Adverse effects of respiratory disease medicaments and tooth brushing on teeth: A scanning electron microscopy, X‐ray fluorescence and infrared spectroscopy study

Abstract

The present study aims to evaluate the effect of brushing with fluoride dentifrice on teeth severely affected by erosion due to respiratory medicaments. Enamel (n = 50) and dentin (n = 50) bovine specimens were prepared and treated with artificial saliva (S‐control), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS) and subjected to cycles of demineralization (immersing in 3 mL, 1 min, three times a day at intervals of 1 hr, for 5 days) followed by remineralization (saliva, 37°C, 1 hr). Simulated brushing with fluoridated toothpaste was performed using 810 strokes in a reciprocal‐action brushing simulator. Scanning electron microscopy, micro energy dispersive X‐ray fluorescence (μ‐EDXRF) spectroscopy and attenuated total reflection Fourier transform infrared (ATR FTIR) spectroscopy were then performed. μ‐EDXRF images showed extensive erosion after treatment with all medicaments. SEM images showed enamel erosion in order SS > BR > AC = AM > S after brushing and fluoridation. FTIR results were in agreement. In case of dentin, μ‐EDXRF measurements showed significant difference in mineral content (percent weight of calcium and phosphate) in SS + brushing + fluoridation treated enamel compared to control, while μ‐EDXRF images showed erosive effects in the order SS > AM>BR > AC = S post brushing + fluoridation. SEM images showed erosion in the order SS > AM = BR > AC > S post brushing + fluoridation. Again, FTIR multivariate results were in agreement. Overall, our study shows that proper oral care is critical when taking certain medication. The study also demonstrates the possible use of FTIR for rapid clinical monitoring of tooth erosion in clinics.

Biomineralization induced by chitosan and collagen‐based materials with fluoride for dentin coverage: Chemical and morphological analysis

“…Briefly, 50 bovine incisor teeth were selected, cleaned, and sectioned buccolingually through the cementoenamel junction. The obtained sections of roots were prepared by mesiodistal sectioning at the middle, resulting in two blocks per tooth ( n = 100, ~8 mm long, 8 mm wide, and 6 mm thick) (Gomes et al, 2019). The dentin slabs were ground and polished to produce parallel surfaces (both labial and lingual sites) with wet 600 and 1,200‐grit silicon carbide paper (Arotec, Cotia, Brazil) at 150 rpm and cleaned by ultrasonication in deionized water for 10 min (Maxiclean 1450, Merse, Campinas, Brazil) (Gomes et al, 2019; Nahorny et al, 2017; Soares et al, 2020).…”

Biological and antimicrobial properties of the association Ambroxol and a water-soluble viscous liquid as a vehicle for a tricalcium silicate-based sealer

“…Deposition of mineralized tissue is associated with the ability of biomaterials to release Ca +2 ions [21]. Studies have shown that Ambroxol blocks calcium and sodium channels [38] and reduces the mineral percentage of calcium and phosphate in dentin [15][16][17]. In this study, mineralization areas were identified, showing that any experimental sealer inhibited calcium release.…”

“…Ambroxol is a mucolytic expectant agent investigated for the treatment of respiratory diseases since it promotes the reduction of mucus viscosity; exhibits antioxidant, anti-inflammatory, and analgesic effects [13]; as well as shows antimicrobial properties [14]. Until now, only a few studies verifying the use of Ambroxol in dentistry have been carried out [15][16][17], which demonstrate that regular and prolonged use of this drug may be considered as a risk factor for dental erosion once a reduction in the mineral percentage of calcium and phosphate is detected. Even though these studies clearly demonstrate Ambroxol's erosive effect, there is an absence of data concerning its use in the endodontic field, especially in the context of the development and/or improvement of sealers.…”

Does the composition of toothpaste affect the tooth resistance to erosion/abrasion processes?

“…Enamel is a highly mineralized tissue, with the inorganic portion being predominant (~96% nonstoichiometric form of hydroxyapatite). A tubular structure forms the dentin architecture, which contains more organic material (collagen) and is more soluble than enamel (Gomes et al, 2019;Lussi et al, 2011;Shellis et al, 2010). Gomes et al (2019) reported morphological and chemical differences between enamel and dentin brushed with a conventional fluoridated dentifrice after chemical erosion by acidic medicaments, showing a severe inorganic material loss in dentin after abrasion by brushing in a compromised substrate.…”

“…A tubular structure forms the dentin architecture, which contains more organic material (collagen) and is more soluble than enamel (Gomes et al, 2019;Lussi et al, 2011;Shellis et al, 2010). Gomes et al (2019) reported morphological and chemical differences between enamel and dentin brushed with a conventional fluoridated dentifrice after chemical erosion by acidic medicaments, showing a severe inorganic material loss in dentin after abrasion by brushing in a compromised substrate. The study suggested that brushing adds to the erosion caused by respiratory medicaments and that fluoridation by a conventional dentifrice has a very limited protective role.…”