Fluoride dentifrice containing calcium silicate and sodium phosphate salts on dental erosion: In vitro study

Effect of the calcium silicate and sodium phosphate remineralizing products on bleached enamel

Context and Aims

This study evaluated the effect of calcium silicate and sodium phosphate (CSSP) dentifrice and serum on the surface of enamel bleached with hydrogen peroxide (H2O2).

Materials and Methods

A total of 160 bovine enamel slabs were bleached with 35% H2O2 and treated with sodium fluoride (NaF) dentifrice-GI, CSSP dentifrice-GII; CSSP dentifrice + CSSP serum-GIII, or NaF dentifrice + NaF gel-GIV. The dentifrices were applied using a brushing machine three times daily for 7 days. After brushing, sodium phosphate gel and CSSP serum were applied. The microhardness (KNH, n = 14), surface roughness (Ra, n = 14), energy dispersive spectroscopy (n = 6), and scanning electron microscopy (n = 6) were assessed at t0 (before bleaching), t1 (after bleaching), and t2 (after postbleaching treatments).

Statistical Analysis Used

The data were subjected to a two-way analysis of variance and Bonferroni's test.

Results

The KNH decreased at t1 (P < 0.001) but recovered at t2 for all treatments, although only GII showed restored baseline values (P = 0.0109). The surface roughness increased at t1 (P < 0.001) and reduced at t2 (P < 0.001) for all groups, with no significant differences among groups. Enamel composition and morphology did not differ after the treatments, except for silicon accumulation in GIII.

Conclusions

Postbleaching treatment with CSSP dentifrice and serum yielded superior remineralizing effects on bleached enamel.

Advances in Preventive and Therapeutic Approaches for Dental Erosion: A Systematic Review

This review discusses both preventive measures and clinically implemented therapy procedures that have been developed recently for the prevention and treatment of tooth erosion.

METHODS

The databases PubMed, Scopus, and Web of Science were used for a thorough search. Studies on the prevention and treatment of dental erosion that were conducted in English and used in vitro were among the inclusion criteria.

RESULTS

The search turned up 391 papers in total, with 34 of those publications matching the requirements for inclusion. Varnishes, toothpastes, and solutions containing fluoride and other substances were used as preventive measures.

CONCLUSIONS

Dental erosion is a significant issue, and taking preventative steps is crucial to lessening the disease's spread and its effects. Interventions based on fluoride seem to be successful at halting erosion and encouraging remineralization. To effectively address severe tooth erosion, therapeutic methods, including composite restorations, prosthetic crowns, and veneers, are available. Dental erosion causes aesthetic and functional issues that are best addressed with less invasive treatments like direct composite restorations. To improve and broaden the range of available treatments for this common dental issue, additional research and development are required.

Linear and areal surface roughness assessments for the study of tooth wear in human enamel

OBJECTIVES

To test 8 models of linear surface roughness assessment in characterizing surface profile description and to correlate these models with equivalent areal parameters over sound human enamel in vitro.

MATERIALS AND METHODS

Thirty enamel blocks were randomly selected. The roughness data (2D-Rp; Rv; Rz; Rc; Rt; Ra; Rq; Rsk; Rku/3D-Sp; Sv; Sz; Sa; Sq; Ssk; Sku) was obtained in duplicate in a non-contact 3D optical profilometer. The models were composed by 1 single vertical trace (model 1) until 8 traces (model 8 composed by three vertical traces, three horizontal traces, and two diagonal).

RESULTS

The addition of linear sampling traces to the enamel blocks did not result in Rp, Rv, Rz, Rc, Rt, Ra, Rq, Rsk, and Rku value changes (low power-from 5 to 72%). Significant Spearman's correlation coefficients were obtained in most correlation analysis (Rp ↔ Sp; Rv ↔ Sv; Rz ↔ Sz; Ra ↔ Sa; Rq ↔ Sq; and Rku ↔ Sku).

CONCLUSIONS

A single vertical trace in the middle of the sample was representative of the overall enamel surface roughness (Rp, Rv, Rz, Rc, Rt, Ra, Rq, Rsk, and Rku) models. The majority of the assessed models in the correlation evaluation presented significant and positive association.

CLINICAL RELEVANCE

The findings highlight the applicable model for roughness analysis over human enamel recommended for research and in situ trials assessments.

Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review

A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

Effects of Remineralizing Agents Based on Calcium Phosphate, Sodium Phosphate, or Sodium Fluoride on Eroded Cervical Dentin

OBJECTIVES

To evaluate the effect of remineralizing agents on collagen matrix pattern, precipitate formation, and dentinal tubule obliteration in eroded cervical dentin.

METHODS AND MATERIALS

One hundred bovine cervical dentin specimens were previously eroded (0.6% hydrochloric acid, pH 2.3, 5 minutes) and then randomized into five groups (n=20): G1, control (without treatment); G2, Desensibilize Nano P (FGM); G3, MI Paste Plus (Recaldent); G4, Regenerate (NR-5); and G5, Desensibilize KF 2% (FGM). These treatments were applied in four sessions with 7-day intervals. During this period, the samples were subjected to an erosive challenge with orange juice (pH 3.8, 5 minutes). The specimens were analyzed by polarized light microscopy with picrosirius red staining, scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX).

RESULTS

The G3 showed a higher concentration of type I collagen than G2 and G5 (p<0.05). The G3 showed greater formation of surface precipitates than that of G1 and G5 (p<0.05). In addition, G4 and G5 showed a greater number of open dentinal tubules than that of G3 (p<0.05).

CONCLUSIONS

Calcium phosphate-based remineralizing agents have shown to be a promising alternative treatment for preventing deleterious effects on the eroded dentin collagen matrix. In addition, they promoted precipitate formation and dentinal tubule obliteration on the eroded dentin.

Protection of calcium silicate/sodium phosphate/fluoride toothpaste with serum on enamel and dentin erosive wear

Objective

To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin.

Methodology

Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva – 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO₄/MFP (Regenerate-Unilever), and Si/PO₄/MFP/BS (Si/PO₄/MFP with dual BS – Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%).

Results

For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO₄/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness.

Conclusion

The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW.