Susceptibility of partially desalivated rats to erosive tooth wear by calcium-supplemented beverages

Objectives To investigate the susceptibility of partially desalivated rats to erosive tooth wear (ETW); the anti-erosive effect of a calcium-supplemented beverage; and the quantification of ETW by microcomputed tomography (micro-CT). Methods The study population consisted of thirty-eight rats, divided into partially desalivated (n = 19) and normal salivary flow (n = 19). They were randomly allocated into three subgroups (n = 6–7): A-diet soda, B-diet soda + calcium, C-water (control). Solutions were provided ad libitum for 28 days, and the rats were euthanized afterwards. Each left hemi-mandible was scanned using micro-CT for enamel volume (three molars) calculation. Visual analysis of photographs of the lingual surface of first molars was performed independently by three blinded examiners. Data were statistically analysed (α = .05). Results Micro-CT revealed no significant differences between partially desalivated or normal groups. Rats consuming A had more enamel loss than those consuming B or C, which did not differ from each other. For visual analysis, desalivation did not affect ETW. Rats consuming C showed the lowest ETW, followed by B and then A, for both partially desalivated and normal rats. Spearman correlation between the two ETW quantification methods was −.65. Conclusions Partial desalivation did not increase ETW. Ca-containing beverage prevented ETW. Micro-CT quantified ETW, although it was not as sensitive as visual analysis

Anti-erosion potential of fluoride solutions associated with aminomethacrylate copolymer: in situ randomized crossover study

The anti-erosion potential of fluoride solutions associated with aminomethacrylate (AMC) was evaluated in the presence of acquired pellicle on enamel and dentin. It is concluded that AMC was able to increase the anti-erosion potential of fluoride solutions in the presence of acquired pellicle

Protection of calcium silicate/sodium phosphate/fluoride toothpaste with serum on enamel and dentin erosive wear

Objective: To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin. Methodology: Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva – 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO4/MFP (Regenerate-Unilever), and Si/PO4/MFP/BS (Si/PO4/MFP with dual BS – Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%). Results: For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO4/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness. Conclusion: The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW

The influence of water temperature during toothbrushing on root dentine: An <i> in vitro</i> study

<b>Background/Aims:</b> The use of cold water during toothbrushing can cause dentine sensitivity and, to avoid this painful stimulus, some patients used to rinse their mouths with warm water when brushing. Thus, the objective of this study was to determine the effect of water temperature on the dental root surface during toothbrushing. <b> Materials and Methods</b> : Fragments of bovine dental roots were submitted to 15,000 strokes in a toothbrushing machine using a slurry of toothpaste/water, medium brushes, and a 200-g load. They were randomly divided into two groups: toothbrushing with cold water or with hot water. Tooth wear was measured by loss of weight and by tissue height. <b> Statistical Analysis: </b> The weight and height data obtained in 17 and 10 replicas respectively are presented as mean &#x00B1; standard error of mean. The data were compared using the Kolgomorov-Smirnof (Lilliefors) test followed by one-way ANOVA. The level of significance was 5&#x0025; (P &lt; 0.05). <b> Results:</b> There were no significant differences between the two experimental groups. The mean percentages of weight losses were 5.61 &#x00B1; 1.66 for cold water and 6.25 &#x00B1; 1.98 for hot water. The mean dentine height losses were 51.02 &#x00B1; 15.92 &#x00B5;m for cold water and 63.54 &#x00B1; 17.75 &#x00B5;m for hot water. <b> Conclusion:</b> The use of warm water during toothbrushing promoted root dentine wear similar to that produced by the use of cold water. The results suggest that warm or cold water may be used during toothbrushing without any additional damage to the patients&#x2032; dental hard tissues

Plant extracts have dual mechanism on the protection against dentine erosion: action on the dentine substrate and modification of the salivary pellicle

