Mechanistic Observations on the Role of the Stannous Ion in Caries Lesion De- and Remineralization

Lippert, Frank

doi:10.1159/000446849

Cited by 13 publications

(27 citation statements)

References 24 publications

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“…The low uptake of fluoride from the reference SnF 2 -Zn toothpaste, and absence of rehardening over-andabove the placebo in this type of model, is consistent with in vitro observations that stannous ions can inhibit enamel remineralisation [26,27]. The relatively high resistance to acid, in spite of the low fluoride uptake, also suggests stannous ions inhibited enamel demineralisation, in addition to the inhibition provided by fluoride in this study [11][12][13][14].…”

Section: Discussionsupporting

confidence: 89%

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

Creeth¹,

Burnett²,

Souverain³

et al. 2020

BMC Oral Health

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Background: A novel sodium fluoride toothpaste containing lactate ion and polyvinylmethylether-maleic anhydride has been developed to promote enamel remineralisation and resistance to demineralisation. In this in situ study, we compared this toothpaste ('Test') with a stannous fluoride-zinc citrate (SnF 2-Zn) toothpaste ('Reference') (both 1100-1150 ppm fluoride) and a fluoride-free toothpaste ('Placebo') using an enamel dental erosion-rehardening model. Methods: In each phase of this randomised, investigator-blind, crossover study, participants wore palatal appliances holding bovine enamel specimens with erosive lesions. They brushed their natural teeth with either the Test, Reference or Placebo toothpastes, then swished the resultant slurry. Specimens were removed at 2 h and 4 h postbrushing and exposed to an in vitro acid challenge. Surface microhardness was measured at each stage; enamel fluoride uptake was measured after in situ rehardening. Surface microhardness recovery, relative erosion resistance, enamel fluoride uptake and acid resistance ratio were calculated at both timepoints. Results: Sixty two randomised participants completed the study. Test toothpaste treatment yielded significantly greater surface microhardness recovery, relative erosion resistance and enamel fluoride uptake values than either Reference or Placebo toothpastes after 2 and 4 h. The acid resistance ratio value for Test toothpaste was significantly greater than either of the other treatments after 2 h; after 4 h, it was significantly greater versus Placebo only. No treatment-related adverse events were reported. Conclusions: In this in situ model, the novel-formulation sodium fluoride toothpaste enhanced enamel rehardening and overall protection against demineralisation compared with a fluoride-free toothpaste and a marketed SnF 2-Zn toothpaste. Trial registration: ClinicalTrials.gov; NCT03296072; registered September 28, 2017.

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Section: Discussionsupporting

confidence: 89%

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

Creeth¹,

Burnett²,

Souverain³

et al. 2020

BMC Oral Health

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“…Recent laboratory data suggest that current SnF 2 formulations have a superior anticaries effect (by preventing enamel demineralization) in the presence of cariogenic biofilms (Fernández et al 2016). Tin also seems to provide acid resistance by precipitating on the tooth surface and creating a diffusion barrier, but to some extent this barrier might also interfere with remineralization (Lippert 2016). Complete understanding on the mechanism of action of SnF 2 remains elusive.…”

Section: Introductionmentioning

confidence: 99%

Recent Advances in Remineralization Therapies for Caries Lesions

González-Cabezas

Fernández

2018

Adv Dent Res.

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Remineralization of caries lesions is naturally achieved by salivary ions, and it can be enhanced by external factors or elements such as fluoride. Numerous studies have demonstrated the remineralizing efficacy of fluoride therapies as well as the limitations with some groups of the population. Consequently, developing new remineralization therapies to close this gap in efficacy has been a priority for the last 2 decades. In this review, we summarize and briefly discuss some of the latest advances in remineralization therapies. Most new therapies try to enhance the effect of fluoride by adding other potentially active ingredients to the formulation, such as calcium, phosphate, stannous, xylitol, and arginine. Other remineralization strategies have focused on creating remineralizing scaffolds within the lesions (e.g., self-assembling peptides). While several of the new remineralization strategies have progressed significantly in recent years, for most of them, the evidence is still insufficient to assess their true clinical potential.

