NaF Dentifrice Research Articles

Effect of the calcium silicate and sodium phosphate remineralizing products on bleached enamel.

This study evaluated the effect of calcium silicate and sodium phosphate (CSSP) dentifrice and serum on the surface of enamel bleached with hydrogen peroxide (H2O2). A total of 160 bovine enamel slabs were bleached with 35% H2O2 and treated with sodium fluoride (NaF) dentifrice-GI, CSSP dentifrice-GII; CSSP dentifrice + CSSP serum-GIII, or NaF dentifrice + NaF gel-GIV. The dentifrices were applied using a brushing machine three times daily for 7 days. After brushing, sodium phosphate gel and CSSP serum were applied. The microhardness (KNH, n = 14), surface roughness (Ra, n = 14), energy dispersive spectroscopy (n = 6), and scanning electron microscopy (n = 6) were assessed at t0 (before bleaching), t1 (after bleaching), and t2 (after postbleaching treatments). The data were subjected to a two-way analysis of variance and Bonferroni's test. The KNH decreased at t1 (P < 0.001) but recovered at t2 for all treatments, although only GII showed restored baseline values (P = 0.0109). The surface roughness increased at t1 (P < 0.001) and reduced at t2 (P < 0.001) for all groups, with no significant differences among groups. Enamel composition and morphology did not differ after the treatments, except for silicon accumulation in GIII. Postbleaching treatment with CSSP dentifrice and serum yielded superior remineralizing effects on bleached enamel.

Efficacy of a stannous fluoride dentifrice for relieving dentinal hypersensitivity in Chinese population: an 8-week randomized clinical trial

ObjectivesTo compare the effectiveness of using a 0.454% stannous fluoride-containing dentifrice twice daily in relieving dentinal hypersensitivity (DH) in a Chinese population.Materials and methodsThis was a single-centre, randomized, controlled, examiner-blind, three-treatment-arm, parallel-group study in participants with clinically diagnosed DH. Subjects who met inclusion criteria (n = 197) were randomly allocated into 3 groups: test group (n = 66)—using a 0.454% stannous fluoride-containing dentifrice twice daily; positive control group (n = 64)—using a 5.0% calcium sodium phosphosilicate-containing dentifrice twice daily; negative control group (n = 67)—using a 1150 ppm of NaF dentifrice twice daily. Status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Schiff sensitivity score, tactile threshold and Dentine Hypersensitivity Experience Questionnaire (DHEQ) score were analysed using analysis of covariance models. The DHEQ evaluated subject-perceived oral health-related quality of life (OHRQoL).ResultsStatistically significant improvements in mean Schiff scores (p < 0.0001 for all products at Weeks 4 and 8), tactile threshold (p < 0.0001 for test and negative control at Weeks 4 and 8: Week 4 p = 0.0040 and Week 8 p < 0.0001 for positive control) and all DHEQ scores (p < 0.01 for all groups) were observed. No statistically significant differences were observed in the adjusted mean between all dentifrices at both timepoints, potentially driven by a placebo effect. Forty-two treatment-emergent adverse events (TEAEs) were reported (n = 32 subjects), with 2 serious AEs (n = 1) in the test group. TEAEs were not considered treatment-related.ConclusionsAll groups demonstrated statistically significant improvements in Schiff score, tactile threshold and OHRQoL. However, due to a possible placebo effect in the negative control, there were no statistically significant differences between the dentifrices.Clinical relevanceThis study adds to the growing research exploring why the placebo effect is a common phenomenon in DH studies.Trial registration: ClinicalTrials.gov Identifier: NCT04950465.

The effects of pediatric dentifrices with different types of fluoride on the color change of restorative materials.

