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Johannes N, Hertel S, Stoffel V, Hannig C, Basche S, Schmitt V, Flemming J, Hannig M. Impact of pH-adjusted fluoride and stannous solutions on the protective properties on the pellicle layer in vitro and in situ. Sci Rep 2024; 14:3378. [PMID: 38336814 PMCID: PMC10858267 DOI: 10.1038/s41598-024-53732-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/04/2024] [Indexed: 02/12/2024] Open
Abstract
This study evaluates the ideal pH for anti-erosion and anti-adherent efficacy of fluoride and stannous solutions (sodium fluoride (SF), amine fluoride (AF), sodium monofluorophosphate (SMFP), stannous fluoride (SnF2) with 500 ppm fluoride concentration each and stannous chloride (SnCl2, 1563 ppm stannous)). In vitro, solutions were tested at pH 4.5 and 5.5. The main in situ experiments were carried out at the pH of 4.5: For pellicle formation 6 volunteers wore bovine enamel slabs intraorally for 1 min, rinsed with 8 ml solution for 1 min and continued for up to 30 min/8 h. Physiological pellicle samples served as controls. After incubation in HCl (2.0, 2.3) for 2 min mineral release was determined photometrically. Bacterial counts on 8 h biofilms were determined by fluorescence microscopy (BacLight™ and DAPI with Concanavalin A). Modification of the pellicle ultrastructure was examined by TEM. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney-U tests with Bonferroni-correction (p < 0.05). SnF2 showed a significant erosion protection. AF, SnF2, and SnCl2 were most anti-adherent. SnF2 and SnCl2 caused a pronounced basal pellicle with stannous precipitates. Compared to other fluoride monosubstances, stannous ions offer greater protection against erosive acidic attacks. Stannous ions act as crucial co-factor in this process.
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Affiliation(s)
- N Johannes
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - S Hertel
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - V Stoffel
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - S Basche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - V Schmitt
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Saar, Germany
| | - J Flemming
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Saar, Germany
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Silva CAM, de Sousa FB, Martinez-Mier EA, Vieira BR, do Nascimento JM, Hara AT. Fluorotic Enamel Susceptibility to Dental Erosion and Fluoride Treatment. Braz Dent J 2023; 34:75-81. [PMID: 38133094 PMCID: PMC10742357 DOI: 10.1590/0103-6440202305595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
The purpose of this in vitro study was to test the hypothesis that fluoride treatment can prevent dental erosion on fluorotic enamel of different severities. It followed a 3×2 factorial design, considering a) fluorosis severity: sound (TF0, Thylstrup-Fejerskov Index), mild (TF1-2), moderate (TF3-4); and b) fluoride treatment: 0 (negative control) and 1150ppmF. Human molars with the three fluorosis severities (n=16, each) were selected and randomly assigned to the two fluoride treatments (n=8). Enamel blocks (4×4mm) were prepared from each tooth and subjected to a dental erosion cycling model, for 10 days. The daily cycling protocol consisted of erosive challenges (1% citric acid, pH 2.4), interspersed by periods of immersion in artificial saliva, and three 2-minute treatments with either 0 or 1150ppm F. The enamel volume loss (mm3) was calculated by subtracting values obtained by microtomography before and after cycling. Two-Way ANOVA showed no significant interaction between fluorosis severity and fluoride treatment (p=0.691), and no significant effect for either fluorosis severity (TF0 mean±standard-deviation: 13.5(10-2±0.42(10-2, TF1-2: 1.50(10-2±0.52(10-2, TF3-4: 1.24(10-2±0.52(10-2, p=0.416) or treatment (0ppmF: 1.49(10-2±0.53(10-2; 1150ppmF: 1.21(10-2±0.42(10-2; p=0.093), when evaluated independently. Considering the limitations of this in vitro study, the presence and severity of fluorosis in enamel do not appear to affect its susceptibility to dental erosion. Fluoride treatment was not effective in preventing the development of dental erosion in both sound and fluorotic enamel substrates under our experimental conditions.
