Enamel Demineralization in situ with Various Frequencies of Carbohydrate Consumption with and without Fluoride Toothpaste

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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In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm

Journal of Dentistry ◽

10.1016/j.jdent.2021.103724 ◽

2021 ◽

pp. 103724

Author(s):

Rômulo Andrade Marcato ◽

Cássia Cilene Dezan Garbelini ◽

Marcelle Danelon ◽

Juliano Pelim Pessan ◽

Nayara Gonçalves Emerenciano ◽

...

Keyword(s):

Fluoride Toothpaste ◽

Dental Biofilm ◽

Enamel Demineralization

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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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Effect of Dentifrice Containing Fluoride and/or Baking Soda on Enamel Demineralization/ Remineralization: An in situ Study

Caries Research ◽

10.1159/000047440 ◽

2001 ◽

Vol 35 (2) ◽

pp. 106-110 ◽

Cited By ~ 13

Author(s):

J.A. Cury ◽

L.N. Hashizume ◽

A.A. Del Bel Cury ◽

C.P.M. Tabchoury

Keyword(s):

In Situ Study ◽

Enamel Demineralization

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Effect of APF gel application time on enamel demineralization and fluoride uptake in situ

Brazilian Dental Journal ◽

10.1590/s0103-64402009000100006 ◽

2009 ◽

Vol 20 (1) ◽

pp. 37-41 ◽

Cited By ~ 8

Author(s):

Rita Sarmiento Villena ◽

Livia Maria Andaló Tenuta ◽

Jaime Aparecido Cury

Keyword(s):

Dental Plaque ◽

Sucrose Solution ◽

Blind Study ◽

Application Time ◽

Treatment Groups ◽

Fluoride Uptake ◽

Time Of Application ◽

Enamel Demineralization

This in situ crossover and blind study was conducted to investigate the effect of professional acidulated phosphate fluoride (APF) gel application time on the subsequent inhibition of enamel demineralization. During 3 phases of 28 days each, 15 volunteers wore palatal appliances containing 4 enamel blocks, which were subjected to 3 treatment groups: not treated (control) and pre-treated with APF gel for 1 or 4 min. Dental plaque was allowed to accumulate on the blocks and the appliances were immersed in 10% sucrose solution 3 times a day simulating a cariogenic challenge. After each phase, the blocks were removed to evaluate enamel demineralization and concentration of fluoride (F) remaining after the cariogenic challenge. F formed on enamel was determined in additional enamel blocks subjected only to APF gel application. APF gel was efficient in reducing enamel demineralization (p<0.05), irrespective of the application time (p>0.05). Also, the concentration of the F formed and retained on enamel was significantly higher after APF gel application (p<0.05), but the effect of time of application was not statistically significant (p>0.05). The results suggest that APF application for either 1 or 4 min is equally efficient to increase F concentration in enamel and reduce enamel demineralization.

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Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children

BDJ Open ◽

10.1038/s41405-019-0026-8 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 12

Author(s):

Bennett T. Amaechi ◽

Parveez Ahamed AbdulAzees ◽

Dina Ossama Alshareif ◽

Marina Adel Shehata ◽

Patrícia Paula de Carvalho Sampaio Lima ◽

...

Keyword(s):

Pairwise Comparison ◽

Oral Appliance ◽

Comparable Efficacy ◽

Double Blind ◽

Fluoride Toothpaste ◽

Initial Caries ◽

Significant Difference ◽

Post Test ◽

Amine Fluoride

Abstract Objective This in situ study compared the effectiveness of two toothpastes containing hydroxyapatite or 500 ppm fluoride in promoting remineralization and inhibiting caries development. Materials and methods Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, were exposed to toothpaste containing either 10% hydroxyapatite or 500 ppm F− (amine fluoride) via intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs. post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups. Results Pairwise comparison (baseline vs. test) indicated significant (p < 0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. No demineralization could be observed in sound enamel blocks exposed to either toothpaste. While F− induced lesion surface lamination, HAP produced a more homogenous lesion remineralization. Conclusions 10% hydroxyapatite achieved comparable efficacy with 500 ppm F− in remineralizing initial caries and preventing demineralization. Thus the HAP toothpaste is confirmed to be equal to the fluoride toothpaste in this study.

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