RESUMEN

This study evaluated the effect of solutions containing aminomethacrylate copolymer (AA) and sodium fluoride (F; 225 ppm F-) or fluoride plus stannous chloride (FSn; 225 ppm F-, 800 ppm Sn2+) against enamel and dentin erosion/abrasion. Solutions F, FSn, AA, F+AA, FSn+AA, and deionized water as negative control were tested. Bovine enamel and dentin specimens (n = 13/solution/substrate) underwent a set of erosion-abrasion cycles (0.3% citric acid [5 min, 4×/day], human saliva [1 h, 4×/day], brushing [15 s, 2×/day], and treatments [2 min, 2×/day]) for each of five days. Initial enamel erosion was evaluated using Knoop microhardness after the first and second acid challenge on day 1, and surface loss with profilometry after day 5. KOH-soluble fluoride was assessed. Data were analyzed with ANOVA/Tukey tests. The combination of fluoride and AA resulted in higher protection against enamel erosion, whereas this was not the case for the combination of AA and FSn. All treatments protected against enamel and dentin loss. The lowest surface loss values were observed with F+AA and FSn+AA. The polymer did not significantly influence the KOH-soluble fluoride formation on enamel/dentin specimens. The aminomethacrylate copolymer effectively enhanced the efficacy of sodium fluoride against initial erosion and improved the control of enamel and dentin wear of F and FSn solutions.

Asunto(s)

Esmalte Dental , Dentina , Fluoruro de Sodio , Abrasión de los Dientes , Erosión de los Dientes , Erosión de los Dientes/prevención & control , Bovinos , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Animales , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/farmacología , Humanos , Abrasión de los Dientes/prevención & control , Abrasión de los Dientes/etiología , Saliva/efectos de los fármacos , Saliva/química , Fluoruros de Estaño/uso terapéutico , Cariostáticos/farmacología , Cariostáticos/uso terapéutico , Dureza , Fluoruros/uso terapéutico , Ácido Cítrico/farmacología , Ácido Cítrico/efectos adversos , Cepillado Dental , Compuestos de Potasio/uso terapéutico , Hidróxidos , Metacrilatos , Compuestos de Estaño

RESUMEN

OBJECTIVE: The present systematic review with a network meta-analysis (NMA) aimed to evaluate the effect of high-power lasers, associated or not with fluoride compounds, to control and prevent Erosive Tooth Wear (ETW). METHODS: The review was registered in the PROSPERO (CRD42021242547) and followed the PICO question: P (population): enamel and dentin substrate; I (Intervention): high-power laser irradiation, associated or not with fluoride compounds; C (Control): no-treatment; and O (Outcomes): prevention/control of ETW. The electronic databases PubMed, Scopus, and EMBASE were searched. Two independent reviewers evaluated in vitro and in situ studies. The risk of bias was assessed using the RoBDEMAT tool. The estimated treatment effect derived from direct and indirect comparisons were analyzed and the difference between these effects was calculated based on the data of enamel and dentin surface loss (in µm). RESULTS: A total of 179 studies were retrieved and after the exclusion of duplicates, 103 studies had their titles and abstracts evaluated. Thirty-nine studies had their full text analyzed for data extraction (Cohen Kappa = 0.88). For sound enamel, the laser irradiation (L), fluoride application (F) and, the association of treatments (L + F) promoted higher protection than No-Treatment (NT). For eroded enamel, L + F and F did not differ, but both treatments reduced surface loss compared to NT and L. For sound and eroded dentin, treatments with laser increased surface loss. CONCLUSIONS: Although a high-power laser has some potential to prevent erosive tooth wear, this effect is not better than that of standard fluoride. The use of laser in the management of dentin erosive wear can be harmful.

Asunto(s)

Fluoruros , Erosión de los Dientes , Humanos , Erosión de los Dientes/prevención & control , Metaanálisis en Red , Desgaste de los Dientes/prevención & control , Desgaste de los Dientes/etiología , Esmalte Dental/efectos de la radiación , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Dentina/efectos de la radiación , Terapia por Luz de Baja Intensidad/métodos , Terapia por Láser

RESUMEN

OBJECTIVES: The present study aimed to synthesize toothpastes containing Beta- TriCalcium Phosphate (ß-TCP) nanoparticles, functionalized with fluoride and tin, and test their ability to reduce erosive tooth wear (ETW). METHODS: Toothpastes were synthesized with the following active ingredients: 1100 ppm of fluoride (as sodium fluoride, F-), 3500 ppm of tin (as stannous chloride, Sn2+), and 800 ppm of ß-TCP (Sizes a - 20 nm; and b - 100 nm). Enamel specimens were randomly assigned into the following groups (n = 10): 1. Commercial toothpaste; 2. Placebo; 3 F-; 4. F- + ß-TCPa; 5. F- + ß-TCPb; 6. F- + Sn2+; 7. F- + Sn2+ + ß-TCPa and 8. F- + Sn2+ + ß-TCPb. Specimens were subjected to erosion-abrasion cycling. Surface loss (in µm) was measured by optical profilometry. Toothpastes pH and available F- were also assessed. RESULTS: Brushing with placebo toothpaste resulted in higher surface loss than brushing with F- (p = 0.005) and F- + ß-TCPb (p = 0.007); however, there was no difference between F- and F- + ß-TCPb (p = 1.00). Commercial toothpaste showed no difference from Placebo (p = 0.279). The groups F-, F- + ß-TCPa, F- + ß-TCPb, F- + Sn2+, F- + Sn2+ + ß-TCPa and F- + Sn2+ + ß-TCPb were not different from the commercial toothpaste (p > 0.05). Overall, the addition of ß-TCP reduced the amount of available fluoride in the experimental toothpastes. The pH of toothpastes ranged from 4.97 to 6.49. CONCLUSIONS: Although toothpaste containing ß-TCP nanoparticles protected enamel against dental erosion-abrasion, this effect was not superior to the standard fluoride toothpaste (commercial). In addition, the functionalization of ß-TCP nanoparticles with fluoride and tin did not enhance their protective effect. CLINICAL SIGNIFICANCE: Although ß-TCP nanoparticles have some potential to control Erosive Tooth Wear, their incorporation into an experimental toothpaste appears to have a protective effect that is similar to a commercial fluoride toothpaste.

