Toothpaste Treatment Research Articles

Dynamics of Dental Enamel Surface Remineralization under the Action of Toothpastes with Substituted Hydroxyapatite and Birch Extract.

To address tooth enamel demineralization resulting from factors such as acid erosion, abrasion, and chronic illness treatments, it is important to develop effective daily dental care products promoting enamel preservation and surface remineralization. This study focused on formulating four toothpastes, each containing calcined synthetic hydroxyapatite (HAP) in distinct compositions, each at 4%, along with 1.3% birch extract. Substitution elements were introduced within the HAP structure to enhance enamel remineralization. The efficacy of each toothpaste formulation was evaluated for repairing enamel and for establishing the dynamic of the remineralization. This was performed by using an in vitro assessment of artificially demineralized enamel slices. The structural HAP features explored by XRD and enamel surface quality by AFM revealed notable restorative properties of these toothpastes. Topographic images and the self-assembly of HAP nanoparticles into thin films on enamel surfaces showcased the formulations' effectiveness. Surface roughness was evaluated through statistical analysis using one-way ANOVA followed by post-test Bonferroni's multiple comparison test with a p value < 0.05 significance setting. Remarkably, enamel nanostructure normalization was observed within a short 10-day period of toothpaste treatment. Optimal remineralization for all toothpastes was reached after about 30 days of treatment. These toothpastes containing birch extract also have a dual function of mineralizing enamel while simultaneously promoting enamel health and restoration.

Optimization of Functional Toothpaste Formulation Containing Nano-Hydroxyapatite and Birch Extract for Daily Oral Care.

This research work aims to develop functional toothpastes with combined enamel remineralization and antibacterial effects using nano-hydroxyapatites (nHAPs) and birch extract. Eleven toothpastes (notated as P1-P11) were designed featuring different concentrations of birch extract and a constant concentration of pure nHAPs or substituted nHAPs (HAP-5%Zn, HAP-0.23%Mg-3.9%Zn-2%Si-10%Sr, and HAP-2.5%Mg-2.9%Si-1.34%Zn). In vitro assessments involved treating artificially demineralized enamel slices and analyzing surface repair and remineralization using Atomic Force Microscopy (AFM). The Agar Disk Diffusion method was used to measure antibacterial activity against Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis, Streptococcus mutans, and Staphylococcus aureus. Topographic images of enamel structure and surface roughness, as well as the ability of nHAP nanoparticles to form self-assembled layers, revealed excellent restorative properties of the tested toothpastes, with enamel nanostructure normalization occurring as soon as 10 days after treatment. The outcomes highlighted enamel morphology improvements due to the toothpaste treatment also having various efficacious antibacterial effects. Promising results were obtained using P5 toothpaste, containing HAP-5%Zn (3.4%) and birch extract (1.3%), indicating notable remineralization and good antibacterial properties. This study represents a significant advancement in oral care by introducing toothpaste formulations that simultaneously promote enamel health through effective remineralization and bacterial inhibition.

Immediate and Sustained Root Caries Prevention of Fluoride Varnish Combined with Toothpastes

The aim of this study was to determine the immediate and sustained effect of a fluoride varnish and its combinations with toothpastes in preventing root caries development using a salivary microcosm in vitro model. Human root dentin specimens (n = 150) were randomly divided into 5 experimental protocols (n = 30): (1) Fluoride Varnish (V); (2) V followed by Paste One (V + PO); (3) V followed by Paste Plus (V + PP); (4) V followed by PO and PP (V + PO + PP); and (5) No treatment (control). One varnish layer was applied on the specimens (except for the control group) and kept for 18 h. Then, the varnish was removed and toothpaste treatments were initiated according to experimental groups. For the short-term incubation model (n = 15), the specimens were also immediately subjected to 7-day cariogenic challenge. For that, human saliva was used as bacterial inoculum and McBain artificial saliva containing 2% sucrose as growth medium. The other half of the specimens (n = 15) were used to study the varnish’s sustained effect by long-term incubation (8 weeks) before cariogenic challenge. The protocols’ anti-caries properties were evaluated by dentin porosity (rhodamine intensity; RI) and mineral density, while their anti-biofilm effects were evaluated using biofilm’s biomass and viability assays. For short- and long-term incubation models, all experimental regimens resulted in statistically significant decreases (p < 0.05) in the RI (up to 180 μm and 120 μm, respectively) as well as higher mineral density compared to No treatment (p < 0.001). V + PO + PP and/or V + PO resulted in statistically lower RI compared to V for some depths (p < 0.05) in both models. There were changes in RI and mineral density within groups over time. All experimental treatments exhibited anti-biofilm effects. All prevention protocols exhibited immediate and sustained anti-caries effect against root caries development. The combination of a fluoride varnish with PO resulted in superior additional anti-caries effects.

