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

2018 ◽  
Vol 53 (3) ◽  
pp. 260-267 ◽  
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.

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

2016 ◽  
Vol 50 (6) ◽  
pp. 571-578 ◽  
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.

Re- and Demineralization Characteristics of Enamel Depending on Baseline Mineral Loss and Lesion Depth in situ

2016 ◽  
Vol 50 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Richard J. Wierichs ◽  
Julian Lausch ◽  
Hendrik Meyer-Lueckel ◽  
Marcella Esteves-Oliveira
Keyword(s):  
Negative Control ◽  
Pronounced Change ◽  
Protocol Violation ◽  
Lesion Depth ◽  
Treatment Groups ◽  
Before And After ◽  
Double Blinded ◽  
Bovine Enamel ◽  
Mineral Loss

Objectives: The aim of this double-blinded, randomized, cross-over in situ study was to evaluate the re- and demineralization characteristics of sound enamel as well as lowly and highly demineralized caries-like enamel lesions after the application of different fluoride compounds. Methods: In each of three experimental legs of 4 weeks, 21 participants wore intraoral mandibular appliances containing 4 bovine enamel specimens (2 lowly and 2 highly demineralized). Each specimen included one sound enamel and either one lowly demineralized (7 days, pH 4.95) or one highly demineralized (21 days, pH 4.95) lesion, and was positioned 1 mm below the acrylic under a plastic mesh. The three randomly allocated treatments (application only) included the following dentifrices: (1) 1,100 ppm F as NaF, (2) 1,100 ppm F as SnF2 and (3) 0 ppm F (fluoride-free) as negative control. Differences in integrated mineral loss (ΔΔZ) and lesion depth (ΔLD) were calculated between values before and after the in situ period using transversal microradiography. Results: Of the 21 participants, 6 did not complete the study and 2 were excluded due to protocol violation. Irrespectively of the treatment, higher baseline mineral loss and lesion depth led to a less pronounced change in mineral loss and lesion depth. Except for ΔΔZ of the dentifrice with 0 ppm F, sound surfaces showed significantly higher ΔΔZ and ΔLD values compared with lowly and highly demineralized lesions (p < 0.05, t test). Conclusion: Re- and demineralization characteristics of enamel depended directly on baseline mineral loss and lesion depth. Treatment groups should therefore be well balanced with respect to baseline mineral loss and lesion depth.

Toothpaste with Nanosized Trimetaphosphate Reduces Enamel Demineralization

2016 ◽  
Vol 2 (3) ◽  
pp. 233-240 ◽  
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.

In situ Effect of Frequent Sucrose Exposure on Enamel Demineralization and on Plaque Composition after APF Application and F Dentifrice Use

2004 ◽  
Vol 83 (1) ◽  
pp. 71-75 ◽  
Author(s):  
A.F. Paes Leme ◽  
R. Dalcico ◽  
C.P.M. Tabchoury ◽  
A.A. Del Bel Cury ◽  
P.L. Rosalen ◽  
...  
Keyword(s):  
Sucrose Solution ◽  
Experimental Period ◽  
Mutans Streptococci ◽  
Plaque Composition ◽  
Treatment Groups ◽  
Enamel Demineralization ◽  
Combination Of Methods ◽  
Bovine Enamel ◽  
Mineral Loss

Since the effect of the combination of methods of fluoride use on enamel demineralization and on plaque composition is not clearly established, this study examined the effect of the combination of acidulated phosphate fluoride (APF) application and F dentifrice on enamel demineralization and on plaque composition. In this crossover study, 16 volunteers, wearing a palatal appliance containing bovine enamel blocks, were subjected to 4 treatment groups: non-fluoridated dentifrice (PD), FD, APF+PD, and APF+FD. The APF was applied to the enamel before the 14-day experimental period. During the experimental period, test dentifrices were applied 3×/day, and a 20% sucrose solution was applied 4× and 8×/day by being dripped on the blocks. Although APF application was able either to increase F concentration in plaque or to reduce the % of mutans streptococci, its combination with F dentifrice use neither reduced enamel mineral loss nor changed any other measured plaque variable with respect to the FD group alone.

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

2016 ◽  
Vol 50 (3) ◽  
pp. 325-330 ◽  
Author(s):  
M.C. Jordão ◽  
C.R.B. Alencar ◽  
I.M. Mesquita ◽  
M.A.R. Buzalaf ◽  
A.C. Magalhães ◽  
...  
Keyword(s):  
Protective Effect ◽  
Ex Vivo ◽  
Surface Hardness ◽  
Chewing Gum ◽  
Single Event ◽  
Control Phase ◽  
Casein Phosphopeptide ◽  
And Control ◽  
Bovine Enamel

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.