Asunto(s)

Fosfatos de Calcio , Esmalte Dental , Nanopartículas , Erosión de los Dientes , Pastas de Dientes , Fosfatos de Calcio/química , Fosfatos de Calcio/uso terapéutico , Pastas de Dientes/química , Pastas de Dientes/uso terapéutico , Erosión de los Dientes/prevención & control , Nanopartículas/química , Esmalte Dental/efectos de los fármacos , Concentración de Iones de Hidrógeno , Compuestos de Estaño/uso terapéutico , Compuestos de Estaño/química , Fluoruro de Sodio/uso terapéutico , Fluoruro de Sodio/química , Animales , Fluoruros/uso terapéutico , Estaño/química , Abrasión de los Dientes/prevención & control , Bovinos , Ensayo de Materiales , Propiedades de Superficie , Distribución Aleatoria , Cepillado Dental , Humanos

RESUMEN

BACKGROUND: This study aimed to evaluate dentin wear and biological performance of desensitizing materials. METHODS: Seventy bovine root dentin blocks were sectioned. Half of the surface of each specimen was untreated (control) and the other half was immersed in EDTA and treated with the following desensitizing materials: placebo varnish (PLA), fluoride varnish (FLU), sodium fluoride (NaF) varnish + sodium trimetaphosphate (TMP), universal adhesive (SBU), S-PRG varnish (SPRG), biosilicate (BIOS), and amelotin solution (AMTN). After application, the specimens were submitted to an erosive-abrasive challenge and the wear analyzed by optical profilometer. Serial dilutions of extracts obtained from the culture medium containing discs impregnated with those desensitizers were applied on fibroblasts and odontoblasts-like cells cultures. Cytotoxicity and production of total protein (TP) by colorimetric assays were determined after 24 h. Data were statistically analyzed using Kruskal-Wallis, Dunn's, One-way ANOVA and Tukey tests (p ≤ 0.05). RESULTS: No dentin wear was observed only for SBU. The lowest dentin wear was observed for AMTN and TMP. Cell viability was significantly reduced after treatment with undiluted extracts of PLA, FLU, TMP and SBU in fibroblasts and TMP and SBU in odontoblast-like cells. SPRG, BIOS and AMTN were cytocompatible at all dilutions tested. Considering TP results, no statistical difference was observed among the groups and high levels for TP were observed after TMP and FLU treatments. CONCLUSIONS: Universal adhesive system may protect dentin with opened tubules from wear after challenge. Extracts of adhesive and fluoride varnishes presented cytotoxic mainly on fibroblasts. The enamel protein may be a future alternative to treat dentin with opened tubules because it may cause low wear under erosive-abrasive challenge with low cytotoxic effects.

Asunto(s)

Desensibilizantes Dentinarios , Dentina , Fluoruro de Sodio , Animales , Bovinos , Desensibilizantes Dentinarios/farmacología , Fluoruro de Sodio/farmacología , Dentina/efectos de los fármacos , Fluoruros Tópicos/farmacología , Fibroblastos/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Desgaste de los Dientes , Ensayo de Materiales , Polifosfatos/farmacología

RESUMEN

OBJECTIVES: To assess the effect of different tin-containing toothpastes on the control of erosive tooth wear in enamel and dentin. METHODS: Enamel and dentin slabs were randomly distributed into 7 experimental groups (n = 10/substrate): C-: negative control (Artificial saliva); AmF (regular fluoridated toothpaste without tin); Sn-1 (SnF2/NaF); Sn-2 (SnF2/NaF/SnCl2); Sn-3 (SnCl2/NaF); Sn-4 (SnF2/SnCl2); Sn-5 (SnCl2/AmF/NaF/chitosan). Specimens were submitted to 5-day erosion-abrasion cycling. Surface loss (SL) was determined with an optical profilometer. Tin deposition on the tooth surfaces and some characteristics of the toothpastes (pH, potentially available F-, %weight of solid particles, and RDA) were also assessed. Data were statistically analyzed (α = 0.05). RESULTS: For enamel, the Sn-2 presented the lowest SL, not differing significantly from AmF, C+, and Sn-3. The SL of these groups was significantly lower than the C-, except for Sn-3. Sn-1 and Sn-4 were also not significantly different from C-. For dentin, C- significantly showed the highest SL values, whilst, Sn-1 presented the lowest SL, not differing significantly from AmF, Sn-2, C+, and Sn-3. There was a significant positive association between enamel SL and the pH and tin deposition. Dentin SL was significantly negatively associated with the %weight of solid particles and RDA. CONCLUSIONS: Most of the tin-toothpastes were able to exhibit some protection against ETW. In this process, the toothpastes characteristics play a role, as lower enamel SL was significantly associated with lower pH values and tin deposition; and lower dentin SL was associated with higher %weight of solid particles and RDA of the toothpastes. CLINICAL SIGNIFICANCE: Tin-containing toothpastes can be used for erosive tooth wear protection, but our study showed that their effect depends on the pH, amount of tin deposition, % weight of solid particles and RDA of the toohpastes.

