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Francese MM, Urasaki BAN, de Barros MC, Ferrari CR, Grizzo LT, Magalhães AC. Toothpaste containing TiF 4 and chitosan against erosive tooth wear in situ. J Dent 2024; 145:104977. [PMID: 38582434 DOI: 10.1016/j.jdent.2024.104977] [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: 03/06/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE This study compared the protective effect of an experimental TiF4/Chitosan toothpaste with a commercial toothpaste on the prevention of erosive tooth wear (ETW) in situ. METHODS Fifteen subjects took part in this crossover and double-blind study, in which they wore a palatal appliance containing 4 bovine enamel and 4 dentin in 3 phases (5 days each). Half of the samples were subjected to erosive challenges (90 s in 0.1 % citric acid, pH 2.5, 4 times/day), and the other half to erosive plus abrasive challenges (15 s plus 45 s of contact, 2 times/day). The phases corresponded to the application of the different toothpastes: 1) TiF4 (1400 ppm F-) plus Chitosan, 2) Elmex®, Erosion Protection (1400 ppm F-, Chitosan), and 3) Placebo (negative control). Tooth wear was measured using contact profilometry (μm) and submitted to two-way RM ANOVA/Tukey test (p < 0.05). RESULTS No significant differences were detected between the experimental and commercial toothpastes, regardless of the challenge on both tissues. Both significantly reduce ETW compared to negative control (p < 0.0006). Tooth wear was increased by brushing only on eroded enamel (p < 0.01), but not on dentin (p = 0.6085). TiF4/Chitosan [erosion 2.98 ± 1.12 μm vs. erosion and abrasion 3.12 ± 1.33 μm] and Elmex® toothpastes [erosion 2.35 ± 0.93 μm vs. erosion and abrasion 2.98 ± 1.0 μm] minimized the impact of brushing compared to placebo on enamel [erosion 4.62 ± 1.48 μm vs. erosion and abrasion 5.15 ± 1.50 μm]. CONCLUSIONS TiF4 plus chitosan toothpastes showed to be effective in minimizing the ETW as the commercial toothpaste is in situ. CLINICAL RELEVANCE The experimental toothpaste has similar effect against ETW compared to the commercial toothpaste. Considering the increased ETW prevalence worldwide, this result supports clinical trials and a possible application of this experimental anti-erosive toothpaste in the future.
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Affiliation(s)
- Monique Malta Francese
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Mariana Carvalho de Barros
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Carolina Ruis Ferrari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Larissa Tercilia Grizzo
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
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Peruchi V, Ribeiro RADO, Mendes Soares IP, Oliveira Fernandes LD, de Oliveira JR, Pires MLBA, Hebling J, Soares DG, de Souza Costa CA. Influence of coating dental enamel with a TiF 4-loaded polymeric primer on the adverse effects caused by a bleaching gel with 35% H 2O 2. J Mech Behav Biomed Mater 2024; 153:106497. [PMID: 38458078 DOI: 10.1016/j.jmbbm.2024.106497] [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: 01/30/2024] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To evaluate whether coating enamel with a polymeric primer (PPol) containing titanium tetrafluoride (TiF4) before applying a bleaching gel with 35% H2O2 (35% BG) increases esthetic efficacy, prevents changes in morphology and hardness of enamel, as well as reduces the cytotoxicity from conventional in-office bleaching. MATERIALS AND METHODS Standardized enamel/dentin discs were stained and bleached for 45 min (one session) with 35% BG. Groups 2TiF4, 6TiF4, and 10TiF4 received the gel on the enamel previously coated with PPol containing 2 mg/mL, 6 mg/mL, or 10 mg/mL, respectively. No treatment or application of 35% BG directly on enamel were used as negative control (NC), and positive control (PC), respectively. UV-reflectance spectrophotometry (CIE L*a*b* system, ΔE00, and ΔWI, n = 8) determined the bleaching efficacy of treatments. Enamel microhardness (Knoop, n = 8), morphology, and composition (SEM/EDS, n = 4) were also