Monofluorophosphate Dentifrice Research Articles

Relationship between 1-, 3-, and 6-Month Gingival Bleeding Outcomes.

Results from systematic reviews and meta-analyses show generally consistent antigingivitis effects between 3- and 6-mo observation time points with twice-daily use of stannous fluoride (SnF2) dentifrice. However, the relationship between 1-, 3-, and 6-mo gingivitis responses has not been investigated. This pooled analysis was conducted to understand the relationship of 1-, 3-, and 6-mo gingival bleeding outcomes. Number of bleeding sites, derived from Löe-Silness Gingival Index (LSGI) or Gingival Bleeding Index, was identified as the primary end point of the analysis for the biological and clinical relevance. Randomized, double-blinded, controlled clinical studies meeting the following predefined selection criteria were identified: 1) published and unpublished gingivitis clinical trials conducted from 1995 to 2022 comparing efficacy of 0.454% SnF2 dentifrices to negative controls (sodium fluoride or sodium monofluorophosphate dentifrice) and 2) studies with a 3-mo assessment and at least a 1- or 6-mo assessment. The search resulted in ten 6-mo and fourteen 3-mo studies meeting selection criteria. A mixed-effects model was performed on the pooled data to assess gingival bleeding outcomes across time. The bleeding efficacy significantly increased between months 1 and 3 (P < 0.0001) and plateaued between months 3 and 6 (P = 0.007), supporting the fact that bleeding reduction relative to control established by 1 mo will increase and be maintained through 3 and 6 mo (R2 = 0.857). In addition, gingival bleeding and gingivitis efficacy, as measured by LSGI, were found to be highly correlated (R2 = 0.874). A clear relationship has been demonstrated between 1-, 3-, and 6-mo gingival bleeding outcomes in gingivitis clinical studies comparing SnF2 dentifrice to negative control dentifrice. These findings have important implications to the dental practice and scientific research as antigingivitis efficacy evaluations can be observed as early as 1 mo and are consistent with those seen at 3 or 6 mo. Outcomes from this investigation indicate that the clinical evaluation of antigingivitis efficacy at 1 mo is predictive of that at 3 and 6 mo, supporting studies of 1-mo duration as a viable method of knowledge acquisition. This more efficient, expedited research design has positive implications for patient care, clinical practice guidelines, protocols, and policies.

Antimicrobial effects of a stannous fluoride toothpaste in distinct oral microenvironments

BackgroundClinical research has shown a relationship between microbial accumulations and oral diseases such as gingivitis and caries. The mouth harbors large densities of bacteria in distinct oral microenvironments, that is, dental plaque on teeth, saliva, and soft tissues such as the tongue, cheek, and gingiva. In this home-use study, the authors compared the effects of brushing with a newly formulated stannous fluoride toothpaste and a sodium monofluorophosphate dentifrice on bacteria of distinct oral microenvironments. MethodsAdult participants completed a washout phase before baseline sampling of dental plaque, saliva, and scrapings from tongue, cheek, and gingiva, which were used for microbiological analysis. Treatments were randomly assigned: test (62 participants) and control (67 participants) for twice-daily toothbrushing over 8 weeks. After 4 weeks and 8 weeks, posttreatment samples 12 hours after brushing were collected for analysis. At these posttreatment visits, participants brushed in the dental clinic, and an additional sample was collected 4 hours later for microbiological analysis. ResultsRelative to the control, 12 hours after brushing, the test toothpaste showed greater reductions of bacteria (ranging from 14% to 27%) at the 4-week evaluation, which increased to 27% to 41% after 8 weeks of brushing. Correspondingly, 4 hours after brushing with the test toothpaste at the 4-week evaluation, there were greater reductions of bacteria in the range of 22% to 59%, which increased to a range of 33% to 61% at the 8-week assessment for participants completing the study. ConclusionsThe stannous fluoride toothpaste provided bacterial reductions in all oral microenvironments 12 hours after brushing. In addition, the authors observed microbial reductions 4 hours after brushing, which increased after extended use. Practical ImplicationsThe results are appropriate for oral hygiene recommendations by dental professionals.

