archives of oral biology 59 (2014) 336–340
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.elsevier.com/locate/aob
Short communication
Effect of fluoride gels supplemented with sodium trimetaphosphate on enamel erosion and abrasion: In vitro study L.P. Pancote, M.M. Manarelli, M. Danelon, A.C.B. Delbem * Faculdade de Odontologia, UNESP – Univ Estadual Paulista, Arac¸atuba, Sa˜o Paulo, Brazil
article info
abstract
Article history:
Objective: This in vitro study aims to evaluate the effect of low fluoride (F) gel associate
Accepted 20 December 2013
sodium trimetaphosphate (TMP) on erosion with or without abrasion. Design: Enamel blocks (4 mm 4 mm) selected through surface hardness (SH) is divided
Keywords:
into five groups (n = 12): gel without F and TMP (placebo), gel containing 4500 ppm F (4500),
Fluoride gels
gel containing 4500 ppm F plus TMP5% (4500 TMP5%), gel containing 9000 ppm F (9000), and
Tooth erosion
gel containing 12,300 ppm F (acid gel). Those groups were additionally subdivided into
Tooth abrasion
conditions of erosion (Ero) and of erosion plus abrasion (Ero/Abra). The blocks have under-
Topical fluorides
gone a single application of gel on the first day of the study. The erosion challenge was
Dental enamel
produced by Sprite Zero1 for five minutes four times a day and abrasion was carried out by
Polyphosphates
machine brushing for 15 s. After the challenges, the surface hardness (%SH), wear and crosssectional hardness (DKHN) were analyzed. The data were analyzed using a 2-way ANOVA test followed by a Student-Newman–Keuls ( p < 0.05). Results: Lower values of %SH, wear and DKHN were observed for erosion challenge ( p < 0.001). The %SH was lower in groups treated with fluoride gels, differing in the placebo ( p < 0.05). With addition of TMP to the gel 4500, enamel wear was lower when compared with another groups ( p < 0.05). Conclusion: In vitro conditions, the 4500 5%TMP gel showed greatest effect against erosion and erosion/abrasion. # 2013 Elsevier Ltd. All rights reserved.
1.
Introduction
Erosion and erosive tooth wear refers to the chemical and chemical-mechanical process that has become more prevalent in 11 to 16-year-old children.1,2 As dental caries disease, the tooth erosion is a multifactorial condition (patient-related and nutritional factors) and over time, the interaction of all these factors may lead to either
progression.3 Different methods have been indicated to prevent or slow the progression of dental erosion such as the use of topical fluorides.4 Fluoride therapy has been suggested as a preventive measure against tooth erosion, and its effects are reported to be higher when applied at high concentrations.5–10 Despite the gel be a more affordable vehicle (lower cost) with high concentrations of fluoride, there are few studies where compounds are added to improve its effect against erosion.11
* Corresponding author at: Arac¸atuba Dental School, Sa˜o Paulo State University (UNESP), Department of Pediatric Dentistry and Public Health, Rua Jose Bonifacio 1193, 16015-050 Arac¸atuba, SP, Brazil. Tel.: +55 18 3636 3314; fax: +55 015 18 3636 3332. E-mail addresses: [email protected], [email protected] (A.C.B. Delbem). 0003–9969/$ – see front matter # 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.archoralbio.2013.12.007
archives of oral biology 59 (2014) 336–340
Utilisation of sodium trimetaphosphate (TMP) and fluoride (F) association has shown decreased enamel demineralisation10,12–15 in caries and dental erosion. In addition, a low fluoride topic gel (4500 ppm F) associated to TMP presented same ability to produce enamel remineralization than the fluoride acid gel (12,300 ppm F).16 However, the erosive challenge is a process that occurs at a pH of 0.610). Lower values of wear were observed with the erosive than Ero+Abra challenge ( p < 0.001). With the addition of TMP to gel 4500, enamel wear was lower when compared to the other groups ( p < 0.001), both in the Ero and Ero+Abra (Table 1). The fluoride groups (4500, 9000 and Acid gel) presented similar enamel wear ( p > 0.608). Placebo group exhibited the highest mineral loss deep into enamel (DKHN) when compared with the other groups ( p < 0.001) (Table 1). The gel with TMP showed similar values of DKHN than Acid gel group ( p > 0.051), regardless of the challenge types. Fig. 1 shows the hardness profile of erosion and erosion/abrasion as a function of depth according to the groups and the others comparisons are shown.