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Affiliation(s)
| | - Frederico Barbosa de Sousa
- Department of Morphology, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Paraíba, Brazil
| | - Esperanza Angeles Martinez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | | | | | - Anderson Takeo Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
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Niemeyer SH, Jovanovic N, Sezer S, Wittwer LS, Baumann T, Saads Carvalho T. Dual protective effect of the association of plant extracts and fluoride against dentine erosion: In the presence and absence of salivary pellicle. PLoS One 2023; 18:e0285931. [PMID: 37200261 DOI: 10.1371/journal.pone.0285931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/05/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To verify the protective effect of plant extracts associated with fluoride against dental erosion of dentine, in the presence and absence of a salivary pellicle. METHODS Dentine specimens (n = 270) were randomly distributed into 9 experimental groups (n = 30/group): GT (green tea extract); BE (blueberry extract); GSE (grape seed extract); NaF (sodium fluoride); GT+NaF (green tea extract and NaF); BE+NaF (blueberry extract and NaF); GSE+NaF (grape seed extract and NaF); negative control (deionized water); and a positive control (commercialized mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the presence (P) or absence (NP) of salivary pellicle. The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (NP), 2 min immersion in experimental solutions, 60 min of incubation in saliva (P) or not (NP), and 1 min erosive challenge. Dentine surface loss (dSL-10 and dSL-total), amount of degraded collagen (dColl) and total calcium release (CaR) were evaluated. Data were analyzed with Kruskal-Wallis, Dunn's and Mann-Whitney U tests (p>0.05). RESULTS Overall, the negative control presented the highest values of dSL, dColl and CaR, and the plant extracts showed different degrees of dentine protection. For the subgroup NP, GSE showed the best protection of the extracts, and the presence of fluoride generally further improved the protection for all extracts. For the subgroup P, only BE provided protection, while the presence of fluoride had no impact on dSL and dColl, but lowered CaR. The protection of the positive control was more evident on CaR than on dColl. CONCLUSION We can conclude that the plant extracts showed a protective effect against dentine erosion, regardless of the presence of salivary pellicle, and that the fluoride seems to improve their protection.
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Affiliation(s)
- Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Nikola Jovanovic
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Sindy Sezer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Lucas Sébastien Wittwer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
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Carvalho TS, Pham K, Rios D, Niemeyer S, Baumann T. Synergistic effect between plant extracts and fluoride to protect against enamel erosion: An in vitro study. PLoS One 2022; 17:e0277552. [PMID: 36383626 PMCID: PMC9668169 DOI: 10.1371/journal.pone.0277552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
Polyphenol-rich solutions, such as plant extracts and teas, can modify the salivary pellicle and improve the protection against dental erosion. In this study, we further explored how these polyphenol-rich plant extracts solutions behave in the presence of fluoride. We distributed enamel specimens into 9 groups (n = 15): Control_No_F- (Deionized water); Control_F- (500 ppm F-), Grape_Seed_No_F- (Grape seed extract), Grape_Seed_F- (Grape seed extract + 500 ppm F-), Grapefruit_Seed_No_F- (Grapefruit seed extract), Grapefruit_Seed_F- (Grapefruit seed extract + 500 ppm F-), Blueberry_No_F- (Blueberry extract), Blueberry_F- (Blueberry extract + 500 ppm F-), and Sn2+/F-_Rinse (commercial solution containing 800 ppm Sn2+ and 500 ppm F-). The specimens were submitted to 5 cycles (1 cycle per day), and each cycle consisted of: salivary pellicle formation (human saliva, 30 min, 37°C), modification of the pellicle (2 min, 25°C), pellicle formation (60 min, 37°C), and an erosive challenge (1 min, citric acid). Between cycles, the specimens were kept in a humid chamber. Relative surface hardness (rSH), relative surface reflection intensity (rSRI) and calcium released to the acid were analysed, using general linear models, and Kruskal-Wallis with post-hoc Dunn's tests. We observed that the presence of fluoride in synergy with the extract solutions provided better protection than the groups containing extract or fluoride only. For rSH, we observed a significant main effect of extracts (F(4,117) = 9.20; p<0.001) and fluoride (F(1,117) = 511.55; p<0.001), with a significant interaction (F(3,117) = 6.71; p<0.001). Grape_Seed_F- showed the best protection, better than fluoride, and Sn2+/F-_Rinse. Calcium results also showed greater protection for the groups containing fluoride, whereas for rSRI, despite a significant interaction between extract and fluoride (F(3,117) = 226.05; p<0.001), the differences between the groups were not as clearly observed. We conclude that polyphenols from plant extracts, when combined with fluoride, improve the protective effect of salivary pellicles against enamel erosion.
