RESUMO

OBJECTIVE: This study evaluated the color change, surface roughness, mineral content and morphology of enamel bleached with 35% hydrogen peroxide (HP) combined with an experimental gel containing 1% titanium tetrafluoride (TiF4). MATERIALS AND METHODS: Bovine enamel blocks were treated with (n = 12): (TiF) experimental gel containing 1% TiF4, (HP) 35% HP, (HPT) 35% HP + 1% TiF4 and (CT) control. Bleaching with HP was performed in 3 sessions (3 × 15 min/applications). pH, colorimetric parameters, surface roughness, mineral content and enamel morphology were determined. The pH was evaluated for 45 min. The color parameters were determined before bleaching (T0), and 14 days elapsed from the last bleaching session (T4). Surface roughness was analyzed at T0 and immediately after last bleaching session (T3). Enamel mineral content and morphology were verified at T4. Data were statistically analyzed by one-way, two-way ANOVA and Kruskal-Wallis (α = 0.05). RESULTS: TiF increased surface roughness, and no differences between HP and HPT in terms of color and CO 3 2 - $$ {\mathrm{CO}}_3^{2-} $$ - PO 4 3 - $$ {\mathrm{PO}}_4^{3-} $$ mineral content. Ti was detected only on TiF, and slight surface morphology changes were observed in bleached enamel. CONCLUSIONS: The combination of TiF4 and 35% HP did not interfere with the enamel bleaching effect, controlled surface roughness, and kept mineral content but promoted a minor surface morphology alteration. CLINICAL SIGNIFICANCE: Due to the adverse effects of bleaching, titanium tetrafluoride (TiF4) has gained attention for its therapeutic properties, including the ability to reverse mineral loss and neutralize remineralization of mineral structures. Therefore, TiF4's remineralizing capacity may be a good alternative for incorporation into hydrogen peroxide bleaching agents.

RESUMO

Objetivo: avaliar a eficácia preventiva e terapêutica do tetrafluoreto de titânio (TiF4) em ensaios clínicos randomizados (ECR) e não randomizados (N-ECR). Materiais e Métodos: estudos sobre a eficácia do tetrafluoreto de titânio em esmalte e dentina, testado em diferentes veículos e formulações, foram obtidos nas seguintes bases de dados: PubMed, Cochrane Library, Scopus, Web of Science, LILACS/BBO e EMBASE, sem limite de ano de publicação ou idioma. Resultados: seis estudos com abordagem preventiva e terapêutica do TiF4 sobre a superfície dentária foram incluídos. Destes, três ECR e três N-ECR. Por meio da tabulação e categorização dos artigos, notou-se que o TiF4 obteve efeito positivo na prevenção da cárie em três estudos; efeito nulo no tratamento de lesões cariosas em dois; e apenas um estudo apresentou efeito negativo no tratamento da erosão quando comparado aos outros compostos fluoretados. Conclusão: Embora haja estudos na literatura, com distintos delineamentos metodológicos comprovando a eficácia do TiF4, tanto na prevenção quanto no tratamento de lesões de cárie e erosivas, ainda é necessário que mais ensaios clínicos randomizados sejam realizados, com o intuito de validar a eficácia da utilização clínica deste composto fluoretado.

Objective: to analyze the preventive and therapeutic efficacy of titanium tetrafluoride (TiF4) in studies with a methodological design based on randomized clinical trials (RCT) and non-randomized (N-RCT). Materials and Methods: data on the behavior of titanium tetrafluoride in enamel and dentin, tested in several vehicles and formulations, were extracted in the following databases: PubMed, Cochrane Library, Scopus, Web of Science, LILACS/BBO and EMBASE, without limitation of publication year or language. Results: six studies were obtained with preventive and therapeutic approach of TiF4 on the dental surface. Three studies were RCT and three were N-RCT. Through tabulation and categorization of articles, it was noticed that TiF4 showed a positive effect in caries prevention in three studies; a null effect in caries treatment was observed in two; and only one study had a negative effect in erosion treatment when compared to the other fluoridated compounds. Conclusion: Although there are several studies in the literature, with different methodological designs, proving the efficacy of TiF4 both in prevention and in therapeutic treatments of caries and dental erosion, it is still necessary that more clinical controlled studies be conducted, in order to validate the clinical use efficacy of this fluoride compound.

