Layered Double Hydroxide Fluoride Release in Dental Applications: A Systematic Review.

Agron Hoxha,David G Gillam,Andy J Bushby,Amani Agha,Mangala P Patel

doi:10.3390/dj7030087

Abstract

This systematic review appraises studies conducted with layered double hydroxides (LDHs) for fluoride release in dentistry. LDH has been used as antacids, water purification in removing excess fluoride in drinking water and drug delivery. It has great potential for controlled fluoride release in dentistry, e.g., varnishes, fissure sealants and muco-adhesive strips, etc. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed with two reviewers performing a literature search using four databases: PubMed, Web of Science, Science Direct and Ovid Medline with no date restrictions. Studies including any LDH for ion/drug release in dentistry were included, while assessing the application of LDH and the value of the methodology, e.g., ion release protocol and the LDH production process. Results: A total of 258 articles were identified and four met the inclusion criteria. Based on two in vitro studies and one clinical study, LDH was previously studied in dental materials, such as dental composites and buccal muco-adhesive strips for fluoride release, with the latter studied in a clinical environment. The fourth study analysed LDH powder alone (without being incorporated into dental materials). It demonstrated fluoride release and the uptake of volatile sulphur compounds (VSC), which may reduce halitosis (malodour). Conclusion: LDHs incorporated in dental materials have been previously evaluated for fluoride release and proven to be clinically safe. LDHs have the potential to sustain a controlled release of fluoride (or other cariostatic ions) in the oral environment to prevent caries. However, further analyses of LDH compositions, and clinical research investigating any other cariostatic effects, are required.

Highlights

A wide range of materials have been extensively investigated to obtain a slow and controlled drug/ion release, especially for applications within medicine and dentistry
This review only found four papers that met the criteria, where a range of techniques were used to investigate some properties of layered double hydroxides (LDHs) for potential use in the dental field
LDH’s incorporation into a buccal muco-adhesive strip to release fluoride as a powder alone and two studies where it was incorporated in dental resins as a filler

Summary

Introduction

A wide range of materials have been extensively investigated to obtain a slow and controlled drug/ion release, especially for applications within medicine and dentistry. It is acknowledged that obtaining a low-level release of fluoride in the oral environment is essential, as it is the most effective method for preventing post-eruptive dental caries. The physiological fluoride concentration in saliva varies between individuals and ranges from 0.02 to 0.05 ppm; numerous studies have demonstrated a decrease in demineralisation, with an increase in fluoride concentration (0.025–2 ppm) [1,2,3]. Fluoride inhibits mineral loss (via forming a less soluble fluorapatite) and enhances remineralisation of enamel or decalcified dentine. It has the ability to inhibit the metabolism and growth of bacteria, including Streptococcus (S.) mutans and S. sobrinus that initiate dental caries [4,5,6].

Results

Discussion

Conclusion