This study aimed to evaluate the effects of dentifrices with different fluoride content on color change of restorative materials commonly used in pediatric dentistry. Three restorative materials (glass hybrid [Equia Forte (EF)], glass carbomer [GCP Glass Fill (GCP)] and compomer [Dyract XP (DXP)]) were used to prepare 120 disc shaped specimens by using a Teflon ring. Four dentifrice groups were created as Sodium Fluoride (NaF), Amine Fluoride (AmF), Stannous Fluoride (SnF2) and no-fluoride (n=40). Simulated tooth brushing was performed for each specimen by applying 6720 strokes for 6 months. Color changes [CIEDE2000 (Δ𝐸00)] were calculated by using generalized linear model procedure and the data were subjected to two-way analysis of variance. The highest color changes for NaF and AmF dentifrice groups were observed in the GCP restorative material (p<0.05). The color changes of restorative materials tested with SnF2 dentifrice group were statistically different (p<0.05) in each restorative material and Δ𝐸00 values were observed as GCP> EF>DXP. SnF2 dentifrice provided better color stability for all restorative materials when compared to NaF and AmF dentifrices; although, this was not statistically significant. GCP underwent significant discoloration values when brushed with all types of dentifrices. Although the glass carbomers caused significant color change, the compomers seem to be more resistant to the color change when brushed with all types of dentifrices. The fluoride content of dentifrices is crucial for the color change of restorative materials.

Reduction in erosive tooth wear using stannous fluoride-containing dentifrices: a meta-analysis.

Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

Efficacy of a Stannous-containing Dentifrice for Protecting Against Combined Erosive and Abrasive Tooth Wear In Situ.

The in-situ efficacy of an experimental stannous (Sn)-containing sodium fluoride (NaF) dentifrice against erosion and erosive tooth wear was compared with a conventional NaF dentifrice. This was a randomised, controlled, double-blind, parallel-group clinical trial. Mandibular appliances containing four enamel specimens (2 per side [L/R] of the appliance) were worn by 60 generally healthy adult subjects. Subjects were randomised to treatment based on age and gender. Treatments included a Sn-containing NaF or conventional NaF dentifrice. Conditions of erosion (dentifrice slurry treatment) and erosion/tooth wear (dentifrice slurry plus brushing) were compared. Dentifrices were used twice per day for 30 s of lingual brushing, followed by 90 s of slurry exposure. In addition, the two specimens on the left side of the mouth were brushed for 5 s each, using a power toothbrush. All specimens were exposed to four daily erosive challenges with commercial orange juice (pH 3.6). Tooth wear was measured as enamel loss using non-contact profilometry on day 10. At the day 10 visit, the adjusted mean (SE) enamel loss for specimens receiving slurry (erosion) treatment was 4.7 µm (0.61) [Sn-containing NaF] and 8.73 µm (1.12) [NaF control], with results demonstrating a statistically significant benefit for the Sn-containing dentifrice (46.2% benefit; p = 0.009). For specimens exposed to erosion/tooth wear conditions, enamel loss = 6.68 µm (1.29) (Sn-containing NaF) and 10.99 µm (1.29) (NaF group), with results statistically significant (p = 0.048; 39.2% better, favouring the Sn-containing dentifrice). When data were combined, enamel loss (SE) for all specimens subjected to erosion + erosion/tooth wear was 5.61 µm (0.77) (Sn-containing NaF]) and 9.9 µm (1.3) (NaF group). The difference again was statistically significant, favouring the Sn-containing group (p = 0.022; 43.4% better). The Sn-containing dentifrice demonstrated significantly better protection than did NaF under erosive and erosive/tooth wear conditions.

In vitro effect of children's toothpaste on brushing abrasion of eroded primary enamel.

Emerging data have suggested that acid erosion has become an increasing clinical problem in pediatric dentistry. This study aimed to investigate the abrasive effects of two commercial toothpastes on primary enamel eroded by orange juice using an in vitro model. Thirty enamel slabs were obtained from primary teeth and then randomly assigned to three groups (n = 8) comprising two different toothpastes: G1-control-distilled water; G2-Dentifrice A (containing no fluoride); and G3-Dentifrice B (1.100 ppmF-NaF). Each slab had one half protected to provide a control side, and the other one was subjected to treatments. The slabs were submitted to daily erosive challenges (3×/day, 2min) in concentrated orange juice (pH 3.38) associated with abrasive challenges using a tooth-brushing machine (150 brush movements for each cycle). During the experimental period, the slabs were kept in 37°C artificial saliva, and the experiment was carried out for 5days. The depths of the resulting eroded areas were measured by stylus profilometry. The data were analyzed using ANOVA and the Tukey-Kramer test (α = 5%). Tooth loss (µm, mean ± SD) was 2.46 ± 1.18 for G1, 3.32 ± 2.12 for G2 and 2.14 ± 1.03 for G3. Therefore, the NaF dentifrice (Dentifrice B) produced significantly less mineral loss (p = 0.04) than dentifrice A. The findings suggest that fluoride toothpaste could protect primary enamel against erosion.

