scholarly journals Effects of Fluoride and Calcium Phosphate-Based Varnishes on pH, Lactic Acid and Trace Elements in Saliva: A Randomized Clinical Trial.

2020 ◽  
Author(s):  
Andrea Poza Pascual ◽  
Clara Serna Muñoz ◽  
Amparo Perez Silva ◽  
Yolanda Martínez-Beneyto ◽  
Antonio Jose Ortiz Ruiz

Abstract Background: When dental plaque is not regularly removed, bacteria break down sugars in the diet forming acids as by-products. Lactic acid is the main acid involved in caries. As acids accumulate minerals are lost from the surface layer of the tooth. The imbalance in demineralization/remineralization favours the loss of calcium and phosphate from the teeth. Saliva contains the most important microelements for the remineralization and maturation of dental tissue and plays a crucial role in maintaining the oral environment. Fluoride is the agent par excellence in preventing and detaining cavities. However, remineralization may be hampered by limited levels of calcium and phosphate, and new products have been developed to ensure a constant supply. Two of the most used products are amorphous calcium phosphate stabilized with casein phosphopeptide (CPP-ACP) and tricalcium phosphate modified by fumaric acid (fTCP).Methods: We conducted a controlled, randomized clinical trial of the effect on the saliva of the application of two varnishes − MI Varnish (CPP-ACP with sodium fluoride 5%) and Clinpro White Varnish (fTCP with sodium fluoride 5%) – applied every three months in children with a high risk of caries, for 12 months. We included 58 children aged 4-12 years, assigned to control (placebo), Clinpro and MI groups. Baseline and three-monthly saliva samples were taken. We assessed changes in pH, lactic acid concentrations and trace elements in saliva.Results: At 12 months, all groups showed a nonsignificant increase in pH levels and a reduction in lactic acid, which was greatest in the placebo group. There was a significant reduction in 24Mg, 31P and 66Zn levels in the placebo group (p≤0.05), but not in the other elements studied: 23Na, 27Al, 39K, 44Ca, 52Cr, 55Mn, 57Fe, 59Co, 63Cu, 75As, 111Cd, 137Ba, 208Pb and 19F.Conclusions: Neither pH, lactic acid concentrations or most salivary trace elements were useful in defining patients at high risk of caries or in monitoring the effect of MI Varnish and Clinpro White Varnish after three-monthly application for 12 months.Trial registration: ISRCTN13681286. Registered 26 May 2020 - Retrospectively registered, http://www.isrctn.com/ISRCTN13681286

2020 ◽  
Author(s):  
Andrea Poza Pascual ◽  
Clara Serna Muñoz ◽  
Amparo Perez Silva ◽  
Yolanda Martínez-Beneyto ◽  
Antonio Jose Ortiz Ruiz

Abstract Background: When dental plaque is not regularly removed, bacteria break down sugars in the diet forming acids as by-products. Lactic acid is the main acid involved in caries. As acids accumulate minerals are lost from the surface layer of the tooth. The imbalance in demineralization/remineralization favors the loss of calcium and phosphate from the teeth. Saliva contains the most important microelements for the remineralization and maturation of dental tissue and plays a crucial role in maintaining the oral environment. Fluoride is the agent par excellence in preventing and detaining cavities. However, remineralization may be hampered by limited levels of calcium and phosphate, and new products have been developed to ensure a constant supply. The aim of this study was to investigate the effect of the application of two varnishes − MI Varnish (5% sodium fluoride with CPP-ACP) and Clinpro White Varnish (5% sodium fluoride with fTCP) – applied every three months in children with high caries risk for 12 months on salivary pH, lactic acid concentrations and trace elements.Methods: We conducted a controlled, randomized clinical trial where MI Varnish and Clinpro White Varnish were applied quarterly in children with a high risk of caries, for 12 months. We included 58 children aged 4-12 years, assigned to control (placebo), Clinpro and MI groups. Baseline and three-monthly saliva samples were taken. We assessed changes in pH, lactic acid concentrations and trace elements in saliva. Results: At 12 months, all groups showed a nonsignificant increase in pH levels and a reduction in lactic acid, which was greatest in the placebo group. There was a significant reduction in 24Mg (p= <0.001), 31P (p = 0.033) and 66Zn (p= 0.005) levels in the placebo group (p≤0.05), but not in the other elements studied: 23Na, 27Al, 39K, 44Ca, 52Cr, 55Mn, 57Fe, 59Co, 63Cu, 75As, 111Cd, 137Ba, 208Pb and 19F. Conclusions: Neither pH, lactic acid concentrations or most salivary trace elements were useful in defining patients at high risk of caries or in monitoring the effect of MI Varnish and Clinpro White Varnish after three-monthly application for 12 months. Trial registration: ISRCTN registry, ISRCTN13681286. Registered 26 May 2020.


