Advertisement

Effect of TiF4 varnish on microbiological changes and caries prevention: in situ and in vivo models

  • Adílis Kalina Alexandria
  • Camila Nassur
  • Carolina Bezerra Cavalcanti Nóbrega
  • Luciana Salles Branco-de-Almeida
  • Katia Regina Netto dos Santos
  • Alexandre Rezende Vieira
  • Aline Almeida Neves
  • Pedro Luiz Rosalen
  • Ana Maria Gondim Valença
  • Lucianne Cople Maia
Original Article

Abstract

Objective

The aim of this study was to evaluate microbiological changes, oral soft tissue toxicity, and caries-preventive effect of an experimental titanium tetrafluoride (TiF4) varnish compared with a commercially available fluoride varnish (NaF), using in situ and in vivo models.

Materials and methods

The treatment groups were the following: TiF4 varnish (experimental varnish), Duraphat® (fluoride positive control), placebo varnish (no fluoride), and no treatment (negative control). The varnishes were applied once over the enamel surface using a microbrush. For the in vivo study, 48 Wistar rats were infected with Streptococcus sobrinus 6715, received a treatment, and were submitted to a cariogenic challenge. After 4 weeks, S. sobrinus, oral soft tissue toxicity, presence, and severity of caries were evaluated. For the in situ study, 12 volunteers took part in this randomized crossover, double-blind study performed in four phases of 14 days each. They used intraoral appliances containing four enamel specimens that received the varnish according treatment group. After 24 h, the varnish was removed and plaque accumulation was allowed. A 20% sucrose solution was dripped over the enamel blocks (10×/day for 5 min each). Total streptococci, S. mutans, Lactobacillus, Candida spp. counts, and presence of white spot lesions were evaluated. Lesion depth was also quantified by micro-CT.

Results

For the in vivo study, the fluoride (F-varnishes) showed a statistically significant reduction in the percentage of S. sobrinus compared to the negative control (p < 0.05). Toxicological analysis revealed no abnormalities in oral tissues of rats from all groups, and both F-varnishes reduced the number and severity of caries lesions, without significant differences (p < 0.05). No statistical differences in microbiological counts were seen for the in situ experiment (p > 0.05). However, the specimens treated with TiF4 exhibited lower percentage of white spot lesions and the lesion depth was significantly reduced by F-varnishes (p < 0.05).

Conclusions

F-varnishes showed reduction in the percentage of S. sobrinus in vivo, no oral soft tissue toxicity, and a caries-preventive effect in vivo and in situ.

Clinical relevance

NaF varnish is largely used due its capacity to form CaF2-like layer on enamel. Therefore, development of studies focused on other fluoride compounds such as a TiF4 varnish, which may have greater efficacy than NaF against tooth demineralization, is important.

Keywords

Caries Titanium tetrafluoride Mutans streptococci Fluoride varnish Oral biofilm 

Notes

Acknowledgements

The authors thank J.A. Cury, R.C. Evangelista, and F.Y. Fujiwara for the scientific support during the varnish development and analytical process; E. Campagnoli for the toxicological analysis; V.S.S. Pierro, M.P. Barbosa, and T.C. França for their support during this experiments; and J.M. Granjeiro, E. Calvano, and T. Vieira for their support during genetic analysis. The authors gratefully thank all the volunteers who participated in the in situ study.

Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil - (CAPES) - finance code 001 and from FAPERJ E-26/202.924/2017 and CNPQ 303535/2016-4. This study is part of the PhD thesis of the first author. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Bagramian RA, Garcia-Godoy F, Volpe AR (2009) The global increase in dental caries. A pending public health crisis. Am J Dent 22:3–8PubMedGoogle Scholar
  2. 2.
    Marsh PD (2004) Dental plaque as a microbial biofilm. Caries Res 38:204–211CrossRefGoogle Scholar
  3. 3.
    Hodgson RJ, Lynch RJ, Watson GK, Labarbe R, Treloar R, Allison C (2001) A continuous culture biofilm model of cariogenic responses. J Appl Microbiol 90:440–448CrossRefGoogle Scholar
  4. 4.
    Tenuta LM, Cury JA (2010) Fluoride: its role in dentistry. Braz Oral Res 24:9–17CrossRefGoogle Scholar
  5. 5.
    Paes Leme AF, Koo H, Bellato CM, Bedi G, Cury JA (2006) The role of sucrose in cariogenic dental biofilm formation-new insight. J Dent Res 85:878–887CrossRefGoogle Scholar
  6. 6.
    Pine CM, Adair PM, Nicoll AD, Burnside G, Petersen PE, Beighton D, Gillett A, Anderson R, Anwar S, Brailsford S, Broukal Z, Chestnutt IG, Declerck D, Ping FX, Ferro R, Freeman R, Gugushe T, Harris R, Lin B, Lo EC, Maupome G, Moola MH, Naidoo S, Ramos-Gomez F, Samaranayake LP, Shahid S, Skeie MS, Splieth C, Sutton BK, Soo TC, Whelton H (2004) International comparisons of health inequalities in childhood dental caries. Community Dent Health 21:121–130PubMedGoogle Scholar
  7. 7.
    Tsakos G (2011) Inequalities in oral health of the elderly: rising to the public health challenge? J Dent Res 90:689–690CrossRefGoogle Scholar
  8. 8.
    Marinho VC (2009) Cochrane reviews of randomized trials of fluoride therapies for preventing dental caries. Eur Arch Paediatr Dent 10:183–191CrossRefGoogle Scholar
  9. 9.
    Wiegand A, Magalhaes AC, Attin T (2010) Is titanium tetrafluoride (TiF4) effective to prevent carious and erosive lesions? A review of the literature. Oral Health Prev Dent 8:159–164PubMedGoogle Scholar
  10. 10.
    Nassur C, Alexandria AK, Pomarico L, de Sousa VP, Cabral LM, Maia LC (2013) Characterization of a new TiF(4) and beta-cyclodextrin inclusion complex and its in vitro evaluation on inhibiting enamel demineralization. Arch Oral Biol 58:239–247CrossRefGoogle Scholar
  11. 11.
    Alcantara PC, Alexandria AK, Souza IP, Maia LC (2015) Energy dispersive x-ray spectroscopy evaluation of demineralized human enamel after titanium tetrafluoride application. J Clin Pediatr Dent 39:124–127CrossRefGoogle Scholar
  12. 12.
    Alcantara PCC, Alexandria AK, Souza IPR, Maia LC (2014) In situ effect of titanium tetrafluoride and sodium fluoride on artificially decayed human enamel. Braz Dent J 25:28–32CrossRefGoogle Scholar
  13. 13.
    Comar LP, Wiegand A, Moron BM, Rios D, Buzalaf MA, Buchalla W, Magalhaes AC (2012) In situ effect of sodium fluoride or titanium tetrafluoride varnish and solution on carious demineralization of enamel. Eur J Oral Sci 120:342–348PubMedGoogle Scholar
  14. 14.
    Buyukyilmaz T, Ogaard B, Duschner H, Ruben J, Arends J (1997) The caries-preventive effect of titanium tetrafluoride on root surfaces in situ as evaluated by microradiography and confocal laser scanning microscopy. Adv Dent Res 11:448–452CrossRefGoogle Scholar
  15. 15.
    Gu Z, Li J, Soremark R (1996) Influence of tooth surface conditions on enamel fluoride uptake after topical application of TiF4 in vitro. Acta Odontol Scand 54:279–281CrossRefGoogle Scholar
  16. 16.
    Mundorff SA, Little MF, Bibby BG (1972) Enamel dissolution. II. Action of titanium tetrafluoride. J Dent Res 51:1567–1571CrossRefGoogle Scholar
  17. 17.
    Skartveit L, Gjerdet NR, Selvig KA (1991) Release of fluoride and metal ions from root surfaces after topical application of TiF4, SnF2, and NaF in vitro. Acta Odontol Scand 49:127–131CrossRefGoogle Scholar
  18. 18.
    Laptash NM, Fedotov MA, Maslennikova IG (2004) Hydrolysis of volatile ammonium oxofluorotitanate according to 19F, 17O, and 49Ti NMR data. J Struct Chem 45:74–82CrossRefGoogle Scholar
  19. 19.
    Nobrega CB, Fujiwara FY, Cury JA, Rosalen PL (2008) TiF4 varnish—a 19 F-NMR stability study and enamel reactivity evaluation. Chem Pharm Bull 56:139–141CrossRefGoogle Scholar
  20. 20.