Remineralizing Potential of Bioactive Glass–Ceramic over White Spot Lesions

Abstract Objective This study evaluated the effect of incorporating biosilicate (Bio) particles into experimental toothpaste (ET) on their abrasiveness and remineralization capacity for white spot lesions (WSLs). Materials and Methods Thirty-two fragments of bovine teeth (6 × 6 × 2 mm) were obtained. Initial microhardness (Knoop hardness number [KHN], HMV Microhardness Meter, Shimadzu) and surface roughness (Rugosimeter Surfcorder SE 1700) readouts were performed. Fragments were submitted to a cariogenic challenge to simulate WSLs and then divided into four groups: Control, conventional toothpaste (Colgate Smiles, Colgate-Palmolive Company); ETF, ET with fluoride (carboxymethylcellulose + glycerol + thickening silica + fluoride); ETB, ET with Bio; BS, biosuspension (10 in weight% Bio). Toothpaste treatments were performed through simulated toothbrushing (Pepsodent, MAVTEC, 14,600 cycles). BS was applied by immersion for 8 hours followed by 16 hours in artificial saliva at 37°C for 60 days, totalizing 1,440 cycles. After treatments, final KHN and surface roughness readings were performed, and scanning electron microcopy (SEM) was conducted (Jeol JSM-6610LV) for morphological analysis. Data were analyzed with one-way analysis of variance, Tukey's test (p &lt; 0.05). Results BS produced the least surface roughness change, different (p &lt; 0.05) from all the other groups. ETB caused higher KHN than ETF (p &lt; 0.05). SEM images revealed that ETB and BS resulted in abraded surfaces with deposition of particles. Conclusion ETB resulted in similar abrasiveness to the control group, and it caused higher microhardness than the ETF. Practical Implication Considering its higher KHN, ETB could be considered a proper alternative for the treatment of WSLs.

Acidic Microenvironment-Sensitive Core-Shell Microcubes: The Self-assembled and the Therapeutic Effects for Caries Prevention.

The aim of this study was to develop a new material with integrated interface design that could achieve the purpose of environmental-sensing controlled release against cariogenic bacteria. Furthermore, this material can rebalance oral flora and serve as a preventive and reparative measure of dental caries. NaF@PAA@HA@polyelectrolytes@HA@PAA particles were synthesized using the method of two-solution phases precipitation followed by biocompatible polymers coating layer by layer. The structure of the particles was confirmed by transmission electron microscope. The fluoride release profile was measured by fluoride ion electrode. Antimicrobial activity against the cariogenic microorganisms was analyzed by scanning electron microscopy and energy dispersive spectrum. The efficacy experiments were conducted on tooth enamel slides to evaluated fluoride absorption and antibacterial activity of the prototype toothpaste containing microcube particles RESULTS: The structure of NaF@PAA@HA@polyelectrolytes@HA@PAA particles showed a core surrounded by tooth-adhesion polymer layers in thin fin or filament structure. The loaded concentration of fluoride in the particles' core was 148,996 ± 28,484 ppm. NaF@PAA@HA@polyelectrolytes@HA@PAA particles showed selective inhibition of cariogenic microorganisms over probiotic strains and stronger fluoride adhesion on tooth enamel. A burst release (over 80%) of fluoride from the particle-containing toothpaste was observed under cariogenic acidic environment (pH < 5), while it remained extremely low under neutral environment. Compared with the best results of commercial toothpastes, our prototype toothpaste increased enamel fluoride uptake by 8-fold in normal enamel slides and by 11-fold in the slides with induced white spot lesions after either 1- or 7-day treatment. The prototype toothpaste also showed better inhibition of cariogenic microorganisms than the commercial brands. The coverage area of cariogenic bacteria under our toothpaste treatment was 73% on normal enamel slides compared with the commercial brands, while it was 69% in the induced white spot lesions. In our study, an intelligent toothpaste was developed that selectively inhibits cariogenic bacteria by microenvironment proton-triggered fluoride release. Such novel design would accomplish a favorable flora balance for optimal long-term oral health.