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Affiliation(s)
- Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- * E-mail:
| | - Khoa Pham
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Samira Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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The influence of calcium fluoride nanoparticles’ addition on the bond integrity, degree of conversion, ion-release, and dentin interaction of an adhesive. APPLIED NANOSCIENCE 2022. [DOI: 10.1007/s13204-021-02282-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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LINS RODRIGOBARROSESTEVES, SANTI MARINARODRIGUES, NORONHA MAYARADOSSANTOS, SEBOLD MAICON, CAVALLI VANESSA. DOES TITANIUM TETRAFLUORIDE PROMOTE A PROTECTIVE EFFECT ON ERODED TOOTH? A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 22:101682. [DOI: 10.1016/j.jebdp.2021.101682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
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Adhesive bond integrity of Y‐TZP post with calcium fluoride infiltrated resin dentin adhesive: An SEM, EDX, FTIR and micro‐Raman study. SURF INTERFACE ANAL 2021. [DOI: 10.1002/sia.6998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Assessment of Bond Integrity, Durability, and Degree of Conversion of a Calcium Fluoride Reinforced Dentin Adhesive. Polymers (Basel) 2021; 13:polym13152418. [PMID: 34372022 PMCID: PMC8347946 DOI: 10.3390/polym13152418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 01/07/2023] Open
Abstract
Our study aimed to synthesize and compare the mechanical properties and dentin interaction of two adhesives; experimental adhesive (EA) and EA containing 5 wt.% calcium fluoride (CaF2) nano-crystals (CaF2 adhesive-CAFA). CaF2 nano-crystals were synthesized by reacting two solutions (containing calcium and fluoride) in a glass chamber using a heated air system. The EA was produced using a mix of monomers, photo-initiators, camphorquinone, and electron initiators. The synthesized CaF2 nano-crystals were centrifuged to guarantee that inside the adhesive there is homogenized dispersion of the filler particles. Their integration in the EA yielded two groups; Gp-1: EA (without CaF2, control) and Gp-2: (5 wt.% CaF2 containing adhesive, CAFA). Sixty teeth were prepared and set to form bonded specimens using the two adhesives. The CaF2 nano-crystals were irregularly shaped with an average particle size of 30–200 nm. The highest μTBS values were obtained for CAFA-non-thermocycled (NTC) samples (32.63 ± 3.15), followed by EA-NTC (31.80 ± 3.75) specimens. On thermocycling (TC), both adhesive groups presented lower μTBS values (CAFA-TC: 29.47 ± 3.33 and EA-TC: 24.04 ± 3.69). Hybrid layer (HL) formation and resin tags of varying depths were perceived for both adhesive groups. The EDX analysis demonstrated the presence of carbon (C), silica (Si), calcium (Ca), and fluoride (F) for CAFA group. Micro-Raman spectroscopy revealed distinct peaks for CaF2 nano-crystals. The CAFA group presented the greatest DC. The addition of CaF2 nano-crystals in the adhesive caused improved bond μTBS and DC. The incorporation also demonstrated suitable dentin interaction, depicted by appropriate HL and resin tag development.