Comparative Evaluation of the Remineralization Potential of Monofluorophosphate, Casein Phosphopeptide-Amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Demineralized Enamel Lesions: An In Vitro Study

Aim: The aim of the study is to compare the remineralization potential of monofluorophosphate, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and calcium sodium phosphosilicate on demineralized enamel lesions.Materials and methods: Enamel sections from 30 sound human premolar crowns were prepared and sectioned into quadrants. Early enamel lesions were created in each sample by immersion in a demineralizing solution for 72 hours. Of the four sections, the first quadrant (A) was not given any surface treatment, the second quadrant (B) was treated with monofluorophosphate dentifrice, the third (C) was treated with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and the fourth (D) was treated with calcium sodium phosphosilicate while being subjected to a five-day pH cycling protocol. The sections were further cross-sectioned to expose the lesion depth and were then viewed under the confocal laser scanning microscope after staining with 0.1 mM rhodamine B dye for 24 hours. The two parameters evaluated were the cross-sectional demineralized lesion area and total fluorescence.Results: Amongst the dentifrices tested, the lowest values for lesion area and total fluorescence were recorded by calcium sodium phosphosilicate (3874.1 µ2 and 107282.6, respectively), followed by casein phosphopeptide-amorphous calcium phosphate (5776.6 µ2 and 129470.8) and then by monofluorophosphate dentifrice (7371.2 µ2 and 233765.9) in increasing order. The highest values for lesion area and total fluorescence were recorded by the no treatment group (16449.2 µ2 and 759743.1). One-way analysis of variance (ANOVA) showed significant variations (p<0.01) between the groups and Scheffe multiple comparisons confirmed the significance (p<0.01) of intergroup variations.Conclusion: The results of this study suggest that, among the three agents tested, calcium sodium phosphosilicate is the most effective remineralizing agent followed by casein phosphopeptide-amorphous calcium phosphate. Monofluorophosphate is the least effective remineralizing agent when tested under the conditions mentioned in this study.

Remineralizing Effectiveness of Calcium Sucrose Phosphate and Fluoride Dentifrices: An In vitro Study.

Context:Dentifrices-containing remineralizing agents are known to be effective in remineralization of early enamel lesions.Aims:This study aimed to compare and evaluate the changes in surface roughness, surface morphology, and mineral content of demineralized enamel lesion after treatment with dentifrices-containing sodium monofluorophosphate, amine fluoride, and Anticay® (calcium sucrose phosphate with inorganic amorphous calcium phosphate).Settings and Design:This was an in vitro study.Subjects and Methods:Eighteen extracted maxillary molars were decoronated and sectioned into four to obtain 72 specimens. Specimens were demineralized and randomly divided into four different test groups: Group A: no treatment (control), Group B: sodium monofluorophosphate dentifrice (Colgate), Group C: amine fluoride dentifrice (Amflor), Group D: Anticay® dentifrice (EnaFix) and subjected to pH-cycling for 4 weeks. After 4 weeks, they were assessed using a profilometer and scanning electron microscope (SEM)-energy dispersive X-ray analysis (EDAX) for changes in surface roughness, surface morphology, and mineral content.Statistical Analysis Used:Intergroup comparison was done using repeated measures ANOVA.Results:Intergroup comparison revealed no significant difference in surface roughness and mineral content after remineralization between the groups. SEM images showed mineral deposition in all the dentifrice groups obliterating the defects caused due to demineralization.Conclusions:Sodium monofluorophosphate, amine fluoride-containing dentifrices, and calcium sucrose phosphate with inorganic amorphous calcium phosphate-containing dentifrice were found equivocal in their remineralizing effectiveness of early enamel lesions.

Fluoride retention in saliva following toothbrushing using different types of fluoridated dentifrices containing 1500 ppm F of NaF and MFP

