Effects of TiF4 solutions on root surfaces in vitro after different application periods

Physicochemical characterization, water sorption and solubility of adhesive systems incorporated with titanium tetrafluoride, and its influence on dentin permeability

Titanium tetrafluoride (TiF₄) in an aqueous solution can decrease dentin permeability, but some effects of its incorporation into adhesive systems are not yet known. Therefore, the aim of this study was to characterize the physicochemical, water sorption (WS) and solubility (SL) properties of two adhesive systems (Clearfil SE Bond/C and Scotchbond Universal/S) incorporated with 0.0% (T0), 2.5% (T2) and 4.0% (T4) titanium tetrafluoride (TiF₄), and determine dentin permeability (L) after application of these adhesive systems both immediately afterwards (baseline) and after 6 months of storage. The physicochemical analyses of the incorporated solutions were performed based on evaluating particle size (PS), polydispersity index (PDI) by dynamic light scattering, and zeta potential (ZP) by electrophoresis. WS and SL tests followed ISO 4049 standards, and used a 7-day water storage period. The L test was performed by analyzing human dentin discs before and after adhesive system application, and after storage. PS and PDI were higher for CT0 and ST4 (p < 0.0001; ANOVA, Tukey). ZP was lower for CT4, ST2 and ST4 (p < 0.0001; ANOVA, Tukey). A 4.0% TiF₄ incorporation showed higher WS (p < 0.05; Mann Whitney, Kruskal Wallis, Dunn). Higher SL was observed for CT0 and ST4 (p < 0.05; Mann Whitney, Kruskal Wallis, Dunn). The L value at baseline was lower for ST4, but was not different from the CT4 groups after storage (p < 0.05; Mann Whitney, Kruskal Wallis, Dunn). It can be concluded that TiF₄ affected the colloidal stability of Scotchbond, but did not alter the other properties. The 2.5% TiF₄ did not affect the PDI, WS or L of the Clearfil, and can be considered an alternative for reducing hybrid layer degradation.

Does post-bleaching fluoridation affect the further demineralization of bleached enamel? An in vitro study

BACKGROUND

Topical fluoride agents have been shown to be the most effective method in treating demineralized enamel after in-office bleaching treatments. Thus, this study aimed to examine the effects of two different post-bleaching fluoridation agents: 1.5% titanium tetrafluoride (TiF(4)) (9200 ppm) and 2.1% sodium fluoride (NaF) (9500 ppm), on the calcium loss of enamel after an acidic challenge.

METHODS

Ten maxillary premolars were sectioned into four pieces and then divided into the following four groups: Group 1: Control, kept in artificial saliva, no treatment; Group 2: 38% hydrogen peroxide (HP); Group 3: 38% HP followed by 1.5% TiF(4); Group 4: 38% HP followed by 2.1% NaF solution. The specimens were subjected to demineralization for 16 days, refreshing the solution every 4 days; that is, on the 4th, 8th, 12th, and 16th days. Calcium ion (Ca(2+)) concentration was determined by an atomic absorption spectrophotometer. Data were analyzed using Friedman and Wilcoxon tests (p = 0.05).

RESULTS

The loss of Ca(2+) in each of the test groups was compared with that of the control group, depicting that there was a statistically significant difference among the groups after 4, 8, 12, and 16 days and in total (p < 0.05). The calcium released from the fluoride-applied groups was lower when compared with the 38% HP and control group. At the end of the 16th day, the total amount of calcium released from the TiF(4-)treated samples (9.12 mg/mL) was less than from the NaF-treated samples (13.67 mg/mL) (p < 0.05).

CONCLUSIONS

Regarding the results of our in vitro study, the risk of further demineralization was significantly reduced with the use of TiF(4) and NaF after bleaching with 38% HP. TiF(4) was found to be more effective in preventing Ca2+ release owing to acid attack when compared with NaF. In the case of an intra-oral acidic exposure, the use of topical 1.5% TiF(4) and 2.1% NaF agents might be beneficial after bleaching with 38% HP.

Effect of 4% titanium tetrafluoride application on shear bond strength of composite resin: An in vitro study

AIMS

The objective of thisstudy is to evaluate and compare 4% titanium tetrafluoride with 2% Sodium fluoride, and the bond strength of composite resin with dentin and their effects on the smear layer.

