A Randomized in situ Clinical Study of Fluoride Dentifrices on Enamel Remineralization and Resistance to Demineralization: Effects of Zinc

2018 ◽  
Vol 52 (1-2) ◽  
pp. 129-138 ◽  
Author(s):  
Jonathan E. Creeth ◽  
Ritu Karwal ◽  
Anderson T. Hara ◽  
Domenick T. Zero
Keyword(s):  
Dose Response ◽  
Acid Resistance ◽  
Acid Exposure ◽  
Zinc Ions ◽  
Significant Relationships ◽  
Bovine Enamel ◽  
Early Caries ◽  
Caries Lesions

This study aimed to determine the effect of zinc ions and F concentration in a dentifrice on remineralization of early caries lesions in situ and on resistance to subsequent demineralization. This was a single-center, 6-period, 6-product, blinded (examiner, subject, analyst), randomized (n = 62), crossover study. Products (all NaF) were: 0, 250, 1,150 and 1,426 ppm F (dose-response controls), “Zn-A” (0.3% ZnCl2, 1,426 ppm F), and “Zn-B” (as Zn-A, with high-foaming surfactants) in a conventional silica base. Subjects wore palatal appliances holding partially demineralized bovine enamel specimens. They brushed their teeth with 1.5 g test dentifrice (25 s), then swished the slurry ensuring even exposure of specimens (95 s), expectorated, and rinsed (15 mL water, 10 s). After 4 h intraoral remineralization, specimens were removed and acid-challenged in vitro. Surface microhardness (SMH), measured pre-experimental, post-initial acid exposure, post-remineralization, and post-second acid exposure, was used to calculate recovery (SMHR), net acid resistance (NAR), and a new, specifically demineralization-focused calculation, “comparative acid resistance” (CAR). Enamel fluoride uptake (EFU) was also measured. For the F dose-response controls, all measures showed significant relationships with dentifrice F concentration (p < 0.0001). The presence of zinc counteracted the ability of F to promote remineralization in this model. Compared to the 1,426 ppm F control, the zinc formulations gave reduced SMHR, EFU, and NAR (all p < 0.0001); however, they showed evidence of increased CAR (Zn-A: p = 0.0040; Zn-B: p = 0.0846). Products were generally well tolerated. In this study, increasing dentifrice F concentration progressively increased in situ remineralization and demineralization resistance of early caries enamel lesions. Zinc ions reduced remineralization but could increase demineralization resistance.

scholarly journals An In Vitro Investigation of Anticaries Efficacy of Fluoride Varnishes

2019 ◽  
Vol 44 (5) ◽  
pp. E234-E243 ◽  
Author(s):  
L Al Dehailan ◽  
EA Martinez-Mier ◽  
GJ Eckert ◽  
F Lippert
Keyword(s):  
Artificial Saliva ◽  
Acid Resistance ◽  
Fluoride Release ◽  
In Vitro Investigation ◽  
Ph Cycling ◽  
Baseline Values ◽  
Bovine Enamel ◽  
Early Caries ◽  
Caries Lesions

SUMMARY Most currently marketed fluoride varnishes (FVs) have not been evaluated for their effectiveness in preventing dental caries. The objective of this study was to investigate the anticaries efficacy, measured as fluoride release into artificial saliva (AS); change in surface microhardness of early enamel caries lesions; and enamel fluoride uptake (EFU) of 14 commercially available FVs and two control groups. Bovine enamel specimens (5×5 mm) were prepared and assigned to 18 groups (n=12). Early caries lesions were created in the specimens and characterized using Vickers microhardness (VHNlesion). FV was applied to each group of specimens. Immediately afterward, specimens were incubated in 4 mL of AS for 18 hours, which were collected and renewed every hour for the first six hours. AS samples were analyzed for fluoride using an ion-specific electrode. Specimens were then brushed for 20 seconds with toothpaste slurry and subjected to pH cycling consisting of a four-hour/day acid challenge and one-minute treatments with 1100 ppm F dentifrice for five days. Microhardness was measured following pH cycling (VHNpost). EFU was determined using microbiopsy. Acid resistance (eight-hour demin challenge) was performed after pH cycling, and microhardness was measured (VHNart) and compared with baseline values to test the FV impact after pH cycling. One-way analysis of variance was used for data analysis (α=0.05). FVs differed in their release characteristics (mean ± SD ranged from 14.97 ± 2.38 μg/mL to 0.50 ± 0.15 μg/mL), rehardening capability (mean ± SD ranged from 24.3 ± 15.1 to 11.7 ± 12.7), and ability to deliver fluoride to demineralized lesions (mean ± SD ranged from 3303 ± 789 μg/cm3 to 707 ± 238 μg/cm3). Statistically significant but weak linear associations were found between ΔVHN(post – lesion), EFU, and fluoride release (correlations 0.21-0.36). The results of this study demonstrated that differences in FV composition can affect their efficacy in in vitro conditions.

