In situ Effect of Chewing Gum with and without CPP-ACP on Enamel Surface Hardness Subsequent to ex vivo Acid Challenge

The erosion-protective effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is controversial. This study aimed to investigate the ability of CPP-ACP chewing gum to prevent a single event of erosive demineralization in situ. Bovine enamel blocks (n = 120) were randomly assigned to 3 phases according to the baseline surface hardness: phase I (PI) - chewing gum with CPP-ACP, phase II (PII) - chewing gum without CPP-ACP, and control phase (PIII) - salivary effect without stimulation (no gum). Nineteen volunteers participated in this study during 3 crossover phases of 2 h. In PI and PII, the volunteers wore intraoral palatal appliances for 120 min and chewed a unit of the corresponding chewing gum for the final 30 min. In the control phase the volunteers wore the appliance for 2 h, without chewing gum. Immediately after intraoral use, the appliances were extraorally immersed in a cola drink for 5 min to promote erosive demineralization. The percentage of surface hardness loss was calculated. The data were analyzed by ANOVA models and Tukey's test. Lower enamel hardness loss was found after the use of chewing gum with CPP-ACP (PI: 32.7%) and without CPP-ACP (PII: 33.5%) compared to the salivary effect without stimulation (PIII: 39.8%) (p < 0.05). There was no difference between PI and PII (p > 0.05). The results suggest that the use of chewing gum immediately before an erosive demineralization can diminish enamel hardness loss. However, the presence of CPP-ACP in the chewing gum cannot enhance this protective effect.

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In situ effect of chewing gum containing CPP–ACP on the mineral precipitation of eroded bovine enamel—A surface hardness analysis

Journal of Dentistry ◽

10.1016/j.jdent.2013.06.006 ◽

2013 ◽

Vol 41 (8) ◽

pp. 747-751 ◽

Cited By ~ 15

Author(s):

Letícia Prestes ◽

Beatriz M. Souza ◽

Lívia P. Comar ◽

Priscila A. Salomão ◽

Daniela Rios ◽

...

Keyword(s):

Surface Hardness ◽

Chewing Gum ◽

Mineral Precipitation ◽

Bovine Enamel

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Effect of Fluoride Toothpaste Containing Nano-Sized Sodium Hexametaphosphate on Enamel Remineralization: An in situ Study

Caries Research ◽

10.1159/000491555 ◽

2018 ◽

Vol 53 (3) ◽

pp. 260-267 ◽

Cited By ~ 4

Author(s):

Marcelle Danelon ◽

Luhana G. Garcia ◽

Juliano P. Pessan ◽

Amanda Passarinho ◽

Emerson R. Camargo ◽

...

Keyword(s):

Surface Hardness ◽

Sodium Hexametaphosphate ◽

Treatment Groups ◽

Fluoride Toothpaste ◽

Integrated Recovery ◽

Phase Surface ◽

Double Blinded ◽

Bovine Enamel ◽

Caries Lesions

Objective: To evaluate the remineralizing potential of a conventional toothpaste (1,100 ppm F) supplemented with nano-sized sodium hexametaphosphate (HMPnano) in artificial caries lesions in situ. Design: This double-blinded crossed study was performed in 4 phases of 3 days each. Twelve subjects used palatal appliances containing 4 bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned into the following treatment groups: no F/HMP/HMPnano (Placebo); 1,100 ppm F (1100F); 1100F plus 0.5% micrometric HMP (1100F/HMP) and 1100F plus 0.5% nano-sized HMP (1100F/HMPnano). Volunteers were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), so that blocks were treated with natural slurries of toothpastes. After each phase, surface hardness post-remineralization (SH2), integrated recovery of subsurface hardness (ΔIHR), integrated mineral recovery (ΔIMR) and enamel F concentration were determined. Data were submitted to analysis of variance and Student-Newman-Keuls’ test (p < 0.001). Results: Enamel surface became 42% harder when treated with 1100F/HMPnano in comparison with 1100F (p < 0.001). Treatment with 1100F/HMP and 1100F/HMPnano promoted an increase of ∼23 and ∼87%, respectively, in ΔIHR when compared to 1100F (p < 0.001). In addition, ΔIMR for the 1100F/HMPnano was ∼75 and ∼33% higher when compared to 1100F and 1100F/HMP respectively (p < 0.001). Enamel F uptake was similar among all groups except for the placebo (p < 0.001). Conclusion: The addition of 0.5% HMPnano to a conventional fluoride toothpaste was able to promote an additional remineralizing effect of artificial caries lesions.