In situ Effect of Arginine-Containing Dentifrice on Plaque Composition and on Enamel Demineralization under Distinct Cariogenic Conditions

2018 ◽  
Vol 52 (6) ◽  
pp. 588-597 ◽  
Author(s):  
Angel Y. Sanchez ◽  
Caroline L. de Oliveira ◽  
Thais C. Negrini ◽  
Lina N. Hashizume ◽  
Anderson T. Hara ◽  
...  
Keyword(s):  
Sucrose Solution ◽  
Surface Hardness ◽  
Extracellular Polysaccharide ◽  
Experimental Phase ◽  
Enamel Demineralization ◽  
Bovine Enamel ◽  
Adult Volunteers ◽  
Mineral Loss ◽  
In Situ Split

There is limited evidence that arginine-containing fluoridated dentifrices (AFD) have a better anticaries effect than regular fluoridated dentifrices (FD), especially in subjects at a higher risk for caries development. This study aimed to assess the effect of AFD on enamel demineralization and on the microbial and biochemical compositions of biofilm formed under different frequencies of sucrose exposure. It consisted of an in situ split-mouth design, where 12 adult volunteers who used FD for at least 2 months prior to the beginning of this study wore acrylic palatal appliances containing 4 bovine enamel specimens (1 pair at each side of the appliance) during 2 phases of 14 days each. FD slurry (3×/day) and 20% sucrose solution (4× and 8×/day) were dripped on the specimens during the first experimental phase. The same volunteers then used AFD during a 2-month washout period, followed by a second experimental phase where the AFD slurry and sucrose solution were applied onto a new subset of specimens. The percentage of enamel surface hardness loss (%SHL), the lesion depth (LD), the integrated mineral loss (IML), microbial counts on biofilms, the biomass, and inorganic and insoluble extracellular polysaccharide (IEPS) biofilm concentrations were determined. Higher %SHL, biomass, and IEPS and lower fluoride values were found at sucrose 8×/day exposure. Lower IEPS were found in the presence of AFD compared to FD. Similar %SHL, LD, and IML values were found between FD and AFD, irrespectively of the cariogenic challenge. The results suggest that AFD have an anticaries effect similar to that of regular FD.

scholarly journals Erosion Remineralization Efficacy of Gel-to-Foam Fluoride Toothpastes in situ: A Randomized Clinical Trial

2016 ◽  
Vol 50 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Marc Nehme ◽  
Peter Jeffery ◽  
Stephen Mason ◽  
Frank Lippert ◽  
Domenick T. Zero ◽  
...  
Keyword(s):  
Erosion Resistance ◽  
Short Term ◽  
Fluoride Treatment ◽  
Treatment Groups ◽  
Significant Difference ◽  
Sensitive Tool ◽  
Assessment Time ◽  
Bovine Enamel ◽  
Single Dosing

This single-center, randomized, placebo-controlled, four-treatment, four-period crossover study compared the enamel remineralization effects of low- and medium-abrasivity gel-to-foam toothpastes and a reference toothpaste (all 1,450 ppm fluoride as NaF) versus placebo toothpaste (0 ppm fluoride) using a short-term in situ erosion model. Subjects (n = 56) wearing a palatal appliance holding acid-softened bovine enamel specimens brushed their teeth with the test toothpastes. Thereafter, the specimens were removed for analysis of percent surface microhardness recovery (%SMHR) and percent relative erosion resistance (%RER) at 2, 4, and 8 h. Both low- and medium-abrasivity gel-to-foam fluoride toothpastes and the reference toothpaste provided significantly greater %SMHR than placebo at all assessment time points (all p < 0.05). No statistically significant difference of %SMHR was observed between the fluoride treatment groups at any time point. Similarly, all fluoride products provided significantly superior %RER versus placebo (all p < 0.0001), whereas no significant difference of this parameter was noted between the fluoride treatment groups. Increasing numerical improvements of %SMHR and %RER were observed in all four treatment groups over time (2, 4, and 8 h). The present in situ model is a sensitive tool to investigate intrinsic and fluoride-enhanced rehardening of eroded enamel. All three fluoride toothpastes were more efficacious than placebo, and there were no safety concerns following single dosing in this short-term in situ model.

scholarly journals Effect of Cpp-aCp and Cpp-aCpf pastes on the Surface Hardness of Initial Dental Erosion Lesions: an In Situ Study

2018 ◽  
Vol 11 (4) ◽  
pp. 1781-1787
Author(s):  
Cibele da Cruz prates ◽  
Liege Helena freitas fernandes ◽  
João Baptista da Costa agra de Melo ◽  
Catarina Ribeiro Barros de alencar ◽  
alessandro Leite Cavalcanti
Keyword(s):  
Surface Hardness ◽  
Dental Erosion ◽  
Significance Level ◽  
Treatment Groups ◽  
Oral Application ◽  
Intraoral Device ◽  
Hardness Values ◽  
One Way Anova