Nigella sativa toothpaste promotes anti-inflammatory and anti-destructive effects in a rat model of periodontitis

ObjectivePeriodontitis is an infectious disease that results in gingiva tissue damage. This study aimed to evaluate the effects of Nigella sativa (N. sativa) toothpaste in a periodontitis tissue repair based on inflammation and periodontal extracellular matrix in vivo. DesignThe periodontitis disease model was developed using Wistar rats infected with Porphyromonas gingivalis (P. gingivalis). The rats were divided into three main groups as follows: those that did not receive any toothpaste treatment; those that were treated with N. sativa toothpaste twice a day (simultaneously with P. gingivalis induction); and normal healthy rats. The rats were sacrificed after 1 and 7 days of animal modeling. The number of inflammatory cells, matrix metalloproteinase (MMP)1 + and MMP8 + cells, levels of cytokines (interleukin-1β (IL-1β) and prostaglandin E2 (PGE2)) and density of collagen type 1 were determined in the gingival tissues of the rats. ResultsThe rats treated with N. sativa toothpaste had significantly lower numbers of neutrophils, macrophages and lymphocytes than the non-treated rats after 1 and 7 days of treatment; likewise, the levels of IL-1β and PGE2 were lower in the treated experimental rats. In addition, the group treated with N. sativa toothpaste had fewer numbers of MMP1 + and MMP8 + cells and higher collagen density after 1 and 7 days of administration. ConclusionsN. sativa toothpaste exhibited anti-inflammatory effects by reducing both inflammatory cell count and activity. Additionally, N. sativa toothpaste demonstrated anti-destructive effects on the periodontal extracellular matrix. Thus, N. sativa toothpaste might be potentially used for the management of periodontitis.

In situ evaluation of 200 ppm fluoride toothpaste content trimetaphosphate, xylitol and erythritol on enamel demineralization and dental biofilm

ObjectiveTo evaluate the effect of low-fluoride (F−) toothpaste and sodium trimetaphosphate (TMP) associated with xylitol and erythritol (XE) on enamel demineralization and biofilm composition. MethodsThis crossover double-blind in situ study consisted of five phases (seven days each), in which 14 volunteers wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by exposure to a 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: placebo (no F−/TMP/XE); 200 ppm F− (NaF) (200F); 1,100 ppm F− (1100F); 16% Xylitol and 4% Erythritol (XE); and 200 ppm F−, 0.2% TMP, 16% xylitol, and 4% erythritol (200F-TMP-XE). Percentage of surface hardness loss (%SH) and integrated loss of subsurface hardness (ΔKHN), and calcium (Ca2+), phosphate (PO43−), and F− on enamel and biofilm were determined; as well as insoluble extracellular polysaccharide (EPS). ResultsXE and 1100F groups showed no significant difference for %SH and ΔKHN values (p = 0.220 and p = 0.886), and the 200F-TMP-XE group had the lowest mineral loss (p < 0.001). Ca2+ and PO43− in the enamel showed the highest values (p < 0.001) for the 200F-TMP-XE group. Higher values of F− in the enamel and biofilm were observed for the 1100F group (p < 0.001). There was no difference for Ca2+ (p = 1.00) and EPS (p =0.918) values between XE and 200-TMP-XE groups in the biofilm, but their values were higher and lower than the 1100F (p = 0.002 and p = 0.029), respectively. Conclusions200F-TMP-XE promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ compared to 1100F toothpaste. Clinical SignificanceLow-F− toothpaste containing TMP and polyols can be considered an effective and safe measure to improve the oral health of individuals, especially patients with high caries activity.

