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Mohammadipour HS, Bagheri H, Babazadeh S, Khorshid M, Shooshtari Z, Shahri A. Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study. BMC Oral Health 2024; 24:507. [PMID: 38685035 PMCID: PMC11059626 DOI: 10.1186/s12903-024-04298-3] [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: 01/31/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity. METHODS Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05). RESULTS The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054). CONCLUSION The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity. TRIAL REGISTRATION http://irct.ir : IRCT20220829055822N1, September 9th, 2022.
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Affiliation(s)
- Hamideh Sadat Mohammadipour
- Department of Restorative and Cosmetic Dentistry, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Bagheri
- Dental Materials Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saber Babazadeh
- Department of Community Oral Health, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Shooshtari
- Dentist, Research Assistant, Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arsalan Shahri
- Dental Materials Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.
- Mashhad dental school, Mashhad university of medical sciences university campus, P.O. Box: 9178613111, Mashhad, Iran.
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Abedi M, Ghasemi Y, Nemati MM. Nanotechnology in toothpaste: Fundamentals, trends, and safety. Heliyon 2024; 10:e24949. [PMID: 38317872 PMCID: PMC10838805 DOI: 10.1016/j.heliyon.2024.e24949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
Several studies have revealed that healthcare nanomaterials are widely used in numerous areas of dentistry, including prevention, diagnosis, treatment, and repair. Nanomaterials in dental cosmetics are utilized to enhance the efficacy of toothpaste and other mouthwashes. Nanoparticles are added to toothpastes for a variety of reasons, including dental decay prevention, remineralization, hypersensitivity reduction, brightening, and antibacterial qualities. In this review, the benefits and uses of many common nanomaterials found in toothpaste are outlined. Additionally, the capacity and clinical applications of nanoparticles as anti-bacterial, whitening, hypersensitivity, and remineralizing agents in the treatment of dental problems and periodontitis are discussed.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Nemati
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Meng Y, Huang F, Wang S, Huang X, Lu Y, Li Y, Dong Y, Pei D. Evaluation of dentinal tubule occlusion and pulp tissue response after using 980-nm diode laser for dentin hypersensitivity treatment. Clin Oral Investig 2023; 27:4843-4854. [PMID: 37382717 DOI: 10.1007/s00784-023-05114-y] [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: 04/12/2023] [Accepted: 06/07/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of the 980-nm diode laser for dentinal tubule occlusion, measure the intrapulpal temperature, and investigate the dental pulp response. MATERIALS AND METHODS The dentinal samples were randomly divided into G1-G7 groups: control; 980-nm laser irradiation (0.5 W, 10 s; 0.5 W, 10 s × 2; 0.8 W, 10 s; 0.8 W, 10 s × 2; 1.0 W, 10 s; 1.0 W, 10 s × 2). The dentin discs were applied for laser irradiation and analyzed by scanning electron microscopy (SEM). The intrapulpal temperature was measured on the 1.0-mm and 2.0-mm thickness samples, and then divided into G2-G7 groups according to laser irradiation. Moreover, forty Sprague Dawley rats were randomly divided into the laser-irradiated group (euthanized at 1, 7, and 14 days after irradiation) and the control group (non-irradiated). qRT-PCR, histomorphology, and immunohistochemistry analysis were employed to evaluate the response of dental pulp. RESULTS SEM indicated the occluding ratio of dentinal tubules in the G5 (0.8 W, 10 s × 2) and G7 (1.0 W, 10 s × 2) were significantly higher than the other groups (p < 0.05). The maximum intrapulpal temperature rises in the G5 were lower than the standard line (5.5 ℃). qRT-PCR showed that the mRNA expression level of TNF-α and HSP-70 upregulated significantly at 1 day (p < 0.05). Histomorphology and immunohistochemistry analysis showed that, compared with the control group, the inflammatory reaction was slightly higher at the 1 and 7 days (p < 0.05) and decreased to the normal levels at 14 days (p > 0.05). CONCLUSIONS A 980-nm laser at a power of 0.8 W with 10 s × 2 defines the best treatment for dentin hypersensitivity in terms of compromise between the efficacy of the treatment and the safety of the pulp. CLINICAL RELEVANCE The 980-nm laser is an effective option for treating dentin sensitivity. However, we need to ensure the safety of the pulp during laser irradiation.
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Affiliation(s)
- Yuchen Meng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Fan Huang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Silin Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Xin Huang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yi Lu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yuncong Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yulin Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China.
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China.