Measurement of eroded dentine tubule patency and roughness following novel dab-on or brushing abrasion

ObjectivesTo investigate the effect of dab-on or brushing of stannous-fluoride SnF2 or sodium-fluoride NaF dentifrice on eroded dentine tubule patency, surface and inter-tubular dentine roughness, using Confocal-Laser-Scanning-Microscopy (CLSM), Atomic-Force-Microscopy (AFM), Energy-Dispersive-X-ray-Spectroscopy (EDX), Scanning-Electron-Microscopy (SEM) and Contact-Profilometry (CP). Methods75-polished human dentine samples were prepared and eroded in agitated 6% citric acid to expose patent tubules and ‘initiate’ DH. Samples were randomly allocated into 5 intervention groups; artificial saliva control (1); electric tooth-brushing with NaF (2) or SnF2 (3), and dab-on application of NaF (4) or SnF2 (5). Samples underwent three cycles of intervention followed by further acid challenge. Patent tubules, likely to cause DH clinically, were measured using validated biocomputational methods with CLSM images of dentine surfaces taken baseline and post-intervention. Randomised samples (n = 15, 20 %) were investigated using AFM, EDX and SEM to study surface and sub-surface tubular occlusion. Dentine surface and inter-tubular roughness were measured using CP and AFM respectively. ResultsAt baseline, mean tubule patency in all samples was 216 (SD 58) with no significant inter-group differences. Post-intervention, the mean patency was 220 (40) and 208 (35) in groups 1 and 2 respectively (p ≥ 0.06), but decreased to 62 (41), 62 (21) and 63 (19) in groups 3, 4 and 5 respectively (p < 0.0001). Patency was confirmed using AFM, SEM and EDX. SnF2 interventions created greater sub-surface occlusion (p < 0.01), and increased CP surface roughness (p = 0.015). Significant negative correlation (-0.6) existed between CP surface roughness and tubule patency (p = 0.009). ConclusionsDab-on with NaF and SnF2 or brushing with SnF2 reduces DH in eroded dentine with ongoing acid challenges. Contacting surface roughness measures indicate risk of DH. Clinical significanceDab-on is a convenient supplementary method of dentifrice application to reduce DH; it beneficially avoids brushing post-erosion or overzealous brushing, enables re-establishment of an appropriate brushing regime post-DH and supports oral health. Significant modes of action of SnF2 in reducing DH are revealed. Finally, CP roughness measures provide indication of dentine lesions that may cause DH clinically.

Adjunctive use of fluoride rinsing and brush-on gel increased incipient caries-like lesion remineralization compared with fluoride toothpaste alone in situ

Objective: The objective of this study was to compare the remineralizing effect of sodium fluoride (NaF) mouth rinse or NaF gel as an adjunct to NaF dentifrice on incipient caries-like lesions in an in situ cross-over design study, with three sessions of 30 days each.Materials and methods: Orthodontic brackets with artificial demineralized enamel slabs were attached to the upper first molars of 12 participants. A set of 3 test specimens from the same tooth was randomly assigned to each participant and allocated into three 30-day sessions: 1) brushing with 0.22% NaF dentifrice 2 times/day (F dentifrice), 2) brushing with 0.22% NaF dentifrice 2 times/day+ rinsing with 0.05% NaF before bedtime (F mouth rinse), 3) brushing with 0.22% NaF dentifrice 2 times/day + brushing with 1.1% NaF gel before bedtime (F brush-on gel). The mineral gain and lesion depth of the specimens were evaluated by micro-computed tomography.Results: The mean mineral gain from the NaF mouth rinse and the NaF brush-on gel was similar, but greater than that from the NaF dentifrice (p < .05). The NaF brush-on gel yielded the greatest mean depth of remineralization (168 µm), followed by the NaF mouth rinse (144 µm). Both depths were significantly greater than that of the NaF dentifrice (84 µm) (p < .05).Conclusions: Both 0.05% NaF mouth rinse and 1.1% NaF brush-on gel, used at bedtime, increased incipient caries-like lesion remineralization in situ in combination with brushing with NaF dentifrice twice a day.