RESUMO

OBJECTIVES: To evaluate the influence of dentin pretreatments on the push-out bond strength (POBS) of self-adhesive resin cements (SARCs) to radicular dentin. MATERIALS AND METHODS: Two experimental pretreatments (2.5% titanium tetrafluoride (TiF4 ) and 26% polyacrylic acid (PA)) and two SARCs: Maxcem Elite (MAX) and Calibra Universal (CAL) were used. For each cement, a control group was applied as indicated by the manufacturer. Sixty bovine incisors were restored (n = 10) and subjected to POBS evaluation. Failure mode, adhesive interface and surface morphology were analyzed by a Scanning Electron Microscopy (SEM) and resin infiltration was performed by confocal laser scanning microscopy (CLSM). Data for POBS and CLSM were analyzed by three-way ANOVA and Bonferroni post-hoc (α = 0.05). RESULTS: For MAX, both experimental pretreatments resulted in increased POBS in the cervical third, and for CAL, only the PA resulted in higher POBS in the cervical third. The most failures occurred between the dentin and the resin cement, except when TiF4 was applied. For PA, analysis of surface morphology showed open dentinal tubules, while TiF4 presented particle agglomerates. SEM and CLSM images confirmed presence of resin tags for both pretreatments. CONCLUSION: Pretreating radicular dentin with PA and TiF4 solutions improves the bond strength of SARCs.

Assuntos

RESUMO

This in vitro study evaluated color change, mineral content, and morphology of enamel, pH and cytotoxicity of experimental bleaching agents containing 35% hydrogen peroxide (HP), titanium tetrafluoride (TiF4), Natrosol, and Chemygel. Sixty enamel/dentin blocks were randomly treated with (n = 10) HP; HP+Natrosol+Chemygel with different TiF4 concentrations: 0.05 g HPT0.5, 0.1 g HPT1, 0.2 g HPT2, 0.3 g HPT3, 0.4 g HPT4. Bleaching was performed in three sessions (3 × 15 min application). Color change (CIELab-ΔEab, CIEDE2000-ΔE00, ΔWID) and Knoop microhardness (KHN) were evaluated. Enamel morphology and composition were observed under scanning electron microscopy and energy-dispersive spectrometry (EDS), respectively. Cell viability of keratinocyte cells was evaluated using MTT assay. Data were analyzed by one-way ANOVA and LSD and Tukey tests, and two-way repeated measures ANOVA and Bonferroni (α = 5%). The pH and EDS were analyzed descriptively. Lightness-L* increased, and a* and b* parameters decreased, except for HPT3 and HPT4 (b*). HPT0.5, HPT1, and HPT2 exhibited ΔEab and ΔWID similar to HP. ΔE00 did not present statistical difference. HP, HPT0.5, and HPT1 promoted higher KHN. HPT0.5 exhibited no changes on enamel surface. Keratinocyte cells were viable when treated with T0.5, and weak viable for T1. Experimental agents exhibited acidic pH and Ti elements. HPT0.5 exhibited bleaching efficacy, maintained KHN without enamel alterations, and did not increase cytotoxicity.