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Paszynska E, Pawinska M, Enax J, Meyer F, Schulze zur Wiesche E, May TW, Amaechi BT, Limeback H, Hernik A, Otulakowska-Skrzynska J, Krahel A, Kaminska I, Lapinska-Antonczuk J, Stokowska E, Gawriolek M. Caries-preventing effect of a hydroxyapatite-toothpaste in adults: a 18-month double-blinded randomized clinical trial. Front Public Health 2023; 11:1199728. [PMID: 37533523 PMCID: PMC10393266 DOI: 10.3389/fpubh.2023.1199728] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste (test) and a toothpaste with sodium fluoride (1450 ppm fluoride; positive control) in adults. Methods The primary endpoint was the percentage of subjects showing no increase in overall Decayed Missing Filled Surfaces (DMFS) index. The study was designed as non-inferiority trial. Non-inferiority was claimed if the upper limit of the exact one-sided 95% confidence interval for the difference of the primary endpoint DMFS between test and control toothpaste was less than the predefined margin of non-inferiority (Δ ≤ 20%). Results In total, 189 adults were included in the intention-to-treat (ITT) analysis; 171 subjects finished the study per protocol (PP). According to the PP analysis, no increase in DMFS index was observed in 89.3% of subjects of the hydroxyapatite group and 87.4% of the subjects of the fluoride group. The hydroxyapatite toothpaste was not statistically inferior to a fluoride toothpaste with regard to the primary endpoint. Conclusion Hydroxyapatite was proven to be a safe and efficient anticaries agent in oral care. Clinical trial registration NCT04756557.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University of Bialystok, Bialystok, Poland
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | | | - Theodor W. May
- Society for Biometrics and Psychometrics, Bielefeld, Germany
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Hardy Limeback
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Anna Krahel
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Inga Kaminska
- Department of Integrated Dentistry, Medical University of Bialystok, Bialystok, Poland
| | | | - Ewa Stokowska
- Department of Gerostomatology, Medical University of Bialystok, Bialystok, Poland
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
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Wang S, Meng Y, Zhang Y, Huang F, Teng R, Lu Y, Li A, Sun J, Pei D. Influence of calcium-based desensitizing toothpastes on the bonding performance of universal adhesive. Microsc Res Tech 2023; 86:402-413. [PMID: 36575979 DOI: 10.1002/jemt.24280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/20/2022] [Accepted: 12/11/2022] [Indexed: 12/29/2022]
Abstract
The study evaluated the effect of calcium-based desensitizing toothpastes on the dentinal tubule occlusion and its influence on the dentin bond strength of universal adhesive. Mid-coronal dentin samples were prepared for hypersensitivity model and treated by the following calcium-based desensitizing toothpastes: no treatment (Control), Clinpro (fTCP), Pro-Relief (Pro-Argin), and Repair & Protect (Novamin). Single Bond Universal adhesive was applied in self-etch or etch-and-rinse mode. The dentinal tubule occlusion and adhesion interface were evaluated under scanning electron microscope (SEM). A double-fluorescence technique was used to examine interfacial permeability under confocal laser scanning microscopy (CLSM). The micro-tensile bond strength (μTBS) was employed, followed by the fracture interface observation. SEM showed the toothpastes occluded dentinal tubules, and the occlusion exhibited stability against acid and abrasion. Hindered resin infiltration was observed in the adhesion interface after desensitization. CLSM showed more water permeation within or under the adhesion interface in etch-and-rinse mode than self-etch mode. Desensitization decreased the μTBS in self-etch mode. When using etch-and-rinse mode, the desensitized samples presented similar μTBS to the control group. No difference in μTBS was found between the two bonding modes, except for the control group. Calcium-based desensitizing toothpastes can effectively occlude the exposed dentinal tubules with acid-resistant and abrasion-resistant stability. The desensitization reduced the dentin bond strength of the universal adhesive system in self-etch mode but did not affect the bond strength of etch-and-rinse mode.
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Affiliation(s)
- Silin Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuchen Meng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Fan Huang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Rui Teng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yi Lu
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Junyi Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
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Jang JH, Oh S, Kim HJ, Kim DS. A randomized clinical trial for comparing the efficacy of desensitizing toothpastes on the relief of dentin hypersensitivity. Sci Rep 2023; 13:5271. [PMID: 37002263 PMCID: PMC10066268 DOI: 10.1038/s41598-023-31616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
The 4-week double-blind clinical trial to manage dentin hypersensitivity (DH) using different desensitizing toothpastes was conducted. 53 participants with DH were enrolled in this trial. The participants were randomized into 3 groups: Group N; no active ingredient-containing toothpaste (Pleasia fluoride-free), Group SC; a toothpaste containing strontium chloride (Sensodyne Original), and Group TP; a toothpaste containing tricalcium phosphate (Vussen S). They were instructed to brush their teeth manually for 3 min, 3 times per day for 4 weeks with the allocated toothpastes, and were assessed at baseline (0), 2, and 4 weeks, respectively. Schiff sensitivity score was recorded to 3 different stimuli (air-blast, cold, and acid) at each assessment. Overall DH was also assessed using a visual analog scale (VAS). The longer participants used the toothpastes, the greater reduction in DH in all groups to the three stimuli. Group TP demonstrated significant reduction of DH compared to group N for air-blast and cold stimuli. Group TP showed significantly lower VAS than group N and SC. Tricalcium phosphate containing toothpaste used in this trial was most useful to reduce DH. It can be one of the treatment options that alleviate DH.
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Affiliation(s)
- Ji-Hyun Jang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea
| | - Soram Oh
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea
| | - Hyun-Jung Kim
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea
| | - Duck-Su Kim
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, 02447, Seoul, Republic of Korea.
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Comparative efficacy of self-administered dentifrices for the management of dentine hypersensitivity - A systematic review and network meta-analysis. J Dent 2023; 130:104433. [PMID: 36753794 DOI: 10.1016/j.jdent.2023.104433] [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: 10/02/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES This systematic review with network meta-analysis synthesises available randomised controlled trials evidence concerning efficacy of self-administered dentifrices for management of dentine hypersensitivity (DH) pain. STUDY SELECTION Following systematic review registration (CRD42019154064), three data bases (MEDLINE, Embase, CENTRAL) were searched to December 2022 for parallel randomised controlled trials conducted in adults diagnosed with DH, using at least two recognised stimuli, assessing the short-term efficacy of home-use dentifrice treatment in reducing pain. Thirty-two studies and 4,638 participants were included. A Network meta-analysis (NMA) approach was used to compare relative effectiveness between interventions. CONCLUSIONS Twice daily application of self-applied dentifrice containing formulations of stannous, potassium +/- stannous, or arginine can be recommended for the reduction of dentine hypersensitivity pain. There is a need for standardised methodology guideline development to improve the conduct, analysis and reporting of DH clinical studies. CLINICAL RELEVANCE This is the first comprehensive NMA to be performed, that follows guidelines for conduct of DH trials to determine the efficacy of self-applied dentifrices for the management of dentine hypersensitivity. Indirect comparisons can be made between formulations that have not been compared to one another in randomised controlled trials.