evaluated. Enamel/dentin discs adapted to artificial pulp chambers (n = 8) were used for trans-amelodentinal cytotoxicity tests. Following the treatments, the extracts (culture medium + bleaching gel components diffused through the discs) were collected and applied to odontoblast-like MDPC-23 cells, which were assessed concerning their viability (alamarBlue, n = 8; Live/Dead, n = 4), oxidative stress (n = 8), and morphology (SEM). The amount of H2O2 in the extracts was also determined (leuco crystal violet/peroxidase, n = 8). The numerical data underwent one-criterion variance analysis (one-way ANOVA), followed by Tukey's test, at a 5% significance level. RESULTS Regarding the ΔE00, no difference was observed among groups 2TiF4, 6TiF4, and PC (p > 0.05). The ΔWI was similar between groups 2TiF4 and PC (p > 0.05). The ΔWI of group 6TiF4 was superior to PC (p < 0.05), and group 10TiF4 achieved the highest ΔE00 and ΔWI values (p < 0.05). Besides limiting enamel microstructural changes compared to PC, group 10TiF4 significantly increased the hardness of this mineralized dental tissue. The highest cellular viability occurred in 10TiF4 compared to the other bleached groups (p < 0.05). Trans-amelodentinal H2O2 diffusion decreased in groups 2TiF4, 6TiF4, and 10TiF4 in comparison with PC (p < 0.05). CONCLUSION Coating enamel with a PPol containing TiF4 before applying a 35% BG may increase enamel microhardness and esthetic efficacy and reduce the trans-amelodentinal cytotoxicity of conventional in-office tooth bleaching. The PPol containing 10 mg/mL of TiF4 promoted the best outcomes.
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Affiliation(s)
- Victória Peruchi
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Lídia de Oliveira Fernandes
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Juliana Rios de Oliveira
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | | | - Josimeri Hebling
- Department of Morphology and Pediatric Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Diana Gabriela Soares
- Department of Operative Dentistry, Endodontics and Dental Materials, School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil.
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Vertuan M, França da Silva J, Ferreira AM, Braga AS, Magalhães AC. Effect of a Toothpaste Containing Surface Pre-Reacted Glass-Ionomer Filler on the Remineralization of Artificial Carious Enamel Lesions in situ. Caries Res 2023; 56:447-454. [PMID: 36215950 DOI: 10.1159/000527388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
This study evaluated the remineralizing effect of a toothpaste containing surface pre-reacted glass-ionomer (S-PRG) filler on demineralized enamel in situ. For this, 180 bovine enamel samples were demineralized by using a microcosm biofilm model for 3 days. Thereafter, the samples were randomly signed to 15 healthy volunteers and to 3 cross-over in situ phases corresponding to the following treatments: (1) toothpaste containing 1,500 ppm F as NaMFP (positive control, Colgate®Cavity Protection), (2) toothpaste containing 5% S-PRG filler (Shofu®), and (3) placebo toothpaste (negative control prepared by Shofu®). Four demineralized enamel blocks were fixed into each palatal appliance per phase. The volunteers wore the appliances for 5 days and were trained to brush their teeth 2 times for 2 min a day, while one drop of the toothpaste's slurry (1:3) was dripped on each sample for the same period. The surface hardness and TMR analyses were done and analyzed by ANOVA/Tukey and t test (p < 0.05). S-PRG filler and Colgate® toothpastes were equally able to improve 2-2.5× enamel remineralization by the analysis of % surface hardness recovery. However, S-PRG toothpaste was the only one able to significantly improve ΔΔZ (the integrated mineral loss recovery: 1,489 ± 503 %vol.μm) compared to placebo (1,050 ± 467 %vol.μm), while Colgate® did not differ from placebo. No differences were seen between the groups with respect to ΔLD. S-PRG filler and Colgate® toothpastes show similar potential to remineralize the lesion surface. However, S-PRG toothpaste is better to recover mineral loss at the subsurface area.
