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Vieira APM, Danelon M, Fernandes GL, Berretta AA, Buszinski AFM, Dos Santos L, Delbem ACB, Barbosa DB. Pomegranate extract in polyphosphate-fluoride mouthwash reduces enamel demineralization. Clin Oral Investig 2024; 28:119. [PMID: 38277034 DOI: 10.1007/s00784-024-05495-8] [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: 10/18/2023] [Accepted: 01/06/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To evaluate the anti-demineralizing effect of a mouthwash comprising pomegranate peel extract (PPE 3%), sodium trimetaphosphate (TMP 0.3%), and fluoride (F 225 ppm) in an in situ study, and to assess its irritation potential in an ex vivo study. METHODS This double-blind crossover study was conducted in four phases with 7 days each. Twelve volunteers used palatal appliances containing enamel blocks, which were subjected to cariogenic challenges. The ETF formulation (PPE + TMP + F, pH 7.0), TF formulation (TMP + F, pH 7.0), deionized water (W, pH 7.0), and essential oil commercial mouthwash (CM, 220 ppm F, pH 4.3) were dropped onto the enamel twice daily. The percentage of surface hardness loss, integrated loss of subsurface hardness, calcium, phosphorus, and fluoride in enamel and biofilms were determined. In addition, alkali-soluble extracellular polysaccharide concentrations were analyzed in the biofilms. The irritation potential was evaluated using the hen's egg chorioallantoic membrane test through the vascular effect produced during 300-s of exposure. RESULTS ETF was the most efficacious in preventing demineralization. It also showed the highest concentrations of calcium and phosphorus in the enamel and in the biofilm, as well as the lowest amount of extracellular polysaccharides in the biofilm. In the eggs, ETF produced light reddening, whereas CM led to hyperemia and hemorrhage. CONCLUSIONS The addition of PPE to formulations containing TMP and F increased its anti-demineralizing property, and this formulation presented a lower irritation potential than the CM. CLINICAL RELEVANCE ETF can be a promising alternative alcohol-free mouthwash in patients at high risk of caries.
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Affiliation(s)
- Ana Paula Miranda Vieira
- Graduate Program of Dental Science, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil
| | - Gabriela Lopes Fernandes
- Graduate Program of Dental Science, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil
| | | | | | - Lucinéia Dos Santos
- Department of Biotechnology, São Paulo State University (UNESP), School of Sciences, Humanities and Languages, Assis, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil
| | - Debora Barros Barbosa
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, José Bonifácio 1193, Araçatuba, 16015-050, Brazil.
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Zen I, Delbem ACB, Martins TP, de Morais LA, Sampaio C, Hosida TY, Monteiro DR, Pessan JP. Evaluation of Solutions Containing Fluoride, Sodium Trimetaphosphate, Xylitol, and Erythritol, Alone or in Different Associations, on Dual-Species Biofilms. Int J Mol Sci 2023; 24:12910. [PMID: 37629091 PMCID: PMC10454744 DOI: 10.3390/ijms241612910] [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: 04/20/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 08/27/2023] Open
Abstract
Although the association of polyols/polyphosphates/fluoride has been demonstrated to promote remarkable effects on dental enamel, little is known on their combined effects on biofilms. This study assessed the effects of solutions containing fluoride/sodium trimetaphosphate (TMP)/xylitol/erythritol on dual-species biofilms of Streptococcus mutans and Candida albicans. Biofilms were grown in the continuous presence of these actives alone or in different associations. Quantification of viable plate counts, metabolic activity, biofilm biomass, and extracellular matrix components were evaluated. Overall, fluoride and TMP were the main actives that significantly influenced most of the variables analyzed, with a synergistic effect between them for S. mutans CFUs, biofilm biomass, and protein content of the extracellular matrix (p < 0.05). A similar trend was observed for biofilm metabolic activity and carbohydrate concentrations of the extracellular matrix, although without statistical significance. Regarding the polyols, despite their modest effects on most of the parameters analyzed when administered alone, their co-administration with fluoride and TMP led to a greater reduction in S. mutans CFUs and biofilm biomass compared with fluoride alone at the same concentration. It can be concluded that fluoride and TMP act synergistically on important biofilm parameters, and their co-administration with xylitol/erythritol significantly impacts S. mutans CFUs and biomass reduction.
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Affiliation(s)
- Igor Zen
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Tamires Passadori Martins
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Leonardo Antônio de Morais
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Caio Sampaio
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Thayse Yumi Hosida
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
| | - Douglas Roberto Monteiro
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
- Postgraduate Program in Health Sciences, University of Western Saão Paulo (UNOESTE), Presidente Prudente 19050-920, SP, Brazil
| | - Juliano Pelim Pessan
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Araçatuba 16015-050, SP, Brazil; (I.Z.); (A.C.B.D.); (T.P.M.); (L.A.d.M.); (C.S.); (T.Y.H.); (D.R.M.)