PurposeThis crossover study was carried out to evaluate the influence of two different types of fluoridated dentifrices containing sodium fluoride (NaF) and sodium monofluorophosphate (MFP) on salivary fluoride levels after toothbrushing. MethodsEight consenting individuals (average age 36.4 years) brushed their teeth in the same manner using a paste type of dentifrices (0.5 g) containing 1500 ppm F. Following toothbrushing for 2 min, they spat out once and rinsed their mouths with 15 mL of distilled water for 5 s. Resting saliva samples were collected for 3 min each at different time intervals; 5 min, 10 min, 15 min, 30 min, 60 min, 120 min, and 180 min following the mouth rinsing. Fluoride concentrations in saliva samples were determined using a fluoride ion specific electrode. Then we compared those of dentifrices, in regard to salivary fluoride concentrations in each individual. The area under the curve (AUC) of fluoride was calculated using a graph on which the horizontal base line represents sampling time and the vertical scale represents fluoride concentration. ResultsStatistical differences (p < 0.05) were shown in the fluoride concentrations [ppm, mean ± standard deviation (SD)] between NaF and MFP dentifrices at 5 min, 10 min, 60 min, 120 min, and 180 min after the rinsing. The AUC (ppm･minute, mean ± SD) during the whole experimental period showed statistical differences (p < 0.05) between NaF (49.5 ± 26.4) and MFP (24.6 ± 8.5). ConclusionThe results indicated that the NaF type of dentifrice retains more fluoride in saliva than that of MFP.

The effect of the dentifrice on gingivitis and dental plaque: A 6-week clinical study in India

Introduction: Dentifrices are commonly used for oral hygiene with some formulated with antimicrobial agents to control plaque. There is little information regarding the effects of dentifrices on controlling dental plaque and gingivitis amongst Indian subjects. Objective: To evaluate the efficacy of three commercially-available fluoride dentifrices on established gingivitis and supragingival dental plaque after 6-week of product use. Materials and Methods: Adult subjects completing informed consent and presenting a Loe-Silness gingival index (GI) score ≥ 1.0 and a Quigley-Hein, Turesky Modification, plaque index (PI) score ≥ 1.5 completed a 2-week washout period with commercial fluoride toothpaste. They were instructed to refrain from all other oral hygiene products (including mints, chewing gums, mouth rinses). Subjects returned to the clinical facility again having refrained from all oral hygiene procedures for 12 h and from eating, drinking or smoking for 4 h for baseline gingivitis and plaque examinations. They were randomly assigned to one of three treatment groups according to baseline gingival and plaque indices scores: (1) A dentifrice containing 0.3% triclosan and 1000 ppm sodium monofluorophosphate (Colgate ® Supershakti Dental Cream), (2) a dentifrice containing 0.54% zinc citrate, 0.64% stannous chloride and 0.33% sodium fluoride (Crest ® Pro-Health All Good 7 Effects Toothpaste), and (3) a dentifrice containing 1000 ppm sodium monofluorophosphate (Colgate ® CIBACA Toothpaste [negative control]). After 6-week use of their assigned dentifrice, all subjects were recalled for posttreatment plaque and GI examinations. Results: 105 subjects completed the study. Baseline plaque and GI scores demonstrated no statistical differences between treatment groups (P > 0.05). Further, Chi-square analysis demonstrated no significant differences between treatment groups for subject age or gender (P > 0.05). At the 6-week examinations, subjects in all three dentifrice groups exhibited statistically significant reductions in GI scores (32.5%, 16.6% and 19.9%, respectively) and PI (38.1%, 16.4% and 20.4%, respectively) scores from baseline (P < 0.05). The triclosan group exhibited statistically significant (P < 0.05) reductions in GI scores (17.5% and 12.5%, respectively) and PI scores (21.7% and 19.1%, respectively) when compared to the zinc citrate/stannous chloride dentifrice and to the sodium monofluorophosphate dentifrice. Conclusion: The triclosan/sodium monofluorophosphate dentifrice (Colgate Supershakti Dental Cream) demonstrated significantly less gingivitis and greater reductions of supragingival dental plaque (P < 0.05) when compared to a dentifrice containing zinc citrate/stannous chloride/sodium fluoride (Crest Pro-Health All Good 7 Effects Toothpaste) and to a dentifrice containing sodium monofluorophosphate (Colgate CIBACA Toothpaste).

