Although several studies have demonstrated the efficacy of AmF/NaF/SnCl₂ solution in inhibiting dental erosion progression, measures for further improvement in its effectiveness are paramount. Thus, this in situ study evaluated whether the protective effect promoted by the AmF/NaF/SnCl₂ solution would be enhanced by increasing its frequency of use. The study was conducted with 12 volunteers, a 4-phase (5 days each) randomized, crossover model. Extraoral erosive challenges (0.5% citric acid, pH 2.6, 6 × 2 min/day) and rinsing protocol (1 or 2 × 2 min/day) were performed. Before the in situ phase, human enamel samples were subjected to an in vitro surface softening (1% citric acid, pH 4.0, for 3 min). Four treatment protocols were tested using samples in replicas (n = 12): group G1 - deionized water (negative control); G2 - NaF solution (positive control, 500 ppm F^-, pH 4.5); G3 - AmF/NaF/SnCl₂ solution (500 ppm F^-, 800 ppm Sn²⁺, pH 4.5) once a day; G4 - AmF/NaF/SnCl₂ solution twice a day. Tissue loss and morphological changes were determined by optical profilometry (n = 12) and scanning electron microscopy (n = 3) analysis, respectively. Data were statistically analyzed by ANOVA with subsequent pairwise comparison of treatments. Tissue loss means (±SD in µm) for each treatment protocol and statistical differences were found as follows: G1 4.55 ± 2.75, G2 4.59 ± 2.13, G3 2.64 ± 1.55, and G4 1.34 ± 1.16. Although there was no difference between the 2 AmF/NaF/SnCl₂ solution application regimens (once or twice a day), application of the product twice a day was the only treatment that was able to control erosion progression, differing from the control groups.

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Erosion incidence is increasing and its control is still a challenge in clinical practice. This study evaluated 4% TiF 4 -gel effects on eroded human dentin subjected to in situ erosive/ abrasive episodes. Seventy-two previously eroded dentin slabs (0.05 M citric acid, pH 2.3, 20 min) were allocated to 6 groups (n=12) according to the treatment to be performed during the in situ phase and number of erosive/abrasive cycles, as follows: 4% TiF 4 -gel applied once (TiF 4 1), twice (TiF 4 2) or three times (TiF 4 3) followed by 1, 2 and 3 erosive/ abrasive cycles, respectively. Gel was applied before the beginning of the next cycle. Control groups were subjected to 1 (C1), 2 (C2) and 3 (C3) erosive/abrasive cycles only. A seventh group (n=12) comprised in vitro uneroded samples (UN) subjected to 3 erosive/ abrasive cycles. Each cycle corresponded to 2 days of erosive (citric acid 0.5%, pH 2.6, 6x/day) and abrasive (electric toothbrush, 10 s/sample, 1 x/day) challenges. Samples were evaluated under profilometry and environmental scanning electron microscopy (ESEM). Atomic force microscopy images (AFM) were also made (n=3). Repeated measures 2-way ANOVA and Tukey test (p<0.001) showed that TiF 4 2, which did not differ from TiF 4 1 and TiF 4 3, revealed a significant reduction in surface loss compared to all control groups. TiF 4 1 and TiF 4 3 showed no significant difference from C1, but both groups demonstrated significantly smaller surface loss than C2 and C3. ESEM and AFM micrographs suggested alterations on treated surfaces compared to samples from control groups, showing reduced diameters of dentinal tubules lumens. Therefore, TiF 4 was able to reduce the progression of erosive/abrasive lesions.

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