Caries Preventive Interventions in Community-Dwelling Elders: A Systematic Review

Objective: To conduct a systematic review of identifying the clinical efficacy of caries preventive interventions in community-dwelling elders. Background: As the human lifespan increases, the elders are known to retain their teeth for longer. Therefore, the need to uncover effective ways of preventing caries among this age group is relevant. Methods: A search was conducted using four databases: Cochrane, MEDLINE, EMBASE and Web of Science using the keywords (caries OR demineralization) AND prevention AND (adult OR aged). The titles and abstracts were initially screened for the use of caries prevention interventions. Studies were excluded based on the predetermined criteria. The full texts of the remaining studies were then evaluated. Results: Of 6952 articles identified from the search, fifty full texts were evaluated. Finally, ten studies were analyzed. One study found rinsing with 0.05% of NaF twice daily resulted in lower coronal caries increment. Another study reported the use of 1,100 ppm of NaF dentifrice twice daily showed lower percentage of coronal and root caries. A reduction of root caries was observed from using 5,000 ppm fluoridated toothpaste twice daily, annual professional 38% SDF solution application, six-monthly professional cleaning and APF gel application. The use of 0.12% CHX rinse and xylitol chewing gum did not show reduction of caries incidence. Conclusion: Toothbrushing with 5,000 ppm of NaF dentifrice, rinsing with 0.05% NaF, professional application of 38% SDF solution and APF gel may be effective at preventing caries among the elders.

Effects of a New Nano-Silver Fluoride-Containing Dentifrice on Demineralization of Enamel and Streptococcus mutans Adhesion and Acidogenicity.

An experimental dentifrice containing nano-silver fluoride (NSF) and a sodium fluoride (NaF) toothpaste were tested in vitro, against S. mutans, to evaluate the minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), antiadherence, antiacid, enamel microhardness, and OCT. The microdilution technique was used to determine the MIC and MBC. Fragments of deciduous enamel were treated with dentifrice slurries, containing bacterial suspension and PBS-treated saliva. The quantification of the microorganisms that adhered to the enamel was determined after 24 hours of incubation, and media pH readings were performed after 2 hours and 24 hours. Deciduous teeth were evaluated for microhardness and OCT during 14 days of pH cycling. Data were statistically analyzed using Student's t-test, Mann–Whitney U test, ANOVA, and Tukey tests at 5% of significance. Dentifrices containing NSF presented a lower MIC and higher statistically significant results compared to NaF dentifrices with respect to preventing bacterial adhesion and pH decreases. NSF and NaF dentifrices showed the same ability to avoid enamel demineralization corroborated by the OCT images. The NSF formulation had a better antibacterial effect compared to NaF dentifrices and similar action on the demineralization of enamel indicating their potential effectiveness to prevent caries.

Effects of Self-Assembling Peptide P11-4, Fluorides, and Caries Infiltration on Artificial Enamel Caries Lesions in vitro