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Farooq I, Ali S, Al-Saleh S, AlHamdan EM, AlRefeai MH, Abduljabbar T, Vohra F. Synergistic Effect of Bioactive Inorganic Fillers in Enhancing Properties of Dentin Adhesives-A Review. Polymers (Basel) 2021; 13:polym13132169. [PMID: 34209016 PMCID: PMC8271823 DOI: 10.3390/polym13132169] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 02/07/2023] Open
Abstract
Dentin adhesives (DAs) play a critical role in the clinical success of dental resin composite (DRC) restorations. A strong bond between the adhesive and dentin improves the longevity of the restoration, but it is strongly dependent on the various properties of DAs. The current review was aimed at summarizing the information present in the literature regarding the improvement of the properties of DAs noticed after the addition of bioactive inorganic fillers. From our search, we were able to find evidence of multiple bioactive inorganic fillers (bioactive glass, hydroxyapatite, amorphous calcium phosphate, graphene oxide, calcium chloride, zinc chloride, silica, and niobium pentoxide) in the literature that have been used to improve the different properties of DAs. These improvements can be seen in the form of improved hardness, higher modulus of elasticity, enhanced bond, flexural, and ultimate tensile strength, improved fracture toughness, reduced nanoleakage, remineralization of the adhesive-dentin interface, improved resin tag formation, greater radiopacity, antibacterial effect, and improved DC (observed for some fillers). Most of the studies dealing with the subject area are in vitro. Future in situ and in vivo studies are recommended to positively attest to the results of laboratory findings.
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Affiliation(s)
- Imran Farooq
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada
- Correspondence:
| | - Saqib Ali
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Samar Al-Saleh
- Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.-S.); (E.M.A.); (T.A.); (F.V.)
| | - Eman M. AlHamdan
- Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.-S.); (E.M.A.); (T.A.); (F.V.)
| | - Mohammad H. AlRefeai
- Operative Division, Department of Restorative Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Tariq Abduljabbar
- Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.-S.); (E.M.A.); (T.A.); (F.V.)
| | - Fahim Vohra
- Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.-S.); (E.M.A.); (T.A.); (F.V.)
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Kensche A, Buschbeck E, König B, Koch M, Kirsch J, Hannig C, Hannig M. Effect of fluoride mouthrinses and stannous ions on the erosion protective properties of the in situ pellicle. Sci Rep 2019; 9:5336. [PMID: 30926846 PMCID: PMC6441001 DOI: 10.1038/s41598-019-41736-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 03/13/2019] [Indexed: 12/19/2022] Open
Abstract
The particular feature of this study is the investigation of effects of pure fluoride- or stannous ions based mouthrinses on the erosion protective properties and the ultrastructure of the in situ pellicle (12 volunteers). Experimental solutions were prepared either from 500 ppm NaF, SMFP, AmF or SnF2 or 1563 ppm SnCl2, respectively. After 1 min of in situ pellicle formation on bovine enamel slabs, rinses with one of the preparations were performed for 1 min and intraoral specimens’ exposure was continued for 28 min. Native enamel slabs and rinses with bidestilled water served as controls. After oral exposure, slabs were incubated in HCl (pH 2; 2.3; 3) for 120 s and kinetics of calcium- and phosphate release were measured photometrically; representative samples were analysed by TEM and EDX. All mouthrinses reduced mineral loss compared to the native 30-min pellicle. The effect was pH-dependent and significant at all pH values only for the tin-containing mouthrinses. No significant differences were observed between the SnF2- and the SnCl2-containing solutions. TEM/EDX confirmed ultrastructural pellicle modifications. SnF2 appears to be the most effective type of fluoride to prevent erosive enamel demineralisation. The observed effects primarily have to be attributed to the stannous ions’ content.