Asunto(s)

Compuestos de Estaño , Abrasión de los Dientes , Erosión de los Dientes , Desgaste de los Dientes , Humanos , Fluoruros de Estaño/farmacología , Pastas de Dientes/farmacología , Fluoruros/farmacología , Erosión de los Dientes/prevención & control , Estaño , Abrasión de los Dientes/prevención & control , Fluoruro de Sodio/farmacología , Cepillado Dental

RESUMEN

OBJECTIVE: The study aims to evaluate the effect of a glass ionomer cement (GIC; Fuji 9 Gold Label, GC) with added calcium orthophosphate particles and a calcium silicate cement (CSC; Biodentine, Septodont) regarding ion release, degradation in water, mineral content, and mechanical properties of demineralized dentin samples. METHODS: GIC, GIC + 5% DCPD (dicalcium phosphate dihydrate), GIC + 15% DCPD, GIC + 5% ß-TCP (tricalcium phosphate), GIC + 15% ß-TCP (by mass), and CSC were evaluated for Ca2+/Sr2+/F- release in water for 56 days. Cement mass loss was evaluated after 7-day immersion in water. Partially demineralized dentin disks were kept in contact with materials while immersed in simulated body fluid (SBF) at 37 °C for 56 days. The "mineral-to-matrix ratio" (MMR) was determined by ATR-FTIR spectroscopy. Dentin hardness and elastic modulus were obtained by nanoindentation. Samples were observed under scanning and transmission electron microscopy. Data were analyzed by ANOVA/Tukey test (α = 0.05). RESULTS: Ca2+ release from CSC and GIC (µg/cm2) were 4737.0 ± 735.9 and 13.6 ± 1.6, respectively. In relation to the unmodified GIC, the addition of DCPD or ß-TCP increased ion release (p < 0.001). Only the dentin disks in contact with CSC presented higher MMR (p < 0.05) and mechanical properties than those restored with a resin composite used as control (p < 0.05). Mass loss was similar for GIC and CSC; however, the addition of DCPD or ß-TCP increased GIC degradation (p < 0.05). CONCLUSION: Despite the increase in ion release, the additional Ca2+ sources did not impart remineralizing capability to GIC. Both unmodified GIC and CSC showed similar degradation in water. CLINICAL RELEVANCE: CSC was able to promote dentin remineralization.

Asunto(s)

Compuestos de Calcio , Fosfatos de Calcio , Calcio , Cementos de Ionómero Vítreo , Silicatos , Cementos de Ionómero Vítreo/farmacología , Cementos de Ionómero Vítreo/química , Calcio/análisis , Fosfatos/análisis , Cemento de Silicato/análisis , Cemento de Silicato/farmacología , Dentina , Agua/química , Ensayo de Materiales

RESUMEN

OBJECTIVE: to evaluate the effect a glass ionomer cement (GIC) containing hydroxyapatite (HAp) or calcium silicate (CaSi) particles on mineral content and mechanical properties of demineralized dentin. Ion release and compressive strength (CS) of the cements were also evaluated. METHODS: GIC (Fuji 9 Gold Label, GC), GIC+ 5%HAp and GIC+ 5%CaSi (by mass) were evaluated. Ion release was determined by induced coupled plasma optical emission spectroscopy (Ca2+/Sr2+) or ion-specific electrode (F-) (n = 3). A composite (Filtek Z250, 3 M ESPE) was used as control in remineralization tests. Demineralized dentin discs were kept in contact with materials in simulated body fluid (SBF) at 37 °C for eight weeks. Mineral:matrix ratio (MMR) was determined by ATR-FTIR spectroscopy (n = 5). Dentin hardness (H) and elastic modulus (E) were determined by nanoindentation (n = 10). CS was tested after 24 h and 7d in deionized water (n = 12). Data were analyzed by ANOVA/Tukey test (α = 0.05). RESULTS: Ca2+ and Sr2+ release was higher for the modified materials (p < 0.05). Only GIC+ 5%HAp showed higher F- release than the control (p < 0.05). All groups showed statistically significant increases in MMR, with no differences among them after 8 weeks (p > 0.05). No differences in dentin H or E were observed among groups (p > 0.05). HAp-modified GIC showed increased initial CS, while adding CaSi had the opposite effect (p < 0.05). After 7 days, GIC+ 5%CaSi presented lower CS in relation to control and GIC+ 5%HAp (p < 0.05). SIGNIFICANCE: GIC modification with HAp or CaSi affected CS and increased ion release; however, none of the groups showed evidence of dentin remineralization in comparison to the negative control.

Asunto(s)

Calcio , Cementos de Ionómero Vítreo , Calcio/análisis , Ensayo de Materiales , Cementos de Ionómero Vítreo/farmacología , Cementos de Ionómero Vítreo/química , Durapatita/farmacología , Durapatita/química , Dentina/química