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Affiliation(s)
- Mariele Vertuan
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Júlia França da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Amanda Moura Ferreira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Liu Z, Lu J, Chen X, Xiu P, Zhang Y, Lv X, Jiang X, Wang K, Zhang L. A novel amelogenesis-inspired hydrogel composite for the remineralization of enamel non-cavitated lesions. J Mater Chem B 2022; 10:10150-10161. [PMID: 36472307 DOI: 10.1039/d2tb01711c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Enamel non-cavitated lesions (NCLs) are subsurface enamel porosity from carious demineralization. The developed enamel cannot repair itself once NCLs occurs. The regeneration of mineral crystals in a biomimetic environment is an effective way to repair enamel subsurface defects. Previously, an amelogenin-derived peptide named QP5 was proven to repair demineralized enamel. In this work, inspired by amelogenesis, a novel biomimetic hydrogel composite containing the QP5 peptide and bioactive glass (BG) was designed, in which QP5 could promote enamel remineralization by guiding the calcium and phosphorus ions provided by BG. Also, BG could adjust the mineralization micro-environment to alkalinity, simulating the pH regulation of ameloblasts during enamel maturity. The BQ hydrogel composite showed biosafety and possessed capacity for enamel binding, ion release and pH buffering. Enamel NCLs treated with the BQ hydrogel composite showed a higher reduction in lesion depth and mineral loss both in vitro and in vivo. Moreover, compared to the hydrogels containing only BG or QP5, groups treated with the BQ hydrogel composite attained more surface microhardness recovery and color recovery, exhibiting resistance to erosion and abrasion of the remineralization layer. We envision that the BQ hydrogel composite can provide a biomimetic micro-environment to favor enamel remineralization, thus reducing the lesion depth and increasing the mineral content as a promising biomimetic material for enamel NCLs.
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Affiliation(s)
- Zhenqi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Junzhuo Lu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xiangshu Chen
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Peng Xiu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Yinmo Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xiaohui Lv
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Xinyi Jiang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Kun Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
| | - Linglin Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China. .,Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, No.14, Section 3, Renmin Road South, Chengdu, China
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Chevitarese AB, França Leite KLD, Marañón-Vásquez GA, Masterson D, Pithon M, Maia LC. What is the effectiveness of titanium tetrafluoride to prevent or treat dental caries and tooth erosion? A systematic review. Acta Odontol Scand 2022; 80:441-456. [PMID: 35147483 DOI: 10.1080/00016357.2022.2032329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Answer the question: What is the effectiveness of titanium tetrafluoride (TiF4) when compared to other fluorides, placebo solution or a negative control to prevent or treat dental caries and tooth erosion? MATERIALS AND METHODS This review is in accordance with PRISMA guidelines. In vivo and in situ studies that used TiF4 over enamel or dentine were included. Electronic searches were conducted on MEDLINE, Scopus, Embase, WOS, Cochrane Library, VLH, Clinical Trials and OpenGrey. Risk of bias (ROB) assessments used RoB2 and ROBINS-I for randomized and non-randomized controlled trials (RCTs and on-RCTs); Syrcle's ROB tool for animal studies; and a modified tool proposed by Hollanders for in situ studies. RESULTS A total of 28 studies met the eligibility criteria. From these, 6 were in humans (3 RCT and 3 Non-RCT); 4 were in animals and 18 were in situ. For in vivo studies, all RCTs have some concerns related to ROB and all of the non-RCT studies were classified as with serious risk. One animal study had a low and three a high ROB. Regarding in situ studies, seven had a low, ten had an average and only one had a high ROB. The certainty of the evidence (GRADE) ranged from moderate to very low. CONCLUSIONS Although most of the results suggest a positive effect of TiF4 on the prevention and treatment of caries and dental erosion, it is not possible to have definitive conclusions due to the high studies' methodological heterogeneity, and the low quality of evidence for most outcomes. REGISTRATION The protocol of this syste. atic review was registered in the OPEN SCIENCE FRAMEWORK database (osf.io/6dgs9) DOI:10.17605/OSF.IO/KUZA7 on 6 August 2020.