    Keyes PH (1959) Dental caries in the Syrian hamster. VIII. The induction of rampant caries activity in albino and golden animals. J Dent Res 38:525–533CrossRefGoogle Scholar
  21. 21.
    Larson RM (1981) Merits and modifications of scoring rat dental caries by Keyes’ method. In: Tanzer JM (ed) Animal models in cariology. IRL Press, Washington, pp 195–203Google Scholar
  22. 22.
    Alexandria AK, Meckelburg NA, Puetter UT, Salles JT, Souza IPR, Maia LC (2016) Do pediatric medicines induce topographic changes in dental enamel? Braz Oral Res 30:1–8CrossRefGoogle Scholar
  23. 23.
    Alexandria AK, Vieira TI, Pithon MM, da Silva Fidalgo TK, Fonseca-Goncalves A, Valenca AM, Cabral LM, Maia LC (2017) In vitro enamel erosion and abrasion-inhibiting effect of different fluoride varnishes. Arch Oral Biol 77:39–43CrossRefGoogle Scholar
  24. 24.
    Aidar M, Line SR (2007) A simple and cost-effective protocol for DNA isolation from buccal epithelial cells. Braz Dent J 18:148–152CrossRefGoogle Scholar
  25. 25.
    Arends J, Ruben JL, Inaba D (1997) Major topics in quantitative microradiography of enamel and dentin: R parameter, mineral distribution visualization and hypermineralization. Adv Dent Res 11:403–413CrossRefGoogle Scholar
  26. 26.
    Sen BH, Kasemi RB, Spangberg LSW (1998) Morphologic effects on L929 fibroblasts of titanium tetrafluoride application. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:341–346CrossRefGoogle Scholar
  27. 27.
    Pandit S, Cai JN, Jung JE, Jeon JG (2015) Effect of 1-minute fluoride treatment on potential virulence and viability of a cariogenic biofilm. Caries Res 49:449–457CrossRefGoogle Scholar
  28. 28.
    Dang MH, Jung JE, Lee DW, Song KY, Jeon JG (2016) Recovery of acid production in Streptococcus mutans biofilms after short-term fluoride treatment. Caries Res 50:363–371CrossRefGoogle Scholar
  29. 29.
    Belli WA, Buckley DH, Marquis RE (1995) Weak acid effects and fluoride inhibition of glycolysis by Streptococcus mutans GS-5. Can J Microbiol 41:785–791CrossRefGoogle Scholar
  30. 30.
    Wefel JS (1982) Artificial lesion formation and fluoride uptake after TiF4 applications. Caries Res 16:26–33CrossRefGoogle Scholar
  31. 31.
    Chevitarese AB, Chevitarese O, Chevitarese LM, Dutra PB (2004) Titanium penetration in human enamel after TiF4 application. J Clin Pediatr Dent 28:253–256CrossRefGoogle Scholar
  32. 32.
    Zaura-Arite E, van Marle J, ten Cate JM (2001) Confocal microscopy study of undisturbed and chlorhexidine-treated dental biofilm. J Dent Res 80:1436–1440CrossRefGoogle Scholar
  33. 33.
    Bradshaw DJ, Marsh PD, Hodgson RJ, Visser JM (2002) Effects of glucose and fluoride on competition and metabolism within in vitro dental bacterial communities and biofilms. Caries Res 36:81–86CrossRefGoogle Scholar
  34. 34.
    Skartveit L, Spak CJ, Tveit AB, Selvig KA (1991) Caries-inhibitory effect of titanium tetrafluoride in rats. Acta Odontol Scand 49:85–88CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Adílis Kalina Alexandria
    • 1
  • Camila Nassur
    • 1
  • Carolina Bezerra Cavalcanti Nóbrega
    • 2
  • Luciana Salles Branco-de-Almeida
    • 3
  • Katia Regina Netto dos Santos
    • 4
  • Alexandre Rezende Vieira
    • 5
  • Aline Almeida Neves
    • 1
  • Pedro Luiz Rosalen
    • 6
  • Ana Maria Gondim Valença
    • 7
  • Lucianne Cople Maia
    • 1
    • 8
  1. 1.Department of Pediatric Dentistry and Orthodontics, School of DentistryFederal University of Rio de JaneiroRio de JaneiroBrazil
  2. 2.Center for Rural Health and Technology, School of DentistryFederal University of Campina GrandeCampina GrandeBrazil
  3. 3.Department of Dentistry IIFederal University of MaranhãoSão LuísBrazil
  4. 4.Department of Medical Microbiology, Microbiology InstituteFederal University of Rio de JaneiroRio de JaneiroBrazil
  5. 5.Department of Oral Biology, School of Dental MedicineUniversity of PittsburghPittsburghUSA
  6. 6.Department of Physiological Sciences, Piracicaba Dental SchoolState University of CampinasPiracicabaBrazil
  7. 7.Department of Clinical and Social Odontology, School of DentistryFederal University of ParaíbaJoão PessoaBrazil
  8. 8.Disciplina de Odontopediatria da FO-UFRJ, Cidade Universitária – CCSRio de JaneiroBrazil

Personalised recommendations