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Remineralizing Potential of a Low Fluoride Toothpaste with Sodium Trimetaphosphate: An in situ Study

Caries Research ◽

10.1159/000449358 ◽

2016 ◽

Vol 50 (6) ◽

pp. 571-578 ◽

Cited By ~ 8

Author(s):

Eliana M. Takeshita ◽

Marcelle Danelon ◽

Luciene P. Castro ◽

Robson F. Cunha ◽

Alberto C. B. Delbem

Keyword(s):

Oral Cavity ◽

Repeated Measures ◽

Surface Hardness ◽

Repeated Measures Anova ◽

Treatment Groups ◽

Fluoride Toothpaste ◽

Sodium Trimetaphosphate ◽

In Situ Study ◽

Bovine Enamel

Objective: To evaluate the effect of a low-fluoride (F) toothpaste supplemented with sodium trimetaphosphate (TMP) on enamel remineralization in situ. Design: Bovine enamel blocks were selected on the basis of their surface hardness (SH) after caries-like lesions had been induced, and randomly divided into 4 treatment groups, according to the toothpastes used: without F or TMP (placebo); 500 ppm F; 500 ppm F plus 1% TMP; and 1,100 ppm F. The study design was blinded and crossover and performed in 4 phases of 3 days each. Eleven subjects used palatal appliances containing 4 bovine enamel blocks which were treated 3 times per day during 1 min each time, with natural slurries of saliva and toothpaste formed in the oral cavity during toothbrushing. After each phase, the percentages of surface (%SHR) and subsurface hardness recovery (%ΔKHNR) were calculated. F, calcium (Ca), and phosphorus (Pi) contents in enamel were also determined. Data were analyzed by 1-way, repeated-measures ANOVA, followed by the Student-Newman-Keuls test (p < 0.05). Results: Toothpaste with 500 ppm F + TMP and 1,100 ppm F showed similar %SHR and %ΔKHNR as well as enamel F, Ca, and Pi concentrations. Conclusion: The addition of TMP to a low-fluoride toothpaste promoted a similar remineralizing capacity to that of a standard (1,100 ppm F) toothpaste in situ.

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Effect of Salivary Stimulation on Erosion of Human and Bovine Enamel Subjected or Not to Subsequent Abrasion: An in situ/ex vivo Study

Caries Research ◽

10.1159/000092229 ◽

2006 ◽

Vol 40 (3) ◽

pp. 218-223 ◽

Cited By ~ 81

Author(s):

D. Rios ◽

H.M. Honório ◽

A.C. Magalhães ◽

A.C.B. Delbem ◽

M.A.A.M. Machado ◽

...

Keyword(s):

Ex Vivo ◽

Bovine Enamel ◽

Ex Vivo Study

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Toothpaste with Nanosized Trimetaphosphate Reduces Enamel Demineralization

JDR Clinical & Translational Research ◽

10.1177/2380084416683913 ◽

2016 ◽

Vol 2 (3) ◽

pp. 233-240 ◽

Cited By ~ 5

Author(s):

M.D.B. Souza ◽

J.P. Pessan ◽

C.S. Lodi ◽

J.A.S. Souza ◽

E.R. Camargo ◽

...

Keyword(s):