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Affiliation(s)
- Ana Beatriz Chevitarese
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Karla Lorene de França Leite
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Guido A. Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle Masterson
- Central Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Matheus Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Chevitarese AB, Leite KLDF, Marañón-Vásquez GA, Masterson D, Vicente-Gomila JM, Gonçalves AF, Pitton M, Maia LC. Research Trends on Preventive and Therapeutic Use of TIF4 for Dental Caries and Erosion. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Souza BMD, Silva MDS, Braga AS, Santos DMSD, Carvalho TDS, Santos NMD, Rios D, Buzalaf MAR, Magalhães AC. Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial. Braz Oral Res 2021; 35:e121. [PMID: 34878076 DOI: 10.1590/1807-3107bor-2021.vol35.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/18/2021] [Indexed: 11/22/2022] Open
Abstract
This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.
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Affiliation(s)
- Beatriz Martines de Souza
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Mayara de Souza Silva
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Aline Silva Braga
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | | | - Thamyris de Souza Carvalho
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Natália Mello Dos Santos
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | - Daniela Rios
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | | | - Ana Carolina Magalhães
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
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Vertuan M, da Silva JF, Braga AS, de Souza BM, Magalhães AC. Effect of TiF 4/NaF and chitosan solutions on biofilm formation and prevention of dentin demineralization. Arch Oral Biol 2021; 132:105275. [PMID: 34619414 DOI: 10.1016/j.archoralbio.2021.105275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated the effect of experimental solutions containing TiF4/NaF and chitosan on bacterial species of microcosm biofilm and on dentin demineralization. DESIGN Microcosm biofilm was produced from human saliva mixed with McBain medium (0.2% sucrose) on bovine dentin for 5 days, under 5% CO2 and 37 °C. From the 2nd day to 5th day, the treatments were applied (1×60s/day) as following: (1) NaF (500 ppm F-, positive control); (2) TiF4 and NaF (TiF4: 190 ppm Ti4+ and 300 ppm F-; NaF: 190 ppm F-); (3) similar to 2 plus 0.5% chitosan (Ch 500 mPa.s, 75% deacetylation); (4) phosphate buffer solution (negative control); and (5) 0.5% chitosan (Ch 500 mPa.s, 75% deacetylation). CFU counting was performed for total microorganism, total streptococci, total lactobacilli and mutans streptococci. Dentin demineralization was measured by transverse microradiography-TMR. The data were compared using ANOVA/Tukey or Kruskal-Wallis/Dunn tests (p < 0.05). RESULTS No differences were found between the treatments with respect to CFU counting (p > 0.05). Dentin treated with TiF4/NaF plus chitosan solution presented the lowest demineralization compared to the negative control and pure chitosan solution. On the other hand, this experimental solution did not significantly differ from TiF4/NaF solution, being both able to significantly reduce mineral loss. CONCLUSION TiF4/NaF plus chitosan solution, at suitable pH to be clinically applicable, had no antimicrobial effect, but it was able to reduce dentin caries development under this model.