Substituted Nano-Hydroxyapatite Toothpastes Reduce Biofilm Formation on Enamel and Resin-Based Composite Surfaces.

Background: Toothpastes containing nano-hydroxyapatite (n-HAp) substituted with metal ions provide calcium and phosphate ions to dental hard tissues, reducing demineralization, and promoting remineralization. Few data are available about the effect of these bioactive compounds on oral microbiota. Methods: This in vitro study evaluated the influence of two commercially-available substituted n-HAp-based toothpastes (α: Zn-carbonate substituted n-HAp; β: F, Mg, Sr-carbonate substituted n-HAp) on early colonization (EC, 12 h) and biofilm formation (BF, 24 h) by oral microbiota. Controls were brushed with distilled water. Artificial oral microcosm and Streptococcus mutans biofilms were developed using human enamel and a resin-based composite (RBC) as adherence surfaces. Two test setups, a shaking multiwell plate and a modified drip-flow reactor (MDFR), were used to simulate clinical conditions during the night (low salivary flow and clearance) and daytime, respectively. Energy-dispersive X-ray spectrometry (EDS) was used to evaluate specimens’ surfaces after toothpaste treatment. Fluoride release from β toothpaste was evaluated. Viable adherent biomass was quantified by MTT assay, and biofilms’ morphology was highlighted using confocal microscopy. Results: EDS showed the presence of remnants from the tested toothpastes on both adherence surfaces. β toothpaste showed significantly lower EC and BF compared to control using the artificial oral microcosm model, while α toothpaste showed lower EC and BF compared to control, but higher EC and BF compared to β toothpaste. The effect shown by β toothpaste was, to a minimal extent, due to fluoride release. Interestingly, this result was seen on both adherence surfaces, meaning that the tested toothpastes significantly influenced EC and BF even on RBC surfaces. Furthermore, the effect of toothpaste treatments was higher after 12 h than 24 h, suggesting that toothbrushing twice a day is more effective than brushing once. Conclusions: The efficacy of these treatments in reducing microbial colonization of RBC surfaces may represent a promising possibility in the prevention of secondary caries.

In situ efficacy of an experimental toothpaste on enamel rehardening and prevention of demineralisation: a randomised, controlled trial

BackgroundA novel sodium fluoride toothpaste containing lactate ion and polyvinylmethylether-maleic anhydride has been developed to promote enamel remineralisation and resistance to demineralisation. In this in situ study, we compared this toothpaste (‘Test’) with a stannous fluoride-zinc citrate (SnF2-Zn) toothpaste (‘Reference’) (both 1100–1150 ppm fluoride) and a fluoride-free toothpaste (‘Placebo’) using an enamel dental erosion-rehardening model.MethodsIn each phase of this randomised, investigator-blind, crossover study, participants wore palatal appliances holding bovine enamel specimens with erosive lesions. They brushed their natural teeth with either the Test, Reference or Placebo toothpastes, then swished the resultant slurry. Specimens were removed at 2 h and 4 h post-brushing and exposed to an in vitro acid challenge. Surface microhardness was measured at each stage; enamel fluoride uptake was measured after in situ rehardening. Surface microhardness recovery, relative erosion resistance, enamel fluoride uptake and acid resistance ratio were calculated at both timepoints.ResultsSixty two randomised participants completed the study. Test toothpaste treatment yielded significantly greater surface microhardness recovery, relative erosion resistance and enamel fluoride uptake values than either Reference or Placebo toothpastes after 2 and 4 h. The acid resistance ratio value for Test toothpaste was significantly greater than either of the other treatments after 2 h; after 4 h, it was significantly greater versus Placebo only. No treatment-related adverse events were reported.ConclusionsIn this in situ model, the novel-formulation sodium fluoride toothpaste enhanced enamel rehardening and overall protection against demineralisation compared with a fluoride-free toothpaste and a marketed SnF2-Zn toothpaste.Trial registrationClinicalTrials.gov; NCT03296072; registered September 28, 2017.