Protective Effect ◽

Surface Hardness ◽

Extracellular Polysaccharide ◽

Degree Of Saturation ◽

Double Blind ◽

Cross Sectional ◽

Fluoride Toothpaste ◽

Sodium Trimetaphosphate ◽

Enamel Demineralization

This double-blind crossover study assessed the effects of a low-fluoride (low-F) dentifrice containing nanosized sodium trimetaphosphate (TMP) on enamel demineralization in situ. Nineteen subjects wore palatal appliances containing 4 blocks of bovine enamel and were randomly assigned to brush their teeth with placebo (without F/TMP), 250-ppm F (250F), 250F plus 0.05% nanosized TMP (250F-TMPnano), and 1,100-ppm F (1,100F) dentifrices during 7 d, under cariogenic challenge. Enamel surface hardness and cross-sectional hardness (ΔKHN [Knoop hardness number]), as well as F, calcium (Ca), and phosphorus (P) concentrations, were determined. Also, biofilm that formed on the blocks was analyzed for F, Ca, P, and insoluble extracellular polysaccharide concentrations. Data were submitted to analysis-of-variance models and Student-Newman-Keuls test ( P < 0.05). The 250F-TMPnano dentifrice promoted the lowest ΔKHN among all groups ( P < 0.001), while the percentage of surface hardness loss was similar to 1,100F. Also, similar F, Ca, and P concentrations in enamel were observed for 1,100F and 250F-TMPnano. In the biofilm, the highest F content was observed for 1,100F; Ca content was similar between 1,100F and 250F-TMPnano; and P content was similar among all groups. Similar extracellular polysaccharide values were observed for 250F-TMPnano and 1,100F ( P < 0.001), ionic activity of CaHPO40, CaF+, and HF0 ( P < 0.05) and degree of saturation of hydroxyapatite and CaF2 ( P < 0.05). It was concluded that the protective effect of 250F-TMPnano dentifrice was similar to a conventional dentifrice for most of the variables studied, having a more pronounced effect on the subsurface lesion when compared with the conventional toothpaste (1,100F). Knowledge Transfer Statement: Although toothpastes containing ≥1,000-ppm fluoride are more effective than low-fluoride formulations against dental caries, their early use can lead to side effects. This has prompted intensive research on alternatives to increase the anticaries effect of low-fluoride toothpastes. The present in situ study demonstrated that the addition of sodium trimetaphosphate nanoparticles to toothpastes containing 250-ppm fluoride significantly enhances the protective effect of this formulation against enamel demineralization to levels comparable to a 1,100-ppm fluoride toothpaste in terms of most of the variables studied. Most important, this formulation promoted the lowest loss of subsurface hardness among all groups, suggesting that caries lesions would take longer to develop under clinical conditions when compared with a conventional (1,100-fluoride) toothpaste.

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Effect of Tannic Acid on the Protective Properties of the in situ Formed Pellicle

Caries Research ◽

10.1159/000451036 ◽

2016 ◽

Vol 51 (1) ◽

pp. 34-45 ◽

Cited By ~ 13

Author(s):

Susann Hertel ◽

Sandra Pötschke ◽

Sabine Basche ◽

Judith Delius ◽

Wiebke Hoth-Hannig ◽

...

Keyword(s):

Tannic Acid ◽

Ex Vivo ◽

Oral Exposure ◽

Dependent Manner ◽

Pellicle Formation ◽

Protective Properties ◽

Transmission Electron ◽

Bovine Enamel ◽

The Impact

Objectives: In the present in situ/ex vivo study the impact of tannic acid on the erosion-protective properties of the enamel pellicle was tested. Additionally, the antiadherent and antibacterial effects of tannic acid were evaluated. Methods: The pellicle was formed in situ on bovine enamel samples fixed on individual splints worn by 6 subjects. Following 1 min of pellicle formation the volunteers rinsed for 10 min with tannic acid. After further oral exposure for 19 min, 109 min, and 8 h overnight, respectively, slabs were incubated in HCl ex vivo (pH 2.0, 2.3, 3.0) over 120 s. Subsequently, kinetics of calcium and phosphate release were measured photometrically. Samples after a 1-min fluoride mouth rinse as well as enamel samples with and without a 30-min in situ pellicle served as controls. Antiadherent effects were evaluated after a 1-min rinse with tannic acid and oral exposure of the slabs overnight. DAPI (4′,6-diamidino-2-phenylindole) combined with concanavalin A staining and live/dead staining was used for fluorescence microscopic visualization and quantification of adherent bacteria and glucans. Modification of the pellicle's ultrastructure by tannic acid was evaluated by transmission electron microscopy (TEM). Results: Tannic acid significantly improved the erosion-protective properties of the pellicle in a pH-dependent manner. Bacterial adherence and glucan formation on enamel were significantly reduced after rinses with tannic acid as investigated by fluorescence microscopy. TEM imaging indicated that rinsing with tannic acid yielded a sustainable modification of the pellicle; it was distinctly more electron dense. Conclusion: Tannic acid offers an effective and sustainable approach for the prevention of caries and erosion.

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Influence of Erosive and Abrasive Cycling on Bonding of Different Adhesive Systems to Enamel: An In situ Study

Brazilian Dental Journal ◽

10.1590/0103-6440201600940 ◽

2016 ◽

Vol 27 (5) ◽

pp. 548-555 ◽

Cited By ~ 2

Author(s):

Marina Ciccone Giacomini ◽

◽

Leslie Caroll Casas-Apayco ◽

Camila Moreira Machado ◽

Maria Cristina Carvalho de Almendra Freitas ◽

...