RESUMEN

OBJECTIVES: To synthesize and characterize a novel dentin adhesive containing Beta-Tricalcium Phosphate (ß-TCP) nanoparticles and test its ability to reduce dentin permeability (dP). METHODS: Experimental adhesives were prepared by mixing Bis-GMA, TEGDMA, HEMA (50/25/25 wt.%), photo-initiators, and inhibitors. The following groups were tested: Experimental adhesives without ß-TCP (Exp.); with 10 wt.% ß-TCP (Exp.10 wt.% ß-TCP); with 15 wt.% ß-TCP (Exp.15 wt.% ß-TCP), Scotchbond Multi-Purpose (SBMP) and Clearfil SE Protect Bond (CFPB). Degree of conversion (DC%, 10 and 20 s); Flexural Strength (FS), Knoop Hardness (KHN), and Cell Viability (OD%) tests were performed. dP was evaluated by hydraulic conductance, using human dentin disks (n=12), at three-time intervals: post-EDTA (T0); post-treatment (T1); and post-erosion/abrasion cycling (T2). Data were statistically analyzed (α=0.05). RESULTS: For all groups, exposure time for 20 s presented a higher DC% than for 10 s. For FS, filled adhesives did not differ from unfilled and from CFPB. Experimental adhesives did not differ among them and showed lower KHN than the commercial products. Cell viability did not differ among adhesives, except Exp. 15 wt.%, which showed lower OD% than Exp., Exp. 10% and, CFPB. For dP, only Exp.10 and 15 wt.% ß-TCP did not present difference between the times T1 and T2. After cycling, Exp.10 wt.% ß-TCP presented lower permeability than Exp. and CFPB. CONCLUSIONS: The incorporation of 10 wt.% ß-TCP nanoparticles into the resin-based dental material did not affect its mechanical properties and biocompatibility, and promoted the greatest reduction in dentin permeability, sustaining this effect under erosive/abrasive challenges. CLINICAL SIGNIFICANCE: A novel resin-based dental material containing ß-TCP nanoparticles was able to reduce dentin permeability, maintaining its efficacy after erosive/abrasive challenges. The synthesized material did not affect dental pulp cell viability and might be promising for other conditions that require dental remineralization, such as tooth wear and dental caries.

Asunto(s)

Fosfatos de Calcio , Recubrimiento Dental Adhesivo , Caries Dental , Nanopartículas , Humanos , Recubrimientos Dentinarios/química , Permeabilidad de la Dentina , Cementos de Resina/farmacología , Cementos de Resina/química , Ensayo de Materiales , Dentina/química , Resistencia a la Tracción , Cementos Dentales/química

RESUMEN

Aim: To evaluate the protection offered by commercial mouthwashes containing sodium fluoride or stannous chloride associated with sodium fluoride to enamel and dentin, prior to erosive and abrasive cycling. Materials and Methods: Enamel and dentin samples were obtained from bovine incisors and subdivided into 3 groups (n=10), according to the fluoridated ingredient tested: FS (sodium fluoride - NaF (225 ppm)); FE (tin fluoride - NaF + SnCl2 (800 ppm Sn2+)); control (distilled water). The samples were submitted to an erosive/abrasive cycle with immersion in citric acid (lemon soda for 5 min, 4×/day, 5 days, with remineralization intervals in artificial saliva for 60 min). Abrasion was carried out with an electric brush (200 g/force) after the first and last cycles, 2x/day, and immediately afterward immersed in the tested solutions. Structure loss was obtained by optical profilometry. The data were subjected to analysis of variance and multiple comparison for each substrate separately. Results: For enamel there was a difference between the groups (p = 0.027), with the FS showing less loss of structure compared to the control 2.02 (±0.48). The FE group showed similar loss to the control and FS 2.32 (±0.58)ab. For dentin there was a difference between the groups (p = 0.011), with FE showing less loss of structure compared to the other groups, 0.82 (25% - 0.34; 75% - 0.95). Discussion: The protection of fluorides in erosive/abrasive challenges depends on the type and dental substrate. Conclusion: Mouthwash with sodium fluoride prior to erosive/abrasive challenges caused less loss of enamel surface, while for dentin, sodium fluoride associated with stannous chloride caused less loss of structure.

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Objetivo: Avaliar a proteção oferecida por soluções para bochecho de fluoreto de sódio ou cloreto de estanho associado ao fluoreto de sódio ao esmalte e à dentina, previamente à ciclagem erosiva e abrasiva. Materiais e Métodos: Amostras de esmalte e dentina foram obtidas a partir de incisivos bovinos e subdivididas em 3 grupos (n=10), de acordo com o princípio ativo fluoretado testado: FS (fluoreto de sódio - NaF (225 ppm)); FE (fluoreto de estanho - NaF + SnCl2 (800 ppm Sn2+)); controle (água destilada). As amostras foram submetidas a um ciclo erosivo/abrasivo com imersão em ácido cítrico (refrigerante de limão por 5 min, 4×/dia, 5 dias, com intervalos de remineralização em saliva artificial por 60 min). A abrasão foi realizada com escova elétrica (200 g/força) após o primeiro e o último ciclos, 2×/dia, e logo em seguida imersos nas soluções testadas. A perda de estrutura foi obtida por perfilometria óptica. Os dados foram submetidos à análise de variância e comparação múltipla para cada substrato separadamente. Resultados: Para esmalte houve diferença entre os grupos (p = 0,027), tendo o FS apresentados menor perda de estrutura comparado ao controle 2,02 (±0,48). O grupo FE apresentou perda similar ao controle e ao FS 2,32 (±0,58)ab. Para dentina houve diferença entre os grupos (p = 0,011), sendo que o FE apresentou menor perda de estrutura comparado aos demais grupos 0,82 (25% - 0,34; 75% - 0,95). Discussão: A proteção dos fluoretos em desafios erosivos/abrasivos depende do tipo e do substrato dental. Conclusão: O bochecho com fluoreto de sódio previamente aos desafios erosivos/abrasivos apresentou menor perda de superfície em esmalte, enquanto para dentina o fluoreto de sódio associado ao cloreto de estanho apresentou menor perda de estrutura.