Abstract To investigate the effect of some polyphenol-rich plant extracts on the protection of dentine against demineralization, both acting on the dentine and on the salivary pellicle. Dentine specimens (n = 180) were randomly distributed into 6 experimental groups (n = 30/group): Control (deionized water), Açaí extract, Blueberry extract, Green tea extract, Grape seed extract, and Sn2+/F− (mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the site of action of the substance: on the dentine surface (D) or on the salivary pellicle (P). The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (D), 2 min immersion in experimental substances, 60 min of incubation in saliva (P) or not (D), and 1 min erosive challenge. Dentine surface loss (DSL), amount of degraded collagen (dColl) and total calcium release were analyzed. Green tea, Grape seed and Sn2+/F− showed significant protection, with least DSL and dColl. The Sn2+/F− showed better protection on D than on P, whereas Green tea and Grape seed showed a dual mode of action, with good results on D, and even better on P. Sn2+/F− showed the lowest values of calcium release, not differing only from Grape seed. Sn2+/F− is more effective when acting directly on the dentine surface, while Green tea and Grape seed have a dual mode of action: with a positive effect on the dentine surface itself, but an improved efficacy in the presence of the salivary pellicle. We further elucidate the mechanism of action of different active ingredients on dentine erosion, where Sn2+/F− acts better on the dentine surface, but plant extracts have a dual mode of action, acting on the dentine itself as well as on the salivary pellicle, improving the protection against acid demineralization

Erosion Protection by Calcium Lactate/Sodium Fluoride Rinses under Different Salivary Flows in vitro

This study investigated the effect of a calcium lactate pre-rinse on sodium fluoride protection in an in vitro erosion-remineralization model simulating two different salivary flow rates. Enamel and dentin specimens were randomly assigned to 6 groups (n = 8), according to the combination between rinse treatments - deionized water (DIW), 12 mm NaF (NaF) or 150 mm calcium lactate followed by NaF (CaL + NaF) and unstimulated salivary flow rates - 0.5 or 0.05 ml/min simulating normal and low salivary flow rates, respectively. The specimens were placed into custom-made devices, creating a sealed chamber on the specimen surface connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min, followed by artificial saliva (0.5 or 0.05 ml/min) for 60 min. This cycle was repeated 4x/day for 3 days. Rinse treatments were performed daily 30 min after the 1st and 4th erosive challenges, for 1 min each time. Surface loss was determined by optical profilometry. KOH-soluble fluoride and structurally bound fluoride were determined in specimens at the end of the experiment. Data were analyzed by 2-way ANOVA and Tukey tests (alpha = 0.05). NaF and CaL + NaF exhibited significantly lower enamel and dentin loss than DIW, with no difference between them for normal flow conditions. The low salivary flow rate increased enamel and dentin loss, except for CaL + NaF, which presented overall higher KOH-soluble and structurally bound fluoride levels. The results suggest that the NaF rinse was able to reduce erosion progression. Although the CaL prerinse considerably increased F availability, it enhanced NaF protection against dentin erosion only under hyposalivatory conditions. (C) 2014 S. Karger AG, Base

Supplementation of an Orange Juice with Dietary Proteins to Prevent Enamel and Dentin Erosion

Protein supplementation may be an alternative to reduce the erosive potential of acidic drinks. The aim of this in vitro study was to evaluate the erosive potential of an orange juice modified by dietary proteins. A commercially available orange juice was added 0.2 g/L casein, 2.0 g/L ovalbumin and their combination. The juice with no additives and a commercially available calcium-modified juice were used as negative and positive controls, respectively. Human enamel and dentin specimens (n=11) were tested in an erosion-remineralization cycling model. Enamel was analyzed by surface microhardness and profilometry, whilst dentin by profilometry only. Statistical analyses were performed using one-way ANOVA followed by Tukey's test (p<0.05). Calcium-modified juice showed the lowest erosive potential for both analyses (p<0.05). For enamel, the protein-added groups did not differ from each other (p>0.05) and showed significantly lower enamel loss compared to negative control (p<0.05). Regarding surface microhardness, casein showed the highest values compared to negative control (p<0.05). For dentin, none of the protein-added groups showed lower values of surface loss compared to negative control (p>0.05). In conclusion, for enamel the protein-modified orange juices presented reduced erosion of enamel, with casein showing a trend for better protection. For dentin, no reduction in the erosive potential was observed for the tested protein-modified orange juices

In vitro effect of calcium-containing prescription-strength fluoride toothpastes on bovine enamel erosion under hyposalivation-simulating conditions