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“…It is therefore reasonable to assume that the measured differences in fluoride uptake and any ensuing benefits must be related to the presence of ingredients which either restrict or promote F uptake or to mechanistic differences in the delivery of free fluoride ion from solution to the enamel surface. With the exception of NaF/CL, all other commercial dentifrice formulations contained ingredients which have been found to either limit fluoride uptake, remineralisation or both, that is, sodium lauryl sulfate – SLS 14 , polyphosphates 40–42 and polyvalent metal ions 17,43,44 . The inhibitory effects displayed by these agents are believed to be related to their affinity for enamel surfaces.…”

Section: Discussionmentioning

confidence: 99%

“…A significant challenge arises when the purpose of the investigation is to monitor chemical compositional changes of remineralised lesions, because the remineralising agents (i.e., calcium and phosphate) are chemically indistinguishable from the enamel substrate. In order to overcome this challenge, 44 Ca-labelling of calcium phosphate in a dentifrice has been used to successfully demonstrate uptake of 'new' calcium into demineralised enamel. 32 In more recent remineralisation studies, the present authors have used isotopically enhanced calcium chloride containing 97% 44 Ca in the remineralising artificial saliva medium.…”

Section: Introductionmentioning

confidence: 99%

“…In order to overcome this challenge, 44 Ca-labelling of calcium phosphate in a dentifrice has been used to successfully demonstrate uptake of 'new' calcium into demineralised enamel. 32 In more recent remineralisation studies, the present authors have used isotopically enhanced calcium chloride containing 97% 44 Ca in the remineralising artificial saliva medium. 33 Measurement of the cross-sectional distribution of calcium isotopes (e.g., 42 Ca, 44 Ca) by DSIMS imaging, following treatment of enamel with 44 Ca-labelled artificial saliva, provides clear distinction between 'original' calcium and 'new' calcium.…”

Section: Introductionmentioning

confidence: 99%

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The effect of dentifrice ingredients on enamel erosion prevention and repair

Fowler

Creeth

Paul

et al. 2021

Surface & Interface Analysis

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Fluoride is a key dentifrice ingredient for mitigating dental erosion and promoting remineralisation in tooth enamel. A dentifrice formulation (NaF/CL ‐ where C = Copolymer, L = Lactate), optimised for fluoride delivery, containing sodium fluoride, polyvinylmethylether–maleic anhydride (PVM/MA) copolymer and lactate ion at controlled pH of 6.2 is compared with six commercial dentifrices from European and US regulatory regions. The in vitro study utilised white light interferometry (WLI) and dynamic secondary ion mass spectrometry (DSIMS) to assess dental erosion resistance and remineralisation potential of the dentifrices. For WLI, polished enamel samples were immersed in dentifrice slurry (1:3 wt./wt. in artificial saliva, 2 min), brushed, washed in deionised water, acid challenged (1% citric acid, pH 3.8, 5 min), washed and air dried. Surface roughness and bulk tissue loss were measured. DSIMS samples for fluoride uptake were acid challenged (1% citric acid, pH 3.8, 5 min), rinsed, immersed in dentifrice slurry (1:3 wt./wt. in artificial saliva, 2 min), washed and air dried. DSIMS samples for 44Ca uptake were prepared similarly but with 44Ca‐doped artificial saliva. The NaF/CL dentifrice provided highest protection against dental erosion, with highest fluoride and 44Ca uptake in all treatment groups (n = 5 per group). Dentifrices containing other fluoride salts and/or ingredients known to inhibit fluoride uptake (e.g., polyphosphates, sodium lauryl sulfate), performed significantly worse.

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Mechanistic Observations on the Role of the Stannous Ion in Caries Lesion De- and Remineralization

Cited by 13 publications

References 24 publications

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

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

Recent Advances in Remineralization Therapies for Caries Lesions

The effect of dentifrice ingredients on enamel erosion prevention and repair

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