP/Ksp, Xenonapatite will form form faster since DSx>DSt
Crystals that are more soluble tend to precipitate faster. True or False? Justify your answer
Since higher DS equals faster rate of precipitation, very low Ksp means fast rate
False, low soluble crystals precipitate fastee
What are some sources of ions for remineralisation?
Fluoride is always good in adults.
Do you agree with this statement? If so explain, if not, justify
Fluoride can be detrimental at high conc; so reactive it can clog surface layer and prevent inward diffusion of ions into deep layers
Dr. Alami and Dr. Abukhadijeh are the leading dentists in the world.
One patient presents to their joint clinic seeking medical attention for crumbling teeth.
The patient presents with normal saliva flowrate.
When treated with fluoride, the patient has no clinical improvement.
What can you infer about the saliva composition of the patient? Why do you think fluoride doesn’t work?
Lack of calcium, or phosphate. Fluoride requires calcium and phosphate to form fluroapatite.
If saliva is already supersaturated, why do we need products to further supersaturate the teeth with ions?
Higher DS means faster and more favourable remin rate
Saliva doesn’t have strong enough ionic saturation to regress white spot lesions and therefore products such as tooth mousse that have amorphous stabilibled calcium phosphate can help
