Remineralizing Potential of a Low Fluoride Toothpaste with Sodium Trimetaphosphate: An in situ Study

Abstract

Objective: To evaluate the effect of a low-fluoride (F) toothpaste supplemented with sodium trimetaphosphate (TMP) on enamel remineralization in situ. Design: Bovine enamel blocks were selected on the basis of their surface hardness (SH) after caries-like lesions had been induced, and randomly divided into 4 treatment groups, according to the toothpastes used: without F or TMP (placebo); 500 ppm F; 500 ppm F plus 1% TMP; and 1,100 ppm F. The study design was blinded and crossover and performed in 4 phases of 3 days each. Eleven subjects used palatal appliances containing 4 bovine enamel blocks which were treated 3 times per day during 1 min each time, with natural slurries of saliva and toothpaste formed in the oral cavity during toothbrushing. After each phase, the percentages of surface (%SH_R) and subsurface hardness recovery (%ΔKHN_R) were calculated. F, calcium (Ca), and phosphorus (Pi) contents in enamel were also determined. Data were analyzed by 1-way, repeated-measures ANOVA, followed by the Student-Newman-Keuls test (p < 0.05). Results: Toothpaste with 500 ppm F + TMP and 1,100 ppm F showed similar %SH_R and %ΔKHN_R as well as enamel F, Ca, and Pi concentrations. Conclusion: The addition of TMP to a low-fluoride toothpaste promoted a similar remineralizing capacity to that of a standard (1,100 ppm F) toothpaste in situ.

State of the Art Enamel Remineralization Systems: The Next Frontier in Caries Management

“…One way to reduce the potential risk of fluorosis while maintaining the anticaries efficacy of conventional dentifrices is to partly replace fluoride with polyphosphate salts like sodium trimetaphosphate (STMP), calcium glycerophosphate, or hexametaphosphate [da Camara et al, 2016;Takeshita et al, 2016;Zaze et al, 2014]. Among the polyphosphates, STMP is seen to be the most effective anticaries agent with an ability to not only inhibit demineralization, but also to enhance remineralization [Freire et al, 2016;Takeshita et al, 2011].…”

“…The protective barrier against acid diffusion created by the adsorption of STMP on enamel does not seem to hinder the diffusion of Ca 2+ and F -ions into the enamel. In situ models have shown that supplementation of a low-fluoride product with STMP produced similar remineralization effects to a 1,100-ppm fluoride formulation Takeshita et al, 2016], while the addition of STPM to conventional fluoride dentifrices and varnishes significantly enhanced their remineralization of artificial caries lesions Manarelli et al, 2015].…”

Remineralization Efficacy of an Amelogenin-Based Synthetic Peptide on Carious Lesions

“…Remineralization is believed to occur by the transfer of mineral ions, such as calcium and phosphate, from saliva, plaque fluid, or an external source to the surface of solid-state mineral, therefore promoting ion deposition into crystal voids caused by demineralization ( Elkassas and Arafa, 2014 ). Various modalities of fluoride ( Brighenti et al, 2006 ; Majithia et al, 2016 ), casein phosphopeptides and amorphous calcium phosphate (ACP) ( Poggio et al, 2013 ; Gupta et al, 2016 ), sodium trimetaphosphate ( Takeshita et al, 2016 ), and some natural products ( Zhang et al, 2015 ; Cardoso et al, 2016 ) have been reported to promote remineralization of incipient demineralized lesions. In particular, fluoride dentifrices are widely used for caries prevention and reversal.…”

Ecological approaches to dental caries prevention: Alteration of biofilms by natural products and casein-phosphopeptide-amorphous calcium phosphate

“…One way to reduce the potential risk of fluorosis while maintaining the anticaries efficacy of conventional dentifrices is to partly replace fluoride with polyphosphate salts like STMP, calcium glycerophosphate, or hexametaphosphate [da Camara et al, 2016;Takeshita et al, 2016;Zaze et al, 2014]. Among the polyphosphates, STMP is seen to be the most effective anticaries agent with an ability to not only inhibit demineralization but also enhance remineralization [Freire et al, 2016;Takeshita et al, 2011].…”

“…The protective barrier against acid diffusion created by the adsorption of STMP on enamel does not seem to hinder the diffusion of Ca 2+ and Fions into the enamel. In situ models have shown that supplementation of a lowfluoride product with STMP produced similar remineralization effects to 1100 ppm fluoride formulation [Danelon et al, 2013;Takeshita et al, 2016], while the addition of STPM to conventional fluoride dentifrices and varnishes significantly enhanced their remineralization of artificial caries lesions [Danelon et al, 2015;Manarelli et al, 2015].…”