Asunto(s)

Animales , Abrasión de los Dientes , Desgaste de los Dientes , Ácido Cítrico , Pulido Dental

RESUMEN

The aim of this study was to evaluate the effect of film-forming polymer solutions of different concentrations and pH values, either associated or not with sodium fluoride (F; 225 ppm F-), when applied during the initial stage of salivary pellicle formation, to prevent the dissolution of hydroxyapatite (HA), which was determined by the pH-stat method. Polyacrylic acid (PA), chitosan, sodium linear polyphosphate (LPP), polyvinyl methyl ether/maleic anhydride (PVM/MA), and propylene glycol alginate (PGA) were tested in three concentrations (lower, medium, and higher), two pH values (native or adjusted), and either associated or not with F. Distilled water, F, and stannous ion+fluoride (Sn/F; 225 ppm F- and 800 ppm Sn2+, as SnCl2) solutions were the controls, totalizing 63 groups. HA crystals were pretreated with human saliva for 1 min to allow pellicle formation, then immersed in the experimental solutions (1 min), and exposed to saliva for another 28 min. Subsequently, they were added to a 0.3% citric acid solution (pH = 3.8), connected to a pH-stat system that added aliquots of 28 µL 0.1 N HCl for a total reaction time of 5 min. Data were analyzed with one-way ANOVA and Tukey's tests (α = 0.05). For PA alone, the concentrations of 0.1% (native pH), 0.06%, and 0.08% (both pH adjusted) showed significantly lower HA dissolution than the negative control. PA concentrations of 0.1% and 0.08%, of both pH values, improved the effect of F against HA dissolution to a near-identical value as Sn/F. All solutions containing chitosan and LPP significantly reduced HA dissolution in comparison with the control. For chitosan, the concentration of 0.5% (in both pH values) improved the effect of F. LPP at 0.5% (native pH) and all associations of LPP with F outperformed the effect of F. Some PVM/MA solutions significantly reduced HA dissolution but PVM/MA could not improve the protection of F. PGA was incapable of reducing HA dissolution or improving F effect. It was concluded that chitosan, LPP, and some PA and PVM/MA solutions used alone were capable of reducing HA dissolution. Only PA, chitosan, and LPP were able to enhance fluoride protection, but for PA and chitosan, this was influenced by the polymer concentration.

Asunto(s)

Quitosano , Erosión de los Dientes , Humanos , Fluoruros/farmacología , Durapatita/química , Polímeros , Quitosano/farmacología , Erosión de los Dientes/prevención & control , Fluoruro de Sodio/farmacología , Fluoruro de Sodio/química , Fluoruros de Estaño , Polifosfatos/farmacología , Polivinilos

RESUMEN

BACKGROUND: Polyphenols interact with salivary proteins and thus can improve the pellicle's erosion protective properties. This effect could be exploited to create rinsing solutions with polyphenols as active ingredients for erosion prevention. Different from the current gold standard for erosion protective rinsing solutions, these rinses would not rely on stannous ions. This would offer alternatives for patients with concerns regarding the composition of rinsing solutions and preferring bio-products. OBJECTIVE: To develop an erosion-preventive rinsing solution containing natural polyphenol-rich extracts. METHODOLOGY: Solutions were prepared with polyphenols from either grapeseed extract or cranberry extract, 500 ppm fluoride added, and additionally flavors and sweeteners. Controls were deionized water, 500 ppm fluoride solution, and the gold standard rinse in the field (Sn2+/F-). In total, 135 enamel specimens (n=15/group) were subjected to five cycles of salivary pellicle formation (30 min, 37°C), modification with the solutions (2 min, 25°C), further salivary pellicle formation (60 min, 37°C), and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), surface reflection intensity (rSRI), and amount of calcium release (CaR) were investigated. Data were analyzed with Kruskal-Wallis and Wilcoxon rank sum tests (α=0.05). RESULTS: The polyphenol solutions containing fluoride, as well as additional flavors, protected enamel better than fluoride alone, and similar to the Sn2+/F- solution, when investigating both rSMH and CaR. When measuring rSRI, Sn2+/F- showed the best protection, while the polyphenol solutions were similar to fluoride. CONCLUSION: For two of the three assessed parameters (rSMH and CaR), both developed polyphenol-rich rinsing solutions were able to protect enamel from erosion, improving/potentializing the effect of fluoride and matching the protection offered by the current gold standard rinsing solution.

Asunto(s)

Fluoruros , Erosión de los Dientes , Humanos , Erosión de los Dientes/prevención & control , Película Dental , Esmalte Dental , Calcio , Polifenoles/farmacología , Fluoruro de Sodio/farmacología

