Comparative Effects of CPP-ACP and Xylitol F-Varnishes on the Reduction of Tooth Erosion and Its Progression

Abstract

Evaluated the effect of CPP-ACP/NaF and xylitol/NaF varnishes in reduce erosion and progression of erosion. Forty enamel blocks were divided into four groups (n=10): G1=CPP-ACP/NaF varnish (MI varnishTM); G2=xylitol/NaF varnish (Profluorid®); G3=NaF varnish (Duraphat®, positive control) and G4=deionized water (MilliQ®, negative control). Samples were immersed in Sprite ZeroTM (pH 2.58, 4x/day, 3 days), in between immersions, the specimens stayed in artificial saliva. After 3 days of erosion, the eroded area was divided in two (half of one received an additional varnish layer while the other half repeated the same 3-day erosion cycle). The 3D, non-contact profilometry technique was used to determinate tooth structure loss (TSL) and surface roughness (SR). Scanning electron microscopy (SEM) and 3D images were utilized to evaluate the topography of the samples. Mann-Whitney, one-way ANOVA and Tukey tests were used (significance level of 0.05%). SEM and 3D images were descriptively evaluated. After 3 or 6 days of erosion, all tested varnishes were better than G4 (p<0.05) for TSL and SR. In addition, G1 had lower values for TSL than G3 (p<0.05) after 3 days of erosion. Under SEM and 3D images observation, all groups presented porosity, irregularities and depressions on the surface enamel after 3 and 6 days of erosion, more pronounced in G4. An application of topical NaF varnishes was effective in reducing TSL and enamel roughness after erosion challenges, being the CCP-ACP/NaF varnish more effective than NaF varnish and water after 3 days of erosion.

Xylitol Fluoride Varnish: In Vitro Effect Analysis on Enamel by Atomic Force Microscopy

“…It acts as a physical barrier, inhibiting the contact of the acid with the enamel. At the same time, this layer is also involved in the demineralization and remineralization processes: once the formation of fluoride reservoirs takes place, it participates in the inhibition of the demineralization process and in the precipitation of fluor(hydroxy)apatite [ 32 ].…”

“…Due to this property, it is believed that xylitol may increase remineralization and may inhibit the dissolution of calcium and/or phosphate ions from the enamel structure. However, the role of xylitol as a preventive or remineralizing agent has not yet been sufficiently demonstrated [ 32 , 33 ].…”

“…The product used in the present study is a varnish containing xylitol/NaF, which produced a reduction in the roughness of the enamel and the loss of hard dental tissue after its abrasion. The values obtained in terms of surface roughness indicate that the varnishes containing this combination of xylitol and NaF are able to achieve surface protection [ 32 ].…”

“…Regarding the presence of xylitol, it probably did not increase the protection capacity of the product against mineral losses. The results of a study conducted by Alexandria [ 32 ] indicated that fluoride- and xylitol-containing varnish reduced the enamel demineralization but not to a greater extent than xylitol-free fluoride-containing varnish.…”

Evaluation of the protective effect on enamel demineralization of CPP‐ACP paste and ROCS by vibrational spectroscopy and SAXS: An in vitro study

“…Alexandria, Valença, Cabral, and Maia (2020) evaluated the effect of CPP‐ACP/NaF and xylitol/NaF varnishes in reducing erosion and progression of erosion on 40 enamel blocs. Samples were immersed in a soft drink.…”