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Affiliation(s)
- A Kensche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | - E Buschbeck
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - B König
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D-66421, Homburg/Saar, Germany
| | - M Koch
- Physical Analytics, INM - Leibnitz Institute for New Materials, D-66123, Saarbrücken, Germany
| | - J Kirsch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D-66421, Homburg/Saar, Germany
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Lussi A, Buzalaf MAR, Duangthip D, Anttonen V, Ganss C, João-Souza SH, Baumann T, Carvalho TS. The use of fluoride for the prevention of dental erosion and erosive tooth wear in children and adolescents. Eur Arch Paediatr Dent 2019; 20:517-527. [PMID: 30762211 DOI: 10.1007/s40368-019-00420-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 02/11/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Erosive tooth wear (ETW) has gained increasing clinical relevance. It is estimated that worldwide 30-50% of deciduous and 20-45% of permanent teeth are affected. One of the most important nutritional factors causing ETW is the overconsumption of soft drinks, but also patient-related factors like reflux or eating disorders can lead to erosive lesions. Whether acids lead to erosive demineralisation depends on their degree of saturation with respect to tooth mineral at their actual pH. REVIEW Fluoride compounds like sodium or amine fluoride seem to be of limited efficacy against erosion, the main reason for this is the missing biofilm in the erosive process as well as the lower pH of the acids compared to bacterial acids. This means that to achieve some kind of preventive effect it would be necessary to use products with higher fluoride concentration, which is not an appropriate option for small children, and/or to increase the frequency of application. In addition, the fluoride compound plays a role as promising effects were found when fluoride is combined with titanium or stannous ions. TiF4 can cause acid-resistant surface coatings and when Sn2+/F- formulations are applied, Sn is not only found on the surface but is also incorporated into enamel and dentine. Both effects make the tooth surface more resistant against acid demineralisation. Different fluoride-containing vehicles have been tested to prevent erosion/ETW, such as toothpastes, rinses, gels and varnishes. Toothpastes offer some degree of protection, especially Sn2+-containing formulations, but effects of the active ingredients are sometimes counteracted by the presence of abrasives. CONCLUSION Detecting associated factors and influencing them is the main instrument in arresting erosive tooth wear. Additionally, patients at risk for dental erosion should always use an additional fluoride source preferably containing Sn2+.
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Affiliation(s)
- A Lussi
- Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - M A R Buzalaf
- Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - D Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - V Anttonen
- Research Unit of Oral Health Sciences, Department of Cariology, Endodontology and Pediatric Dentistry, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - C Ganss
- Department for Conservative and Preventive Dentistry, Dental Clinic, Justus-Liebig-University Giessen, Giessen, Germany
| | - S H João-Souza
- Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - T Baumann
- Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - T S Carvalho
- Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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12
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Kensche A, Kirsch J, Mintert S, Enders F, Pötschke S, Basche S, König B, Hannig C, Hannig M. Impact of customary fluoride rinsing solutions on the pellicle's protective properties and bioadhesion in situ. Sci Rep 2017; 7:16584. [PMID: 29185495 PMCID: PMC5707358 DOI: 10.1038/s41598-017-16677-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/10/2017] [Indexed: 01/20/2023] Open
Abstract
This study investigated the impact of customary fluoride based mouthrinses on the ultrastructure and the functional properties of the in situ pellicle, considering the prevention of erosion (8 volunteers) and initial biofilm formation (12 volunteers). Bovine enamel slabs were carried intraorally. After 1 min of pellicle formation, the subjects rinsed with elmex Kariesschutz (A), Dontodent Med Care (B), meridol (C) or elmex Zahnschmelzschutz Professional (D) for 1 min. In situ pellicle formation was continued up to 30 min/8 h before processing the slabs in vitro. Erosion was simulated by incubating the specimens in HCl (pH 3.0, 2.3, 2.0) for 120 s, measuring the kinetics of calcium/phosphate release photometrically; representative samples were evaluated by TEM and EDX. Bacterial adhesion was visualized fluorescence microscopically (DAPI/BacLight). Native enamel slabs or physiological pellicle samples served as controls. All investigated mouthrinses enhanced the erosion preventive pellicle effect in dependence of the pH-value. A significant decrease of Ca/P release at all pH values was achieved after rinsing with D; TEM/EDX confirmed ultrastructural pellicle modifications. All mouthrinses tendentially reduced bacterial adherence, however not significantly. The mouthrinse containing NaF/AmF/SnCl2 (D) offers an effective oral hygiene supplement to prevent caries and erosion.