RESUMO

OBJECTIVES: Answer the question: What is the effectiveness of titanium tetrafluoride (TiF4) when compared to other fluorides, placebo solution or a negative control to prevent or treat dental caries and tooth erosion? MATERIALS AND METHODS: This review is in accordance with PRISMA guidelines. In vivo and in situ studies that used TiF4 over enamel or dentine were included. Electronic searches were conducted on MEDLINE, Scopus, Embase, WOS, Cochrane Library, VLH, Clinical Trials and OpenGrey. Risk of bias (ROB) assessments used RoB2 and ROBINS-I for randomized and non-randomized controlled trials (RCTs and on-RCTs); Syrcle's ROB tool for animal studies; and a modified tool proposed by Hollanders for in situ studies. RESULTS: A total of 28 studies met the eligibility criteria. From these, 6 were in humans (3 RCT and 3 Non-RCT); 4 were in animals and 18 were in situ. For in vivo studies, all RCTs have some concerns related to ROB and all of the non-RCT studies were classified as with serious risk. One animal study had a low and three a high ROB. Regarding in situ studies, seven had a low, ten had an average and only one had a high ROB. The certainty of the evidence (GRADE) ranged from moderate to very low. CONCLUSIONS: Although most of the results suggest a positive effect of TiF4 on the prevention and treatment of caries and dental erosion, it is not possible to have definitive conclusions due to the high studies' methodological heterogeneity, and the low quality of evidence for most outcomes. REGISTRATION: The protocol of this syste. atic review was registered in the OPEN SCIENCE FRAMEWORK database (osf.io/6dgs9) DOI:10.17605/OSF.IO/KUZA7 on 6 August 2020.

Assuntos

RESUMO

The aim of this study was to assess the protective effect of experimental solutions containing chitosan at different viscosities with or without fluoride (TiF4 /NaF) on dentin loss in vitro. Bovine dentin samples (n = 15) were prepared and allocated to one of the following treatments: (i) 0.5% chitosan (500 mPas); (ii) 0.5% chitosan (2,000 mPas); (iii) 0.042% NaF and 0.049% TiF4 ; (iv) as (iii) with addition of 0.5% chitosan (500 mPas); (v) as (iii) with addition of 0.5% chitosan (2,000 mPas); (vi) commercial solution with SnCl2 /AmF/NaF (positive control); or (vii) deionized water (negative control). The samples were submitted to pH cycling for 7 d (0.1% citric acid, 4 × 90 s d-1 ). The treatment was applied once a day for 30 s. The dentin loss was quantified using a contact profilometer. Three samples per group were evaluated using scanning electron microscopy. The dentin loss (µm) was submitted to anova and Tukey's test for differences between treatments. Among the treatments tested, only chitosan 500 mPas was able to statistically significantly reduce the dentin loss compared to the negative control, being similar to the positive control. TiF4 /NaF, whether with or without chitosan, had no protective effect. Chitosan 500 mPas and SnCl2 /AmF/NaF solutions have comparable protective effect against dentin erosion in vitro.

Assuntos

RESUMO

The study aimed to apply micro-computed tomography (micro-CT) and transverse microradiography (TMR) to measure dentine demineralization and to test the preventive effect of titanium tetrafluoride (TiF4 ) under microcosm biofilm. Sound dentine specimens from bovine root were treated for 6 h with: (i) 4.0% titanium tetrafluoride (TiF4 ) varnish [pH 1.0, 2.45% fluoride (F-); (ii) 5.42% sodium fluoride (NaF) varnish (pH 5.0, 2.45% F); (iii) 2% chlorhexidine (CHX) gel (pH 7.0); (iv) placebo varnish (pH 5.0); or (v) no agent (untreated). Dentine specimens were then exposed to human saliva mixed with McBain saliva for 8 h. Thereafter, McBain saliva containing 0.2% sucrose was applied daily, for 5 d, onto dentine specimens to stimulate formation of microcosm biofilm. Although a high correlation was found between the results of both methods regarding integrated mineral loss, the results of the methods did not show good agreement in Bland-Altman plots, with significant biases in calculations of lesion depth. Fluoride varnishes were able to reduce dentine demineralization (P < 0.05), while CHX failed to do so. Fluorides are still the best option to reduce dentine demineralization. Micro-CT may be used to measure dentine mineral loss, but not the lesion depth, for which TMR is superior.