The ICT in situ Experimental Model in Dental Research

1992 ◽  
Vol 71 (3_suppl) ◽  
pp. 822-827 ◽  
Author(s):  
T. Koulourides ◽  
M.C. Chien
Keyword(s):  
Experimental Model ◽  
Acid Resistance ◽  
Repeated Testing ◽  
Surface Microhardness ◽  
Control Solution ◽  
Sucrose Solutions ◽  
Acid Test ◽  
Bovine Enamel

The intra-oral cariogenicity test (ICT) in situ experimental model was introduced in 1964 for the study of caries on sample enamel in the human mouth. Slabs of human or bovine enamel are mounted with a Dacron gauze cover in the acrylic flanges of prosthetic appliances. The extent of enamel demineralization or remineralization of lesions is assessed from surface microhardness measurements and microradiography of the enamel sections. The ICT model offers the potential of studying various parameters related to caries. This publication presents a typical ICT study comparing the cariogenicity of 10% sucrose solutions containing 1, 3, 10, and 30 ppm F with that of the control solution, 10% sucrose (without fluoride). The treatments were applied to the ICT as 10-minute extra-oral immersions. The results indicate: (1) a strong effect of F in decreasing demineralization of sound enamel and increasing remineralization of pre-softened enamel in the ICT; (2) pronounced resistance to a subsequent in vitro acid test; (3) pronounced F incorporation into pre-softened enamel; and (4) a characteristic acid-resistant zone, as seen in microradiographs, associated with exposure to F. This in situ model enables one to study experimental caries with repeated testing of enamel that follows the development and/or the regression of subsurface enamel lesions, F incorporation, increased acid resistance, cariogenicity of substrates, and other parameters of caries that can be assessed under standard conditions of tooth substrate and microbial sheltering.

scholarly journals Artificial Caries Lesion Characteristics after Secondary Demineralization with Theobromine-Containing Protocol

Molecules ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 300
Author(s):  
Hani M. Nassar ◽  
Frank Lippert
Keyword(s):  
Mineral Content ◽  
Significance Level ◽  
Lesion Depth ◽  
Caries Lesion ◽  
Mineral Profile ◽  
Bonferroni Test ◽  
Bovine Enamel ◽  
Caries Lesions ◽  
Nail Varnish

Developing artificial caries lesions with varying characteristics is needed to adequately study caries process in vitro. The objective of this study was to investigate artificial caries lesion characteristics after secondary demineralization protocol containing theobromine and fluoride. Sixty bovine enamel slabs (4 × 3 mm) were demineralized using a Carbopol-containing protocol for 6 days. A baseline area (2 × 3 mm) was protected with acid-resistant nail varnish, after which specimens were exposed for 24 h to a secondary demineralization protocol containing acetic acid plus one of four fluoride/theobromine combinations (n = 15): theobromine (50 or 200 ppm) and fluoride (0 or 1 ppm). Specimens were sectioned and analyzed using transverse microradiography for changes in mineral content, lesion depth, and surface layer mineralization. Data was analyzed using paired t-test and analysis of variance followed by Bonferroni test at 0.05 significance level. After secondary demineralization, fluoride-containing groups had significantly deeper lesions (p = 0.002 and 0.014) compared to the group with 0 ppm fluoride and 50 ppm theobromine. Mineral content and lesion depth were significantly different compared to baseline for all groups. Theobromine did not show an added effect on mineral uptake. Theobromine-containing groups exhibited particularly deep lesions with a more uniform mineral profile in the presence of fluoride.