Table 1 – Mean (SD) values of surface hardness (%SH), wear and DKHN of the enamel according to conditions of challenge (Ero and Ero+Abra) and groups. Analysis
Groups Placebo
%SH
Wear (mm)
DKHN
Ero Ero+Abra
A B
4500 A B
4.71a (0.80) 5.81a (0.47)
Ero Ero+Abra Ero Ero+Abra
91.2a (1.3) 84.8a (1.6)
83.6b (1.6) 79.0b (1.4)
A
A
B
B
A
A
B
3609.6a (139.6) 2240.1a (129.9)
B
9000 A B
4.19b (0.70) 5.15b (0.35)
2712.9b (81.0) 1749.3b (158.2)
A B
77.9c (1.6) 74.1c (2.3)
4500 5%TMP A B
3.95b (0.69) 5.22b (0.34)
83.7b (2.2) 78.6b (1.6)
Acid gel A B
A
A
A
B
B
B
2320.3c (122.9) 1466.1c (128.2)
2.95c (0.51) 3.78c (0.36)
74.0d (1.5) 68.3d (1.4)
A
A
B
2215.5d (64.5) 1161.6d (102.0)
B
4.11b (0.91) 5.33a,b (0.57)
2321.5c,d (78.5) 1253.4d (100.5)
Different letters show significant differences in each analysis between groups of gel (ANOVA 2-way, Student–Newman–Keuls’s test; p < 0.05).
Fig. 1 – Graphical representation of mean hardness as a function of depth according to the erosive challenges. Symbols indicates comparison among groups in each depth (Student–Newman–Keuls, p < 0.05). Vertical bars indicate the standard deviations of means. (*) indicates no statistical difference among groups. (a) g: indicates equality between the groups healthy, 9000, 4500 5%TMP and Acid gel ( p > 0.163). v: indicates difference among group ( p = 0.037). b: indicates equality between the groups healthy, 4500, 9000 and Acid gel ( p > 0.116), 4500 5%TMP and Acid gel ( p = 0.070). l: indicates equality between the groups healthy, 4500, 9000, 4500 5%TMP and Acid gel ( p > 0.478). &: indicates difference between Placebo and the other groups ( p < 0.001). (b) V: indicates equality between the groups healthy, 4500 5%TMP and Acid gel ( p = 0.286). C: indicates equality between the groups healthy, 4500 5%TMP and Acid gel ( p = 0.248). ¥: indicates that the healthy groups, 4500 5%TMP and Acid gel are similar statistically ( p = 0.339). §: indicates equality between the groups healthy, Placebo and 4500 ( p = 0.158), 4500 and 9000 ( p = 0.074), 9000 and Acid gel ( p = 0.189).
archives of oral biology 59 (2014) 336–340
There was no correlation between wear (Ero and Ero+Abra) and surface hardness. (Pearson’s r = 0.072; p = 0.587 and Pearson’s r = 0.067; p = 0.611). Positive correlation was noted between wear (Ero and Ero+Abra) and DKHN (Pearson’s r = 0.532; p < 0.001 and Pearson’s r = 0.703; p < 0.001).
4.
Discussion
As the erosive challenge is a process that occurs at a pH of
Available online at www.sciencedirect.com
ScienceDirect journal homepage: http://www.elsevier.com/locate/aob
Short communication
Effect of fluoride gels supplemented with sodium trimetaphosphate on enamel erosion and abrasion: In vitro study L.P. Pancote, M.M. Manarelli, M. Danelon, A.C.B. Delbem * Faculdade de Odontologia, UNESP – Univ Estadual Paulista, Arac¸atuba, Sa˜o Paulo, Brazil
article info
abstract
Article history:
Objective: This in vitro study aims to evaluate the effect of low fluoride (F) gel associate
Accepted 20 December 2013
sodium trimetaphosphate (TMP) on erosion with or without abrasion. Design: Enamel blocks (4 mm 4 mm) selected through surface hardness (SH) is divided
Keywords:
into five groups (n = 12): gel without F and TMP (placebo), gel containing 4500 ppm F (4500),
Fluoride gels
gel containing 4500 ppm F plus TMP5% (4500 TMP5%), gel containing 9000 ppm F (9000), and
Tooth erosion
gel containing 12,300 ppm F (acid gel). Those groups were additionally subdivided into
Tooth abrasion
conditions of erosion (Ero) and of erosion plus abrasion (Ero/Abra). The blocks have under-
Topical fluorides
gone a single application of gel on the first day of the study. The erosion challenge was
Dental enamel
produced by Sprite Zero1 for five minutes four times a day and abrasion was carried out by
Polyphosphates
machine brushing for 15 s. After the challenges, the surface hardness (%SH), wear and crosssectional hardness (DKHN) were analyzed. The data were analyzed using a 2-way ANOVA test followed by a Student-Newman–Keuls ( p < 0.05). Results: Lower values of %SH, wear and DKHN were observed for erosion challenge ( p < 0.001). The %SH was lower in groups treated with fluoride gels, differing in the placebo ( p < 0.05). With addition of TMP to the gel 4500, enamel wear was lower when compared with another groups ( p < 0.05). Conclusion: In vitro conditions, the 4500 5%TMP gel showed greatest effect against erosion and erosion/abrasion. # 2013 Elsevier Ltd. All rights reserved.
1.
