Development of a Radiopaque Infiltration Resin for Early Enamel Carious Lesion

Abstract

A white spot lesion (WSL) is defined as enamel porosity, which could be due to an enamel defect or an initial carious lesion. ICON® resin is a resin infiltrant that penetrates into the enamel porosity and seals the lesion, thus inhibiting the progression of caries. This method is micro-invasive; however, the resin is radiolucent and the clinician cannot detect the material using radiographs. In order to develop a radiopaque resin, understanding the pore size and pore structure in WSLs is helpful. Therefore, the aim of this study was to characterise: (1) the pore size and structure, (2) the incorporation of radiopaque agents into ICON® resin. Brunauer–Emmett–Teller (BET) and focused ion beam-scanning electron microscopy (FIB-SEM) were used to characterise the porosity in WSLs. The data showed the enamel prisms become more pronounced in the advanced areas of the WSLs and demineralisation occurs within or/and between the enamel prisms. The pore size could be as small as an enamel crystallite, 28x48nm. Nano-strontium hydroxyapatite (non-coated and coated) and strontium bioglass were made as radiopaque fillers and characterised using different techniques including fourier transform infrared spectroscopy (FTIR), BET, transmission electron microscopy (TEM), X-ray diffraction (XRD) and particle size measurements. The radiopaque fillers had micron-sized particles, which made them unsuitable for infiltration into WSLs despite their possible ability to remineralise the WSLs. Radiopaque monomers including bromine-methacrylate and tin-methacrylate were able to make ICON® resin radiopaque and they showed a similar viscosity, wettability and biocompatibility compared to ICON® resin. The X-ray microtomography (XMT) showed that the experimental radiopaque resins were able to infiltrate into the WSLs, artificial and natural lesions, and they could be detected using image subtraction. Backscattered electron (BSE) imaging after each step of application of materials showed that the etching pattern and etchant gel could be barriers for a successful infiltration of the resins into WSLs.