In situ evaluation of fluoride-, stannous- and polyphosphate-containing solutions against enamel erosion

Samira Helena João-Souza; Sávio José C Bezerra; Patrícia Moreira de Freitas; Nelson B de Lima; Ana Cecília Corrêa Aranha; Anderson T Hara; Taís Scaramucci

doi:10.1016/j.jdent.2017.05.014

In situ evaluation of fluoride-, stannous- and polyphosphate-containing solutions against enamel erosion

J Dent. 2017 Aug:63:30-35. doi: 10.1016/j.jdent.2017.05.014. Epub 2017 May 25.

Authors

Samira Helena João-Souza¹, Sávio José C Bezerra², Patrícia Moreira de Freitas³, Nelson B de Lima⁴, Ana Cecília Corrêa Aranha⁵, Anderson T Hara⁶, Taís Scaramucci⁷

Affiliations

¹ Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, Zip code: 05508-000, São Paulo, SP, Brazil. Electronic address: samyhelen@hotmail.com.
² Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, Zip code: 05508-000, São Paulo, SP, Brazil. Electronic address: saviocbezerra@hotmail.com.
³ Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, Zip code: 05508-000, São Paulo, SP, Brazil. Electronic address: pfreitas@usp.br.
⁴ Centro de Ciência e Tecnologia dos Materiais, Instituto de Pesquisas Energéticas e Nucleares, IPEN-CNEN/SP, Butantã, P.O. Box 11049, São Paulo, SP 05422-970, Brazil. Electronic address: nblima@ipen.br.
⁵ Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, Zip code: 05508-000, São Paulo, SP, Brazil. Electronic address: acca@usp.br.
⁶ Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University, School of Dentistry, 415 Lansing street, 46202-2855, Indianapolis, IN, USA. Electronic address: ahara@iu.edu.
⁷ Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, Zip code: 05508-000, São Paulo, SP, Brazil. Electronic address: tais.sca@usp.br.

PMID: 28552363
DOI: 10.1016/j.jdent.2017.05.014

Abstract

Objective: To evaluate the anti-erosive effect of solutions containing sodium fluoride (F: 225ppm of fluoride), sodium fluoride+stannous chloride (F+Sn: 225ppm of fluoride+800ppm of stannous), sodium fluoride+stannous chloride+sodium linear polyphosphate (F+Sn+LPP: 225ppm of fluoride+800ppm of stannous+2% of sodium linear polyphosphate), and deionized water (C: control), using a four-phase, single-blind, crossover in situ clinical trial.

Methods: In each phase, 12 volunteers wore appliances containing 4 enamel specimens, which were submitted to a 5-day erosion-remineralization phase that consisted of 2h of salivary pellicle formation with the appliance in situ, followed by 2min extra-oral immersion in 1% citric acid (pH 2.4), 6x/day, with 90min of exposure to saliva in situ between the challenges. Treatment with the test solutions was performed extra-orally for 2 min, 2x/day. At the end of the experiment, surface loss (SL, in μm) was evaluated by optical profilometry. Data were analyzed using ANOVA and Tukey tests (α=0.05). The surface of additional specimens was evaluated by x-ray diffraction after treatments (n=3).

Results: C (mean SL±standard-deviation: 5.97±1.70) and F (5.36±1.59) showed the highest SL, with no significant difference between them (p>0.05). F+Sn (2.68±1.62) and F+Sn+LPP (2.10±0.95) did not differ from each other (p>0.05), but presented lower SL than the other groups (P<0.05). Apatite and stannous deposits on specimen surfaces were identified in the x-ray analysis for F+Sn and F+Sn+LPP.

Conclusions: Sodium fluoride solution exhibited no significant anti-erosive effect. The combination between sodium fluoride and stannous chloride reduced enamel erosion, irrespective of the presence of linear sodium polyphosphate.

Clinical significance: Under highly erosive conditions, sodium fluoride rinse may not be a suitable alternative to prevent enamel erosion. A rinse containing sodium fluoride and stannous chloride was shown to be a better treatment option, which was not further improved by addition of the sodium linear polyphosphate.

Keywords: Enamel; Erosion; Fluoride; Phosphate polymer; Stannous chloride.

Publication types

Clinical Trial

MeSH terms

Citric Acid / adverse effects
Cross-Over Studies
Dental Enamel / drug effects*
Dental Enamel / pathology
Dental Pellicle / drug effects
Fluorides / pharmacology
Humans
Hydrogen-Ion Concentration
Phosphates
Polyphosphates / pharmacology*
Saliva
Single-Blind Method
Sodium Fluoride / pharmacology*
Surface Properties
Tin Compounds / pharmacology*
Tin Fluorides / pharmacology*
Tooth Erosion / drug therapy*
Tooth Erosion / pathology
Tooth Erosion / prevention & control*
Water
X-Ray Diffraction

Substances

Phosphates
Polyphosphates
Tin Compounds
Tin Fluorides
Water
fluorophosphate
stannous chloride
Citric Acid
Sodium Fluoride
Fluorides