Risk factors of oral Helicobacter pylori infection among children in two kindergartens in Suzhou and the effects of oral cleaning on reducing oral Helicobacter pylori infection

This work aimed to identify the risk factors ofHelicobacter pylori (H. pylori) infection in preschool children and provide effective measures for the prevention and reduction of the incidence ofH. pyloriinfections. A total of 204 children from two kindergartens in Suzhou city were recruited through a questionnaire survey. Risk factors were selected through the single factor paired data χ² test and multiple factor Logistic regression analysis. Oral and gastricH. pyloriinfections were detected by using H. pylori saliva detection (HPS) and ¹³C-urea breath test (¹³C-UBT). Special toothpaste for H. pylori control was selected for oral cleaning. OralH. pyloriinfection rates at 2 months after special toothpaste treatment were examined by using HPS. The high-risk factors ofH. pyloriinfections among preschool children included poor personal hygiene habits, such as the nibbling of fingers and the avoidance of hand-washing before meals, diet, and parent's history of stomach disease.Among the 204 subjects enrolled in this study, 158 (77.45%), 37 (18.14%), and 28 (13.73%) were HPS positive, ¹³C-UBT positive, and HPS and ¹³C-UBT positive, respectively. The incidence of oralH. pyloriinfections was significantly higher than that of gastric H. pyloriinfections (P<0.01).The positive rate of infections significantly decreased after special toothpaste treatment (P<0.01). This result indicates that the intervention was effective. Children must receive education on good eating habits. Individualized dining habits or the use of public chopsticks must be implemented. H. pyloriinfections must be detected as early as possible. Specific toothpaste for oral cleaning must be selected. These approaches could drastically prevent or reduce theincidence of H. pyloriinfections among preschool children.

In situ effect of fluoride toothpaste supplemented with nano-sized sodium trimetaphosphate on enamel demineralization prevention and biofilm composition

ObjectiveTo evaluate the effect of a fluoride toothpaste containing nano-sized sodium trimetaphosphate (TMPnano) on enamel demineralization in situ and composition of the biofilm. DesignThis crossover double-blind study consisted of four phases (seven days each) and 12 volunteers who wore oral appliances containing four enamel bovine blocks. The cariogenic challenge was performed by 30% sucrose solution (6x/day). The toothpaste treatments (3x/day) were as follows: no F/TMP/TMPnano (Placebo), 1100 ppm F (1100F), 1100F plus 3% micrometric or nano-sized TMP (1100F/TMP; 1100F/TMPnano). Percentage of surface hardness loss (%SH), and integrated loss of subsurface hardness (ΔKHN), as well as enamel calcium (Ca), phosphorus (P), and fluoride (F) were determined. Moreover, biofilm formed on the blocks were analyzed for F, Ca, P, and insoluble extracellular polysaccharide (EPS) concentrations. Data were analyzed using one-way ANOVA, repeated measures followed by Fisher LSD test (p < 0.001). Results1100F/TMPnano promoted the lowest %SH and ΔKHN among all groups (p < 0.001). Regarding the F concentrations in the enamel and in the biofilm, there were no significant differences between 1100 F and 1100 F/TMPnano, but significantly increased enamel Ca concentrations (p < 0.001). 1100F/TMPnano showed lower values of EPS concentration when compared with 1100F (∼80%) (p < 0.001). Conclusion1100F/TMPnano promoted a greater protective effect against enamel demineralization and significantly affected the composition of biofilm formed in situ when compared to 1100F toothpaste.

Remineralizing effect of a zinc-hydroxyapatite toothpaste on enamel erosion caused by soft drinks: Ultrastructural analysis.

