Remineralization of eroded enamel by a NaF rinse containing a novel calcium phosphate agent in an in situ model: a pilot study

Abstract

PurposeAn in situ study evaluated the remineralization potential of 225 ppm fluoride (F) rinses with and without a calcium phosphate agent (TCP-Si-Ur) on eroded enamel.Methods20 human patients participated in this IRB approved study. Enamel blocks extracted from 20 human molars were assigned to each of the three study phases (G1, G2, G3). Each block was eroded using 1% citric acid (pH = 2.5), with a slice cut from each block to establish baseline lesion parameters (ie, integrated mineral loss ΔZ, and lesion depth LD) using transverse microradiography (TMR). Participants and assigned blocks were randomly divided into three 28-day phases. The blocks were mounted into modified orthodontic brackets and bonded to the buccal surface of one of the subject’s mandibular molars. The appliance remained in the subject’s mouth for 28 days. Prior to each study phase, participants observed a one-week-washout period using a fluoride-free dentifrice. In each phase, participants brushed with the fluoride-free dentifrice for 1 min, followed by one of the following coded treatments: G1: 225 ppm F + 40 ppm TCP-Si-Ur rinse (1 min); G2: 225 ppm F rinse (1 min); G3: no rinse (saliva-only). After each phase, appliances were removed and specimens were analyzed using TMR.ResultsTMR data (ie, ΔZ and LD) revealed all three groups significantly remineralized eroded enamel (paired t-tests, P < 0.001). Net mineralization (% change in ΔZ, LD) were as follows (mean (std.dev): G1: 44.1 (22.6), 30.5 (27.0); G2: 30.0 (7.4), 29.4 (10.5); G3: 23.8 (16.4), 25.7 (15.5). Furthermore, G1 was found to cause significantly more remineralization than G2 (P = 0.039) and G3, (P = 0.002).ConclusionMouthrinse containing 225 ppm F plus TCP-Si-Ur provided significantly greater remineralization relative to 225 ppm F only or saliva alone.

Overview of Calcium Phosphates used in Biomimetic Oral Care

“…When the toothpaste or varnish is applied intraorally, saliva degrades the protective coating, releasing calcium at the tooth surface, resulting in high fluoride and calcium ions bioavailability on the lesion surface, and subsequent diffusion into the lesion to promote remineralization. The ƒTCP technology has been investigated in mouthrinse and toothpaste tailored for in situ remineralization of dental caries [ 67 ] and acid erosion [ 68 , 69 ].…”

Effect of different salivary exposure times on the rehardening of acid-softened enamel

“…In situ models offer the advantage of allowing a controlled erosive challenge and expose specimens to the oral environment. 7,8 Nevertheless, in situ studies that consider saliva a remineralizing agent do not specify the time required for remineralization to occur in order to simulate clinical conditions. While some studies recommend the continuous use of intraoral appliances, which are removed from the oral cavity only for eating and for oral hygiene, 9 other studies establish the use of intraoral devices only during the day.…”

Evaluation of efficacy of various remineralizing agents on artificially demineralized human enamel – An in-vitro study

“…This makes calcium, fluoride and phosphate available in an aqueous form which enables remineralization process. 17 In group III (CSPS), Biomin Restore tooth paste was used which contains Calcium sodium phosphosilicate (Bioactive glass). It is a biocompatible material which was developed as bone regenerative material initially.…”

“…It provides freely available calcium and phosphate ions at concentrations significantly higher than those normally present in the saliva at pH values found in the oral cavity. [18][19][20][21] CSP acts as a cariostatic agent through different mechanisms and prevents development of WSLs.…”