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Sakae LO, Prado TP, Bezerra SJC, Niemeyer SH, Borges AB, Carvalho TS, Scaramucci T. Film-Forming Polymers for Inhibition of Hydroxyapatite Dissolution: A Screening Study. Caries Res 2023; 57:602-612. [PMID: 37848001 DOI: 10.1159/000533546] [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: 04/20/2022] [Accepted: 08/07/2023] [Indexed: 10/19/2023] Open
Abstract
The aim of this study was to evaluate the effect of film-forming polymer solutions of different concentrations and pH values, either associated or not with sodium fluoride (F; 225 ppm F-), when applied during the initial stage of salivary pellicle formation, to prevent the dissolution of hydroxyapatite (HA), which was determined by the pH-stat method. Polyacrylic acid (PA), chitosan, sodium linear polyphosphate (LPP), polyvinyl methyl ether/maleic anhydride (PVM/MA), and propylene glycol alginate (PGA) were tested in three concentrations (lower, medium, and higher), two pH values (native or adjusted), and either associated or not with F. Distilled water, F, and stannous ion+fluoride (Sn/F; 225 ppm F- and 800 ppm Sn2+, as SnCl2) solutions were the controls, totalizing 63 groups. HA crystals were pretreated with human saliva for 1 min to allow pellicle formation, then immersed in the experimental solutions (1 min), and exposed to saliva for another 28 min. Subsequently, they were added to a 0.3% citric acid solution (pH = 3.8), connected to a pH-stat system that added aliquots of 28 μL 0.1 N HCl for a total reaction time of 5 min. Data were analyzed with one-way ANOVA and Tukey's tests (α = 0.05). For PA alone, the concentrations of 0.1% (native pH), 0.06%, and 0.08% (both pH adjusted) showed significantly lower HA dissolution than the negative control. PA concentrations of 0.1% and 0.08%, of both pH values, improved the effect of F against HA dissolution to a near-identical value as Sn/F. All solutions containing chitosan and LPP significantly reduced HA dissolution in comparison with the control. For chitosan, the concentration of 0.5% (in both pH values) improved the effect of F. LPP at 0.5% (native pH) and all associations of LPP with F outperformed the effect of F. Some PVM/MA solutions significantly reduced HA dissolution but PVM/MA could not improve the protection of F. PGA was incapable of reducing HA dissolution or improving F effect. It was concluded that chitosan, LPP, and some PA and PVM/MA solutions used alone were capable of reducing HA dissolution. Only PA, chitosan, and LPP were able to enhance fluoride protection, but for PA and chitosan, this was influenced by the polymer concentration.
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Affiliation(s)
- Letícia Oba Sakae
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Taiana Paola Prado
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Sávio José Cardoso Bezerra
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Operative Dentistry, School of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alessandra Buhler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São Paulo, Brazil
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tais Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Augusto MG, Scaramucci T, Campos TMB, Aoki IV, Schlueter N, Borges AB. Film-Forming Polymers for Tooth Erosion Prevention. Polymers (Basel) 2022; 14:polym14194225. [PMID: 36236172 PMCID: PMC9573524 DOI: 10.3390/polym14194225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Different agents have been proposed to prevent the progression of acid induced dental substance losses, which are called erosive tooth wear (ETW), such as fluorides, calcium, and phosphate-based products; however, there is a need for a further increase in efficacy. Recently, the ability of polymers to interact with the tooth surface, forming acid resistant films, has come into the focus of research; nevertheless, there is still the need for a better understanding of their mode of action. Thus, this article provides an overview of the chemical structure of polymers, their mode of action, as well as the effect of their incorporation into oral care products, acid beverages, and antacid formulations, targeting the prevention of ETW. Recent evidence indicates that this may be a promising approach, however, additional studies are needed to confirm their efficacy under more relevant clinical conditions that consider salivary parameters such as flow rate, composition, and clearance. The standardization of methodological procedures such as acid challenge, treatment duration, and combination with fluorides is necessary to allow further comparisons between studies. In conclusion, film-forming polymers may be a promising cost-effective approach to prevent and control erosive demineralization of the dental hard tissue.
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Affiliation(s)
- Marina Gullo Augusto
- Institute of Science and Technology, Department of Restorative Dentistry, São Paulo State University-UNESP, São José dos Campos 12245-000, Brazil
- School of Dentistry, Centro Universitário de Cascavel–UNIVEL, Av. Tito Muffato, 317-Santa Cruz, Cascavel 85806-080, Brazil
| | - Tais Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo-USP, São Paulo 12245-000, Brazil
| | | | - Idalina Vieira Aoki
- Department of Chemical Engineering, Polytechnic School, University of São Paulo-USP, São Paulo 12245-000, Brazil
| | - Nadine Schlueter
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, 30625 Hannover, Germany
| | - Alessandra Bühler Borges
- Institute of Science and Technology, Department of Restorative Dentistry, São Paulo State University-UNESP, São José dos Campos 12245-000, Brazil
- Correspondence: ; Tel.: +55-12-3947-9374
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Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10081413. [PMID: 36011070 PMCID: PMC9408325 DOI: 10.3390/healthcare10081413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/24/2022] Open
Abstract
A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.
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