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Affiliation(s)
- A Kensche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
| | - J Kirsch
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Mintert
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - F Enders
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Pötschke
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - S Basche
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - B König
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421, Homburg/Saar, Germany
| | - C Hannig
- Clinic of Operative and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, TU Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - M Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, D- 66421, Homburg/Saar, Germany
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Schlueter N, Lussi A, Tolle A, Ganss C. Effects of Erosion Protocol Design on Erosion/Abrasion Study Outcome and on Active Agent (NaF and SnF2) Efficacy. Caries Res 2016; 50:170-9. [DOI: 10.1159/000445169] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/01/2016] [Indexed: 11/19/2022] Open
Abstract
There is no standard for testing anti-erosive/anti-abrasive agents, making the assessment and comparison of study results difficult. Factors which are varied in study designs are amongst others the erosive medium regarding concentration and pH or movement type of acid. The present study therefore investigated the impact of these factors on dimension of tissue loss and on efficacy of active agents used as anti-erosive/anti-abrasive therapeutics. In 8 experiments, consisting of 8 groups each (n = 20 each), resulting in a total of 64 groups, enamel specimens were demineralised (10 days, 6 × 2 min/day) using different acids (1, 0.5 and 0.3% citric acid at native pH 2.3, 2.5 and 2.8, respectively, and 0.3% citric acid adjusted to pH 3.6) with two different movement types (jerky or smooth). Specimens were immersed (2 × 2 min/day) in slurries of 1,450 ppm F- toothpaste (NaF), 1,450 ppm F- and 3,436 ppm Sn2+ toothpaste (NaF/SnF2), 970 ppm F- and 3,000 ppm Sn2+ gel (SnF2) or placebo, or were additionally brushed during immersion (15 s, 200 g). All groups were in between stored in a mineral salt solution. Tissue loss was determined profilometrically. Movement type, pH and concentration of acid had a substantial impact on study outcome. The combination of jerky movement and concentrated acid masked, to some extent, differences between erosive and erosive-abrasive tissue loss. The acid at low concentration (0.3%), independent of pH, was too mild to produce any tissue loss. The model with the best ability to demonstrate effects of abrasive impacts and active agents used the 1% acid concentration combined with smooth acid movements.
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MEDEIROS MIDD, CARLO HL, LACERDA-SANTOS R, LIMA BAGD, SOUSA FBD, RODRIGUES JA, CARVALHO FGD. Thickness and nanomechanical properties of protective layer formed by TiF4 varnish on enamel after erosion. Braz Oral Res 2016; 30:S1806-83242016000100264. [DOI: 10.1590/1807-3107bor-2016.vol30.0075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/14/2016] [Indexed: 11/22/2022] Open
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Lussi A, Carvalho TS. The Future of Fluorides and Other Protective Agents in Erosion Prevention. Caries Res 2015; 49 Suppl 1:18-29. [DOI: 10.1159/000380886] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The effectiveness of fluoride in caries prevention has been convincingly proven. In recent years, researchers have investigated the preventive effects of different fluoride formulations on erosive tooth wear with positive results, but their action on caries and erosion prevention must be based on different requirements, because there is no sheltered area in the erosive process as there is in the subsurface carious lesions. Thus, any protective mechanism from fluoride concerning erosion is limited to the surface or the near surface layer of enamel. However, reports on other protective agents show superior preventive results. The mechanism of action of tin-containing products is related to tin deposition onto the tooth surface, as well as the incorporation of tin into the near-surface layer of enamel. These tin-rich deposits are less susceptible to dissolution and may result in enhanced protection of the underlying tooth. Titanium tetrafluoride forms a protective layer on the tooth surface. It is believed that this layer is made up of hydrated hydrogen titanium phosphate. Products containing phosphates and/or proteins may adsorb either to the pellicle, rendering it more protective against demineralization, or directly to the dental hard tissue, probably competing with H+ at specific sites on the tooth surface. Other substances may further enhance precipitation of calcium phosphates on the enamel surface, protecting it from additional acid impacts. Hence, the future of fluoride alone in erosion prevention looks grim, but the combination of fluoride with protective agents, such as polyvalent metal ions and some polymers, has much brighter prospects.
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