BackgroundThe aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste on repairing enamel erosion produced by a soft drink (Coca-Cola) compared to toothpastes with and without fluoride using Scanning Electron Microscopy (SEM).Material and MethodsFifty specimens were assigned to 5 groups of 10 specimens each. (Group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, 3: erosive challenge, toothpaste without fluoride, group 4: erosive challenge, fluoride toothpaste treatment, group 5: erosive challenge, zinc-hydroxyapatite toothpaste treatment). Repeated erosive challenges were provided by immersing bovine enamel specimens (10 per group) in a soft drink for 2 min (6mL, room temperature) at 0, 8, 24 and 32 h. After each erosive challenge, the toothpastes were applied neat onto the surface of specimens for 3 min without brushing and removed with distilled water. Between treatments the specimens were kept in artificial saliva. The surface of each specimen was imaged by SEM.ResultsStatistically significant differences were found between the samples used as control and those immersed in Coca-Cola (group 1 and 2): indeed among all groups the highest grade of damage was found in group 2. Instead the lowest grade was recorded in the samples of group 5 (Zinc hydroxyapatite toothpaste).ConclusionsThe results of this study confirmed the potential benefit the Zn-HAP technology could provide in protecting enamel from erosive acid challenges. The treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. Key words:Dental erosion, enamel, SEM, toothpaste.

Comparative effect of a stannous fluoride toothpaste and a sodium fluoride toothpaste on a multispecies biofilm

ObjectivesThis paper aimed to compare the mode of action of a stannous fluoride-containing toothpaste with a conventional sodium fluoride-containing toothpaste on anti-biofilm properties. MethodsA three-species biofilm model that consists of Streptococcus mutans, Streptococcus sanguinis and Porphyromonas gingivalis was established to compare the anti-biofilm properties of a stannous fluoride-containing toothpaste (CPH), a conventional sodium fluoride-containing toothpaste (CCP) and a negative control (PBS). The 48h biofilms were subjected to two-minute episodes of treatment with test agents twice a day for 5 consecutive days. Crystal violet staining and XTT assays were used to evaluate the biomass and viability of the treated biofilm. Live/dead staining and bacteria/extracellular polysaccharides (EPS) double-staining were used to visualize the biofilm structure and to quantify microbial/extracellular components of the treated biofilms. Species-specific fluorescent in situ hybridization and quantitative polymerase chain reaction (qPCR) were used to analyze microbial composition of the biofilms after treatment. ResultsThe biomass and viability of the biofilms were significantly reduced after CPH toothpaste treatment. The inhibitory effect was further confirmed by the live/dead staining. The EPS amounts of the three-species biofilm were significantly reduced by CCP and CPH treatments, and CPH toothpaste demonstrated significant inhibition on EPS production. More importantly, CPH toothpaste significantly suppressed S. mutans and P. gingvalis, and enriched S. sanguinis in the three-species biofilm. In all experiments CPH had a significantly greater effect than CCP (p<0.05) and CCP had a greater effect than PBS (p<0.05). ConclusionsStannous fluoride-containing toothpaste not only showed better inhibitory effect against oral microbial biofilm, but was also able to modulate microbial composition within multi-species biofilm compared with conventional sodium fluoride-containing toothpaste.

Effect of Fluoride-Containing Toothpastes on Enamel Demineralization and Streptococcus mutans Biofilm Architecture

This study aimed to explore the effect of fluoridated toothpastes on biofilm architecture and enamel demineralization in an in vitro biofilm model. Streptococcus mutans was grown on enamel and treated with slurries of commercial toothpastes, containing SnF₂ or NaF. Water and chlorhexidine were used as negative and positive controls, respectively. The developed biofilms were imaged and enamel demineralization was measured. SnF₂ and NaF toothpaste treatments significantly reduced enamel demineralization, but SnF₂ toothpaste was more effective. Only SnF₂ toothpaste and chlorhexidine treatments caused reductions on biofilm mass and thickness. In conclusion, this biofilm model was able to differentiate the effects of the SnF₂ and NaF toothpastes on biofilm architecture and enamel demineralization.