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Limeback H, Meyer F, Enax J. Tooth Whitening with Hydroxyapatite: A Systematic Review. Dent J (Basel) 2023; 11:dj11020050. [PMID: 36826195 PMCID: PMC9955010 DOI: 10.3390/dj11020050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
A steadily increasing public demand for whiter teeth has resulted in the development of new oral care products for home use. Hydroxyapatite (HAP) is a new ingredient to whiten teeth. This systematic review focuses on the evidence of whether HAP can effectively whiten teeth. A systematic search using the PICO approach and PRISMA guidelines was conducted using PubMed, Scopus, Web of Science, SciFinder, and Google Scholar as databases. All study designs (in vitro, in vivo) and publications in foreign language studies were included. Of the 279 study titles that the searches produced, 17 studies met the inclusion criteria. A new "Quality Assessment Tool For In Vitro Studies" (the QUIN Tool) was used to determine the risk of bias of the 13 studies conducted in vitro. Moreover, 12 out of 13 studies had a low risk of bias. The in vivo studies were assigned Cochrane-based GRADE scores. The results in vitro and in vivo were consistent in the direction of showing a statistically significant whitening of enamel. The evidence from in vitro studies is rated overall as having a low risk of bias. The evidence from in vivo clinical trials is supported by modest clinical evidence based on six preliminary clinical trials. It can be concluded that the regular use of hydroxyapatite-containing oral care products effectively whitens teeth, but more clinical trials are required to support the preliminary in vivo evidence.
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Affiliation(s)
- Hardy Limeback
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada
- Correspondence:
| | - Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Limeback H, Enax J, Meyer F. Clinical Evidence of Biomimetic Hydroxyapatite in Oral Care Products for Reducing Dentin Hypersensitivity: An Updated Systematic Review and Meta-Analysis. Biomimetics (Basel) 2023; 8:biomimetics8010023. [PMID: 36648809 PMCID: PMC9844412 DOI: 10.3390/biomimetics8010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/21/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023] Open
Abstract
Dentin hypersensitivity (DH) is a very common dental problem that can have a negative impact on the quality of life and can lead to invasive dental procedures. Prevention of DH and control of symptoms are highly desirable. Hydroxyapatite (HAP) has been shown in vitro to block dentinal tubules and in vivo to be a safe and effective additive in oral care products that reduce DH clinically. This study's aim was to conduct a systematic review and meta-analysis of the current evidence that HAP-containing oral care products reduce DH. Databases were searched, and only clinical trials in humans were included; studies conducted in vitro or on animals were not included. Publications in a foreign language were translated and included. We found 44 published clinical trials appropriate for systematic analysis. More than half of the trials had high-quality GRADE scores. HAP significantly reduced dentin hypersensitivity compared to placebo (39.5%; CI 95% [48.93; 30.06]), compared to fluoride (23%; CI 95% [34.18; 11.82]), and with a non-significant tendency compared to other desensitizing agents (10.2%; CI 95% [21.76; -19.26]). In conclusion, the meta-analysis showed that HAP added to oral care products is a more effective agent than fluoride in controlling dentin hypersensitivity and may be superior to other desensitizers.
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Affiliation(s)
- Hardy Limeback
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G1G6, Canada
- Correspondence:
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Enax J, Amaechi BT, Schulze zur Wiesche E, Meyer F. Overview on Adjunct Ingredients Used in Hydroxyapatite-Based Oral Care Products. Biomimetics (Basel) 2022; 7:biomimetics7040250. [PMID: 36546950 PMCID: PMC9775056 DOI: 10.3390/biomimetics7040250] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial oral care products such as toothpastes and mouthwashes worldwide. Clinical studies (in vivo) as well as in situ and in vitro studies have shown the preventive effects of hydroxyapatite in various field of oral care. In some products, hydroxyapatite is combined with other active ingredients, to achieve an additional antibacterial effect or to promote gum health. This review analyzes the efficacy of six selected natural and nature-inspired ingredients that are commonly used together with hydroxyapatite. These additional actives are either antibacterial (lactoferrin, xylitol, and zinc) or promote gum health (allantoin, bisabolol, and hyaluronic acid). A systematic literature search was performed, and all studies found on each ingredient were analyzed. In summary, all analyzed ingredients mentioned in this review are well described in scientific studies on their beneficial effect for oral health and can be used to expand the preventive effect of hydroxyapatite in oral care products.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (F.M.)
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Erik Schulze zur Wiesche
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (F.M.)
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Amaechi BT, Farah R, Liu JA, Phillips TS, Perozo BI, Kataoka Y, Meyer F, Enax J. Remineralization of molar incisor hypomineralization (MIH) with a hydroxyapatite toothpaste: an in-situ study. BDJ Open 2022; 8:33. [PMID: 36496424 PMCID: PMC9741585 DOI: 10.1038/s41405-022-00126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
AIM This randomized, double-blind, crossover, in-situ study, compared the efficacy of toothpastes based on microcrystalline hydroxyapatite (HAP; fluoride-free) or fluoride, in remineralizing molar incisor hypomineralization (MIH). METHODS Two lesion-bearing enamel blocks were produced from each of thirty extracted permanent molars diagnosed with MIH. Sixty produced blocks were randomly assigned to two groups (30/group): 20% HAP or 1450 ppm fluoride toothpaste. Each group was subdivided into, etched (n = 20), with lesion surface treated with 32% phosphoric acid-etchant for 5 s, and unetched (n = 10). Blocks were cemented into intra-oral appliances (2 blocks/appliance) worn full-time by 15 subjects. Subjects used the toothpastes in a two-phase crossover manner, lasting 14 days per phase, after one-week washout period. Baseline and post-treatment mineral density (MD) was quantified using microcomputed tomography. RESULTS Overall, both groups showed statistically significant (paired t-test; p < 0.001) net-gain when MD was compared pre-treatment and post-treatment. HAP: pre-treatment (1.716 ± 0.315) and post-treatment (1.901 ± 0.354), Fluoride: pre-treatment (1.962 ± 0.363) and post-treatment (2.072 ± 0.353). Independent t-test demonstrated a practically significantly (≥10%) higher percentage remineralization with HAP toothpaste (26.02 ± 20.68) compared with fluoride toothpaste (14.64 ± 9.60). Higher percentage remineralization was observed in etched than unetched samples. CONCLUSION The tested toothpaste based on hydroxyapatite can remineralize MIH lesions. Pre-treating the tooth surface with acid-etchant enhanced remineralization.