To analyze the effect of intra-oral application of CPP-ACP and CPP-ACPF pastes on the surface hardness of initial dental erosion lesions.Bovine enamel specimens were randomly assigned into 6 volunteers in 3 treatment groups: GI: CPP-ACP paste, GII: CPP-ACPF paste and GIII (Control): Placebo paste without CPP-ACP and without fluoride. Enamel specimens were selected by surface hardness (SHi), in vitro eroded by immersion in hydrochloric acid for 30 seconds (SHdes) and randomized between treatment groups and volunteers, who used the palatal intraoral device for 2 hours, applied the treatment on the specimens and used the palatal intraoral device for an additional 3 hours in 3 crossed phases, interspersed with a 7-day washout period. Subsequently, the surface hardness (SHre) was measured to estimate the re-hardening potential of the softened enamel promoted by treatments. Data were analyzed using the t-test and one-way ANOVA, adopting 5% significance level. Mean final and post-erosion hardness values were statistically significant for pastes tested (p<0.05), which presented re-hardening effect of the softened enamel, but with no difference between them and placebo (p>0.05). CPP-ACP and CPP-ACPF pastes did not demonstrate higher efficacy in re-hardening the eroded enamel compared to placebo paste.

A Randomized in situ Clinical Study of Fluoride Dentifrices on Enamel Remineralization and Resistance to Demineralization: Effects of Zinc

2018 ◽  
Vol 52 (1-2) ◽  
pp. 129-138 ◽  
Author(s):  
Jonathan E. Creeth ◽  
Ritu Karwal ◽  
Anderson T. Hara ◽  
Domenick T. Zero
Keyword(s):  
Dose Response ◽  
Acid Resistance ◽  
Acid Exposure ◽  
Zinc Ions ◽  
Significant Relationships ◽  
Bovine Enamel ◽  
Early Caries ◽  
Caries Lesions

This study aimed to determine the effect of zinc ions and F concentration in a dentifrice on remineralization of early caries lesions in situ and on resistance to subsequent demineralization. This was a single-center, 6-period, 6-product, blinded (examiner, subject, analyst), randomized (n = 62), crossover study. Products (all NaF) were: 0, 250, 1,150 and 1,426 ppm F (dose-response controls), “Zn-A” (0.3% ZnCl2, 1,426 ppm F), and “Zn-B” (as Zn-A, with high-foaming surfactants) in a conventional silica base. Subjects wore palatal appliances holding partially demineralized bovine enamel specimens. They brushed their teeth with 1.5 g test dentifrice (25 s), then swished the slurry ensuring even exposure of specimens (95 s), expectorated, and rinsed (15 mL water, 10 s). After 4 h intraoral remineralization, specimens were removed and acid-challenged in vitro. Surface microhardness (SMH), measured pre-experimental, post-initial acid exposure, post-remineralization, and post-second acid exposure, was used to calculate recovery (SMHR), net acid resistance (NAR), and a new, specifically demineralization-focused calculation, “comparative acid resistance” (CAR). Enamel fluoride uptake (EFU) was also measured. For the F dose-response controls, all measures showed significant relationships with dentifrice F concentration (p < 0.0001). The presence of zinc counteracted the ability of F to promote remineralization in this model. Compared to the 1,426 ppm F control, the zinc formulations gave reduced SMHR, EFU, and NAR (all p < 0.0001); however, they showed evidence of increased CAR (Zn-A: p = 0.0040; Zn-B: p = 0.0846). Products were generally well tolerated. In this study, increasing dentifrice F concentration progressively increased in situ remineralization and demineralization resistance of early caries enamel lesions. Zinc ions reduced remineralization but could increase demineralization resistance.

scholarly journals In Vitro Enamel Remineralization by Low-Fluoride Toothpaste with Calcium Citrate and Sodium Trimetaphosphate

2013 ◽  
Vol 24 (3) ◽  
pp. 253-257 ◽  
Author(s):  
Edo Hirata ◽  
Marcelle Danelon ◽  
Isabelle Rodrigues Freire ◽  
Alberto Carlos Botazzo Delbem
Keyword(s):  
Artificial Saliva ◽  
Fluoride Concentration ◽  
Surface Hardness ◽  
Positive Control ◽  
Calcium Citrate ◽  
Fluoride Toothpaste ◽  
Sodium Trimetaphosphate ◽  
Ph Cycling ◽  
Bovine Enamel

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 µgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 µgF/g and commercial dentifrice (positive control, 1,100 µgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%∆Z). Fluoride in enamel was also determined. The data from %SH, %∆Z and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %∆Z) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 µgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.

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