RESUMEN

OBJECTIVES: To compare the effect of whitening toothpastes with different mechanisms of action on discolored teeth subjected to additional staining/or not. METHODS: One hundred twenty tooth specimens were stained for 14 days (staining broth under constant agitation and pH=7) and then allocated into the groups of toothpastes with different whitening ingredients (n=10): 1. Regular - Colgate Total 12 Clean Mint; 2. CLWI - Colgate Luminous White Instant (blue pigment); 3. CLWA - Colgate Luminous White Advanced Expert (hydrogen peroxide); 4. CLWAC - Colgate Luminous White Activated Charcoal (activated charcoal); 5. OB3D - Oral-B 3D WHITE Brilliant Fresh (abrasive); 6. TW - Teeth Whitening (charcoal powder). Specimens were submitted to two experimental models: A. Daily staining-toothbrush cycling: staining solution (5min), toothbrushing (45 strokes) and artificial saliva (3h), 2x/day, for 5 days; B. Only toothbrushing (30.000 brushing strokes). Color change was determined with a spectrophotometer (CIEDE2000 and Whiteness Index for Dentistry - WID) and statistically analyzed (α=0.05). RESULTS: For both models, ΔE00 and Δa did not differ significantly between the whitening toothpastes and the regular. All groups showed a decrease in tooth yellowness (-Δb) and an increase in WID. Group Teeth Whitening exhibited a decrease in luminosity (-ΔL). In model A, Groups did not differ significantly from the Regular in terms of ΔL (p=0.35) and Δb (p=0.74). Groups CLWI and OB3D exhibited a decrease in luminosity. Reduced redness (-Δa) occurred only in Group CLWI. In Model B, Groups OB3D (p=0.021) and CLWA (p=0.001) exhibited higher change in luminosity than in Group Teeth Whitening. All exhibited increased redness (+Δa) and lightness (+ΔL), except the Regular, CLWAC, and Teeth Whitening. Group OB3D had a significantly higher change in Δb than the Regular (p=0.021). CONCLUSIONS: Irrespective of the mechanism of action, all toothpastes reduced tooth yellowness and promoted similar overall color change. Exposure of the teeth to additional staining during the toothbrushing cycles did not influence the effect of the whitening toothpastes. CLINICAL SIGNIFICANCE: Whitening toothpastes should be tested in conditions that more closely simulate their use in a clinical scenario, in which alternate cycles of staining and brushing occur on a daily basis. However, even in such conditions, they were unable to promote a color change that differed from that of a regular toothpaste.

Asunto(s)

Blanqueamiento de Dientes , Decoloración de Dientes , Diente , Humanos , Pastas de Dientes/farmacología , Cepillado Dental , Carbón Orgánico/farmacología , Coloración y Etiquetado , Fluoruro de Sodio/farmacología , Color

RESUMEN

OBJECTIVE: To investigate the influence of different ultra-soft toothbrushes on the progression of erosive tooth wear (ETW). METHODS: Bovine enamel and dentin specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3% citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, with the different toothbrushes tested (A- Edel White: flexible handle, tapered bristles; B- Oral-B Gengiva Detox: regular handle, criss-cross tapered bristles; C- Colgate Gengiva Therapy: flexible handle, tapered bristles, high tuft density; d- Oral-B Expert Gengiva Sensi: regular handle, round end bristles, high tuft density; E- Oral-B Indicator Plus: soft brush, round end bristles (control). Surface loss (SL, in µm) was assessed by optical profilometry. The toothbrush characteristics were evaluated by a surgical microscope. Data were statistically analyzed (α=0.05). RESULTS: For enamel, toothbrush C showed the highest SL (means±SD: 9.86 ± 1.28) and it did not differ significantly from A (8.60 ± 0.50), both with flexible handles. The lowest SL was observed for the toothbrush Control E (6.76 ± 0.63), which differed significantly from A and C, but not from the other toothbrushes. For dentin, the highest SL was found for toothbrush D (6.97 ± 1.05) and it did not differ significantly from E (6.23 ± 0.71). The lowest SL was observed for B (4.61 ± 0.71) and C (4.85 + 0.83), without significant differences from A (5.01 ± 1.24). CONCLUSIONS: The ultra-soft toothbrushes had different impacts on the progression of ETW on the dental substrates. On enamel, higher ETW values were observed for the flexible handle toothbrushes, while for dentin, round-end bristles (ultra-soft and soft) caused more ETW. CLINICAL SIGNIFICANCE: Knowledge about the effect of different ultra-soft toothbrushes on ETW can help clinicians to recommend the most suitable types for their patients, bearing in mind that toothbrushes can impact enamel and dentin differently.

Asunto(s)

Abrasión de los Dientes , Atrición Dental , Erosión de los Dientes , Desgaste de los Dientes , Humanos , Animales , Bovinos , Cepillado Dental/efectos adversos , Abrasión de los Dientes/etiología , Erosión de los Dientes/complicaciones , Desgaste de los Dientes/complicaciones

RESUMEN

Abstract Polyphenols interact with salivary proteins and thus can improve the pellicle's erosion protective properties. This effect could be exploited to create rinsing solutions with polyphenols as active ingredients for erosion prevention. Different from the current gold standard for erosion protective rinsing solutions, these rinses would not rely on stannous ions. This would offer alternatives for patients with concerns regarding the composition of rinsing solutions and preferring bio-products. Objective To develop an erosion-preventive rinsing solution containing natural polyphenol-rich extracts. Methodology Solutions were prepared with polyphenols from either grapeseed extract or cranberry extract, 500 ppm fluoride added, and additionally flavors and sweeteners. Controls were deionized water, 500 ppm fluoride solution, and the gold standard rinse in the field (Sn2+/F-). In total, 135 enamel specimens (n=15/group) were subjected to five cycles of salivary pellicle formation (30 min, 37°C), modification with the solutions (2 min, 25°C), further salivary pellicle formation (60 min, 37°C), and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), surface reflection intensity (rSRI), and amount of calcium release (CaR) were investigated. Data were analyzed with Kruskal-Wallis and Wilcoxon rank sum tests (α=0.05). Results The polyphenol solutions containing fluoride, as well as additional flavors, protected enamel better than fluoride alone, and similar to the Sn2+/F- solution, when investigating both rSMH and CaR. When measuring rSRI, Sn2+/F- showed the best protection, while the polyphenol solutions were similar to fluoride. Conclusion For two of the three assessed parameters (rSMH and CaR), both developed polyphenol-rich rinsing solutions were able to protect enamel from erosion, improving/potentializing the effect of fluoride and matching the protection offered by the current gold standard rinsing solution.