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Affiliation(s)
- Mariele Vertuan
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Júlia França da Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Beatriz Martines de Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
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The Current Strategies in Controlling Oral Diseases by Herbal and Chemical Materials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3423001. [PMID: 34471415 PMCID: PMC8405301 DOI: 10.1155/2021/3423001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/26/2021] [Indexed: 01/23/2023]
Abstract
Dental plaque is a biofilm composed of complex microbial communities. It is the main cause of major dental diseases such as caries and periodontal diseases. In a healthy state, there is a delicate balance between the dental biofilm and host tissues. Nevertheless, due to the oral cavity changes, this biofilm can become pathogenic. The pathogenic biofilm shifts the balance from demineralization-remineralization to demineralization and results in dental caries. Dentists should consider caries as a result of biological processes of dental plaque and seek treatments for the etiologic factors, not merely look for the treatment of the outcome caused by biofilm, i.e., dental caries. Caries prevention strategies can be classified into three groups based on the role and responsibility of the individuals doing them: (1) community-based strategy, (2) dental professionals-based strategy, and (3) individual-based strategy. The community-based methods include fluoridation of water, salt, and milk. The dental professionals-based methods include professional tooth cleaning and use of varnish, fluoride gel and foam, fissure sealant, and antimicrobial agents. The individual-based (self-care) methods include the use of fluoride toothpaste, fluoride supplements, fluoride mouthwashes, fluoride gels, chlorhexidine gels and mouthwashes, slow-release fluoride devices, oral hygiene, diet control, and noncariogenic sweeteners such as xylitol. This study aimed to study the research in the recent five years (2015–2020) to identify the characteristics of dental biofilm and its role in dental caries and explore the employed approaches to prevent the related infections.
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Vertuan M, Machado PF, de Souza BM, Braga AS, Magalhães AC. Effect of TiF 4/NaF and chitosan solutions on the development of enamel caries under a microcosm biofilm model. J Dent 2021; 111:103732. [PMID: 34174348 DOI: 10.1016/j.jdent.2021.103732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To evaluate the effect of experimental solutions containing TiF4/NaF and chitosan on bacterial species and on enamel caries prevention. METHODS Microcosm biofilm was produced from human saliva mixed with McBain saliva (0.2% sucrose) on bovine enamel for five days, under 5% CO2 and 37 °C. From the second day until the end, the treatments were applied (1 × 60 s/day): (1) NaF (500 ppm F-, positive control); (2) TiF4 and NaF (TiF4: 190 ppm Ti4+ and 300 ppm F-; NaF: 190 ppm F-); (3) similar to 2 plus 0.5% chitosan (Ch 500 mPas, 75% deacetylation); (4) phosphate buffer solution (negative control); and (5) 0.5% chitosan (Ch 500 mPas, 75% deacetylation). CFU counting was performed for total microorganism, total streptococcus, total lactobacillus and Streptococcus mutans. Enamel demineralization was measured by transverse microradiography-TMR. The data were compared using ANOVA/Tukey or Kruskal-Wallis/Dunn tests (p < .050). RESULTS No differences were found between the treatments with respect to CFU counting (ANOVA, p > .050). Enamel treated with TiF4/NaF plus chitosan solution presented the lowest demineralization compared to the negative control and pure chitosan solution. On the other hand, this experimental solution did not significantly differ from TiF4/NaF and NaF solutions, being all of them able to significantly reduce mineral loss (50-74%), but only TiF4/NaF plus chitosan reduced lesion depth (55%) compared to the negative control (p = .001). CONCLUSION TiF4/NaF plus chitosan solution had no antimicrobial effect, but it was able to reduce enamel caries development in 79% compared to control under this model. CLINICAL SIGNIFICANCE This study showed that TiF4/NaF plus chitosan solution had no antimicrobial effect, but it was able to reduce enamel caries development under a microcosm biofilm model.
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Affiliation(s)
- Mariele Vertuan
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Bauru-SP, Zip code: 17012-901, Brazil.
| | - Paula Fontana Machado
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Bauru-SP, Zip code: 17012-901, Brazil.
| | - Beatriz Martines de Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Bauru-SP, Zip code: 17012-901, Brazil
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Bauru-SP, Zip code: 17012-901, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Bauru-SP, Zip code: 17012-901, Brazil.