Keyword(s):

Bond Strength ◽

Orange Juice ◽

Failure Modes ◽

Ex Vivo ◽

Adhesive Systems ◽

Digital Microscope ◽

Bonding Systems ◽

Bovine Enamel ◽

The Impact

Abstract This study evaluated the impact of orange juice on the bond strength (BS) of dentin bonding systems (DBSs) to enamel surface after simulation with an in situ/ ex vivo erosive cycling. One hundred and ninety two bovine enamel fragments (4x4x2mm) were obtained and randomized regarding superficial microhardness and distributed to palatal devices for 8 volunteers, in three phases (one for each DBS), containing 8 blocks, which were, allocated in 4 pairs. Daily, these pairs were subjected extraorally to the following conditions: CONT- neither erosive nor abrasive challenge; ERO- erosive challenge only; ABR- abrasive challenge only and ERO + ABR- with erosive and abrasive challenges. Erosive cycles (immersion in orange juice, 3 times/day/5 min/5 days) or/and abrasive challenges (electric toothbrush, 3 times/day/1 min/5 days) were performed. After these cycles, all specimens were restored with the adhesive systems Adper Scotchbond Multi Purpose (MP), Adper Single Bond 2 (SB) or Clearfil SE Bond (SE), and the composite resin Filtek Z250. After 7 days, sticks (area ≅1 mm2) were obtained and subjected to the microtensile bond strength test (μTBS) at 0.5 mm/min. Data was statistically analyzed by ANOVA and Tukey tests (a=0.05). Failure modes were determined using a digital microscope (40´). DBS was the only statistical significant factor. SE was the unique DBS not affected in any challenge, whereas MP and SB performed according to the scenario. The adhesive and mixed failures were predominant in all groups. Overall performance suggested that BS to enamel after erosive /abrasive challenged by orange juice was not affected and it was material-dependent.

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Effect of Addition of Citric Acid and Casein Phosphopeptide-Amorphous Calcium Phosphate to a Sugar-Free Chewing Gum on Enamel Remineralization in situ

Caries Research ◽

10.1159/000104796 ◽

2007 ◽

Vol 41 (5) ◽

pp. 377-383 ◽

Cited By ~ 50

Author(s):

F. Cai ◽

D.J. Manton ◽

P. Shen ◽

G.D. Walker ◽

K.J. Cross ◽

...

Keyword(s):

Citric Acid ◽

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Chewing Gum ◽

Casein Phosphopeptide

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Retention in Plaque and Remineralization of Enamel Lesions by Various Forms of Calcium in a Mouthrinse or Sugar-free Chewing Gum

Journal of Dental Research ◽

10.1177/154405910308200311 ◽

2003 ◽

Vol 82 (3) ◽

pp. 206-211 ◽

Cited By ~ 229

Author(s):

E.C. Reynolds ◽

F. Cai ◽

P. Shen ◽

G.D. Walker

Keyword(s):

Inorganic Phosphate ◽

Chewing Gum ◽

Bacterial Cells ◽

Double Blind ◽

Gum Chewing ◽

Intercellular Matrix ◽

Supragingival Plaque ◽

Casein Phosphopeptide ◽

Blind Trials

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) nanocomplexes incorporated into sugar-free chewing gum have been shown to remineralize enamel subsurface lesions in situ. The aim of this study was to compare the ability of CPP-ACP, with that of other forms of calcium, to be retained in supragingival plaque and remineralize enamel subsurface lesions in situ when delivered in a mouthrinse or sugar-free gum in randomized, double-blind trials. In the mouthrinse study, only the CPP-ACP-containing mouthrinse significantly increased plaque calcium and inorganic phosphate levels, and the CPP were immunolocalized to the surfaces of bacterial cells as well as the intercellular matrix. In the chewing gum studies, the gum containing the CPP-ACP, although not containing the most calcium per piece of gum, produced the highest level of enamel remineralization independent of gum-chewing frequency and duration. The CPP could be detected in plaque extracts 3 hrs after subjects chewed the CPP-ACP-containing gum. The results showed that CPP-ACP were superior to other forms of calcium in remineralizing enamel subsurface lesions.

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