Abstract
Erosion incidence is increasing and its control is still a challenge in clinical practice. This study evaluated 4% TiF4-gel effects on eroded human dentin subjected to in situ erosive/abrasive episodes. Seventy-two previously eroded dentin slabs (0.05 M citric acid, pH 2.3, 20 min) were allocated to 6 groups (n=12) according to the treatment to be performed during the in situ phase and number of erosive/abrasive cycles, as follows: 4% TiF4-gel applied once (TiF41), twice (TiF42) or three times (TiF43) followed by 1, 2 and 3 erosive/abrasive cycles, respectively. Gel was applied before the beginning of the next cycle. Control groups were subjected to 1 (C1), 2 (C2) and 3 (C3) erosive/abrasive cycles only. A seventh group (n=12) comprised in vitro uneroded samples (UN) subjected to 3 erosive/abrasive cycles. Each cycle corresponded to 2 days of erosive (citric acid 0.5%, pH 2.6, 6x/day) and abrasive (electric toothbrush, 10 s/sample, 1 x/day) challenges. Samples were evaluated under profilometry and environmental scanning electron microscopy (ESEM). Atomic force microscopy images (AFM) were also made (n=3). Repeated measures 2-way ANOVA and Tukey test (p<0.001) showed that TiF42, which did not differ from TiF41 and TiF43, revealed a significant reduction in surface loss compared to all control groups. TiF41 and TiF43 showed no significant difference from C1, but both groups demonstrated significantly smaller surface loss than C2 and C3. ESEM and AFM micrographs suggested alterations on treated surfaces compared to samples from control groups, showing reduced diameters of dentinal tubules lumens. Therefore, TiF4 was able to reduce the progression of erosive/abrasive lesions.
Highlights
Dental erosion is a chemical process, characterized by chronic and pathological dissolution of dental hard tissues due to exposure to a variety of non-bacterial acids [1]
Tukey test demonstrated that the specimens from the TiF4 2 group (2 cycles), which did not differ from any of the other two TiF4-treated groups, revealed significantly lower surface loss when compared to all the untreated control groups
Some authors reported that TiF4 produces a glaze on the dentin surface [6,18] and one of the strongest actual theories to explain this formation considers the direct interaction between titanium and the organic matrix [8]
Summary
Dental erosion is a chemical process, characterized by chronic and pathological dissolution of dental hard tissues due to exposure to a variety of non-bacterial acids [1]. Fluoride products commonly used for caries prevention, as sodium fluoride, amine fluoride and acidulated phosphate fluoride, have proven to be partially effective in controlling erosive lesions [2,3], as they promote the precipitation of minerals like calcium fluoride (CaF2) on the eroded surface [4]. They form a layer that acts as a physical barrier to the action of acids, apart from acting as a mineral reservoir, which under erosive challenge is able to release calcium and fluoride [5]. Among the existing theories to explain its action, one is that titanium is capable of reacting with the oxygen atoms of the phosphate groups of the dental tissue, forming stable titanium oxides [7] or organometallic complexes that can act as a diffusion barrier [8]
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