Erosion protection benefits of stabilized SnF2 dentifrice versus an arginine–sodium monofluorophosphate dentifrice: results from in vitro and in situ clinical studies

Abstract

ObjectivesThe aim of these investigations was to assess the ability of two fluoride dentifrices to protect against the initiation and progression of dental erosion using a predictive in vitro erosion cycling model and a human in situ erosion prevention clinical trial for verification of effectiveness.Materials and methodsA stabilized stannous fluoride (SnF2) dentifrice (0.454 % SnF2 + 0.077 % sodium fluoride [NaF]; total F = 1450 ppm F) [dentifrice A] and a sodium monofluorophosphate [SMFP]/arginine dentifrice (1.1 % SMFP + 1.5 % arginine; total F = 1450 ppm F) [dentifrice B] were tested in a 5-day in vitro erosion cycling model and a 10-day randomized, controlled, double-blind, two-treatment, four-period crossover in situ clinical trial. In each study, human enamel specimens were exposed to repetitive product treatments using a standardized dilution of test products followed by erosive acid challenges in a systematic fashion.ResultsBoth studies demonstrated statistically significant differences between the two products, with dentifrice A providing significantly better enamel protection in each study. In vitro, dentifrice A provided a 75.8 % benefit over dentifrice B (p < 0.05, ANOVA), while after 10 days in the in situ model, dentifrice A provided 93.9 % greater protection versus dentifrice B (p < 0.0001, general linear mixed model).ConclusionThese results support the superiority of stabilized SnF2 dentifrices for protecting human teeth against the initiation and progression of dental erosion.Clinical relevanceStabilized SnF2 dentifrices may provide more significant benefits to consumers than conventional fluoride dentifrices.

Randomized in situ clinical trial evaluating erosion protection efficacy of a 0.454% stannous fluoride dentifrice

“…This study, using 10‐day treatment periods, demonstrated a significant erosion protection benefit of 93.5% for the multi‐benefit, 1100 ppm fluoride, high bioavailable stabilized stannous fluoride dentifrice compared to the triclosan‐containing dentifrice formulated with 1100 ppm fluoride as NaF. These results are consistent with other in situ clinical studies in the literature that have similarly demonstrated enhanced erosion protection, ranging from 27% to 94%, delivered from stabilized stannous fluoride dentifrices compared to other dentifrices that are not formulated with this ingredient . For example, a similar study by West et al found 68% greater erosion protection for a 0.454% stannous fluoride plus 0.077% sodium fluoride (1450 ppm fluoride) dentifrice marketed in the United Kingdom compared to a 1450 ppm fluoride NaF/triclosan dentifrice after 15 days of treatment and a 67% benefit after 10 treatment days.…”

“…These results are consistent with other in situ clinical studies in the literature that have similarly demonstrated enhanced erosion protection, ranging from 27% to 94%, delivered from stabilized stannous fluoride dentifrices compared to other dentifrices that are not formulated with this ingredient. [19][20][21][22][23][24] For example, a similar study by West et al 19 found 68% greater erosion protection for a 0.454% stannous fluoride plus 0.077% sodium fluoride (1450 ppm fluoride) dentifrice marketed in the United Kingdom compared to a 1450 ppm fluoride NaF/triclosan dentifrice after 15 days of treatment and a 67% benefit after 10 treatment days. These study results are also consistent with recommendations from professional groups and organizations.…”

“…While some fluoride sources have been shown to provide a limited level of erosion protection, stannous fluoride, a multi‐benefit active used in some toothpastes, has been shown to provide significant anti‐erosion benefits in various types of laboratory studies . There is a growing body of in situ evidence to support the claim that the use of stabilized stannous fluoride dentifrice is an effective means to help control both the initiation and progression of dental erosion in vivo …”

“…[15][16][17][18] There is a growing body of in situ evidence to support the claim that the use of stabilized stannous fluoride dentifrice is an effective means to help control both the initiation and progression of dental erosion in vivo. [19][20][21][22][23][24] The study reported here was the first to evaluate a high bioavailable 1100 ppm fluoride stabilized stannous fluoride dentifrice relative to a marketed 1100 ppm fluoride triclosan dentifrice control for erosion protection efficacy using an in situ erosion model with 10-day treatment periods.…”

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

“…The most common fluoride sources for modern toothpastes are sodium fluoride (NaF) and stannous fluoride (SnF 2 ), with some studies suggesting that stabilised SnF 2 offers greater protection against dental erosion than other fluoride compounds [11][12][13][14]. The formulation of a toothpaste has been shown to have the potential to influence fluoride's ability to protect against dental erosion; in situ studies have indicated that some non-fluoride ingredients in a toothpaste formulation, such as zinc ions, sodium hexametaphosphate and sodium phytate, may modulate the effects of fluoride on remineralisation-demineralisation [6,[15][16][17].…”