Detecting outlying studies in meta-regression models using a forward search algorithm.

When considering data from many trials, it is likely that some of them present a markedly different intervention effect or exert an undue influence on the summary results. We develop a forward search algorithm for identifying outlying and influential studies in meta-analysis models. The forward search algorithm starts by fitting the hypothesized model to a small subset of likely outlier-free studies and proceeds by adding studies into the set one-by-one that are determined to be closest to the fitted model of the existing set. As each study is added to the set, plots of estimated parameters and measures of fit are monitored to identify outliers by sharp changes in the forward plots. We apply the proposed outlier detection method to two real data sets; a meta-analysis of 26 studies that examines the effect of writing-to-learn interventions on academic achievement adjusting for three possible effect modifiers, and a meta-analysis of 70 studies that compares a fluoride toothpaste treatment to placebo for preventing dental caries in children. A simple simulated example is used to illustrate the steps of the proposed methodology, and a small-scale simulation study is conducted to evaluate the performance of the proposed method. Copyright © 2016 John Wiley & Sons, Ltd.

Protective effects of a zinc-hydroxyapatite toothpaste on enamel erosion: SEM study.

The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste against an erosive challenge produced by a soft drink (Coca-Cola) using Scanning Electron Microscopy (SEM). Forty specimens were assigned to 4 groups of 10 specimens each (group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, group 3: erosive challenge, fluoride toothpaste treatment, group 4: erosive challenge, zinc-hydroxyapatite toothpaste treatment). The surface of each specimen was imaged by SEM. A visual rating system was used to evaluate the condition of the enamel surface; results were analyzed by nonparametric statistical methods. Statistically significant differences were found between the samples untreated and those immersed in Coca-Cola (group 1, 2); the highest grade of damage was found in group 2, while the lowest grade was recorded in the samples of group 4. Comparing the groups, the two analyzed toothpaste tended to protect in different extend. In this study treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect. This was greater than the effect observed for a normal fluoride toothpaste and confirmed the potential benefit the Zn-HAP technology can provide in protecting enamel from erosive acid challenges.

A Clinical trial on oral H. pylori infection of preschool children

GOALS Over the past twenty years, the existence of oral Helicobacter pylori (H. pylori) infection has been controversial and is still disputed. It proposes that living H. pylori do not exist in the oral cavity. However, the progressive loss of efficacy of standard eradication therapies has made the treatment of H. pylori more challenging than ever due to oral H. pylori infection. We conducted a study to explore the existence of oral H. pylori infection in preschool children. PROCEDURES A total of 178 children were recruited and evaluated using the saliva H. pylori antigen test (HPS) and the urea breath test (UBT C13) to diagnose oral and stomach H. pylori infections, respectively. The treatments of oral H. pylori infection included toothpaste only, and toothpaste combined with mouth washing morning and night daily for two months. Group A: Children live with parents who have a stomach disease history. Group B: Children live with parents who have no stomach disease history. Group C: Children with toothpaste treatment. Group D: Children with combined toothpaste and mouth rinse treatments. Group E: Control group with no treatments. RESULTS The positive rate of HPS and C13 were 76.4% and 15.73% in the 95% confidence interval (95% CI) range, respectively, among the 178 children. The positive rate of HPS was significantly higher (p<0.001) with the parents who suffered from stomach H. pylori infections which had been diagnosed by C13. After two-month treatments, Group D and Group E provided 26.87% and 26.44% (95% CI) range efficient rates of the oral H. pylori infection, respectively. The difference between the C, D, and E groups was significant (p<0.001). CONCLUSION Oral H. pylori exists in the oral cavity of preschool children. The positive rate of HPS was higher with parents suffering from stomach disease, and treatment was effective in reducing oral infection.

Protective effect of zinc-hydroxyapatite toothpastes on enamel erosion: An in vitro study.