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de Souza BM, Silva MS, Braga AS, Bueno PSK, da Silva Santos PS, Buzalaf MAR, Magalhães AC. Protective effect of titanium tetrafluoride and silver diamine fluoride on radiation-induced dentin caries in vitro. Sci Rep 2021; 11:6083. [PMID: 33727650 PMCID: PMC7966395 DOI: 10.1038/s41598-021-85748-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/28/2021] [Indexed: 11/11/2022] Open
Abstract
This in vitro study evaluated the protective effect of titanium tetrafluoride (TiF4) varnish and silver diamine fluoride (SDF) solution on the radiation-induced dentin caries. Bovine root dentin samples were irradiated (70 Gy) and treated as follows: (6 h): 4% TiF4 varnish; 5.42% NaF varnish; 30% SDF solution; placebo varnish; or untreated (negative control). Microcosm biofilm was produced from human dental biofilm (from patients with head-neck cancer) mixed with McBain saliva for the first 8 h. After 16 h and from day 2 to day 5, McBain saliva (0.2% sucrose) was replaced daily (37 °C, 5% CO2) (biological triplicate). Demineralization was quantified by transverse microradiography (TMR), while biofilm was analyzed by using viability, colony-forming units (CFU) counting and lactic acid production assays. The data were statistically analyzed by ANOVA (p < 0.05). TiF4 and SDF were able to reduce mineral loss compared to placebo and the negative control. TiF4 and SDF significantly reduced the biofilm viability compared to negative control. TiF4 significantly reduced the CFU count of total microorganism, while only SDF affected total streptococci and mutans streptococci counts. The varnishes induced a reduction in lactic acid production compared to the negative control. TiF4 and SDF may be good alternatives to control the development of radiation-induced dentin caries.
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Affiliation(s)
- Beatriz Martines de Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Mayara Souza Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Patrícia Sanches Kerges Bueno
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Paulo Sergio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, Bauru, São Paulo, 17012-191, Brazil.
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Soares Dos Santos DM, Braga AS, Rizk M, Wiegand A, Magalhães AC. Comparison between micro-computed tomography and transverse microradiography of sound dentine treated with fluorides and demineralized by microcosm biofilm. Eur J Oral Sci 2019; 127:508-514. [PMID: 31584713 DOI: 10.1111/eos.12656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The study aimed to apply micro-computed tomography (micro-CT) and transverse microradiography (TMR) to measure dentine demineralization and to test the preventive effect of titanium tetrafluoride (TiF4 ) under microcosm biofilm. Sound dentine specimens from bovine root were treated for 6 h with: (i) 4.0% titanium tetrafluoride (TiF4 ) varnish [pH 1.0, 2.45% fluoride (F-); (ii) 5.42% sodium fluoride (NaF) varnish (pH 5.0, 2.45% F); (iii) 2% chlorhexidine (CHX) gel (pH 7.0); (iv) placebo varnish (pH 5.0); or (v) no agent (untreated). Dentine specimens were then exposed to human saliva mixed with McBain saliva for 8 h. Thereafter, McBain saliva containing 0.2% sucrose was applied daily, for 5 d, onto dentine specimens to stimulate formation of microcosm biofilm. Although a high correlation was found between the results of both methods regarding integrated mineral loss, the results of the methods did not show good agreement in Bland-Altman plots, with significant biases in calculations of lesion depth. Fluoride varnishes were able to reduce dentine demineralization (P < 0.05), while CHX failed to do so. Fluorides are still the best option to reduce dentine demineralization. Micro-CT may be used to measure dentine mineral loss, but not the lesion depth, for which TMR is superior.