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Affiliation(s)
- Bennett Tochukwu Amaechi
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Rayane Farah
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Jungyi Alexis Liu
- grid.267309.90000 0001 0629 5880Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Thais Santiago Phillips
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Betty Isabel Perozo
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Yuko Kataoka
- grid.267309.90000 0001 0629 5880Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Kanouté A, Dieng SN, Diop M, Dieng A, Sene AK, Diouf M, Lo CM, Faye D, Carrouel F. Chemical vs. natural toothpaste: which formulas for which properties? A scoping review. J Public Health Afr 2022; 13:1945. [PMID: 36277937 PMCID: PMC9585602 DOI: 10.4081/jphia.2022.1945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The proliferation of the oral care industry has made it more challenging for shoppers to zero in on the best possible toothpaste for their preventative requirements. It also makes the toothpaste’s various components safer. Objective The researchers set out to evaluate the state of information about the biological properties and cytotoxicity of adult toothpaste so that they might make some informed recommendations. Methods A scoping review of research published between 2015 and 2020 according to PRISMA guidelines was performed. Results In vitro clinical trials account for 44% of the papers, in vivo clinical trials for 25%, systematic reviews for 19%, and metaanalyses for 12%. They have active chemical components that have been shown to be antimicrobial, anti-inflammatory, or desensitizing. Herbal toothpaste has these characteristics and is very secure to use. Toothpaste with sodium lauryl sulfate has been found to be harmful. Conclusions Scientists have investigated the biological effects of a wide range of chemically active compounds and plant extracts. Herbal toothpaste, it has been discovered, is both efficient and secure. Companies making toothpaste should be required to clearly label the product’s qualities, active ingredients, and potentially harmful ingredients on the packaging.
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Incorporation of Fluoride into Human Teeth after Immersion in Fluoride-Containing Solutions. Dent J (Basel) 2022; 10:dj10080153. [PMID: 36005251 PMCID: PMC9406395 DOI: 10.3390/dj10080153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023] Open
Abstract
Toothpastes and mouth rinses contain fluoride as a protective agent against caries. The aim of this study was to determine the degree of fluoride-uptake by human tooth mineral during immersion into fluoride-containing aqueous solutions as different pH. Human teeth were immersed in fluoride-containing solutions to assess the extent of fluoride incorporation into tooth enamel. A total of 16 extracted teeth from 11 patients were immersed at 37 °C for one minute into aqueous fluoride solutions (potassium fluoride; KF) containing either 250 ppm or 18,998 ppm fluoride (1-molar). Fluoride was dissolved either in pure water (neutral pH) or in a citrate buffer (pH 4.6 to 4.7). The elemental surface composition of each tooth was studied by energy-dispersive X-ray spectroscopy in combination with scanning electron microscopy and X-ray powder diffraction. The as-received teeth contained 0.17 ± 0.16 wt% fluoride on average. There was no significant increase in the fluoride content after immersion in 250 ppm fluoride solution at neutral or acidic pH values. In contrast, a treatment with a 1-molar fluoride solution led to significantly increased fluoride concentrations by 0.68 wt% in water and 9.06 wt% at pH 4.7. Although such fluoride concentrations are far above those used in mouth rinses or toothpastes, this indicates that fluoride can indeed enter the tooth surface, especially at a low pH where a dynamic dissolution-reprecipitation process may occur. However, precipitations of calcium fluoride (globuli) were detected in no cases.
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Grover V, Kumar A, Jain A, Chatterjee A, Grover HS, Pandit N, Satpathy A, Madhavan Pillai BR, Melath A, Dhruvakumar D, Thakur R, Joshi NV, Deshpande N, Dadlani H, Meenakshi AA, Ashok KP, Reddy KV, Bhasin MT, Salaria SK, Verma A, Gaikwad RP, Darekar H, Amirisetty R, Phadnaik M, Karemore V, Dhulipalla R, Mody D, Rao TS, Chakarpani S, Ranganath V. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol 2022; 26:307-333. [PMID: 35959314 PMCID: PMC9362809 DOI: 10.4103/jisp.jisp_233_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Jain
- Department of Periodontology, Dental Institute, Regional Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anirban Chatterjee
- Department of Periodontology, Renupriya Dental Health Care, Bengaluru, Karnataka, India
| | | | - Nymphea Pandit
- Department of Periodontology, D. A. V Dental College and Hospital, Yamunanagar, Haryana, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha "O" Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | | | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India
| | - Deepa Dhruvakumar
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, India
| | - Nilesh V Joshi
- Department of Periodontology, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be) University, Navi Mumbai, India
| | - Neeraj Deshpande
- Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Meerut, Uttar Pradesh, India
| | - A Archana Meenakshi
- Department of Periodontology, Ragas Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - K P Ashok
- Department of Periodontics, GSL Dental College, Rajahmundry, India
| | - K Vinathi Reddy
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | - Meenu Taneja Bhasin
- Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Haryana, India
| | | | - Abhishek Verma
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | | | | | - Ramesh Amirisetty
- Department of Periodontology, G. Pulla Reddy Dental College and Hospital, Dr. NTR University of Health Sciences, Kurnool, Andhra Pradesh, India
| | - Mangesh Phadnaik
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Vaibhav Karemore
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Ravindranath Dhulipalla
- Department of Periodontology, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - Dhawal Mody
- VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Tushar Shri Rao
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Swarna Chakarpani
- Department of Periodontics, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - V Ranganath
- Department of Periodontics, AECS Maaruti Dental College and Research Center, Bengaluru, Karnataka, India
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Meyer F, Enax J, Amaechi BT, Limeback H, Fabritius HO, Ganss B, Pawinska M, Paszynska E. Hydroxyapatite as Remineralization Agent for Children's Dental Care. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.859560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Children are prone to develop dental caries. This is supported by epidemiological data confirming early childhood caries (ECC) as a highly prevalent disease affecting more than every second child worldwide. ECC is known to result from an imbalance between re- and demineralization where demineralization dominates due to frequent acid production by cariogenic bacteria present in oral biofilms. The application of oral care formulations containing remineralizing agents helps to prevent dental caries. As young children are sensitive and usually swallow (intended or unintended) a majority of toothpaste or other oral care products during daily dental care, all ingredients, especially the actives, should be non-toxic. Biomimetic hydroxyapatite [HAP; Ca5(PO4)3(OH)] is known to have favorable remineralizing properties combined with an excellent biocompatibility, i.e., it is safe if accidently swallowed. Several clinical trials as well as in situ and in vitro studies have shown that HAP remineralizes enamel and dentin. Remineralization occurs due to deposition of HAP particles on tooth surfaces forming mineral-mineral bridges with enamel crystals, but also indirectly through calcium and phosphate ions release as well as HAP's buffering properties in acidic environments (i.e., in plaque). HAP induces a homogenous remineralization throughout the subsurface enamel lesions. This review summarizes the current evidence showing HAP as an effective remineralizing agent in oral care products for children. Additional studies showing also further beneficial effects of HAP such as the reduction of biofilm formation and the relief of hypersensitivity in children with molar incisor hypomineralization (MIH). It can be concluded that HAP is an effective and safe remineralizing agent for child dental care.
