In vitro Reduction of Dental Erosion by Low-Concentration TiF₄ Solutions

Abstract

The aims of this study were to compare daily versus single applications of low-concentration TiF₄ solutions for reduction of enamel erosion and to evaluate the enamel surface loss due to application of these solutions. Sixty bovine enamel samples were randomly divided into 2 groups: single versus daily treatment with TiF₄ solution (ST vs. DT), which were subdivided into 5 subgroups (n = 6): 0% (control); 0.1, 0.5, 0.75 and 1% TiF₄ concentration. Fluoride treatment was performed by immersing specimens in 10 ml of the TiF₄ solutions for 5 min and rinsing them with tap water for 30 s. ST specimens were treated once only, DT specimens were treated before each erosion cycle. All specimens were subjected to 4 erosion cycles: 6 immersions of 2 min in Sprite, tap water rinse for 1 min and storage in artificial saliva for 1.5 h. Erosive enamel loss was measured using light profilometry, after each fluoride treatment and each erosive cycle. The values of surface loss/gain at application of the TiF₄ solutions did not significantly differ from zero. At the end of the 4 erosion cycles, 0.5% showed the least (ST: 3.45 ± 0.27 µm, DT: 1.08 ± 1.69 µm) and 1% showed the most surface loss (ST: 4.87 ± 1.13 µm, DT: 6.56 ± 1.49 µm). A significant reduction of surface loss was found only for 0.5% DT (p = 0.009). Within the limitations of an in vitro study, it was concluded that multiple applications of a 0.5% TiF₄ solution significantly reduced enamel erosion in vitro and caused no enamel loss at application.

Mechanism of Action of TiF₄ on Dental Enamel Surface: SEM/EDX, KOH-Soluble F, and X-Ray Diffraction Analysis

“…The authors showed no difference between sound and demineralised human permanent enamel regarding titanium penetration [Chevitarese et al, 2004]. NaF-treated samples did not show any morphological change and significant fluoride deposition (EDX) compared to control, which may support its low protective effect compared to TiF 4 in vitro and in situ, as previously discussed [Magalhães et al, 2008a;2008b;Vieira et al, 2011;Comar et al, 2012;Stenhagen et al, 2013;Castilho et al, 2015]. The reason for the differences found between NaF and TiF 4 in respect to F deposition on enamel may be due to the pH values, since the fluoride content was similar in both varnishes.…”

“…Most laboratorial studies comparing TiF 4 and NaF were conducted using bovine enamel [Vieira et al, 2011;Comar et al, 2012;Souza et al, 2014]; few studies have been done with human permanent enamel [Hove et al, 2007;Levy et al, 2012;Stenhagen et al, 2013]. Considering the KOH-soluble F deposition, once again the protective effect of TiF 4 compared to NaF seems to decrease when human permanent enamel is compared to bovine enamel, which should be taken in account when the data are interpreted and applied for planning clinical trials.…”

“…There are many in vitro and in situ studies showing the superiority of TiF 4 (0.1-4%) compared to NaF against dental erosion and caries [Magalhães et al, 2008a, b;Wiegand et al, 2010a;Vieira et al, 2011;Comar et al, 2012;Stenhagen et al, 2013;Souza et al, 2014;Castilho et al, 2015].…”

Effect of a Single Application of TiF₄ Varnish versus Daily Use of a Low-Concentrated TiF₄/NaF Solution on Tooth Erosion Prevention in vitro

“…The mechanism behind the preventive effect of TiF 4 against tooth demineralization is the formation of a glazelike layer rich in Ti and F [Gu et al, 1996;Magalhães et al, 2008], which is influenced by the pH of the agent and the F concentration [Hove et al, 2008[Hove et al, , 2011Wiegand et al, 2009;Vieira et al, 2011]. In contrast to the CaF 2 -like layers, the titanium-rich deposits on enamel are acid resistant, leading to an increase in efficacy compared to NaF [Magalhães et al, 2011].…”

“…Generally, good results have been seen using TiF 4 solutions and varnishes against tooth erosion and abrasion in vitro and in situ [Hove et al, 2006[Hove et al, , 2008[Hove et al, , 2011Magalhães et al 2008;Wiegand et al, 2010;Vieira et al, 2011;Levy et al, 2012;Souza et al, 2014]. However, most studies tested the effect of products containing a high TiF 4 concentration (4% TiF 4 , 24,500 ppm F) suitable for professional application only.…”