Abstract
Objectives: The aim of this study was to compare the caries preventive effect of highly fluoridated dentifrices and gels on sound dentin as well as on artificial dentin caries-like lesions. Methods: Bovine dentin specimens (n = 240), with 2 different surfaces each (1 sound surface [sound treatment (ST)] and one caries lesion [demineralized treatment (DT)]), were prepared and randomly allocated to one highly (6 × 120 min demineralization/day [H]) and one lowly cariogenic (6 × 60 min demineralization/day [L]) pH-cycling model. Treatments during pH-cycling (28 days) were: brushing 2×/day with: 0 ppm F [H<sub>0</sub>/L<sub>0</sub>], 1,450 ppm F [H<sub>1,450</sub>/L<sub>1,450</sub>], 2,800 ppm F [H<sub>2,800</sub>/L<sub>2,800</sub>], 5,000 ppm F [H<sub>5,000</sub>/L<sub>5,000</sub>], 5,000 ppm F plus TCP [H<sub>5,000+TCP</sub>/L<sub>5,000+TCP</sub>], and 12,500 ppm F [H<sub>12,500</sub>/L<sub>12,500</sub>] containing dentifrices/gels. Dentifrice/gel slurries were prepared with deionized water (1:2 wt/wt). Differences in integrated mineral loss (∆∆Z) and ∆ lesion depth were calculated between values before and after pH-cycling using transversal microradiography. Results: The correlation between ΔΔZ<sub>DT</sub> and F<sup>–</sup> was strong for the highly (r<sub>H</sub> = 0.691; p < 0.001) and moderate (r<sub>L</sub> = 0.500; p < 0.001) for the lowly cariogenic model, indicating a fluoride dose-response for both. Significant differences for ΔΔZ<sub>DT</sub> and ΔΔZ<sub>ST</sub> could be found between H<sub>0</sub>, H<sub>1,450</sub>, H<sub>5,000</sub>, and H<sub>12,500</sub> as well as L<sub>0</sub>, L<sub>5,000</sub>, and L<sub>125,000</sub> (p ≤ 0.046; analysis of covariance [ANCOVA]). Except for 0 ppm F<sup>–</sup>, no significant difference in ΔΔZ<sub>ST</sub> and ΔΔZ<sub>DT</sub> could be found between the highly and lowly cariogenic model (p ≥ 0.056; ANCOVA). Conclusion: For both pH-cycling conditions a dose-response for fluoride could be revealed. For elderly people with exposed root surfaces, the use of gels containing 12,500 ppm F instead of regularly (1,450 ppm F) or highly (5,000 ppm F) fluoridated dentifrices should be further investigated, as it offered higher caries-preventive effects in vitro.
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