Efecto de la arginina 8%-carbonato de calcio y del fluoruro de sodio al 5% en la reducción de la hipersensibilidad dentinaria post terapia periodontal: ensayo clínico

AimThe aim of this clinical study was to evaluate and to compare the efficacy in reducing the dentine hypersensitivity of an 8% arginine, calcium carbonate, 1.450ppm sodium monofluorophosphate dentifrice with topical application and twice-daily brushing, with a negative control toothpaste containing calcium carbonate and 1.450ppm fluoride as MFP, after periodontal treatment (baseline) and four weeks respectively. MethodsA fourweek clinical study with 20 subjects with diagnosis of slight to moderate chronic periodontitis under mechanical periodontal treatment and presence of gingival recessions in incisors, canines or premolars, stratified based on baseline tooth sensitivity. Subjects brushed with either a 1.450 ppm fluoride dentifrice or a marketed 8% arginine calcium carbonate dentifrice twice daily for approximately one minute. At screening, baseline and weeks four, subjects’ tooth sensitivity was determined through both evaporative (Schiff and Visual Analogue Scale [VAS]). The same examiner throughout the study performed subject assessments using each stimulus. ResultsBoth subject groups exhibited significant reductions from baseline to four weeks in dentine hypersensitivity. However, patients who received 8% arginine calcium carbonate therapy, exhibited a greater reduction, with a 60% of individuals lacking of pain and with a final median of 0 in comparison with the 5% fluoride varnish and fluoride toothpaste group in which a 100% of subjects felt some degree of pain, presenting a final medium VAS scale of 2.

Kinetics of Monofluorophosphate Hydrolysis in a Bacterial Test Plaque in situ

Models to evaluate the anticaries potential of fluoride (F) formulations containing monofluorophosphate (MFP) should consider the release of F ion to the oral environment by its enzymatic hydrolysis. This was tested in situ, using a test plaque of a strain of Streptococcus mutans which presents high MFPase activity at pH 5.0. The test plaque was exposed to non-F or MFP (1,450 µg F/g) dentifrices and the fluid phase of the plaque was analyzed after 15, 30, 45 and 75 min. MFP concentration in the plaque fluid decreased over time after exposure to MFP dentifrice, but F ion reached 134.9 ± 32.0 µM at 15 min and decreased significantly only at 75 min, suggesting continuous MFP hydrolysis by the test plaque.

Assessment of Autofluorescence to Detect the Remineralization Capabilities of Sodium Fluoride, Monofluorophosphate and Non-Fluoride Dentifrices

The purpose of the study was to determine if longitudinal measurements of enamel autofluorescence (quantitative light-induced fluorescence, QLF) could detect differences in remineralization of early enamel caries on buccal surfaces of anterior teeth following supervised daily brushing with either sodium fluoride (NaF; 1,450 ppm F), sodium monofluorophosphate (MFP; 1,450 ppm F) dentifrices or a herbal, non-fluoride placebo dentifrice. The study was a pragmatic cluster-randomized controlled trial with schools as the unit of randomization. Twenty-one schools in Chengdu, China, comprised the clusters; 296 children with at least 1 visible white-spot lesion were examined using QLF at baseline and after 3 and 6 months. Each of the 21 clusters was randomly assigned 1 of the 3 dentifrices, and the childrenbrushed under supervision once per day for 2 min. The primary outcome measure was ΔQ (product of fluorescence loss and area) at a 5% threshold after 6 months of product use. A multi-level model was fitted to the data at the site level, taking into account the hierarchical structure with baseline ΔQ, age and sex as covariates. After 3 months there was a significant difference between the MFP group and placebo (p = 0.02) and after 6 months between the NaF group (p = 0.002), MFP group (p < 0.001) and the placebo. QLF methodology could detect, within 3- and 6-month periods of supervised brushing, a difference in remineralization between fluoride-containing and non-fluoride-containing dentifrices. Typically lesions in all 3 treatment groups demonstrated improvement. Groups receiving fluoride experienced a more rapid and more substantial remineralization than those in the placebo group.

Effect of a Calcium Carbonate-Based Dentifrice on in situ Enamel Remineralization

This crossover study evaluated the effect of calcium carbonate (CaCO₃)-based monofluorophosphate dentifrice on enamel remineralization. Ten volunteers wore palatal appliances containing four enamel blocks with caries-like lesions, two of them covered by a test plaque of mutans streptococci. The following treatments were evaluated: a negative control, a silica-based or a CaCO₃-based dentifrice, and the percentage of enamel surface microhardness recovery was determined. The CaCO₃-based dentifrice was more effective than the negative control on the enhancement of enamel remineralization, either in the presence or absence of test plaque. This efficacy was also shown by the silica-based dentifrice but only in the presence of test plaque.

