The use of raman-fluorescent medical technologies to assess the effect of physical and chemical factors on the mineralization of hard tooth tissues in normal and noncarious lesions

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Abstract

BACKGROUND: Assessment of the rapid state of mineralization of hard tooth tissues in normal and in various carious and noncarious lesions based on objective in situ methods is an unsolved and urgent issue in dental science and practice.

AIM: To substantiate the need for the clinical application in situ of express digital raman-fluorescent technology to increase the objectivity and effectiveness of assessing the degree of mineralization of hard tooth tissues in carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions under the influence of various physical and chemical factors on tissues.

MATERIALS AND METHODS: A survey of 80 patients aged 25–50 years was conducted; the patients were divided into three groups: comparison and with carious and with noncarious (wedge-shaped defect, pathological erasability) lesions of hard dental tissues. In each group, changes in hygienic conditions and mineralization parameters of hard tooth tissues were assessed by the difference in the spectral intensity of raman-fluorescent measurements before and after controlled and/or uncontrolled hygienic treatment. Previously, under experimental conditions, the effects of various physical (mechanical processing, X-ray irradiation on the LNK-268 installation) and chemical (citric acid, hydroxylapatite (GAP) dry and moistened) factors on the hard tissues of the tooth were studied. Simultaneously, “locally” in real time, the mineralization parameters of the hard tissues of the tooth were recorded before and after hygienic treatment. In this study, we used an installation of the “InSpectrM” type in our modification.

RESULTS: Experimental studies have shown the effectiveness and objectivity of the use of raman-fluorescence diagnostics to assess the hygienic condition and mineralization of hard dental tissues. The objectivity of the assessment of mineralization in a moistened state was investigated (dry GAP, 702 rel. units; wet GAP, 1520 rel. units), and the absence of the effect of radiation on the mineralization of hard tissues of the teeth (p >0.95) was revealed.

Clinical observations showed that in patients with a wedge-shaped defect and increased erasability of hard tooth tissues, the hygienic condition is 5–10% worse than that in patients with intact tooth tissues and initial formation of caries. The main difference in the condition of hard tissues of teeth with noncarious lesions is a statistically significantly reduced (p >0.95) mineralization of hard tissues of the tooth, requiring remineralizing therapy immediately after hygienic treatment.

CONCLUSION: In experimental and clinical conditions, the objectivity and effectiveness of the use of express raman-fluorescent technologies to assess the mineralization of hard tooth tissues when exposed to various physical and chemical factors in normal conditions, with carious (initial form) and noncarious (wedge-shaped defect, pathological erasability) lesions, are substantiated.

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About the authors

Mikhail T. Aleksandrov

Moscow Regional Research Clinical Institute named after M.F. Vladimirsky

Author for correspondence.
Email: alex_mta@mail.ru
ORCID iD: 0000-0003-2777-296X

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Maria N. Podoynikova

Moscow Regional Research Clinical Institute named after M.F. Vladimirsky

Email: podoinikova_mary@mail.ru
ORCID iD: 0009-0009-7504-2321

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

David G. Eganian

Moscow Regional Research Clinical Institute named after M.F. Vladimirsky

Email: eganyandavid@mail.ru
ORCID iD: 0009-0008-6405-4207
Russian Federation, Moscow

References

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  3. Khomenko L, Sorochenko G, Ostapko E, et al. Experimental justification of mineralization processes’ control for permanent teeth’ enamel. Sovremennaja stomatologija. 2020;(1):48–53. EDN: ILFPSG
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Supplementary files

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2. Fig. 1. The device "InSpectrM".

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3. Fig. 2. Comparison of the spectra of the Raman lines of hydroxyapatite of the reference sample — the hydroxyapatite line (data from the RAS reference samples — lower spectrum on the left) — with the Raman spectrum of tooth enamel in the dynamics of hygienic treatment of hard tooth tissues (change from top to bottom). On the left are the upper graphs, on the right — similarly for tooth enamel with varying degrees of mineralization (the technique was proposed by Professor M.T. Alexandrov and Candidate of Physical and Mathematical Sciences V.I. Kukushkin).

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4. Fig. 3. The characteristics of raman fluorescence of microbes are presented, which indicate the high sensitivity of raman fluorescence technologies (on the right), when they are registered in the agroindustrial complex (hardware and software complex) of the "InSpectrM" type(the sensitivity of the method is 104 COE/ml, i.e. it corresponds to the concentration of the symbiotic microflora of the oral cavity in a healthy person). The almost linear dependence (on the left) of the fluorescence intensity on the concentration of microbes (10 test objects of microbes) is shown. The measurements were carried out using turbodimetric and serial dilution methods, which made it possible to develop a calibration curve.

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5. Fig. 4. Raman-fluorescent spectrum — Msr for 30 test objects (measurement error 2%): a — wet hydroxyapatite (30 test objects); b — dry hydroxyapatite (30 test objects); c — raman-fluorescent spectrum of 30 test objects before and after brushing teeth with Colgate total toothpaste 3 min; hygienic condition, determined by the intensity of fluorescence, and corresponding to the corresponding calibration curve of the concentration of microbes. It was found that the concentrations of microbial contamination and fluorescence intensity depend on each other. All the presented indicators are estimated in relative units (before — at the top, after — at the bottom).

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