Assuntos

RESUMO

OBJECTIVE: The aim of this study was to evaluate microbiological changes, oral soft tissue toxicity, and caries-preventive effect of an experimental titanium tetrafluoride (TiF4) varnish compared with a commercially available fluoride varnish (NaF), using in situ and in vivo models. MATERIALS AND METHODS: The treatment groups were the following: TiF4 varnish (experimental varnish), Duraphat® (fluoride positive control), placebo varnish (no fluoride), and no treatment (negative control). The varnishes were applied once over the enamel surface using a microbrush. For the in vivo study, 48 Wistar rats were infected with Streptococcus sobrinus 6715, received a treatment, and were submitted to a cariogenic challenge. After 4 weeks, S. sobrinus, oral soft tissue toxicity, presence, and severity of caries were evaluated. For the in situ study, 12 volunteers took part in this randomized crossover, double-blind study performed in four phases of 14 days each. They used intraoral appliances containing four enamel specimens that received the varnish according treatment group. After 24 h, the varnish was removed and plaque accumulation was allowed. A 20% sucrose solution was dripped over the enamel blocks (10×/day for 5 min each). Total streptococci, S. mutans, Lactobacillus, Candida spp. counts, and presence of white spot lesions were evaluated. Lesion depth was also quantified by micro-CT. RESULTS: For the in vivo study, the fluoride (F-varnishes) showed a statistically significant reduction in the percentage of S. sobrinus compared to the negative control (p < 0.05). Toxicological analysis revealed no abnormalities in oral tissues of rats from all groups, and both F-varnishes reduced the number and severity of caries lesions, without significant differences (p < 0.05). No statistical differences in microbiological counts were seen for the in situ experiment (p > 0.05). However, the specimens treated with TiF4 exhibited lower percentage of white spot lesions and the lesion depth was significantly reduced by F-varnishes (p < 0.05). CONCLUSIONS: F-varnishes showed reduction in the percentage of S. sobrinus in vivo, no oral soft tissue toxicity, and a caries-preventive effect in vivo and in situ. CLINICAL RELEVANCE: NaF varnish is largely used due its capacity to form CaF2-like layer on enamel. Therefore, development of studies focused on other fluoride compounds such as a TiF4 varnish, which may have greater efficacy than NaF against tooth demineralization, is important.

Assuntos

RESUMO

This in situ study evaluated the tubular occlusion caused by 4% TiF4 gel on the surface of eroded/abraded dentin. Sixty human dentin samples were eroded in vitro and assigned into six groups (n = 10) according to the in situ surface treatment and number of cycling days: 4% TiF4 gel applied once (TiF4 1), twice (TiF4 2), or three times (TiF4 3) followed by 2, 4, and 6 days of erosive/abrasive in situ cycling, respectively. Control groups (no treatment) were subjected to 2 (C1), 4 (C2), and 6 (C3) days of erosive/abrasive in situ cycling only. A seventh group (n = 10) was comprised by in vitro uneroded samples (UN), subjected to 6 days of in situ erosive/abrasive cycling. Each cycling day consisted on six erosive (0.5% citric acid, pH 2.6) and one abrasive events. Environmental scanning electron microscopy micrographs were taken. For all groups, blinded examiners assessed dentin tubules occlusion using visual scores (0-unoccluded, 1-partially occluded by granular deposits, 2-partially occluded by reduction in tubular lumen into diamond shape, 3-completely occluded) on images captured prior and after the in situ phase. Scheirer-Ray-Hare test demonstrated that treatments significantly affected tubule occlusion (p < .001). Dunn's test showed that tubule occlusion in TiF4 3 was significantly higher than in C1. Tubule occlusion in remaining groups did not differ from that observed in groups TiF4 3 and C1. Tubule occlusion was significantly higher after in situ phase. It may be suggested that TiF4 , when applied three times, was able to positively change tubule occlusion of dentin samples.