The application of a self-assembling peptide on noncavitated caries lesions is supposed to be a feasible approach to facilitate remineralization and mask their unfavorable appearance. However, demineralizing conditions are common in the oral environment, so the aim of this pH-cycling study was to compare recommended and novel treatment methods regarding their ability to hamper demineralization and as a consequence mask artificial enamel caries lesions. Artificial caries lesions were prepared in bovine enamel and randomly allocated to 11 groups (n = 22). Treatments before pH-cycling were as follows: the application of a self-assembling peptide (Curodont™ Repair [C]), a low-viscosity resin (Icon® [I]), 2 fluoride solutions (10,000 ppm F^-: Elmex fluid [E] and 43,350 ppm F^-: Tiefenfluorid® [T]), and no intervention (N). During pH-cycling (28 days, 6 × 60 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 ×/day) with either fluoride-free (named e.g., C₀) or NaF (1,100 ppm F^-; e.g., C₁) dentifrice slurry. In another subgroup specimens were pH-cycled but not brushed (N_NB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between values after pre-demineralization, surface treatment, and pH-cycling. Specimens of C₀, C₁, N_NB, N₀, N₁, T₀, and E₀ showed significantly increased ΔZ and LD values after pH-cycling (p ≤ 0.003; paired t test). C₀, C₁, N_NB, and N₀ showed significantly higher changes in ΔΔZ than E₁, I₀, I₁, and T₁ (p < 0.001; ANOVA). Significantly reduced colorimetric values could only be observed for I₁, I₀, E₁, and E₀ after treatment and after pH-cycling (p ≤ 0.027; paired t test). In conclusion, under the conditions chosen only the application of a low-viscosity resin could mask caries lesions significantly, whereas self-assembling peptides could neither inhibit lesion progression nor mask the lesions considerably.

Application of the QLF technology to monitor recovery rates of enamel caries lesions with human saliva

Purpose: The aim of this in vitro study was to assess changes in remineralization by stimulated human saliva over a short period of 48 hours with quantitative light-induced fluorescence (QLF) technology. Materials and Methods: Bovine incisor surfaces were demineralized for 10 days. Two types of stimulated saliva were collected from 7 healthy persons. 24 hours after tooth brushing (Stimulated saliva group) and immediately after tooth brushing with 1,000 ppm NaF dentifrice (Dentifrice saliva group). The specimens were immersed in saliva and fluorescence images were obtained by QLF-digital (QLF-D biluminatorTM,) at 2, 4, 6, 12, 24, and 48 hours fluorescence loss (DeltaF%) of the lesions. A paired t-test was performed to assess fluorescence differences between before (DeltaF_baseline) and after (DeltaF_treatment;time) the remineralization process. Results: Before the remineralization, the mean DeltaF_baseline of the initial demineralized specimens was -18.42pm0.15 (%). In both groups, the DeltaF values obtained at baseline and after 2 hours were statistically significant (P &lt; 0.001), indicating recovery of the lesions by approximately 40% after 2 hours. After 48 hours, remineralization rates were slightly higher (49%) for the stimulated saliva group than for the dentifrice saliva group (41%), but the difference was not statistically significant. Conclusions: With QLF minute degrees of remineralization by saliva can be measured in periods as short as 2 hours. Additionally no significantly higher effects of remineralization were observed in the dentifrice saliva group when compared to the stimulated saliva group.

Observations of Enamel Microstructure in Incipient Lesions Remineralized by NaF Dentifrices

Synchrotron Radiation (SR) Wide-angle X-ray Diffraction (WAXD) and Small-angle X-ray Scattering (SAXS) techniques were used to assess microstructure of bovine enamel white-spot lesions (WSL) evaluated in a 10-day pH cycling model comprising three different dentifrice groups: (A) 0.21% NaF plus TCP (Clinpro Tooth Crème), (B) 1.1% NaF plus TCP (Clinpro 5000), or (C) 0% NaF (Tom’s of Maine) dentifrice. Each day consisted of four 2-minute treatments, one 4-hour acid challenge (pH=5.0), and immersion in artificial saliva (pH=7.0) between these events. These specimens were also examined with cross-sectional microhardness, digital light microscopy and FE-SEM (field emission scanning electron microscope), and demonstrated the remineralization model effected changes in subsurface microstructure. X-ray diffraction data from WAXD and SAXS were collected on enamel slab cross-sections extending from 0 μm to 150 μm, in 6 μm microbeam increments. A primary outcome of this observational study was that simultaneous WAXD and SAXS measurements were able to resolve significant differences (ANOVA, Student’s t-test, p&lt;0.05) between the effects of the two fluoridecontaining dentifrices on subsurface lesion microstructure. In particular, enamel lesions treated with 1.1% NaF dentifrice group manifested an abundance of nanometer-sized crystallites, while treatment with the 0.21% NaF dentifrice produced larger apatite-like crystals. While the presence of fluoride in both cases promoted regularity in crystal size and orientation, this was not observed for lesions treated without fluoride. Altogether, our observations demonstrate the pathological processes for remineralization are markedly influenced by the presence and concentration of fluoride, the microstructural characteristics of which can be distinguished using the simultaneous WAXD and SAXS technique.