Calcium fluoride formation in enamel from semi- or low-concentrated F agents in vitro.

The formation of CaF2 was measured on sound enamel and in artificial, standardized (acidified gelatin, pH 4.5) caries-like enamel lesions after exposure to: (a) dentifrice/saliva slurries adjusted to relevant F-concentrations of approximately 100 or 8 ppm by appropriate addition of 1,000 ppm F NaF or Na monofluorophosphate (MFP) dentifrice, respectively, or (b) a mixture of saliva with a 0.2% NaF solution obtained by a usual 1-min rinse procedure or an aqueous solution of 0.2% NaF. CaF2 was determined after extraction with KOH and fluoride analysis by gas chromatography. Only negligible amounts of CaF2 were produced on sound enamel ranging from (mean +/- SEM) 0.76 +/- 0.14 micrograms F/cm2 with the 0.2% NaF solution to as little as 0.04 +/- 0.06 with the MFP dentifrice slurry. In caries-like enamel lesions, the CaF2 production with the 0.2% NaF solution/saliva mixture corresponded to 3.7 +/- 0.4 micrograms F/cm2 and corresponding amounts obtained with the dentifrice/saliva slurries were 1.5 +/- 0.19 micrograms F/cm2 with NaF, but only 0.19 +/- 0.04 with MFP. It was suggested that the deposition of CaF2 in the micropores of early lesions can be expected to be an important mechanism with F rinses, probably to some extent with NaF dentifrices, but barely with MFP dentifrices. The formation of CaF2 on sound enamel is unlikely to play a significant role in the caries-reducing effect of F rinses and F dentifrices.

An in situ enamel section model for assessment of enamel re/demineralization potential.

An enamel-section-carrying intra-oral appliance to predict the results of double-blind anti-caries studies has been developed. Initial validation was against the F concentration effect attained in a clinical trial where three sodium monofluorophosphate (SMFP) dentifrices were used. Original appliance-based work showed significant differences in remineralization between non-F and F dentifrices, but not between different F dentifrices. However, it was shown later that acidified gel-prepared lesions were not as responsive as solution-prepared lesions to de- and remineralizing processes, and lesion remineralization rates were found to be dependent on initial lesion size. An in situ cross-over study was then repeated with use of acid-solution-created lesions, and seven volunteers completed the project. Each brushed twice daily x 2 min with either 0, 1000, or 2500 ppm F, as SMFP dentifrice. After a two-week wash-out, subjects wore the appliances for four weeks. Enamel mineral content was assessed at 0, two, and four weeks via microradiography/microdensitometry, and a statistically significant dose-response was obtained between non-F and F as well as between 1000 and 2500 ppm F pastes, i.e., as per the three-year clinical trial data. Hence, the model's suitability for pre-clinical screening was confirmed. It has also been used in caries microbiological studies, in root caries investigations, and currently in chewing gum cariogenicity experiments.

High resolution fluoride profiles of artificial in vitro lesions treated with fluoride dentifrices and mouthrinses during pH cycling conditions.

A pH cycling model which incorporated a severe demineralization component was used to evaluate fluoride uptake and lesion progression for each of a NaF-based dentifrice, NaF-based mouthrinse and a monofluorophosphate (MFP)-based dentifrice. Simultaneous transverse fluoride and calcium profiles across the resulting artificial lesions were obtained using a proton microprobe technique with a resolution of approximately 10 microns. Longitudinal microhardness testing and proton microprobe calcium profiles were used to determine the extent of lesion progression (delta Z) with respect to untreated controls. Under the pH cycling conditions of the present study, the NaF dentifrice and mouthwash were observed to have a considerably higher uptake of fluoride in the lesion than the MFP dentifrice. Although the mineral content profiles of the lesions differed for treatments with each of the fluoride products, the differences were not significantly different in this model.