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Martins CC, Riva JJ, Firmino RT, Schünemann HJ. Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review. J Appl Oral Sci 2022; 30:e20210410. [PMID: 35262559 PMCID: PMC8908863 DOI: 10.1590/1678-7757-2021-0410] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). Methodology: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). Results: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. Conclusion: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.
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Affiliation(s)
- Carolina Castro Martins
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.,McMaster University, Hamilton, Canada
| | | | - Ramon Targino Firmino
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.,McMaster University, Hamilton, Canada.,UNIFACISA Centro Universitário, Campina Grande, Brasil
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Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Novozhilova N. The effect of toothpastes containing hydroxyapatite, fluoroapatite, and Zn-Mg-hydroxyapatite nanocrystals on dentin hypersensitivity: A randomized clinical trial. J Int Soc Prev Community Dent 2022; 12:252-259. [PMID: 35462739 PMCID: PMC9022388 DOI: 10.4103/jispcd.jispcd_333_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 11/04/2022] Open
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Fabritius-Vilpoux K, Enax J, Mayweg D, Meyer F, Herbig M, Raabe D, Fabritius HO. Ultrastructural changes of bovine tooth surfaces under erosion in presence of biomimetic hydroxyapatite. BIOINSPIRED BIOMIMETIC AND NANOBIOMATERIALS 2021. [DOI: 10.1680/jbibn.21.00017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Enamel and dentin are susceptible to acids from food sources leading to dental erosion, a global problem affecting millions of individuals. Particulate hydroxyapatite (HAP) on the tooth surface can influence the effects of acid attacks. Standardized bovine enamel and dentin samples with artificial saliva are used in an in vitro cyclic demineralization–remineralization protocol to analyze the structural changes experienced by tooth surfaces using high-resolution scanning electron microscopy and to evaluate the potential of a HAP-based oral care gel in the protection of teeth from erosive attacks. The interfaces between HAP particle and enamel HAP crystallites are investigated using focused ion beam preparation and transmission electron microscopy. The results show that erosion with phosphoric acid severely affects enamel crystallites and dentin tubules, while artificial saliva leads to remineralization effects. The HAP-gel forms a microscopic layer on both enamel and dentin surfaces. Upon acid exposure, this layer is sacrificed before the native tooth tissues are affected, leading to significantly lower degrees of demineralization compared to the controls. This demonstrates that the use of particulate HAP as a biomaterial in oral care formulations can help protect enamel and dentin surfaces from erosive attacks during meals using a simple and effective protection principle.
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Affiliation(s)
- Kathia Fabritius-Vilpoux
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - David Mayweg
- Department of Physics, Chalmers University of Technology, Göteborg, Sweden; Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Michael Herbig
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Dierk Raabe
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany
| | - Helge-Otto Fabritius
- Microstructure Physics and Alloy Design, Max-Planck-Institut für Eisenforschung GmbH, Düsseldorf, Germany; Bionics and Materials Development, Hamm-Lippstadt University of Applied Sciences, Hamm, Germany
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19
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The use of hydroxyapatite toothpaste to prevent dental caries. Odontology 2021; 110:223-230. [PMID: 34807345 PMCID: PMC8930857 DOI: 10.1007/s10266-021-00675-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/31/2021] [Indexed: 12/30/2022]
Abstract
Dissolution of hydroxyapatite from the tooth structure at low pH can lead to the irreversible destruction of enamel and dentin, which if left untreated can result in pain and tooth loss. Hydroxyapatite toothpastes contain hydroxyapatite particles in micro- or nanocrystalline form that have been shown to deposit and restore demineralized enamel surfaces. As such, they are currently being explored as a fluoride-free anti-caries agent. This narrative review article aims to summarize the recent findings of the research investigating the remineralization potential of HAP toothpaste in vitro, in situ and in vivo, as well as some other applications in dentistry.