RESUMEN

Different agents have been proposed to prevent the progression of acid induced dental substance losses, which are called erosive tooth wear (ETW), such as fluorides, calcium, and phosphate-based products; however, there is a need for a further increase in efficacy. Recently, the ability of polymers to interact with the tooth surface, forming acid resistant films, has come into the focus of research; nevertheless, there is still the need for a better understanding of their mode of action. Thus, this article provides an overview of the chemical structure of polymers, their mode of action, as well as the effect of their incorporation into oral care products, acid beverages, and antacid formulations, targeting the prevention of ETW. Recent evidence indicates that this may be a promising approach, however, additional studies are needed to confirm their efficacy under more relevant clinical conditions that consider salivary parameters such as flow rate, composition, and clearance. The standardization of methodological procedures such as acid challenge, treatment duration, and combination with fluorides is necessary to allow further comparisons between studies. In conclusion, film-forming polymers may be a promising cost-effective approach to prevent and control erosive demineralization of the dental hard tissue.

RESUMEN

OBJECTIVES: To assess the effect of an experimental 58S bioactive glass on dentin permeability (dP) and erosive tooth wear (dentin surface loss - dSL). METHODS: 58S bioactive glass was synthetized using a sol-gel methodology, following by lyophilization and calcination, then mixed with phosphoric acid to obtain a paste (BGP). Forty-eight dentin disks (1 mm-thick) were used for dP, and 48 dentin slabs (3 mm × 3 mm) for dSL, which were assessed at three time intervals: post-EDTA (5 min in 17% EDTA solution); post-treatment (C: distilled water; BGP: experimental bioactive glass paste; NP: Nupro prophylaxis paste; CXT: Clinpro XT varnish); and post-erosive/abrasive cycling. Data were statistically analyzed (α=0.05). RESULTS: For dP and dSL, Groups did not differ significantly post-EDTA (p>0.05). Post-treatment, all groups showed lower dP than C (p<0.05), without differing significantly among them. For the dSL analysis, Groups C, BGP and NP did not differ significantly, showing lower values than CXT (p<0.05). Post-cycling, C continued to show the highest dP (p<0.05). Specimens from Group CXT had the lowest dP and did not differ from NP (p=0.86) which did not differ from BGP (p=0.193). For C and BGP, dP value was higher post-cycling than post-treatment (p<0.05). For NP and CXT, these experimental times did not differ (p>0.05). Post-cycling, dSL for C, BGP and NP did not differ significantly; values were higher than those for CXT (p<0.05). CONCLUSIONS: BGP reduced dP after application, with a reduced effect after cycling. Nonetheless, it was not able to protect dentin against erosive tooth wear. CLINICAL SIGNIFICANCE: Minimizing dentin hypersensitivity is a challenge in the field of dentistry. The development of alternative products with potential to obliterate dentinal tubules and provide resistance to chemical/mechanical stimuli is, thus, highly desirable. We have proposed a material able to reduce dentin permeability, which has emerged as a promising alternative for this purpose.

Asunto(s)

Sensibilidad de la Dentina , Atrición Dental , Erosión de los Dientes , Desgaste de los Dientes , Humanos , Sensibilidad de la Dentina/tratamiento farmacológico , Ácido Edético/farmacología , Ácido Edético/uso terapéutico , Dentina , Microscopía Electrónica de Rastreo , Erosión de los Dientes/prevención & control

RESUMEN

This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.

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Este estudo desenvolveu e testou géis experimentais contendo íons fluoreto (F-) e estanho (Sn2+) para o controle da erosão dentária. Os espécimes polidos, de esmalte e dentina, foram previamente erodidos (solução de ácido cítrico a 1%, 10 min) e alocados aleatoriamente em 5 grupos (n = 10): Placebo - gel de hidroxipropilmetilcelulose (HMC); F + Sn + HMC - 7.500 ppm F- / 15.000 ppm Sn2+; F + HMC - 7.500 ppm F-; Gel de flúor fosfato acidulado comercial (12.300 ppm F-); e Controle - sem tratamento. Após o tratamento (aplicado por 60 s), os espécimes foram submetidos a uma ciclagem de erosão-remineralização (5 min em solução de ácido cítrico a 0,3%, 60 min em saliva artificial, 4 × / dia, 20 dias). A perda de superfície (SL, em µm) foi determinada após o 5º, 10º e 20º dias de ciclagem (α = 0,05). Para o esmalte, após 5 e 10 dias, o F + Sn + HMC apresentou a menor PS, não diferindo do gel comercial. Após 20 dias, não foram encontradas diferenças entre os grupos comercial, F + HMC e F + Sn + HMC. O placebo não diferiu do controle em nenhum momento, e ambos os grupos apresentaram a maior PS, comparado aos demais grupos. Para dentina, no 5º dia , F + Sn + HMC, F + HMC e comercial não diferiram significativamente, apresentando menor PS que o grupo controle e placebo. No 10º dia, F+Sn+HMC e comercial apresentaram a menor PS comparado ao grupo controle e placebo. No 20º dia, apenas o gel comercial apresentou PS menor que o controle e o placebo. Assim, o gel experimental F + Sn + HMC foi capaz de controlar a progressão da erosão dentária.

