Abstract
The goal of this study was to evaluate the effectiveness of the toothpaste Tooth Mousse compared to conventional fluoride-based versions in the prevention of enamel and dentin demineralization. Human enamel and dentin samples (n = 120 each) were exposed to artificial demineralization at pH 4.92. During the demineralization process, the samples in the test groups were periodically treated with Tooth Mousse (TM) containing casein-phosphopeptide -amorphous-calcium-phosphate (CPP-ACP) and Tooth Mousse Plus (TMP) containing amorphous-calcium-fluoride-phosphate (CPP-ACPF) to evaluate their protective properties. Fluoride toothpastes containing 1400 ppm amine fluoride (AmF) and 1450 ppm sodium fluoride (NaF) were applied in the positive control groups. Treatment with distilled water (group C-W) or demineralization without treatment (group C-D) served as negative controls. After the demineralization and treatment process, all samples were cut longitudinally and lesion depths were determined at six locations using polarized light microscopy. In TM/TMP groups (enamel: 80/86 µm, dentin: 153/156 µm) lesion depths were significantly smaller compared to the negative control groups C-W/C-D (enamel: 99/111 µm, dentin: 163/166 µm). However, TM and TMP compared to the positive controls AmF/NaF (enamel: 58/63 µm, dentin: 87/109 µm) showed higher lesion depths. The application of TM/TMP (89%/78%) during demineralization led to a reduced number of severe lesions compared to the negative controls C-W/C-D (100%/95%). In this study we demonstrate that Tooth Mousse is less effective regarding prevention of enamel and dentin demineralization compared to fluoride containing toothpastes.
Highlights
Dental enamel and dentin are the hardest tissues in the human body
Enamel lesion depths observed after artificial demineralization and treatment with Tooth Mousse and Tooth Mousse Plus (TM: 86 ± 14 μm; TMP: 80 ± 14 μm) were in most cases significantly smaller than in the control groups (C-W: 99 ± 18 μm; CD: 111 ± 23 μm)
In a systematic review by Ekambaram et al, it has been discussed, that casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing products have a higher enamel remineralization effect compared to other calcium- and phosphate-based agents [8]
Summary
Dental enamel and dentin are the hardest tissues in the human body. they are susceptible to the impact of different acids. Depending on the origin of the acids, a differentiation is made between dental decay caused by organic acids produced by bacteria, i.e., dental caries, and destruction of dental tissues by acids that are not related to the metabolism of bacteria, i.e., dental erosion. According to Reynolds et al the anti-cariogenic activity of CPP-ACP is based on the ability of CPP to stabilize calcium and phosphate ions in a metastable solution [11]. Analogous to this system, stable complexes with fluoride ions like CPP amorphous calcium fluoride phosphate (phosphopeptideamorphous calcium phosphate CPP-ACFP) were generated [19,20]. CPP-ACP and CPP-ACFP might function as buffer systems which reduce the destructive impact of acids [21]
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