Introduction
Erosion and erosive tooth wear refers to the chemical and chemical-mechanical process that has become more prevalent in 11 to 16-year-old children.1,2 As dental caries disease, the tooth erosion is a multifactorial condition (patient-related and nutritional factors) and over time, the interaction of all these factors may lead to either
progression.3 Different methods have been indicated to prevent or slow the progression of dental erosion such as the use of topical fluorides.4 Fluoride therapy has been suggested as a preventive measure against tooth erosion, and its effects are reported to be higher when applied at high concentrations.5–10 Despite the gel be a more affordable vehicle (lower cost) with high concentrations of fluoride, there are few studies where compounds are added to improve its effect against erosion.11
* Corresponding author at: Arac¸atuba Dental School, Sa˜o Paulo State University (UNESP), Department of Pediatric Dentistry and Public Health, Rua Jose Bonifacio 1193, 16015-050 Arac¸atuba, SP, Brazil. Tel.: +55 18 3636 3314; fax: +55 015 18 3636 3332. E-mail addresses: [email protected], [email protected] (A.C.B. Delbem). 0003–9969/$ – see front matter # 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.archoralbio.2013.12.007
archives of oral biology 59 (2014) 336–340
Utilisation of sodium trimetaphosphate (TMP) and fluoride (F) association has shown decreased enamel demineralisation10,12–15 in caries and dental erosion. In addition, a low fluoride topic gel (4500 ppm F) associated to TMP presented same ability to produce enamel remineralization than the fluoride acid gel (12,300 ppm F).16 However, the erosive challenge is a process that occurs at a pH of 0.610). Lower values of wear were observed with the erosive than Ero+Abra challenge ( p < 0.001). With the addition of TMP to gel 4500, enamel wear was lower when compared to the other groups ( p < 0.001), both in the Ero and Ero+Abra (Table 1). The fluoride groups (4500, 9000 and Acid gel) presented similar enamel wear ( p > 0.608). Placebo group exhibited the highest mineral loss deep into enamel (DKHN) when compared with the other groups ( p < 0.001) (Table 1). The gel with TMP showed similar values of DKHN than Acid gel group ( p > 0.051), regardless of the challenge types. Fig. 1 shows the hardness profile of erosion and erosion/abrasion as a function of depth according to the groups and the others comparisons are shown.
Table 1 – Mean (SD) values of surface hardness (%SH), wear and DKHN of the enamel according to conditions of challenge (Ero and Ero+Abra) and groups. Analysis
Groups Placebo
%SH
Wear (mm)
DKHN
Ero Ero+Abra
A B
4500 A B
4.71a (0.80) 5.81a (0.47)
Ero Ero+Abra Ero Ero+Abra
91.2a (1.3) 84.8a (1.6)
83.6b (1.6) 79.0b (1.4)
A
A
B
B
A
A
B
3609.6a (139.6) 2240.1a (129.9)
B
9000 A B
4.19b (0.70) 5.15b (0.35)
2712.9b (81.0) 1749.3b (158.2)
A B
77.9c (1.6) 74.1c (2.3)
4500 5%TMP A B
3.95b (0.69) 5.22b (0.34)
83.7b (2.2) 78.6b (1.6)
Acid gel A B
A
A
A
B
B
B
2320.3c (122.9) 1466.1c (128.2)
2.95c (0.51) 3.78c (0.36)
74.0d (1.5) 68.3d (1.4)
A
A
B
2215.5d (64.5) 1161.6d (102.0)
B
4.11b (0.91) 5.33a,b (0.57)
2321.5c,d (78.5) 1253.4d (100.5)
Different letters show significant differences in each analysis between groups of gel (ANOVA 2-way, Student–Newman–Keuls’s test; p < 0.05).
Fig. 1 – Graphical representation of mean hardness as a function of depth according to the erosive challenges. Symbols indicates comparison among groups in each depth (Student–Newman–Keuls, p < 0.05). Vertical bars indicate the standard deviations of means. (*) indicates no statistical difference among groups. (a) g: indicates equality between the groups healthy, 9000, 4500 5%TMP and Acid gel ( p > 0.163). v: indicates difference among group ( p = 0.037). b: indicates equality between the groups healthy, 4500, 9000 and Acid gel ( p > 0.116), 4500 5%TMP and Acid gel ( p = 0.070). l: indicates equality between the groups healthy, 4500, 9000, 4500 5%TMP and Acid gel ( p > 0.478). &: indicates difference between Placebo and the other groups ( p < 0.001). (b) V: indicates equality between the groups healthy, 4500 5%TMP and Acid gel ( p = 0.286). C: indicates equality between the groups healthy, 4500 5%TMP and Acid gel ( p = 0.248). ¥: indicates that the healthy groups, 4500 5%TMP and Acid gel are similar statistically ( p = 0.339). §: indicates equality between the groups healthy, Placebo and 4500 ( p = 0.158), 4500 and 9000 ( p = 0.074), 9000 and Acid gel ( p = 0.189).
archives of oral biology 59 (2014) 336–340
There was no correlation between wear (Ero and Ero+Abra) and surface hardness. (Pearson’s r = 0.072; p = 0.587 and Pearson’s r = 0.067; p = 0.611). Positive correlation was noted between wear (Ero and Ero+Abra) and DKHN (Pearson’s r = 0.532; p < 0.001 and Pearson’s r = 0.703; p < 0.001).
4.
Discussion
As the erosive challenge is a process that occurs at a pH of