Effectiveness of some herbals on initial enamel caries lesion

ObjectiveTo evaluate the effectiveness of herbal medicaments such as ginger, rosemary and honey on remineralization of initial enamel lesion. MethodsDemineralized human enamel specimens were measured for baseline surface microhardness and fluorescence methods. Ten specimens in each of four groups were used in this in vitro recycling study with the following treatments which applied three times a day: 1) sodium fluoride toothpaste (Ipana, Procter & Gamble, Turkey), 2) ginger-honey (Arifoglu Herbals, Anzer Honey, Turkey), 3) ginger-honey-chocolate (Bind Chocolate, Turkey), 4) rosemary oil (Arifoglu Herbals, Turkey). Treatment regimens of demineralization and remineralization cycle were applied for 21 days. The post-treatment data were obtained by measurements of surface microhardness and fluorescence methods. Data were statistically analyzed by ANOVA test with Tukey's honest significant difference test. ResultsEnhanced remineralization was observed with several of the treatment systems including ginger + honey and rosemary. Significant differences between treatments were observed by microhardness and FluoreCam fluorescence assesment, compared to the positive control group (NaF dentifrice). Significantly, greater remineralization was observed with the honey + ginger treatment regimen. No significant differences between groups were observed using the fluorescence assessment method, quantitative light-induced fluorescence. ConclusionsHerbals (ginger, honey and rosemary) have enhanced remineralization of initial enamel lesion.

Effects of dentifrices differing in fluoride compounds on artificial enamel caries lesions in vitro.

The aim of this study was to compare the caries-preventive effect of a stabilized stannous fluoride/sodium fluoride dentifrice containing sodium hexametaphosphate with those of a regular, solely sodium fluoride-containing and amine fluoride-containing dentifrice on pre-demineralized bovine enamel specimens using a pH-cycling model. Bovine enamel specimens with two artificial lesions each were prepared. Baseline mineral loss of both lesions was analyzed using transversal microradiography (TMR). Eighty-five specimens with a mean (SD) baseline mineral loss of 3393 (683) vol%×µm were selected and randomly allocated to five groups (n=13/15). Treatments during pH-cycling (28days and 2×20min demineralization/day) were: brushing twice daily with slurries of AmF (1400ppm F-), NaF (1450ppm F-), SnF2/NaF (1100ppm F-/350ppm F-), and fluoride-free (FF) dentifrices or they were immersed in distilled water and remained unbrushed (NB). Subsequently, from each specimen one lesion was covered with acid-resistant varnish, while the remaining lesion was demineralized for another 14days. Differences in integrated mineral loss (∆∆Z) were calculated between values before and after pH-cycling (∆∆Z E1) as well as before pH-cycling and after second demineralization (∆∆Z E2) using TMR. Treatments AmF and NaF induced a significantly higher mineral gain (∆∆Z E1/∆∆Z E2) compared to treatments FF and NB (p<0.05; ANOVA test). Except for treatments AmF and NaF no significant differences in mineral loss between before and after pH-cycling could be observed (p<0.05; t test) [∆∆Z E1: AmF:1563 (767); NaF:1222 (1246); SnF2/NaF:258 (1259); FF:-52 (1223); NB:-151 (834)]. Both dentifrices with either AmF or NaF promoted remineralization, whereas SnF2/NaF dentifrice did not promote remineralization in a biofilm-free pH-cycling model.