Effect of Mouthrinsing after Toothbrushing with a Fluoride Dentifrice on Human Salivary Fluoride Levels

In a recent clinical trial of sodium monofluorophosphate dentifrices, oral rinsing habits were found to influence dental caries. Thus an oral fluoride clearance study has been undertaken which was designed to test a possible mechanism for the observed effects. Eight subjects brushed with one of the trial dentifrices and then rinsed using 1 of 8 procedures of varying thoroughness. The salivary fluoride concentration measured 5 min after dentifrice application decreased significantly with increasing rinse volume, rinse duration, and rinse frequency (p less than 0.01, analysis of variance). The area under the clearance curve determined over a further 3 h was significantly higher (300%; p less than 0.01) following use of the least thorough rinsing procedure (5 ml x 2 s once) as compared with the corresponding area under the clearance curve following the most thorough procedure (20 ml x 10 s twice). These findings indicate that rinsing habits may play an important role in the oral retention of fluoride from dentifrices which may, in turn, affect their clinical efficacy.

Caries-Preventive Effect of Fluoride Dentifrices with and without Anticalculus Agents: A 3-Year Controlled Clinical Trial

A 3-year, double-blind, randomized caries trial was conducted to evaluate the relative anticaries efficacy of four sodium fluoride dentifrices containing 250 ppm fluoride, 1,000 ppm fluoride in combination with 1% disodium 1-hydroxyethylidene-1.1-bisphosphonate (HEBP), and 1,000 ppm fluoride in combination with 1% disodium azacycloheptylidene-2.2-bisphosphonate (AHBP). As a positive control, a monofluorophosphate dentifrice (1,000 ppm fluoride) was used. At outset 1,161 Icelandic children, 11 and 12 years of age, were randomly assigned to one of the five treatment groups and 1,035 subjects completed the trial. After 3 years of unsupervised brushing, the dentifrice containing 250 ppm fluoride was significantly less effective in controlling the caries increment. The combination of sodium fluoride and AHBP was significantly more effective than the positive control.

Fluoride uptake in vivo by artificial caries lesions in root surface dentin from sodium monofluorophosphate dentifrices.

Fluoride uptake in vivo by artificial caries lesions in root surface dentin from sodium monofluorophosphate dentifrices.

Remineralization by a monofluorophosphate dentifrice in vitro of root dentin softened by artificial caries.

Artificial caries-softened dentin lesions in root surfaces were treated with 50% slurries of a monofluorophosphate (MFP) dentifrice or a placebo dentifrice twice daily for ten days. Between dentifrice treatments, the lesions were kept in a remineralizing solution. Both treatments resulted in statistically significant remineralization, with the MFP dentifrice being significantly better than the placebo. Deposition of new mineral from the MFP dentifrice occurred about equally at or within the surface zone and at the deepest part of the lesion. Mineral deposition from the placebo appeared to be more uniformly distributed within the lesion.

Remineralization in vivo of Artificial Caries Lesions by a Monofluorophosphate Dentifrice

Blocks of human enamel containing artificial caries lesions covered with Dacron mesh were implanted in the dentures of 14 subjects. Each subject, according to random design, was instructed to brush his/her teeth, with their denture in place, three times daily for 2 months using a sodium monofluorophosphate-dicalcium phosphate dihydrate (MFP/DCPD) dentifrice or a placebo dentifrice containing no fluoride, soluble calcium or phosphate. Every subject used both dentifrices in a crossover, double-blind design. Matched pairs of enamel blocks with artificial lesions were used, one of which was treated with a dentifrice and one kept untreated as a control. Statistically significant remineralization as determined by several parameters occurred in the artificial lesions treated with both the MFP/DCPD and the placebo dentifrices (p

Effect of soluble calcium on fluoride uptake by artificial caries lesions in vivo.

Artificial caries lesions were implanted in the partial dentures of 10 subjects and treated for 2 weeks by brushing in vivo with a monofluorophosphate (MFP®) dentifrice, a similar dentifrice containin

Study of a bland dentifrice for persons with radiation-induced mucositis and vesiculo-erosive disease

Althought the patient group was limited to persons with radiation-induced mucositis, lichen planus, and erythema multiforme, the study indicates the potential usefulness of a bland dentifrice to other patients with sensitive mouths. Although it is presumed that regular brushing habits will aid in oral hygiene and health, the specific effect of a bland dentifrice on control of plaque, caries, and periodontal disease cannot be assessed in this preliminary study. Also, no comparison was made with cleaning techniques in which dentifrice is not used. Therefore, this study indicated only that dentifrice with reduced flavor, like the one used in this study, may encourage better oral hygiene through continued brushing when irritation from regular dentifrices discouages it.