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Affiliation(s)
| | - Aline S Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marta Rizk
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Ana C Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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dos Santos D, Pires J, Silva A, Salomão P, Buzalaf M, Magalhães A. Protective Effect of 4% Titanium Tetrafluoride Varnish on Dentin Demineralization Using a Microcosm Biofilm Model. Caries Res 2019; 53:576-583. [DOI: 10.1159/000499317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/28/2019] [Indexed: 11/19/2022] Open
Abstract
This study evaluated the effect of titanium tetrafluoride (TiF4) varnish on the development of dentin carious lesions. Bovine root dentin samples were treated for 6 h with: (A) 4% TiF4 varnish (2.45% F); (B) 5.42% sodium fluoride (NaF) varnish (2.45% F); (C) 2% chlorhexidine (CHX) gel – positive control; (D) placebo varnish; or (E) untreated – negative control (n = 4 × biological triplicate, n = 12). Treated dentin samples were exposed to human saliva mixed with McBain saliva (1:50) for the first 8 h in 24-well plates. Thereafter, the medium was removed, and McBain saliva containing 0.2% sucrose was applied for 16 h. From days 2 to 5, McBain saliva with sucrose was replaced daily (37°C, 5% CO2). The demineralization was measured using transverse microradiography, while the effect on biofilm was analyzed using viability, extracellular polysaccharide (EPS), and lactic acid production assays. The data were statistically analyzed (p < 0.05). All treatments (fluorides and CHX) significantly reduced the biofilm viability compared to placebo varnish and negative control. However, none of them was able to reduce the colony-forming unit counting for total microorganism, total streptococci, and Streptococcus mutans. NaF significantly reduced the number of Lactobacillus sp. compared to negative control. No effect was seen on lactic acid production neither on EPS synthesis, except that CHX significantly reduced the amount of insoluble EPS. Both fluorides were able to reduce dentin demineralization compared to placebo varnish and negative control; TiF4 had a better effect in reducing mineral loss and lesion depth than NaF. Therefore, TiF4 varnish has the best protective effect on dentin carious lesion formation using this model.
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Wassel MO, Sherief DI. Ion release and enamel remineralizing potential of miswak, propolis and chitosan nano-particles based dental varnishes. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Aranda Salomão PM, de Oliveira FA, dos Santos DMS, Domezi JP, Dionísio TJ, de Oliveira RC, Magalhães AC. TiF4 and NaF varnishes induce low levels of apoptosis in murine and human fibroblasts through mitochondrial Bcl-2 family and death receptor signalling. Arch Oral Biol 2019; 97:245-252. [DOI: 10.1016/j.archoralbio.2018.10.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/19/2018] [Accepted: 10/31/2018] [Indexed: 01/03/2023]
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de Souza BM, Santi LRP, de Souza Silva M, Buzalaf MAR, Magalhães AC. Effect of an experimental mouth rinse containing NaF and TiF 4 on tooth erosion and abrasion in situ. J Dent 2018; 73:45-49. [DOI: 10.1016/j.jdent.2018.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/30/2018] [Accepted: 04/01/2018] [Indexed: 11/24/2022] Open
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Souza BMD, Fernandes Neto C, Salomão PMA, Vasconcelos LRSMD, Andrade FBD, Magalhães AC. Analysis of the antimicrobial and anti-caries effects of TiF4 varnish under microcosm biofilm formed on enamel. J Appl Oral Sci 2018; 26:e20170304. [PMID: 29489933 PMCID: PMC5829548 DOI: 10.1590/1678-7757-2017-0304] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/25/2017] [Indexed: 11/22/2022] Open
Abstract
Titanium tetrafluoride (TiF4) is known for interacting with enamel reducing demineralization. However, no information is available about its potential antimicrobial effect. OBJECTIVES This study evaluated the antimicrobial and anti-caries potential of TiF4 varnish compared to NaF varnish, chlorhexidine gel (positive control), placebo varnish and untreated (negative controls) using a dental microcosm biofilm model. MATERIAL AND METHODS A microcosm biofilm was produced on bovine enamel previously treated with the varnishes, using inoculum from human saliva mixed with McBain saliva, under 0.2% sucrose exposure, for 14 days. All experiments were performed in biological triplicate (n=4/group in each experiment). Factors evaluated were: bacterial viability (% dead and live bacteria); CFU counting (log10 CFU/mL); and enamel demineralization (transverse microradiography - TMR). Data were analysed using ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). RESULTS Only chlorhexidine significantly increased the number of dead bacteria (68.8±13.1% dead bacteria) compared to untreated control (48.9±16.1% dead bacteria). No treatment reduced the CFU counting (total microorganism and total streptococci) compared to the negative controls. Only TiF4 was able to reduce enamel demineralization (ΔZ 1110.7±803.2 vol% μm) compared to both negative controls (untreated: ΔZ 4455.3±1176.4 vol% μm). CONCLUSIONS TiF4 varnish has no relevant antimicrobial effect. Nevertheless, TiF4 varnish was effective in reducing enamel demineralization under this model.
