Effect of a diffusion layer on the nature of enamel demineralization

The aim of the present study was to evaluate the significance of diffusion barriers in the development of artificial caries-like lesions. A 30-mm2 enamel surface area was covered with a layer of filter paper and exposed to a gently agitated 50 mM acetate buffer, pH 4.5, containing either 0.1 or 1.0 ppm fluoride for up to 48 h at 20 degrees C. Similar enamel surfaces, but unprotected by filter paper, served as controls. It was found that below the filter paper an approximately 60-microns-deep caries-like lesion was developed exhibiting a preserved surface layer, the mineral content of which depended on the fluoride concentration of the buffer. The lesions of the control teeth without a filter paper coverage were erosion-like surface lesions. In the filter paper calcium and phosphate released from the enamel combined with fluoride from the bulk solution had established a supersaturation with respect to fluorapatite while the undersaturation with respect to hydroxyapatite was maintained, which caused a caries lesion to develop. The lesions produced in noncovered enamel by bulk solution unsaturated with respect to both apatites were erosion-like. It was concluded that a diffusion barrier can significantly favor the establishment of supersaturation with respect to fluorapatite and thus facilitate the development of a subsurface caries-like lesion at the expense of the erosion.