Mineral Density and Fluoride Content of in vitro Remineralized Lesions

1988 ◽  
Vol 67 (3) ◽  
pp. 577-581 ◽  
Author(s):  
Y. Jima ◽  
T. Koulourides
Keyword(s):  
Complete Recovery ◽  
Fluoride Content ◽  
Mineral Density ◽  
Acid Dissolution ◽  
Thin Sections ◽  
Partially Saturated ◽  
In Vitro Investigation ◽  
Bovine Enamel ◽  
Caries Lesions

This in vitro investigation studied the remineralization of experimental caries lesions in bovine enamel by use of three methods: (1) surface microhardness, (2) microradiography, and (3) abrasion biopsy for mineral density and fluoride content. The lesions were produced by a two-day exposure to 0.01 mol/L lactic acidlsodium hydroxide buffer partially saturated with 3.0 mmol/L Ca, 1.8 mmol/L P, in 1% CMC, at pH 4.0 and 37°C. The lesions were exposed to a remineralizing solution containing 3.0 mmol/L Ca, 1.8 mmol/L P, and 3 ppm F in 1% CMC at pH 7.0 and 37°C for two, six, and ten days, with solution changes every two days. The data derived from the three methods are presented in sequence from the baseline and at days two, six, and ten of the remineralizing treatment. Microhardness measurements showed hardness recoveries of 35.9, 78.9, and 87.5%, respectively. Microradiography suggested complete recovery with the ten-day remineralization. Abrasion biopsy of successive 10-μm layers to a depth of 100 μm indicated 15.2, 39.8, and 68.8% mineral density recoveries, with fluoride content of the surface layer increasing from a baseline of 300 ppm to 4600, 9000, and 9800 ppm F for the 2, 6, 10 days of remineralization, respectively. Subsequent acid-etching of thin sections from the ten-day-remineralized specimens showed that the fluoride-enriched remineralized area was more resistant to acid dissolution than was the underlying nonnal enamel.

scholarly journals Remineralization of natural early caries lesions in vitro by P11-4 monitored with photothermal radiometry and luminescence

2017 ◽  
Vol 8 (4) ◽  
pp. e12257 ◽  
Author(s):  
Joshua D. Silvertown ◽  
Bonny P. Y. Wong ◽  
Koneswaran S. Sivagurunathan ◽  
Stephen H. Abrams ◽  
Jennifer Kirkham ◽  
...  
Keyword(s):  
Photothermal Radiometry ◽  
Early Caries ◽  
Caries Lesions

Effect of Fluoride Toothpaste Containing Nano-Sized Sodium Hexametaphosphate on Enamel Remineralization: An in situ Study

2018 ◽  
Vol 53 (3) ◽  
pp. 260-267 ◽  
Author(s):  
Marcelle Danelon ◽  
Luhana G. Garcia ◽  
Juliano P. Pessan ◽  
Amanda Passarinho ◽  
Emerson R. Camargo ◽  
...  
Keyword(s):  
Surface Hardness ◽  
Sodium Hexametaphosphate ◽  
Treatment Groups ◽  
Fluoride Toothpaste ◽  
Integrated Recovery ◽  
Phase Surface ◽  
Double Blinded ◽  
Bovine Enamel ◽  
Caries Lesions

Objective: To evaluate the remineralizing potential of a conventional toothpaste (1,100 ppm F) supplemented with nano-sized sodium hexametaphosphate (HMPnano) in artificial caries lesions in situ. Design: This double-blinded crossed study was performed in 4 phases of 3 days each. Twelve subjects used palatal appliances containing 4 bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned into the following treatment groups: no F/HMP/HMPnano (Placebo); 1,100 ppm F (1100F); 1100F plus 0.5% micrometric HMP (1100F/HMP) and 1100F plus 0.5% nano-sized HMP (1100F/HMPnano). Volunteers were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), so that blocks were treated with natural slurries of toothpastes. After each phase, surface hardness post-remineralization (SH2), integrated recovery of subsurface hardness (ΔIHR), integrated mineral recovery (ΔIMR) and enamel F concentration were determined. Data were submitted to analysis of variance and Student-Newman-Keuls’ test (p < 0.001). Results: Enamel surface became 42% harder when treated with 1100F/HMPnano in comparison with 1100F (p < 0.001). Treatment with 1100F/HMP and 1100F/HMPnano promoted an increase of ∼23 and ∼87%, respectively, in ΔIHR when compared to 1100F (p < 0.001). In addition, ΔIMR for the 1100F/HMPnano was ∼75 and ∼33% higher when compared to 1100F and 1100F/HMP respectively (p < 0.001). Enamel F uptake was similar among all groups except for the placebo (p < 0.001). Conclusion: The addition of 0.5% HMPnano to a conventional fluoride toothpaste was able to promote an additional remineralizing effect of artificial caries lesions.