Purpose: To evaluate the ability of calcium-containing prescription-strength fluoride (F) toothpastes in preventing enamel erosion under low salivary flow simulating conditions. Methods: Enamel and dentin bovine specimens were assigned to the following groups: A - placebo; B - 1,100 ppm F/NaF (Aquafresh Advanced); C - 5,000 ppm F/NaF (Prevident 5000 Booster); D - 5000 ppm F/NaF+calcium sodium phosphosilicate (Topex Renew); and E - 5,000 ppm F/NaF+tri-calcium phosphate (Clinpro 5000). Specimens were positioned in custom-made devices, creating a sealed chamber on the surface, connected to peristaltic pumps. Citric acid was injected into the chamber for 2 minutes, followed by artificial saliva (0.05 ml/minute), for 60 minutes, 4x/day, for 3 days. Aquafresh was also tested under normal salivary flow (0.5 ml/minute), as reference (Group F). Specimens were exposed to the toothpastes for 2 minutes, 2x/day. After cycling, surface loss (SL) and concentration of loosely- and firmly-bound F were determined. Data were analyzed by ANOVA. Results: Group A (placebo) presented highest surface loss (SL), while Group F had the lowest, for both substrates. For enamel, none of the dentifrices differed from Group B or among each other. For dentin, none of the dentifrices differed from Group B, but Group E showed greater protection than Group C. Group E presented the highest F concentrations for both substrates, only matched by Group D for firmly-bound fluoride on enamel. All fluoridated dentifrices tested reduced SL, with no additional benefit from higher F concentrations. Some formulations, especially Clinpro 5000, increased F availability on the dental substrates, but no further erosion protection was observed

Effect of mouthrinses with different active agents in the prevention of initial dental erosion

Introduction: Hydrochloric acid (HCl) from the gastric juice is the only source of intrinsic acid, which can reach the oral cavity in cases of gastroesophageal reflux or chronic vomiting, enhancing the risk of dental erosion. Aim: Compare the effects of mouthrinses with different active agents in the prevention of initial dental erosion caused by HCl. Subjects and Methods: Casein (CAS at 0.2%), sodium hexametaphosphate (HMP at 0.02%), titanium tetrafluoride (TiF 4 at 0.34%), and stannous fluoride (SnF 2 at 0.87%) were individually added to an experimental mouthrinse. The mouthrinse without additives was used as the negative control (C) and a commercially available mouthrinse for erosion (ELM - Elmex ® ) as the reference product. Enamel specimens were exposed to human saliva and randomly assigned to 6 experimental groups (n = 8). Specimens were submitted to erosion in HCl for 10 s, followed by to the experimental mouthrinses for 30 s, and artificial saliva for 60 min. This cycle was repeated 3 times. The total amounts of calcium and phosphorus released by the specimens in the 2 nd and 3 rd erosive challenges were evaluated by atomic emission spectrometry. Statistical analysis used Shapiro-Wilks and Hartley tests, followed by one-way ANOVA and Tukey tests. Results: When compared with C, ELM and HMP presented significantly less calcium in solution, with no difference between them. All the groups showed similar and significantly less phosphorus than C, except CAS. Conclusions: HMP was the only agent that could match the protection against initial erosion of the commercially available mouthrinse in both analyses

Film-Forming Polymers for Tooth Erosion Prevention

Different agents have been proposed to prevent the progression of acid induced dental substance losses, which are called erosive tooth wear (ETW), such as fluorides, calcium, and phosphate-based products; however, there is a need for a further increase in efficacy. Recently, the ability of polymers to interact with the tooth surface, forming acid resistant films, has come into the focus of research; nevertheless, there is still the need for a better understanding of their mode of action. Thus, this article provides an overview of the chemical structure of polymers, their mode of action, as well as the effect of their incorporation into oral care products, acid beverages, and antacid formulations, targeting the prevention of ETW. Recent evidence indicates that this may be a promising approach, however, additional studies are needed to confirm their efficacy under more relevant clinical conditions that consider salivary parameters such as flow rate, composition, and clearance. The standardization of methodological procedures such as acid challenge, treatment duration, and combination with fluorides is necessary to allow further comparisons between studies. In conclusion, film-forming polymers may be a promising cost-effective approach to prevent and control erosive demineralization of the dental hard tissue