MATERIALS AND METHODS

Fifty freshly extracted non-carious molar and premolar teeth were selected. The occlusal surfaces of the teeth were ground, to prepare flat dentin surfaces at a depth of 2 mm and were randomly grouped with 10 specimens in each. Group I (Etching + Adhesive + Composite resin) was taken as a control group. In Group II, 4% titanium tetrafluoride was applied before etching and in Group III, 4% titanium tetrafluoride was applied after etching. In Group IV, 2% Sodium fluoride was applied before etching and in Group V, 2% Sodium fluoride was applied after etching. Shear bond strength was tested using the Lloyds Universal testing machine and was recorded in MPa.

RESULTS

The results were statistically analyzed using the one-way Anova test. Group III showed the highest bond strength among the experimental groups, but less than the control group.

CONCLUSIONS

Under the conditions of this in vitro study, titanium tetrafluoride did not significantly affect the bond strength of the composite. Sodium fluoride was found to deleteriously affect the bond strength of the composite.

The effect of calcium chelating or binding agents on Candida albicans

OBJECTIVE

The aim of this study was to evaluate antifungal effects of calcium-chelating or -binding agents on Candida albicans comparing with conventional antifungal agents.

STUDY DESIGN

Two clinical oral isolates and 1 standard strain of C albicans were included in the study. Test solutions were ethylenediamine-tetraacetic acid (EDTA), ethyleneglycol-tetraacetic acid (EGTA), sodium fluoride (NaF), titanium tetrafluoride (TiF4), nystatin, and ketoconazole. Minimum inhibitory and fungicidal concentrations of the solutions were determined. The results were analyzed statistically using Friedman's nonparametric 2-way ANOVA and Mann-Whitney U tests.

RESULTS

All isolates demonstrated similar susceptibility patterns (P>.05). Except ketoconazole, EDTA had the highest antifungal and fungicidal activity, followed by TiF4. EGTA and NaF were the weakest agents against C albicans among all test solutions.

CONCLUSION

EDTA and TiF4 may be recommended as an alternative irrigating solution particularly in persistent root canal infections and in root canals of patients having a high incidence of oral candidosis.

Permeability changes of dentine treated with titanium tetrafluoride

OBJECTIVES

The aim of this research was to evaluate the effect of titanium tetrafluoride on dentine permeability in comparison with sodium fluoride and acidulated phosphate fluoride to determine their contribution to acid resistance of dentine.

METHODS

Thirty-two dentine discs were prepared from extracted mandibular molars. The hydraulic conductance of all discs was measured before and after the formation of smear layer. The discs were then randomly divided into five experimental and one-control groups. Coronal surfaces of dentine discs were treated with either fluoride solutions of NaF, APF, 1% TiF4, 0.5% TiF4 and 0.1% TiF4 or de-ionised water. Following the measurement of hydraulic conductance, treated surfaces were subjected to 25% citric acid application. Then, final permeability measurements were made. The data were statistically analysed using ANOVA and Tukey's HSD multiple comparisons.

RESULTS

While smear layer formation considerably reduced dentinal permeability of dentine discs, fluoride or de-ionised water application to smeared surfaces did not cause any significant change in hydraulic conductance (p > 0.05). After citric acid application, control and NaF groups showed higher permeability values than 1%, 0.5% and 0.1% TiF4 and APF groups (p < 0.01).

CONCLUSION

Clinical use of acidic solutions of titanium tetrafluoride in dentine cavities may be considered since smeared dentine surfaces are modified to a stabile and acid-resistant state.

Morphologic effects on L929 fibroblasts of titanium tetrafluoride application

OBJECTIVE

The aim of this study was to investigate the effect of titanium tetrafluoride solution on L929 fibroblasts by scanning electron microscopy. Titanium tetrafluoride was then compared with sodium fluoride and acidulated phosphate fluoride.

STUDY DESIGN

Cells were treated with fluoride solutions for 1 minute either directly, through a filter membrane with a pore size of 0.4-micron, or indirectly, through dentin disks; they were then investigated at an electron microscopic level.

RESULTS

Fluoride application on smeared dentin disks showed fewer cytotoxic effects on fibroblasts than application on nonsmeared dentin disks. Acidulated phosphate fluoride and titanium tetrafluoride appeared to be more cytotoxic than sodium fluoride. Because all fluoride solutions used in this study contained the same fluoride concentration, pH was considered to be the main factor causing the higher toxicity.

CONCLUSION

Because these solutions demonstrated toxicity in vitro, they must be further evaluated under in vivo conditions to ascertain their clinical safety.