Hard-tissue Substrates for Evaluation of Cariogenic and Anti-cariogenic Activity in situ

1992 ◽  
Vol 71 (3_suppl) ◽  
pp. 913-919 ◽  
Author(s):  
J.R. Mellberg
Keyword(s):  
Root Surface ◽  
Hard Tissue ◽  
Suitable Alternative ◽  
Human Enamel ◽  
Human Dentin ◽  
Bovine Enamel ◽  
Root Surface Caries

Hard-tissue substrates include primarily human and bovine enamel and human dentin. They have been used for in situ studies in a natural or sound condition, as well as flattened or containing an in vitro-formed caries-like lesion. Human enamel and dentin are generally the substrates of choice for studies of coronal and root-surface caries, respectively, but bovine enamel appears to offer a suitable alternative for many studies of enamel caries. Substrates with caries-like lesions will respond more rapidly to changes in the intra-oral mineral equilibrium and will allow both demineralization and remineralization to be determined. Findings from some studies suggest that caries-like lesions may respond somewhat differently, depending upon the degree of mineralization of the surface layer. Because in vitro findings with dentin show it to be significantly more soluble in acid than enamel, results from a study that used dentin may not be directly applicable to enamel. Both enamel and dentin substrates can be used in thin-section models. Hard-tissue substrates can also differ, depending upon their intra-oral location. Locations that result in the accumulation of plaque will behave differently from those that are plaque-free. So that plaque would accumulate, substrates have been placed approximally, beneath a fabric or steel mesh, in a protected trough, beneath a metal band or within a depression on the buccal surface. For studies requiring a determination of both demineralization and remineralization, human enamel or dentin containing a surface-softened caries-like lesion and covered with a uniform natural plaque are the substrates of choice.

scholarly journals The Efficacy of Soprolife® in Detecting in Vitro Remineralization of Early Caries Lesions

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Mona Zeitouny ◽  
Frédéric Cuisinier ◽  
Hervé Tassery ◽  
Hussein Fayyad-Kazan
Keyword(s):  
Early Caries ◽  
Caries Lesions

Silver diamine fluoride and glass ionomer differentially remineralize early caries lesions, in situ

2015 ◽  
Vol 20 (6) ◽  
pp. 1151-1157 ◽  
Author(s):  
Ratichanok Nantanee ◽  
Busayarat Santiwong ◽  
Chutima Trairatvorakul ◽  
Hidenori Hamba ◽  
Junji Tagami
Keyword(s):  
Glass Ionomer ◽  
Silver Diamine Fluoride ◽  
Early Caries ◽  
Caries Lesions

scholarly journals Overview of Calcium Phosphates used in Biomimetic Oral Care

2018 ◽  
Vol 12 (1) ◽  
pp. 406-423 ◽  
Author(s):  
Frederic Meyer ◽  
Bennett T. Amaechi ◽  
Helge-Otto Fabritius ◽  
Joachim Enax
Keyword(s):  
Calcium Phosphates ◽  
Oral Care ◽  
Original Research ◽  
Preventive Dentistry ◽  
Human Teeth ◽  
Search Terms ◽  
Early Caries ◽  
Caries Lesions

Background:The use of biomimetic agents is an emerging field in modern oral care. Promising biomimetic substances for such applications are calcium phosphates, because their chemical composition is very similar to that of the mineral phase in human teeth, especially of natural enamel. Examples for their application include the remineralization of early caries lesions and repair of small enamel defects.Objective:This review provides an interdisciplinary view on calcium phosphates and their applications in biomimetic oral care. The aim of this work is to give an overview ofin vivoandin situstudies comparing several calcium phosphates in preventive dentistry that can be used as a knowledge base for the development of innovative alternative oral care concepts.Methods:Books, reviews, and original research papers with a focus onin vivoandin situstudies were included. The databases PubMed®and SciFinder®were used for literature search. Calcium phosphates that are frequently utilized in oral care products are covered in this review and were used as search terms alone and together with the following key words:in vivo,in situ, caries, clinical study, and remineralization. From 13,470 studies found, 35 studies complied with the inclusion criteria and were used for this review.Results:Publishedin vivoandin situstudies demonstrate calcium phosphates’ potential in enamel remineralization. However, more studies are needed to further substantiate existing results and to extend and refine the application of calcium phosphates in modern oral care.Conclusion:Calcium phosphates represent an innovative biomimetic approach for daily oral care because of their high similarity to natural enamel that will broaden the range of future treatments in preventive dentistry.

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