Assuntos

RESUMO

OBJECTIVES: The objective of this study was to evaluate the inhibition of demineralization around enamel-dentin/restoration interface after dentin pretreatment with 2.5% titanium tetrafluoride (TiF4). MATERIALS AND METHODS: Forty dental class V cavities at the cementoenamel junction were distributed into four groups (n = 10), according to the presence or absence of TiF4 and to the adhesive system (Clearfil SE Bond/CL and Adper EasyOne/AD), and restored with a resin composite. A dynamic pH cycling model was used to induce the development of artificial caries lesions. After sectioning the dental blocks, Knoop microhardness tests were performed at different depths (20, 40, and 60 µm from the occlusal margin of the restoration) and at different distances (100, 200, and 300 µm from the adhesive interface). Repeated measures three-way analysis of variance (ANOVA) and Tukey's test were used (α = 0.05). RESULTS: For enamel, there were no differences in the microhardness values for CL, AD, and TiF4-AD at depths, regardless of the distances. Considering each depth, there were no significant differences among treatments. For dentin, ANOVA showed no significant interaction among the independent variables treatment*distance*depth (p = 0.994), no significant interaction between treatment*depth (p = 0.722), no significant interaction between treatment*distance (p = 0.265), no significant interaction between depth*distance (p = 0.365), and no significant effect on treatment (p = 0.151), depth (p = 0.067), or distance (p = 0.251). CONCLUSIONS: Dentin pretreatment of the cavity walls with TiF4 before self-etching adhesive systems was not effective in inhibiting demineralization around the enamel-dentin/restoration interfaces. CLINICAL RELEVANCE: The mechanism of incorporating fluoride in enamel and dentin of the cavity walls to inhibit demineralization around restorations seems ineffective when using TiF4 as a dentin pretreatment.

Assuntos

RESUMO

OBJECTIVES: This study evaluated the bond strength of a two-step conventional adhesive system to dentin pretreated with 2.5 % titanium tetrafluoride (TiF(4)) according to application timing (before or after acid conditioning) and primer/adhesive application method (active or passive). MATERIALS AND METHODS: Dentin surfaces were randomly treated with different adhesive procedures (n = 6): etching with phosphoric acid (PA) + primer/adhesive (Adper Single Bond 2/3M ESPE) actively applied; PA + primer/adhesive passively applied; TiF(4) before PA + primer/adhesive actively applied; TiF(4) before PA + primer/adhesive passively applied; TiF(4) after PA + primer/adhesive actively applied; and TiF(4) after PA + primer/adhesive passively applied. A composite block was built onto the tooth, which was sectioned into sticks (adhesive area of approximately 1 mm(2)). Microtensile bond strength tests and the failure mode were determined. RESULTS: Two-way ANOVA revealed no significant interaction between TiF(4) application timing and primer/adhesive application method (p = 0.184). The use of TiF(4), before or after PA significantly increased bond strength values (p < 0.001). There was no significant difference in bond strength values when using TiF4 before or after PA. The primer/adhesive application method had no influence on bond strength, regardless of whether TiF(4) was used (p = 0.906). Failure mode was predominantly adhesive. CONCLUSIONS: The use of TiF(4) promoted higher immediate bond strength to dentin. The conventional adhesive system may be applied either actively or passively, regardless of TiF(4) application timing. CLINICAL SIGNIFICANCE: Pretreatment with TiF(4) increased bond strength in a conventional two-step adhesive system to dentin, regardless of the primer/adhesive application method and the timing of dentin pretreatment.

Assuntos

RESUMO

The aim was to assess the nanohardness (H) and the reduced modulus of elasticity (Er ) of 2.5% titanium tetrafluoride (TiF4 ) modified dentin, before and after an erosive challenge with 0.3% citric acid (CA). Exposed dentin surfaces were divided into two groups (n = 5): (1) Control-no dentin pretreatment with TiF4 prior to etching with CA, and (2) Experimental-dentin pretreatment with TiF4 + CA. The H and the Er of intertubular dentin were measured using a triboindenter at different time points: baseline for both groups, after using 2.5% TiF4 for the experimental group, and after using CA for both the experimental and the control groups. Scanning electron microscope and energy dispersive X-ray spectroscopy (EDS) analysis of the dentin surfaces were undertaken at the same time points for both groups. Two-way ANOVA for randomized block design was applied. There was significant interaction between the application of the TiF4 solution and different time points (p = 0.001 for H and p < 0.001 for Er ), identified by Tukey's test. Erosive challenge provided a significant decrease in H and Er mean values. The TiF4 solution caused a significant increase in H and Er values, but no significant differences were found between post-TiF4 and post-CA application. TiF4 application produced a precipitate surface layer on intertubular and intratubular dentin. EDS analysis indicated the presence of titanium. The H and Er of the dentin surface were greatly increased after application of 2.5% TiF4 . TiF4 may modify the micromorphology of the dentin surface and produces an erosive resistance surface.