Retention of titanium tetrafluoride (TiF4), used as fissure sealant on human deciduous molars

When dental hard tissues are exposed to aqueous solutions of TiF4, an acid-resistant glaze forms on tooth surfaces. The aim of the present study was to examine the long-term retention of the glaze on TiF4-treated deciduous molars. The occlusal surfaces of four deciduous molars in each of seven children were treated with 4% TiF4 for 1 min. The sealed teeth were extracted after 1, 3, 6, or 12 months and examined with scanning electron microscopy. An extensive surface layer was present on all deciduous molars after 1 month. After 3 months the glaze appeared to be worn out on the cusp tips and in some areas on the cusp inclines. At 6 months the glaze was observed as small areas distributed over the cusp inclines with total coverage of the pits and fissures. After 1 year the presence of the glaze was limited to pits and fissures. Clinically, all fissures were caries-free by visual inspection at the end of the experimental period. The results indicate that the glaze formed after topical TiF4 application may be an effective way of sealing pits and fissures under clinical conditions.

Release of fluoride and metal ions from root surfaces after topical application of TiF4, SnF2, and NaF in vitro

Aqueous solutions of TiF4 cause a rapid uptake and a long-lasting retention of fluoride when applied to dentin. The aim of this study was therefore to investigate the pattern of fluoride release after TiF4 application in vitro, compared with SnF2 and NaF application. TiF4, SnF2, and NaF were applied for 4 min and 1 min to standardized areas of six groups of root surface specimens immersed in distilled water. Untreated specimens were used as controls. The water was changed daily for 30 days, and F concentrations measured by an ion-selective electrode. All test groups showed a rapid decline in F concentration. In the 4-min group F concentration more than double the detection limit of the F electrode could be registered the first 28 days for TiF4, 11 days for SnF2, and 7 days for NaF. In the 1-min group periods of F registration were shorter. Analysis of Sn by atomic absorption spectrophotometry showed decreasing concentrations in the first 12-day samples in the 1-min and 4-min groups. Traces of Ti were found in the first few samples, but no pattern of release could be observed.

Root surface reactions to TiF4 and SnF2 solutions in vitro. An ultrastructural study

Previous studies have indicated that TiF4 and SnF2 differ in their demineralizing effect when applied topically to root surfaces at the same acidity. The aim of this study was to examine in more detail the outermost layer of root surface specimens by transmission electron microscopy (TEM) after short-term exposure to these acidic fluoride solutions. Root surface specimens were exposed for 1 min and 4 min to equimolar (1.1 M F) solutions of a) TiF4, native pH 1.0; b) SnF2, acidified to pH 1.0; and c) SnF2, native pH 2.5. The specimens were then rinsed in saline and processed for TEM. Exposure to TiF4 resulted in a partly demineralized zone 8-10 microns deep after 1 min and 5-27 microns deep after 4 min of application. A 0.1-micron-thick, electron-dense coating was present in all TiF4-treated specimens. Acidified SnF2 resulted in a completely demineralized zone, 4-7 microns deep, when applied for 1 min and 4 min, whereas SnF2 at native pH produced a 0.5- to 1.0-micron-wide partially demineralized zone. Unevenly distributed crystalline deposits were a frequent finding on SnF2-treated surfaces. The results indicate that solutions of TiF4 and SnF2 at native pH will cause only slight demineralization when applied topically to root surfaces.

Caries-inhibitory effect of titanium tetrafluoride in rats

The purpose of this study was to evaluate the caries-inhibitory effect of TiF4 as compared with equimolar solutions of neutral and acidified NaF. Sixty Sprague-Dawley rats were weaned 19 days after birth and given a cariogenic diet. They were randomly divided into four groups and given a 1-min topical treatment of the molar teeth on day 1 and day 17 of the experiment with the following solutions: group 1: 1% TiF4, pH 1.5; group 2: 1.3% NaF, pH 7.0; group 3: 1.3% NaF, pH 1.5; and group 4: control, distilled water. From day 2 the rats were inoculated with Streptococcus mutans twice weekly. On day 55 the rats were killed, and caries scored in accordance with Keyes. Total caries scored were (mean +/- SD): group 1, 12.7 +/- 9.5; group 2, 17.4 +/- 8.6; group 3, 14.3 +/- 9.7; and group 4, 29.5 +/- 9.0. There were significantly (p less than 0.05) reduced caries scores for total caries and for buccal + lingual and sulcal areas for all test groups as compared with the control group. Differences between control and test groups in proximal surfaces and between fluoride groups were non-significant. The results showed that the caries-inhibitory effect of TiF4 is at least as good as that of NaF in rats.