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Arshad S, Zaidi SJA, Farooqui WA. Comparative efficacy of BioMin-F, Colgate Sensitive Pro-relief and Sensodyne Rapid Action in relieving dentin hypersensitivity: a randomized controlled trial. BMC Oral Health 2021; 21:498. [PMID: 34615511 PMCID: PMC8493541 DOI: 10.1186/s12903-021-01864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
Background Dentin hypersensitivity (DH) is a sharp toothache that influences a patients' oral health-related quality of life. Oral dentifrices have been marketed for pain relief within a minute for DH. The permanent management of DH is being investigated with the remineralisation potential of bioactive agents in dentinal tubules. This study investigated the relief from pain in DH in one minute after applying over the counter (OTC) dentifrices with Pro-Argin™ and strontium acetate and directly compared them with fluoro-calcium phospho-silicate (FCPS)-based dentifrices for immediate and sustained inhibition of painful stimulus provoking DH.
Methods A randomised, controlled, triple-blinded clinical trial was conducted with 140 participants clinically diagnosed with DH and equally randomized into four groups with parallel treatment assignment of FCPS, Pro-Argin™, 8% strontium acetate, and sodium fluoride-based OTC dentifrices, and tested for DH with air blast, mechanical, and water jet stimuli on SCHIFF cold air sensitivity scale (SCASS) and visual analogue scale (VAS) at interim efficacy intervals of one minute, three days, two, four, and six weeks, subsequently. Results A total of 128 participants completed the trial. All the treatment groups showed statistically significant improvement in DH with p < 0.001 relative to baseline at all time points. Pro-Argin™ showed a greater reduction in DH with mean scores of (1.34 ± 0.68) (4.20 ± 1.70) (3.05 ± 2.17) followed by strontium acetate (1.57 ± 0.81) (4.65 ± 1.87) (3.75 ± 1.97) on SCASS and VAS for mechanical and water jet stimuli, one minute after application. There was no statistically significant treatment difference between the two (p = 0.499). FCPS showed the highest reduction in DH on SCASS and VAS for waterjet stimuli with mean scores of (0.97 ± 0.68) (1.80 ± 1.73) and Pro-Argin™ on VAS for mechanical stimuli with mean scores of (2.15 ± 1.92) in six weeks. Conclusion OTC dentifrices with Pro-argin™ and strontium acetate are effective for immediate pain relief from DH, and FCPS could be the best possible treatment option for long term management of DH. Trial registration ID: NCT04249336 (https://clinicaltrials.gov/ct2/show/NCT04249336), Date of Registration: January 30, 2020 (Retrospectively registered).
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Affiliation(s)
- Saba Arshad
- Department of Oral Biology, Dr. Ishrat-Ul-Ebad Khan Institute of Oral Health Sciences (DIKIOHS), Dow University of Health Sciences, Karachi, Pakistan.
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Waqas Ahmed Farooqui
- Department of Research, School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
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Sun YX, Yang GY, Karamacoska D, Wang X, Li YX, Hou WB, Zheng YY, Liu JP, Liu ZL. Chinese Patent Medicine as Adjuvant for Mild-to-Moderate Active Ulcerative Colitis: A Network Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:1075886. [PMID: 34484384 PMCID: PMC8413025 DOI: 10.1155/2021/1075886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/17/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the effectiveness and safety of Chinese patent medicine for mild-to-moderate active ulcerative colitis (UC) using network meta-analysis (NMA). METHODS We systematically searched PubMed, Cochrane library, Embase, Sino-Med, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific Journal Database (VIP) databases to October, 2020. We included randomized controlled trials (RCTs) on Chinese patent medicine for mild-to-moderate active UC. The main analysis was complemented by network subanalyses and standard pairwise comparisons. Statistical heterogeneity, inconsistencies, and ranking probability were also evaluated. RESULTS The databases search identified 3222 citations, of which 33 RCTs involving 2971 patients met the inclusion criteria. A total of 15 Chinese patent medicines were analyzed. The overall quality of the included studies was low. Pairwise meta-analysis showed that Chinese patent medicine was superior to Mesalazine in improving disappearances of clinical symptoms, recurrence rate, and Mayo score. Based on decreases in adverse events, results from NMA showed that Xilei powder plus Mesalazine was more effective than other drugs. Other NMA results indicated that Danshen freeze-dried powder plus Mesalazine (RR: 0.13; 95% CI, 0.02-0.78) and Kangfuxin lotion plus Mesalazine (RR: 0.24; 95% CI, 0.07-0.57) were superior to Mesalazine in decreasing recurrence rate. Another NMA result indicated that Kangfuxin lotion plus Mesalazine (RR: 0.00; 95% CI, 0.00-0.02) and Zhi Kang capsule plus Mesalazine (RR: 0.00; 95% CI, 0.00-0.02) were superior to Mesalazine in increasing the disappearance of tenesmus. CONCLUSION In the probability sorting, Xilei powder combined with Mesalazine ranked first for having the fewest adverse events, Maintaining Intestines Antidiarrheal Pills combined with Mesalazine ranked first for having the lowest recurrence rate, Xilei powder combined with Mesalazine ranked first for improving disappearance rate of mucopurulent bloody stool/abdominal pain, and Kangfuxin lotion combined with Mesalazine ranked first for improving the disappearance rate of diarrhea/tenesmus. However, there is a lack of direct comparisons among Chinese patent medicines for UC. More multiarm RCTs are needed in the future to provide direct comparative evidence.