Comparison of varnishes and fluoridated toothpaste for the prevention of dental caries in school children

Objective To compare preventive effect on dental caries of two frequencies of fluoridated varnish (FV) applications and a group given brushing instructions and using fluoridated toothpaste. Materials and Methods Follow-up study of 203 children attending an elementary school in the municipality of Tláhuac, Mexico City. The children were followed for 22 months. The students were randomly assigned to one of the following groups: 1) brushing instructions with fluoridated toothpaste, 2) FV every six months, 3) three FV applications per week per year. The FV contained fluorosilane (1000 ppm F) and NaF dentifrice (1450 ppm F). The DMFT-caries index and the presence of white spots were recorded (ICDAS, International Caries Detection and Assessment System). Results At baseline, the mean age of the children was 9.3 (SD 0.76) years, white lesions 0.63 (SD 1.48) and DMFT =0.70 (SD 1.11). Averages of the initial and final DMFT scores in the three groups were 0.67 and 1.17 for the toothpaste group, 0.77 and 1.46 for FV twice a year group, and 0.67 y 1.03 for the three-applications-FV group. According to the results of the GEE (Generalized-Estimating Equations) model, there were no significant differences in the rate of white lesions or the increase of the DMFT index. The results for the DMFT were: for bi-annual applications of FV, RR=1.24 (p=0.178) and for the three consecutive applications of FV, RR=0.83, (p=0.298) in comparison with the brushing-instructions group using fluoridated toothpaste, among the three treatment groups, controlling for age, sex, and initial-caries index in primary teeth and brushing frequency. Conclusions Schoolchildren showed a low incidence of caries using any of the three preventive regimens applied.

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.

Remineralization effect of CPP-ACP and fluoride for white spot lesions in vitro

ObjectivesThis in vitro study compared the remineralization effect on white spot lesions of casein phosphopeptide-amorphous calcium phosphate crème, or CPP-ACP (MI Paste™), 1.1% NaF dentifrice containing 5000ppm of fluoride (ControlRX™), or CPP-ACP crème with 900ppm of fluoride (MI Paste Plus™) with that of a control. MethodsArtificial white spot lesions were created on smooth enamel surfaces of sound molars using a previously reported demineralization model. Specimens were randomly assigned to four treatments (n=35) with a pH-cycling model over 30 days: Control (no treatment); MI Paste (10% CPP-ACP crème); F5000 (1.1% NaF dentifrice); or MI Paste Plus (10% CPP-ACP plus 900ppm fluoride crème). Products were applied following manufacturers’ directions. Changes in mean lesion depth expressed by percent fluorescence loss (ΔF%), and lesion area (mm2) from baseline to after treatment were measured with light-induced fluorescence (QLF). Mean values of each parameter were compared between groups (p<0.05). ResultsThe remineralization pattern for the F5000 group was unique with marked initial remineralization during the first 10 days and little subsequent change. Based on mean lesion area, the F5000 demonstrated greater remineralization than Control, MI Paste and MI Paste Plus groups. Based on mean fluorescence loss, the F5000 group showed improved remineralization relative to MI Paste Plus, but did not differ statistically from the Control at the end of 30 days. ConclusionsThe 1.1% NaF dentifrice demonstrated overall greater remineralization ability than 10% CPP-ACP crème. However, the 1.1% NaF dentifrice was only as effective as the Control to reduce fluorescence loss. Clinical significanceThis study showed that a 1.1% NaF dentifrice (5000ppm) demonstrated greater remineralization ability than the CPP-ACP topical tooth crème and that the addition of fluoride to its formulation seems to enhance remineralization. Saliva also has the ability to exert an important remineralization effect over time.