Assuntos

RESUMO

OBJECTIVE: This study analysed the anti-erosive effect of experimental solutions containing TiF4 and NaF. METHODS: Bovine enamel samples (n=15) were treated with: (1) commercial solution with SnCl2/NaF (Erosion Protection(®)); (2) experimental solution with 0.0815% TiF4; (3) 0.105% NaF; (4) 0.042% NaF + 0.049% TiF4; (5) 0.063% NaF + 0.036% TiF4 or (6) control. The samples were submitted to pH cycles and daily fluoride applications for seven days. The enamel wear was measured using a contact profilometer and analysed by ANOVA (p < 0.05). RESULTS: The best anti-erosive effect was found for experimental solution with 0.0815% TiF4 (99% reduction in enamel wear), followed by SnCl2/NaF (78%) and 0.049% TiF4 + 0.042% NaF solution (41%). CONCLUSIONS: The experimental solution containing a specific combination of TiF4 + NaF has the ability to partially reduce enamel erosion.

Assuntos

RESUMO

Fluoride varnishes play an important role in the prevention of dental caries, promoting the inhibition of demineralization and the increase of remineralization. Objective: This study aimed to analyze the amount of fluoride released into water and artificial saliva from experimental TiF4 and NaF varnishes, with different concentrations, for 12 h. Material and Methods: Fluoride varnishes were applied on acrylic blocks and then immersed in 10 ml of deionized water and artificial saliva in polystyrene bottles. The acrylic blocks were divided in seven groups (n=10): 1.55% TiF4 varnish (0.95% F, pH 1.0); 3.10% TiF4 varnish (1.90% F, pH 1.0); 3.10% and 4% TiF4 varnish (2.45% F, pH 1.0); 2.10% NaF varnish (0.95% F, pH 5.0); 4.20% NaF varnish (1.90% F, pH 5.0); 5.42% NaF varnish (2.45% F, pH 5.0) and control (no treatment, n=5). The fluoride release was analyzed after 1/2, 1, 3, 6, 9 and 12 h of exposure. The analysis was performed using an ion-specific electrode coupled to a potentiometer. Two-way ANOVA and Bonferroni's test were applied for the statistical analysis (p<0.05). Results: TiF4 varnishes released larger amounts of fluoride than NaF varnishes during the first 1/2 h, regardless of their concentration; 4% TiF4 varnish released more fluoride than NaF varnishes for the first 6 h. The peak of fluoride release occurred at 3 h. There was a better dose-response relationship among the varnishes exposed to water than to artificial saliva. Conclusions: The 3.10% and 4% TiF4 -based varnishes have greater ability to release fluoride into water and artificial saliva compared to NaF varnish; however, more studies must be conducted to elucidate the mechanism of action of TiF4 varnish on tooth surface. .

Assuntos

RESUMO

This in situ/ex vivo study assessed the effect of titanium tetrafluoride (TiF4) solution on erosion of permanent (P) and deciduous (d) human enamel. Ten volunteers wore acrylic palatal appliances containing 4 enamel samples, divided into two rows: TiF4 and no - TiF4 (control). Each row contained one deciduous and one permanent enamel sample. During the 1st day, formation of a salivary pellicle was allowed. At the 2nd day, the 4 percent TiF4 solution was applied on one row (TiF4), while the other row remained untreated (control). From the 3rd until the 7th day, the samples were subjected to erosion by immersion in a cola drink for 5 min, 4 times/day. Enamel alterations were determined by microhardness testing ( percentSMHC). Data were analyzed using 2 two-way ANOVA and Tukey's post hoc test (α=0.05). The mean percentSMHC (±SD) amounted to: P (TiF4 - 73.32 ± 5.16 and control - 83.49 ± 4.59) and d (TiF4 - 83.01 ± 7.41 and control - 75.75 ± 2.57). In conclusion, the application of 4 percent TiF4 solution reduced the softening of permanent enamel but not of deciduous enamel significantly. However, no significant differences were detected between the permanent and deciduous enamel when the factor substrate was considered.

Assuntos