Asunto(s)

Fluoruro de Sodio , Erosión de los Dientes , Ácido Cítrico/uso terapéutico , Fluoruros , Geles/uso terapéutico , Humanos , Fluoruro de Sodio/uso terapéutico , Compuestos de Estaño , Erosión de los Dientes/prevención & control

RESUMEN

Resumo Este estudo desenvolveu e testou géis experimentais contendo íons fluoreto (F-) e estanho (Sn2+) para o controle da erosão dentária. Os espécimes polidos, de esmalte e dentina, foram previamente erodidos (solução de ácido cítrico a 1%, 10 min) e alocados aleatoriamente em 5 grupos (n = 10): Placebo - gel de hidroxipropilmetilcelulose (HMC); F + Sn + HMC - 7.500 ppm F- / 15.000 ppm Sn2+; F + HMC - 7.500 ppm F-; Gel de flúor fosfato acidulado comercial (12.300 ppm F-); e Controle - sem tratamento. Após o tratamento (aplicado por 60 s), os espécimes foram submetidos a uma ciclagem de erosão-remineralização (5 min em solução de ácido cítrico a 0,3%, 60 min em saliva artificial, 4 × / dia, 20 dias). A perda de superfície (SL, em µm) foi determinada após o 5º, 10º e 20º dias de ciclagem (α = 0,05). Para o esmalte, após 5 e 10 dias, o F + Sn + HMC apresentou a menor PS, não diferindo do gel comercial. Após 20 dias, não foram encontradas diferenças entre os grupos comercial, F + HMC e F + Sn + HMC. O placebo não diferiu do controle em nenhum momento, e ambos os grupos apresentaram a maior PS, comparado aos demais grupos. Para dentina, no 5º dia , F + Sn + HMC, F + HMC e comercial não diferiram significativamente, apresentando menor PS que o grupo controle e placebo. No 10º dia, F+Sn+HMC e comercial apresentaram a menor PS comparado ao grupo controle e placebo. No 20º dia, apenas o gel comercial apresentou PS menor que o controle e o placebo. Assim, o gel experimental F + Sn + HMC foi capaz de controlar a progressão da erosão dentária.

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Abstract: This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.

RESUMEN

OBJECTIVE: The aim of this study is to test, in vitro, the anti-cariogenic effect of experimental hybrid coatings, with nano clays of halloysite or bentonite, loaded with sodium fluoride or with a combination of sodium fluoride and stannous chloride, respectively. METHODOLOGY: The varnish Fluor Protector (1,000 ppm of F-) was used as positive control and no treatment was the negative control. Enamel specimens (5 mm × 5 mm) were obtained from bovine teeth. The specimens (n=10) had their surfaces divided into two halves (5 mm × 2.5 mm each), in which one half received one of the treatments (Hybrid; Hybrid + NaF; Hybrid + NaF + SnCl2; Hybrid + NaF Loaded; Hybrid + NaF + SnCl2 Loaded). The specimens were submitted to a cariogenic challenge using a biofilm model (S. mutans UA159, for 5 days). Enamel surfaces both under and adjacent to the treated area were analyzed for mineral loss and lesion depth, by transverse microradiography. The pH of the medium was measured twice a day, and the fluoride release was analyzed. Additional specimens were submitted to confocal analysis. RESULTS: Data were statistically analyzed by two-way ANOVA followed by Tukey test (α=0.05). None of hybrid groups were able to reduce the lesion depth; the Hybrid + NaF group, however, was able to reduce mineral loss differing from the negative control (p=0.008). The groups showed no significant difference in the pH measurement and fluoride release. Confocal analysis confirmed that for all groups the biofilm growth was similar. CONCLUSION: None of the hybrid groups reduced lesion depth, but the Hybrid + NaF group was able to promote protection against mineral loss.

Asunto(s)

Fluoruro de Sodio , Erosión de los Dientes , Animales , Cariostáticos/farmacología , Bovinos , Esmalte Dental , Fluoruros/farmacología , Minerales/farmacología , Fluoruro de Sodio/farmacología , Compuestos de Estaño , Erosión de los Dientes/prevención & control

RESUMEN

PURPOSE: To evaluate in vitro the potential of an intraoral scanner (IOS) to monitor erosive tooth wear (ETW) using different alignment software with distinct quantitative measurement metrics. METHODS: 15 unpolished bovine crowns were exposed to citric acid (pH ~2.5) at 24-hour intervals up to 168 hours. At baseline and after each acid exposure episode, the teeth were scanned with IOS (3Shape TRIOS 3). Scanned images from each data point were superimposed on baseline image using WearCompare software to obtain volume loss (mm³) and area loss (mm²) and using IOS built-in software (3Shape TRIOS Patient Monitoring) to obtain depth loss (mm). Pearson's test was used to determine the correlation between acid exposure time (h) and each outcome measure (α= 0.05). RESULTS: As the acid exposure time increased, the lesion parameters (depth, volume, and area) increased. Friedman's test showed that relative to baseline volume loss became significant (P< 0.05) after 72 hours from median 11.48 mm³ (IQI 25% = 8.72 mm³), eroded area became significant (P< 0.05) from median 48.67 mm² (IQI 25% = 44.46 mm², P< 0.05) after 96 hours, and erosion depth became significant (P< 0.05) from median 0.69 mm (IQI 25% = 0.66 mm²) after 144 hours. A strong correlation was observed between depth (mm²) and time (r= 0.9993 P< 0.0001), volume (mm³) and time (r= 0.9968, P< 0.0001), and area (mm²) and time (r= 0.9475, P= 0.0003). CLINICAL SIGNIFICANCE: Currently, there is no quantitative method for clinical monitoring of erosive tooth wear. The present study demonstrated that the intraoral scanner is a potential clinical tool for detecting and quantitatively monitoring early and advanced erosive tooth wear.

Asunto(s)

Desgaste de los Dientes , Diente , Animales , Bovinos , Estudios de Factibilidad , Humanos , Desgaste de los Dientes/diagnóstico por imagen