Author(s):  
Andrea Poza-Pascual ◽  
Clara Serna-Muñoz ◽  
Amparo Pérez-Silva ◽  
Yolanda Martínez-Beneyto ◽  
Inmaculada Cabello ◽  
...  

Background: The aim of this study was to investigate the effect of the application of two varnishes—MI Varnish (5% sodium fluoride with CPP-ACP) and Clinpro White Varnish (5% sodium fluoride with fTCP)—applied every three months in children with high caries risk for 12 months on plaque indexes, salivary pH, salivary lactic acid and chemical elements concentrations. Methods: We included 58 children aged 4–12 years, assigned to control (placebo), Clinpro and MI groups. Baseline and three-month saliva samples were taken. We assessed changes in pH, lactic acid concentrations and chemical elements in saliva. Results: At 12 months, all groups showed a nonsignificant increase in pH levels and a reduction in lactic acid, which was greatest in the placebo group. There was a significant reduction in 24Mg (p = <0.001), 31P (p = 0.033) and 66Zn (p = 0.005) levels in the placebo group (p ≤ 0.05), but not in the other elements studied: 23Na, 27Al, 39K, 44Ca, 52Cr, 55Mn, 57Fe, 59Co, 63Cu, 75As, 111Cd, 137Ba, 208Pb and 19F. Conclusions: Neither pH, lactic acid concentrations or most salivary chemical elements were useful in defining patients at high risk of caries or in monitoring the effect of MI Varnish and Clinpro White Varnish after three-month application for 12 months. However, the appearance of new cavities was stopped, and the hygiene index improved, probably due to hygienic and dietary measures and the use of fluoridated toothpaste. Trial registration: ISRCTN registry, ISRCTN13681286.


Author(s):  
Maryam Mehrabkhani ◽  
Iman Parisay ◽  
Niayesh Mastoory ◽  
Vajihe Barati Doghai

Objectives: This study aimed to assess the effect of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and xylitol chewing gums, and probiotic yogurt, as chemical plaque control strategies, on periodontal parameters. Materials and Methods: This randomized clinical trial evaluated 120 eligible dental students that were randomly divided into four groups (n=30) for use of (I) CPP-ACP chewing gum, (II) xylitol chewing gum, (III) probiotic yogurt, and (IV) chlorhexidine (CHX) mouthwash. The oral hygiene index-simplified (OHI-S), Silness and Loe gingival index (GI), and Silness and Loe modified plaque index (PI) were measured before and on days 15 and 30 after using the products. Paired t-test or its non-parametric equivalent was used to analyze the parameters after the intervention compared with baseline. The study groups were compared using one-way ANOVA or its non-parametric equivalent. Results: The OHI-S did not change over time, and most participants had a good OHI-S. The CHX group had the most favorable, and the probiotic yogurt group had the least favorable GI. Pairwise comparisons of the groups did not reveal a significant difference in GI between the CPP-ACP gum and CHX groups (P>0.05). CHX caused the greatest improvement in PI, with significant differences with other groups. Conclusion: CHX was the most effective for improvement of periodontal parameters followed by CPP-ACP, which showed better results compared with other groups.


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