Is the dentifrice containing calcium silicate, sodium phosphate, and fluoride able to protect enamel against chemical mechanical wear? An in situ/ex vivo study
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The aim of this study was to investigate the effect of a dentifrice that contains calcium silicate, sodium phosphate, and fluoride on erosive-abrasive enamel wear.
Material and Methods
This randomized, single-blind in situ/ex vivo study was conducted with four crossover phases of 5 days (one group tested per phase). Bovine enamel blocks (n = 256) were allocated to 16 volunteers and 8 groups. The groups under study were test dentifrice, with calcium silicate, sodium phosphate, and 1450 ppm sodium monofluorophosphate; tin dentifrice, with 3500 ppm stannous chloride, 700 ppm amine fluoride, and 700 ppm sodium fluoride; conventional dentifrice, with 1450 ppm sodium monofluorophosphate; and control (deionized water). Half of the enamel blocks were subjected to erosion and the other half to erosion plus abrasion. The daily extraoral protocol consisted in four citric acid exposures (2 min) and two applications of dentifrice slurry on all blocks for 30 s; after, half of the blocks were brushed for 15 s. The response variable was enamel loss. Data were analyzed by two-way ANOVA and Fisher’s test (p < 0.05).
For erosion, the test dentifrice promoted less enamel loss than water (4.7 ± 3.1 and 5.8 ± 2.5 μm, respectively, p < 0.05), and did not differ from tin (4.8 ± 2.5 μm) and conventional (4.8 ± 1.4 μm) dentifrices (p > 0.05). However, the test dentifrice (7.7 ± 3.8 μm) promoted higher wear after erosive plus abrasive procedures than tin (5.4 ± 1.5 μm) and conventional (6.2 ± 1.7 μm, p < 0.05) dentifrices, and did not differ from water (6.9 ± 2.0 μm).
The investigated dentifrice reduced enamel loss against acid challenge but had no effect against acid and brushing challenge.
Little is known regarding the preventive effect of dentifrices indicated for dental erosion. The tested anti-erosive dentifrice was unable to protect enamel when erosion was associated to toothbrushing abrasion.
KeywordsTooth Erosion Tooth abrasion Calcium silicate Stannous fluoride
The authors would like to gratefully acknowledge the volunteers who participated in this study.
The work was supported by Fundação de Amparo a Pesquisa de São Paulo [FAPESP grant numbers 2015/26520-6, 2015/21552-7, 2015/23911-4] and Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq grant numbers 431264/2016-3, 310679/2015-0]. 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 there is no conflict of interest.
All procedures performed in 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 (protocol number 48753115.0.0000.5417).
Informed consent was obtained from all participants included in the study.
- 1.Carvalho TS, Colon P, Ganss C, Huysmans MC, Lussi A, Schlueter N, Schmalz G, Shellis RP, Tveit AB, Wiegand A (2015) Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear—diagnosis and management. Clin Oral Investig 19:1557–1561. https://doi.org/10.1007/s00784-015-1511-7 CrossRefPubMedGoogle Scholar
- 4.Salas MM, Nascimento GG, Huysmans MC, Demarco FF (2015) Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis. J Dent 43:42–50. https://doi.org/10.1016/j.jdent.2014.10.012 CrossRefPubMedGoogle Scholar
- 8.Joiner A, Schäfer F, Naeeni MM, Gupta AK, Zero DT (2014) Remineralisation effect of a dual-phase calcium silicate/phosphate gel combined with calcium silicate/phosphate toothpaste on acid-challenged enamel in situ. J Dent 42:S53–S59. https://doi.org/10.1016/S0300-5712(14)50008-5 CrossRefPubMedGoogle Scholar
- 9.Jones SB, Davies M, Chapman N, Willson R, Hornby K, Joiner A, West NX (2014) Introduction of an interproximal mineralisation model to measure remineralisation caused by novel formulations containing calcium silicate, sodium phosphate salts and fluoride. J Dent 42:S46–S52. https://doi.org/10.1016/S0300-5712(14)50007-3 CrossRefPubMedGoogle Scholar
- 24.Schlueter N, Hardt M, Lussi A, Engelmann F, Klimek J, Ganss C (2009) Tin-containing fluoride solutions as anti-erosive agents in enamel: an in vitro tin-uptake, tissue-loss and scanning electron micrograph study. Eur J Oral Sci 117:427–434. https://doi.org/10.1111/j.1600-0722.2009.00647.x CrossRefPubMedGoogle Scholar
- 41.ISO11609, ISO 1995 International Standard: Dentistry- Toothpaste Requirements, test methods and marking, ISO, SwitzerlandGoogle Scholar
- 44.Algarni AA, Mussi MC, Moffa EB, Lippert F, Zero DT, Siqueira WL et al (2015) The impact of stannous, fluoride ions and its combination on enamel pellicle proteome and dental erosion prevention. PLoS One 10(6):e0128196. https://doi.org/10.1371/journal.pone.0128196 CrossRefPubMedPubMedCentralGoogle Scholar
- 51.Rios D, Honório HM, Magalhães AC, Delbem AC, Machado MA, Silva SM, Buzalaf MA (2006) Effect of salivary stimulation on erosion of human and bovine enamel subjected or not to subsequent abrasion: an in situ/ex vivo study. Caries Res 40:218–223. https://doi.org/10.1159/000092229