BackgroundThe aim of the present study was to test the impact of different toothpastes with Zinc-Hydroxyapatite (Zn-HAP) on preventing and repairing enamel erosion compared to toothpastes with and without fluoride.Material and MethodsThe following four toothpastes were tested: two toothpastes with Zn-HAP, one toothpaste with fluoride and one toothpaste without fluoride. An additional control group was used in which enamel specimens were not treated with toothpaste. Repeated erosive challenges were provided by immersing bovine enamel specimens (10 per group) in a soft drink for 2 min (6mL, room temperature) at 0, 8, 24 and 32 h. After each erosive challenge, the toothpastes were applied neat onto the surface of specimens for 3 min without brushing and removed with distilled water. Between treatments the specimens were kept in artificial saliva. Enamel hardness, after the erosive challenge and toothpaste treatment was monitored using surface micro-hardness measurements.ResultsAs expected, repeated erosive challenge by a soft drink for total of 8 min significantly reduced enamel surface hardness (ANOVA, p < 0.05). No re-hardening of the surface softened enamel was observed in the group treated with fluoride-free toothpaste. Surface hardness of the softened enamel increased when the specimens were treated with the fluoride toothpaste and the two toothpastes with Zn-HAP (p < 0.05).ConclusionsToothpaste with Zn-HAP resulted in significant enamel remineralisation of erosively challenged enamel, indicating that these toothpastes could provide enamel health benefits relevant to enamel erosion. Key words:Enamel, erosion, remineralization, surface hardness, toothpastes.

Prevention of enamel demineralization with a novel fluoride strip: enamel surface composition and depth profile.

There is no topically applicable low concentration fluoride delivery device available for caries prevention. This study was aimed to assess the use of a low concentration (1450 ppm) fluoride strip as an effective fluoride delivery system against enamel demineralization. The enamel surface composition and calcium-deficient hydroxyapatite or toothpaste treatments were investigated using X-ray photoelectron spectroscopy. In vitro enamel demineralization was assayed using a pH cycling model and the dissolution of calcium ions from the treated specimens was quantified using ion chromatography. After 24-hr fluoride-strip treatment, the enamel was covered with a CaF2 layer which showed a granular morphology of 1 μm in size. Below the CaF2 layer was a region of mixed fluorapatite and CaF2. Fluoride infiltrated extensively in enamel to produce highly fluorinated fluorohydroxyapatite. In comparison, low-fluoride-level fluorinated fluorohydroxyapatite was formed on the enamel specimen exposed to toothpaste. The treatments with the fluoride strip as short as 1 hr significantly inhibited enamel demineralization. The fluoride strip was effective for topical fluoride delivery and inhibited in vitro demineralization of enamel by forming CaF2 and fluoride-containing apatites at the enamel surface. It exhibited the potential as an effective fluoride delivery device for general use in prevention of caries.

Effectiveness of a Toothpaste with Low Fluoride Content Combined with Trimetaphosphate on Dental Biofilm and Enamel Demineralization in situ

Objective: The aim of the present study was to evaluate in situ whether a toothpaste with low fluoride associated with sodium trimetaphosphate (TMP) would provide similar effect to that of a 1,100 ppm F toothpaste. Design: This crossover double-blind study consisted of 4 phases (14 days each), during which 10 volunteers wore oral appliances containing 4 enamel bovine blocks. The cariogenic challenge was performed by the application of a 20% sucrose solution (6×/day). The toothpaste treatments (2×/day) were: placebo, 500 ppm F, 500 ppm F plus 1% TMP, and 1,100 ppm F. At the end, enamel mineral loss and biofilm composition were analyzed. Results: The toothpaste with 500 ppm F plus 1% TMP showed the lowest mineral loss (p < 0.05). Regarding the fluoride and calcium concentrations in the enamel and in the biofilm, there were no significant differences between 500 ppm F plus 1% TMP, and 1,100 ppm F toothpastes (p > 0.569), but they were significantly different when compared to toothpaste with 500 ppm F (p < 0.050). Conclusion: The addition of 1% TMP to a low-fluoride toothpaste reduces enamel demineralization in situ similar to a 1,100 ppm F toothpaste.