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Affiliation(s)
- Beatriz Martines de Souza
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | - Constantino Fernandes Neto
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | - Priscila Maria Aranda Salomão
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | | | - Flaviana Bombarda de Andrade
- Departamento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | - Ana Carolina Magalhães
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
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18
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Souza BM, Santos DMS, Braga AS, Santos NMD, Rios D, Buzalaf MAR, Magalhães AC. Effect of a Titanium Tetrafluoride Varnish in the Prevention and Treatment of Carious Lesions in the Permanent Teeth of Children Living in a Fluoridated Region: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e26. [PMID: 29374001 PMCID: PMC5807625 DOI: 10.2196/resprot.9376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/15/2017] [Accepted: 12/16/2017] [Indexed: 11/17/2022] Open
Abstract
Background Titanium tetrafluoride (TiF4) has regained interest due to new formulations that have been shown to be more effective against tooth demineralization than sodium fluoride (NaF) formulations in vitro and in situ. Objective The aim of this study is to evaluate the effect of two types of varnishes (4% TiF4 and a commercial 5% NaF) on the prevention of carious lesions and the treatment of noncavitated enamel carious lesions in the permanent teeth of children living in a fluoridated area. Methods This randomized, controlled, parallel and single-blind clinical trial involves 63 children, 6-7 years old, living in Bauru, São Paulo, Brazil. Children were selected according to their caries activity (ie, presence of at least 1 tooth with a Nyvad score of 1) and randomly divided into the following treatment categories: 4% TiF4 varnish (2.45 % F-, pH 1, FGM); 5% NaF varnish (2.26% F-, pH 5, Duraphat, Colgate) and control (placebo varnish, pH 5, FGM). The varnishes will be applied on all permanent teeth, once a week for 4 weeks and they will be reapplied only once 6 and 12 months after the study begins. Two calibrated examiners will carry out the clinical examination (International Caries Detection and Assessment System [ICDAS] and Nyvad indexes, kappa>.8) at baseline, before the first application, after the 1st, 6th, 12th, and 18th month of the study begins. Furthermore, quantitative fluorescence changes will be measured using Quantitative Light-Induced Fluorescence (QLF). The degree of patient satisfaction with the treatment will also be computed. The data will undergo statistical analysis (P<.05). Results This ongoing study is funded by funding agencies from Brazil (São Paulo Research Foundation, FAPESP-015/14149-1, and National Council for Scientific and Technological Development, CNPq-401313/2016-6). We expect to confirm the efficacy of TiF4 on the prevention and treatment of carious lesions by comparing it to NaF varnish. The subjects are under 1 month evaluation and the dropout was about 8%. No differences between the treatments have been detected at the first month so far (P>.05). Conclusions If our hypothesis is confirmed, TiF4 varnish can be marketed and applied at the individual level and used in community programs to control dental caries. Trial Registration Brazilian Clinical Trials Registry: RBR-5VWJ4Y; http://www.ensaiosclinicos.gov.br/rg/?q=RBR-5VWJ4Y (Archived by WebCite at http://www.webcitation.org/6wUurEnm7)
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Affiliation(s)
- Beatriz Martines Souza
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Natália Mello Dos Santos
- Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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