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Oliveira LG, Delbem ACB, Gonçalves FMC, Fernandes GLP, Cannon ML, Danelon M. In vitro effect of low-fluoride toothpaste supplemented with sodium trimetaphosphate, xylitol, and erythritol on enamel demineralization. J Appl Oral Sci 2023; 31:e20220410. [PMID: 37018786 PMCID: PMC10118289 DOI: 10.1590/1678-7757-2022-0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/07/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE Regular use of toothpaste with fluoride (F) concentrations of ≥ 1000 ppm has been shown to contribute to reducing caries increment. However, when used by children during the period of dental development, it can lead to dental fluorosis. In this study, we aimed to evaluate the in vitro effect of a toothpaste formulation with reduced fluoride (F) concentration (200 ppm) supplemented with sodium trimetaphosphate (TMP: 0.2%), Xylitol (X:16%), and Erythritol (E: 4%) on dental enamel demineralization. METHODOLOGY Bovine enamel blocks were selected according to initial surface hardness (SHi) and then divided into seven experimental toothpaste groups (n=12). These groups included 1) no F-TMP-X-E (Placebo); 2) 16% Xylitol and 4% Erythritol (X-E); 3) 16% Xylitol, 4% Erythritol and 0.2%TMP (X-E-TMP); 4) 200 ppm F (no X-E-TMP: (200F)); 5) 200 ppm F and 0.2% TMP (200F-TMP); 200 ppm F, 16% Xylitol, 4% Erythritol, and 0.2% TMP (200F-X-E-TMP); and 7) 1,100 ppm F (1100F). Blocks were individually treated 2×/day with slurries of toothpastes and subjected to a pH cycling regimen for five days (DES: 6 hours and RE: 18 hours). Then, the percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN), fluoride (F), calcium (Ca), and phosphorus (P) in enamel were determined. The data were analyzed by ANOVA (1-criterion) and the Student-Newman-Keuls test (p<0.001). RESULTS We found that the 200F-X-E-TMP treatment reduced %SH by 43% compared to the 1100F treatments (p<0.001). The ΔKHN was ~ 65% higher with 200F-X-E-TMP compared to 1100F (p<0.001). The highest concentration of F in enamel was observed on the 1100F treatment (p<0.001). The 200F-X-E-TMP treatment promote higher increase of Ca and P concentration in the enamel (p<0.001). CONCLUSION The association of 200F-X-E-TMP led to a significant increase of the protective effect on enamel demineralization compared to the 1100F toothpaste.
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Affiliation(s)
| | | | | | | | | | - Marcelle Danelon
- Universidade Estadual Paulista, Brasil; Universidade de Ribeirão Preto, Brasil
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de Toledo PTA, Delbem ACB, Cannon ML, Sakamoto AE, Pedrini D. The effect of toothpaste with reduced concentration of fluoride-containing sodium trimetaphosphate and polyols on initial enamel erosion. Clin Oral Investig 2022; 26:7243-7252. [PMID: 35984512 DOI: 10.1007/s00784-022-04684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This in vitro study evaluated the efficacy of toothpaste containing fluoride (F), sodium trimetaphosphate (TMP), and xylitol and erythritol (XE) to inhibit or repair initial enamel erosion lesions. MATERIALS AND METHODS Bovine enamel blocks (n = 120) were selected according to surface hardness (SH) and randomly divided into 5 experimental groups (n = 24 blocks/group): Placebo (no F, TMP, XE); 1100 ppm F; 16% xylitol + 4% erythritol (XE); 200 ppm F + 0.2% TMP (200 ppm F/TMP); and 200 ppm F + 0.2% TMP + 16% xylitol + 4% erythritol (200 ppm F/TMP/XE). The sound and softened blocks were immersed in toothpaste slurry in human saliva for 2 min. The blocks were then submitted to 4 erosive challenges in citric acid (0.75%, pH 3.5), each challenge for 1 min, with stirring. The SH of the blocks was determined after treatment (t) and after the 4 erosive challenges. In addition, the precipitates were analyzed by scanning electron microscopy (SEM). Variables were submitted to a two-way repeated-measures analysis of variance followed by a Student-Newman-Keuls test (p < 0.05). RESULTS Toothpaste containing 200 ppm F/TMP/XE led to the highest protective and repair effect compared to the other groups (p < 0.001). The protective and repair effect was XE > 200 ppm F/TMP > 1100 ppm F > placebo (p < 0.001). All groups produced precipitates with a thicker layer for XE and TMP groups. CONCLUSIONS Toothpaste containing 200 ppm F, TMP, and polyols demonstrated a superior protective and repair effect in initial enamel erosive lesions in vitro. CLINICAL RELEVANCE Toothpaste containing F and polyols could be an advantage in patients affected by dental erosion, due to its higher preventive potential, mainly in individuals who frequently drink acidic beverages. However, future studies are needed to confirm these results.
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Affiliation(s)
- Priscila Toninatto Alves de Toledo
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Mark Lloyd Cannon
- Feinberg School of Medicine, Northwestern University, Ann and Robert Lurie Children's Hospital, 420 E Superior St, Chicago, IL, 60611, USA
| | - Amanda Eliane Sakamoto
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Denise Pedrini
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
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