Abstract
Purpose Considering the suggested advantages of cold atmospheric plasma (CAP) in increasing the fluoride uptake by the enamel, this study aimed to assess enamel erosion following the application of helium CAP and two types of fluoride varnishes. Methods The microhardness of 70 bovine enamel specimens was measured using a Vickers hardness tester. The specimens were randomly divided into 7 groups (n = 10): control, CAP (P), resin-containing fluoride varnish (RF), CAP + resin-containing fluoride varnish (PRF), fluoride varnish (F), CAP + fluoride varnish (PF), and erosion (E). The specimens in the control and erosion groups did not receive CAP or fluoride varnish. All specimens underwent erosive challenge 4 times/day using hydrochloric acid and artificial saliva except for the control specimens that remained in distilled water during the course of the study. After 5 days of erosive challenge, microhardness was measured again, and the percentage of microhardness change was calculated. Surface roughness of two specimens in each group was assessed by atomic force microscopy (AFM). Data were analyzed using one-way ANOVA followed by Tamhane's post-hoc test. Results The percentage of microhardness change in all groups was significantly higher than that of the control group. All groups showed significantly lower percentage of microhardness change compared with the E group except for the P group; no significant difference was noted in microhardness change of P and E groups. Other experimental groups had no significant difference with each other. Surface roughness was the highest in PRF and the lowest in the F group. Conclusion CAP application had no significant effect on increasing the enamel resistance to erosion. However, enamel resistance to erosion increased significantly after fluoride varnish application alone or fluoride varnish application combined with CAP. No significant difference was noted between the two types of varnishes in this regard. CAP increased the surface roughness while fluoride varnish application alone decreased the roughness.
Highlights
Dental erosion refers to the progressive and irreversible loss of the tooth structure by chemical processes without the involvement of bacteria [1]. is process can be caused by exposure to intrinsic or extrinsic acids
A previous study showed that sodium fluoride (NaF) significantly decreased dental erosion caused by exposure to citric acid [10]. e protective effect of fluoride varnishes is mainly attributed to the adhesion of varnish to the tooth surface, creating a mechanical barrier and increasing the contact time of fluoride with the tooth surface [11]
Considering the novelty of the combined use of cold atmospheric plasma (CAP) and fluoride varnishes, the presence of evidence supporting increased fluoride retention following the application of helium CAP, and the resin component in the formulation of Enamelast varnish, which has been claimed to increase the contact time of the varnish with tooth, this study aimed to assess enamel erosion following the application of CAP and two types of resin-containing and xylitol-containing fluoride varnishes. e first null hypothesis was that CAP application would have no significant effect on enamel resistance to erosion. e second null hypothesis was that the combined application of CAP and Enamelast or FluoroDose would have no significant effect on enamel resistance to erosion
Summary
Dental erosion refers to the progressive and irreversible loss of the tooth structure by chemical processes without the involvement of bacteria [1]. is process can be caused by exposure to intrinsic or extrinsic acids. Dental erosion refers to the progressive and irreversible loss of the tooth structure by chemical processes without the involvement of bacteria [1]. Is process can be caused by exposure to intrinsic or extrinsic acids. Dental erosion has a multifactorial etiology, encompassing a wide range of chemical, biological, and behavioral factors. E prevalence of dental erosion ranges from 27% to 83% [6] and often increases with age due to prolonged exposure to erosive factors [7, 8]. Application of fluoride to enhance the resistance of tooth structure to acid attacks has long been acknowledged. A previous study showed that sodium fluoride (NaF) significantly decreased dental erosion caused by exposure to citric acid (pH of 2.6) [10]. Fluoride varnishes may contain resin-modified glass ionomer, xylitol, calcium, and phosphate; such varnishes often show more favorable results than the conventional fluoride varnishes [12]
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