ENHANCING REMINERALIZATION OF PRIMARY ENAMEL LESIONS WITH FLUORIDE DENTIFRICE CONTAINING TRICALCIUM PHOSPHATE. 2017

Praphasri Rirattanapong, and Kadkao Vongsavan, and Chavengkiat Saengsirinavin, and Sumana Waidee

Fluoride dentifrice is effective in preventive dental caries but may cause fluorosis, especially in young children. Reducing the concentration of fluoride from the regular concentration of 1,000 parts per million (ppm) to 500 ppm can reduce the risk for fluorosis but increases the risk of caries. Adding tricalcium phosphate (TCP) to the dentifrices may improve the efficacy of remineralization possibly allowing for a lower concentration of fluoride to reduce the risk of fluorosis. We studied this to inform future caries prevention efforts in children. We immersed 40 sound primary incisors into demineralizing solution (pH=4.4) for 96 hours at 37°C to create demineralized lesions. The 40 teeth were then divided into 4 groups of 10 teeth each. Group A: control (treated with deionized water only); Group B: treated with fluoride dentifrice at a concentration of 1,000 ppm; Group C: treated with fluoride dentifrice at a concentration of 500 ppm and 500 ppm TCP, and Group D: treated with fluoride dentifrice at a concentration of 1,000 ppm and 500 ppm TCP. The teeth were each subjected to 7 days of pH-cycling and the studied dentifrice was applied for one minute, 3 times daily during the 7 day period. After the 7 day period the teeth were each sectioned and examined with polarized light microscopy. The depths of demineralized areas were measured using Image-Pro plus software. A pair t-test was used to compare lesion depths before and after dentifrice treatment. Differences in mean lesion depths within each group were analyzed using the One-way ANOVA and LSD tests; a 95% confidence intervals were calculated. The mean lesion depths in all the groups before dentifrice treatment were not significantly different (p=0.143). The mean demineralized lesion depths after dentifrice treatment were significantly different by group (p=0.00). The mean demineralized lesion depth in Group A significantly deeper than the other groups (p=0.00). Group D had the shallowest depth, significantly shallower than the other groups (p=0.006). There was no significant difference in the mean demineralized lesion depth between Groups B and C (p=0.478). The mean demineralized lesion depth changed significantly after dentifrice treatment in all the groups (p=0.00). Group A was significantly deeper (p=0.00) and groups B, C and D were all significantly shallow. Group D had the greatest reduction in mean demineralized lesion depth (p<0.05). The 1,000 ppm fluoride plus TCP dentifrice gave superior remineralization than the 500 ppm fluoride plus TCP and the 1,000 ppm fluoride dentifrice. The 500 ppm fluoride plus TCP gave the same remineralizing effect as the 1,000 ppm fluoride dentifrice. TCP enhances remineralization on primary enamel when added to fluoride dentifrice. Our results show if TCP is added to fluoride dentifrice a lower concentration of fluoride is needed to provide the same benefit as fluoride dentifrice with a higher concentration of fluoride, reducing the risk of fluorosis in children.

UI MeSH Term Description Entries
D002130 Calcium Phosphates Calcium salts of phosphoric acid. These compounds are frequently used as calcium supplements. Phosphates, Calcium
D002327 Cariostatic Agents Substances that inhibit or arrest DENTAL CARIES formation. (Boucher's Clinical Dental Terminology, 4th ed) Cariostatic Effect,Cariostatic Effects,Agent, Cariostatic,Agents, Cariostatic,Cariostatic Agent,Effect, Cariostatic,Effects, Cariostatic
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D003802 Dentifrices Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. Polishes, Dental,Dental Polishes,Dentifrice
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005459 Fluorides Inorganic salts of hydrofluoric acid, HF, in which the fluorine atom is in the -1 oxidation state. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Sodium and stannous salts are commonly used in dentifrices. Fluoride
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014089 Tooth Remineralization Therapeutic technique for replacement of minerals in partially decalcified teeth. Remineralization, Tooth
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

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