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Affiliation(s)
- Yu-Xin Sun
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Guo-Yan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Xiao Wang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Yuan-Xi Li
- College of Statistics and Data Science, Faculty of Science, Beijing University of Technology, Beijing 100124, China
| | - Wen-Bin Hou
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - You-You Zheng
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Zhao-Lan Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
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22
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Bonding Performance of Universal Adhesives Applied to Nano-Hydroxyapatite Desensitized Dentin Using Etch-and-Rinse or Self-Etch Mode. MATERIALS 2021; 14:ma14164746. [PMID: 34443268 PMCID: PMC8398634 DOI: 10.3390/ma14164746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
The study assessed the bonding performance of three universal adhesives on desensitized dentin with etch-and-rinse mode or self-etch mode after nano-hydroxyapatite (nHAp)-based desensitizers application. Simulated sensitive dentin specimens were prepared and separated into four groups: no treatment as the negative control, groups desensitized by Biorepair toothpaste, Dontodent toothpaste, or nHAp paste. Three universal adhesives of All-Bond Universal, Single Bond Universal, and Clearfil Universal Bond with etch-and-rinse or self-etch mode were bonded to the desensitized dentin specimens separately, followed by resin composite build-ups. Micro-tensile bond strength was measured using a micro-tensile tester. The wettability of desensitized dentin was evaluated by the contact angle of the adhesives. Resin infiltration was observed by confocal laser scanning microscopy. Dentin tubular occlusion and nanoleakage were observed by scanning electron microscope. The results showed that the etch-and-rinse or self-etch mode of each adhesive showed similar bond strength when bonding to nHAp-based desensitized dentin. The dentin surface was partially covered by desensitizers after desensitization. Compared with the self-etch mode, stronger demineralization and more reopened dentin tubules were observed in the etch-and-rinse mode after acid etching; longer resin tags and more nanoleakage in the resin-dentin interface were observed when using the etch-and-rinse mode. When bonding to nHAp-based desensitized dentin with universal adhesives, no significant difference in bond strength was found between self-etch mode or etch-and-rinse mode; while the latter produced more nanoleakage in the resin-dentin interfaces.
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Meyer F, Enax J, Epple M, Amaechi BT, Simader B. Cariogenic Biofilms: Development, Properties, and Biomimetic Preventive Agents. Dent J (Basel) 2021; 9:dj9080088. [PMID: 34436000 PMCID: PMC8394942 DOI: 10.3390/dj9080088] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022] Open
Abstract
Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva contains many different organic and inorganic compounds that help to buffer organic acids produced by cariogenic microorganisms. However, most oral care products only contain remineralizing agents. To improve the benefit of those products, further active ingredients are needed. Books, review articles, and original research papers were included in this narrative review. Putting all these data together, we give an overview of oral biofilms and active compounds used in modern oral care products to interact with them. The special focus is on inorganic compounds and their interaction with oral biofilms. While organic compounds have several limitations (e.g., cell toxicity), inorganic compounds based on calcium and/or phosphate (e.g., sodium bicarbonate, hydroxyapatite, calcium carbonate) offer several advantages when used in oral care products. Calcium release can inhibit demineralization, and the release of hydroxide and phosphate ions might help in the buffering of acids. Therefore, the focus of this review is to summarize the scientific background of further active ingredients that can be used for oral care formulations.
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Affiliation(s)
- Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
- Correspondence: ; Tel.: +49-521-8808-6061
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
| | - Matthias Epple
- Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Universitaetsstr. 5-7, 45117 Essen, Germany;
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA;
| | - Barbara Simader
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
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Ongphichetmetha N, Lertpimonchai A, Champaiboon C. Bioactive glass and arginine dentifrices immediately relieved dentine hypersensitivity following non-surgical periodontal therapy: A randomized controlled trial. J Periodontol 2021; 93:246-255. [PMID: 34061357 DOI: 10.1002/jper.21-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/12/2021] [Accepted: 05/25/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is no report concerning calcium sodium phosphosilicate (CSPS) and arginine dentifrices in reducing dentine hypersensitivity (DH) in patients undergoing non-surgical periodontal therapy. The aim of the study was to compare the efficacy of a dentifrice containing bioactive glass, 5% CSPS, and 8% arginine dentifrice in relieving DH in patients undergoing non-surgical therapy. METHODS Using a double-blind randomized controlled trial, 45 volunteers with DH following non-surgical therapy were immediately applied with one of three dentifrices containing: 5% CSPS, 8% arginine, or control on DH teeth. The participants then continued to brush twice daily for 8 weeks. DH was assessed using the Schiff cold air sensitivity scale and tactile tests at baseline, immediately after application, and up to 8 weeks. RESULTS The Schiff analysis revealed that the CSPS dentifrice significantly reduced DH immediately and declined through week 8. The arginine group demonstrated reduced DH through week 2. In contrast, DH reduction in the control began later at week 1. The visual analog scale analysis demonstrated that only CSPS had a significantly reduced percentage DH at the immediate, 2, 4, and 8 weeks compared with the baseline. The percentage of patients with DH (Schiff score ≥2) in the CSPS and arginine groups reduced to ≈ 50% after the in-office application. The number of DH patients treated with CSPS then decreased to 9% at the 2-week evaluation. CONCLUSION The CSPS and arginine dentifrices were beneficial in reducing periodontitis patient's discomfort, immediately and in the first 2 weeks following non-surgical periodontal therapy.
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Affiliation(s)
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implants, Chulalongkorn University, Bangkok, Thailand
| | - Chantrakorn Champaiboon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implants, Chulalongkorn University, Bangkok, Thailand
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Seong J, Newcombe RG, Foskett HL, Davies M, West NX. A randomised controlled trial to compare the efficacy of an aluminium lactate/potassium nitrate/hydroxylapatite toothpaste with a control toothpaste for the prevention of dentine hypersensitivity. J Dent 2021; 108:103619. [PMID: 33647373 DOI: 10.1016/j.jdent.2021.103619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES To determine the efficacy of a cosmetic aluminium lactate/potassium nitrate/hydroxylapatite toothpaste for the reduction of dentine hypersensitivity (DH) pain as compared to a control toothpaste containing potassium nitrate. METHODS The study was a randomised, examiner-blind, two treatment arm, parallel controlled trial in healthy adults with at least 2 sensitive teeth (Schiff >2). At baseline, immediately after treatment and at 7 and 14 days of twice-daily brushing of the test or control toothpaste the sensitivity of 2 test teeth was measured following iced-water (Schiff and VAS) and tactile (Yeaple probe) stimuli, and a whole mouth plaque score was obtained. Participants also completed a whole-mouth VAS and DHEQ15 quality of life questionnaire at baseline, 7 and 14 days. RESULTS Both toothpastes reduced DH in test teeth, but pain reduction in the test group was significantly better at all timepoints and by all measures (p = 0.005, tooth-level VAS immediately after brushing; p < 0.001 all other comparisons). There was a relative risk reduction of Schiff sensitivity of 55 % immediately after brushing which rose to 81 % after 7 and 88.6 % after 14 days (all p < 0.001). There were no differences in plaque, whole mouth VAS or DHEQ15 scores at any time point. CONCLUSION This study demonstrated the efficacy of an aluminium lactate/potassium nitrate/hydroxylapatite toothpaste compared to a potassium nitrate control toothpaste for the prevention of dentine hypersensitivity both immediately and over a 2 week period. This agent appears to have potential for pain alleviation from the common oral pain condition of DH and further research is warranted. CLINICAL SIGNIFICANCE DH pain, whilst transient in nature, is arresting in magnitude, affecting quality of life. Daily application of efficacious toothpastes can relieve DH pain however, as yet, there is no gold standard treatment. The results of this study support further investigation of an aluminium lactate/potassium nitrate/hydroxylapatite toothpaste for DH management.
