Combined effect of a fluoride-, stannous- and chitosan-containing toothpaste and stannous-containing rinse on the prevention of initial enamel erosion-abrasion

J Dent. 2014 Apr;42(4):450-9. doi: 10.1016/j.jdent.2014.01.004. Epub 2014 Jan 15.

Abstract

Objectives: The aim of this study was to assess the preventive effect of a fluoride-, stannous- and chitosan-containing (F/Sn/chitosan-) toothpaste (TP) on initial enamel erosion and abrasion.

Methods: In total, 150 human premolar enamel specimens were ground, polished and divided into 5 toothpaste/rinse groups (n=30): (G1) placebo-TP/tap water, (G2) sodium fluoride (NaF-) TP/tap water, (G3) F/Sn/chitosan-TP/tap water, (G4) F/Sn/chitosan-TP/Sn-rinse, (G5) NaF-TP/NaF-rinse. The 8-day erosion-abrasion cyclic treatment (one cycle/day) consisted of incubating the samples in artificial saliva (30min), then submitting the samples to toothbrush abrasion (2min incubation in toothpaste slurry; brushing with 20 toothbrush strokes) and rinsing (2min; 10ml) with the respective solution: tap water (G1-G3), Sn-rinse (G4) or NaF-rinse (G5). Afterwards, the samples were submitted to erosion (2min; 30ml 1% citric acid, pH=3.6). Surface microhardness (SMH) was measured initially and after every abrasion and erosion treatment. Enamel substance loss was calculated after each abrasion. Non-parametric ANOVA followed by Wilcoxon rank tests were used for analysis.

Results: G1 presented the greatest SMH decrease, while G4 presented the least SMH decrease (p<0.001). G3 had a similar SMH decrease to G2 and G5. Substance loss was significantly lower in G4 than all other groups (p<0.05), closely followed by G3. Both G2 and G5 showed similar calculated enamel substance loss to G1.

Conclusion: The treatment with F/Sn/chitosan-TP and tap water provided a similar SMH decrease to both NaF-TP groups, but significantly lower substance loss. F/Sn/Chitosan-TP and Sn-rinse showed a better preventive effect, which promoted less SMH decrease and reduced substance loss.

Clinical significance: The toothpaste containing fluoride, stannous and chitosan shows promising results in reducing substance loss from erosion and abrasion. The combination of this toothpaste with the stannous-containing rinse showed even better prevention against erosion-abrasion.

Keywords: Abrasion; Biopolymer; Chitosan; Dental erosion; Dentifrice; Tin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chelating Agents / therapeutic use
  • Chitosan / therapeutic use*
  • Citric Acid / adverse effects
  • Dental Enamel / drug effects*
  • Dental Enamel / ultrastructure
  • Hardness
  • Humans
  • Hydrogen-Ion Concentration
  • Materials Testing
  • Microscopy, Electron, Scanning
  • Mouthwashes / therapeutic use
  • Placebos
  • Random Allocation
  • Saliva, Artificial / chemistry
  • Sodium Fluoride / therapeutic use*
  • Spectrometry, X-Ray Emission
  • Tin Compounds / therapeutic use*
  • Tooth Abrasion / pathology
  • Tooth Abrasion / prevention & control*
  • Tooth Erosion / pathology
  • Tooth Erosion / prevention & control*
  • Toothbrushing / adverse effects
  • Toothpastes / therapeutic use*
  • Water / chemistry

Substances

  • Chelating Agents
  • Mouthwashes
  • Placebos
  • Saliva, Artificial
  • Tin Compounds
  • Toothpastes
  • Water
  • stannous chloride
  • Citric Acid
  • Sodium Fluoride
  • Chitosan