Protective benefits of a stabilised stannous-containing fluoride dentifrice against erosive acid damage

To assess the potential of a stabilised stannous (Sn)-containing NaF dentifrice (Oral B/blend-a-Med(®) Pro-Expert), in addition to a number of other marketed European dentifrices formulated with various fluoride actives and two control dentifrices, to protect enamel against erosive acid damage. Cores of human enamel (four per group) were soaked in pooled human saliva, and then treated with a 1:3 slurry (dentifrice:saliva) using a standardised in vitro erosion model (5-day cycling) that includes 10-minute challenges with 1% citric acid applied 60 minutes after each dentifrice treatment. Enamel surface loss was measured using transverse microradiography (TMR). Specimens treated with the Sn-containing NaF dentifrice showed 6.5 μm of surface loss ± 1.2 (SEM), which was not significantly different (P < 0.05, Fisher LSD) from that of a clinically proven, stabilised SnF2 positive control [Crest(®) Pro-Health, 1,100 ppm F as SnF2 : 3.0 μm of surface loss ± 1.1 (SEM)]. The Sn-containing NaF dentifrice and the clinically proven positive control both provided significantly greater protection (P < 0.05, Fisher LSD) compared with all of the other products tested. Enamel loss (SEM) values for other European products and the reference control (active agents) were: Meridol(®) : (1,400 ppm F as AmF + SnF2 ) 12.0 μm (1.47); Colgate(®) Cavity Protection: (1,450 ppm F as SMFP + NaF) 12.9 μm (1.66); Odol med 3(®) (1,400 ppm F as NaF) 14.2 μm (1.49); Elmex(®) (1,400 ppm F as AmF) 14.5 μm (1.76); Colgate(®) Enamel Protect: (1,450 ppm F as NaF + KNO3 ) 16.3 μm (2.02); Lacalut(®) aktiv: (1,400 ppm F as AlF3 ) 18.5 μm (1.71); Sensodyne(®) ProNamel(™) : (1,450 ppm F as NaF + KNO3 ) 20.5 μm (1.26); Crest Cavity Protection (1,100 ppm F as NaF, reference control) 22.00 μm (2.04); and Mentadent(®) : (1,450 ppm F as NaF + Zn citrate) 22.3 μm (0.63). These results support the potential for the stabilised, Sn-containing NaF dentifrice to provide erosion protection benefits that are not significantly different from the positive control benchmark for erosion protection (stabilised SnF2 ), and are significantly better than a broad range of dentifrice formulations available on the European market.

In situ clinical evaluation of a stabilised, stannous fluoride dentifrice

To compare the erosion protection efficacy of a stabilised, stannous fluoride (SnF2 ) dentifrice versus a sodium fluoride (NaF) dentifrice using a modified in situ clinical model. This study, a randomised parallel group in situ design with in vivo product use and ex vivo acid challenge, compared: A, a dentifrice containing 1,450 ppm F as NaF; B, a dentifrice containing 1,450 ppm F (1,100 ppm F as SnF2 + 350 ppm F as NaF); and T, tap water. Sample size was n = 4 per group (total of 12 subjects) and within each subject appliances were placed on each side of the mouth (left and right). Enamel specimens were placed in different positions of the mouth (front, mid-front, mid-rear, rear) in each appliance (total = 8 specimens per subject). Product treatment was twice per day (lingual brushing for 30 seconds followed by swishing for 90 seconds with the resultant product/saliva slurry) in vivo for 15 days, and ex vivo acid treatment (0.02 m citric acid 5 minutes four times per day; total exposure time = 300 minutes). Data were analysed using a general linear repeated measures model with treatment, side and position as fixed effects. Within subjects, correlations were modelled assuming a different correlation and variance for treatment B relative to the other groups. Pairwise treatment differences were performed using a 5% two-sided significance level. Enamel loss (in μm) was significantly lower (P < 0.005) for treatment B versus treatments A and T. Treatment B reduced enamel surface loss by 86.9% relative to treatment A. There was no statistical difference in mean enamel loss (P = 0.51) between treatments A and T. Enamel loss was not statistically different for side (left vs. right; P = 0.44) or position (front, mid-front, mid-rear, rear; P = 0.36). This modified in situ erosion model confirmed the enhanced erosion protection benefits of a stabilised SnF2 dentifrice versus a conventional NaF dentifrice, validating the ability of the model to safely and effectively demonstrate differences in the erosion protection potential of oral care products.