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Affiliation(s)
- Joon Seong
- Clinical Trials Group, School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | | | - Helen L Foskett
- Clinical Trials Group, School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Maria Davies
- Clinical Trials Group, School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
| | - Nicola X West
- Clinical Trials Group, School of Oral and Dental Sciences, University of Bristol, Lower Maudlin Street, Bristol, BS1 2LY, UK.
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Oubenyahya H. Nano hydroxyapatite toothpaste as a treatment for dentine hypersensitivity: A systematic review. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjoralsci.sjoralsci_27_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Whitening Effects of a Novel Oral Care Gel with Biomimetic Hydroxyapatite: A 4-Week Observational Pilot Study. Biomimetics (Basel) 2020; 5:biomimetics5040065. [PMID: 33255509 PMCID: PMC7768512 DOI: 10.3390/biomimetics5040065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/26/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
The whitening effects of an oral care gel based on particulate microcrystalline hydroxyapatite, Ca5(PO4)3(OH), were tested in a 4-week observational pilot study. Patients were recruited from two dental practices in Germany. Participants were asked to complete a questionnaire regarding their personal perception of their tooth color and brightness as well as the level of dentin hypersensitivity at the baseline and after 4 weeks of twice daily use of an oral care gel with hydroxyapatite. Data of 25 patients with a mean age of 46 ± 16 years were analyzed. Various subjective whitening parameters showed a tendency to be improved after the 4-week use. Additionally, patients reported that symptoms of dentin hypersensitivity were significantly reduced (p < 0.05, 95% confidence interval (CI): (0.8; 2.4)), and the tooth surface was significantly smoother (p < 0.05, 95% CI: (0.54; 1.6)). In conclusion, microcrystalline hydroxyapatite is a promising whitening agent for oral care formulations and represents a biomimetic alternative to other whitening agents for daily dental care.
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Martins CC, Firmino RT, Riva JJ, Ge L, Carrasco-Labra A, Brignardello-Petersen R, Colunga-Lozano LE, Granville-Garcia AF, Costa FO, Yepes-Nuñez JJ, Zhang Y, Schünemann HJ. Desensitizing Toothpastes for Dentin Hypersensitivity: A Network Meta-analysis. J Dent Res 2020; 99:514-522. [PMID: 32037944 DOI: 10.1177/0022034520903036] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The goal of this systematic review and network meta-analysis was to compare the relative effects of toothpaste formulations for dentin hypersensitivity (DH), tested in randomized controlled trials (RCTs). We searched 7 databases to February 2019. Paired reviewers independently screened studies, extracted data, and performed risk of bias assessment. The outcome of interest was painful response measured through tactile, cold, and air stimuli. We conducted a random-effects Bayesian network meta-analysis using standardized mean difference (SMD) and their credible intervals (CIs) as the measure of effect for each pain stimuli. We assessed certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We included 125 RCTs (12,541 patients). For tactile stimulus, the following active ingredients showed large beneficial effects compared to fluoride with moderate certainty of evidence (SMD; 95% CI): potassium + stannous fluoride (SnF2) (3.05; 1.69-4.41), calcium sodium phosphosilicate (CSP) (2.14; 0.75-3.53), SnF2 (2.02; 1.06-2.99), potassium + hydroxyapatite (2.47; 0.3-4.64), strontium (1.43; 0.46-2.41), and potassium (1.23; 0.48-1.98). For cold stimulus, CSP showed large beneficial effects compared to fluoride (3.93; 0.34-7.53) with moderate certainty; for air stimulus, arginine (2.22; 1.45-2.99), potassium + hydroxyapatite (2.44; 0.33-4.55), potassium + SnF2 (2.28; 0.87-3.69), CSP (1.98; 0.99-2.98), and SnF2 (1.9; 1.03-2.77) showed large beneficial effects compared to fluoride with moderate to high certainty. Most toothpaste formulations showed evidence of superiority against placebo or fluorides (amine fluoride, sodium monofluorophosphate, or sodium fluoride). CSP was most beneficial for all 3 stimuli with high to moderate certainty. SnF2 alone and potassium combined with SnF2 or hydroxyapatite were beneficial for tactile and air stimulus with high to moderate certainty. Arginine was beneficial for air stimulus, and strontium and potassium were beneficial for tactile stimulus, with moderate certainty.
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Affiliation(s)
- C C Martins
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - R T Firmino
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - J J Riva
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Family Medicine; McMaster University, Hamilton, ON, Canada
| | - L Ge
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - A Carrasco-Labra
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
| | - R Brignardello-Petersen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - L E Colunga-Lozano
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | | | - F O Costa
- Department of Clinical, Pathology and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - J J Yepes-Nuñez
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.,School of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Y Zhang
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - H J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
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