Effect of xylitol varnishes on enamel remineralization of immature teeth: in vitro and in situ studies

Abstract

We evaluated the efficacy of xylitol varnishes on the remineralization of newly erupted permanent and deciduous teeth in vitro and in situ. Human enamel specimens were randomly allocated to 8 groups (n = 15/group). Artificial caries lesions were produced and enamel alterations were quantified by surface/subsurface hardness and transverse microradiography. The blocks were then treated with the following varnishes: Duraphat TM ; 20 wt% xylitol (146 μm) varnish; 20 wt% milled xylitol (80 μm) varnish, and placebo varnish, and removed after 6 h of immersion in artificial saliva. In vitro: the blocks were subjected to pH-cycles for 8 days. In situ: fifteen subjects wore palatal appliances containing four pre-demineralized and treated enamel specimens, for 5 days. Data were statistically analyzed by ANOVA/ Tukey and Kruskal-Wallis/Tukey's test (p < 0.05). The %SHR in both studies was significantly increased by xylitol and Duraphat™ varnishes when compared to placebo. Considering subsurface remineralization, only the xylitol varnishes were able to significantly reduce the enamel lesion. Xylitol varnishes can be promising alternatives to promote enamel remineralization of newly erupted permanent and deciduous teeth.

Comparison Effect of Two Remineralizing Varnishes on Demineralized Enamel in Vitro

“…Within the cyclical pH model, remineralization is an important process, which is why in this study it was carried out with a remineralizing solution at a pH of 7.0 in which the samples were immersed for 21 hours after the application of the remineralizing agents, treated for a period of 15 days; On the other hand, some authors (SahitiJ Sai., 2020;Pinto Priscila., 2017;Santos Gabriela., 2021) carry out the remineralization process using artificial saliva, changing it every 24 hours before immersion of the treated samples for 7 days only; Likewise, Rodríguez (Rodriguez Maria Ana, 2018) used human saliva as a remineralizing medium, collecting daily fresh saliva from five volunteers, after which the different saliva samples were mixed and shaken to obtain a homogeneous solution. However, this process is not completely reliable since the oral conditions of each volunteer are different, which is why in this study a remineralizing solution was prepared instead.…”

Inhibition of incipient caries lesion progression by different fluoridated varnishes

“…However, the manufacturer does not report the concentration of xylitol added to the varnish. Since the best results of previous studies were obtained with 20% xylitol in varnishes (16,17,18,19) or 10% xylitol in toothpaste (20), it is not possible to say whether the effect of xylitol added to Profluorid™ is only favoring the taste of the varnish or if it could also be therapeutic.…”

Preventive and remineralization agents in pediatric dentistry: review of the literature

“…The increased levels of calcium and phosphate in stimulated saliva limit demineralization and enhance remineralization. 16 In an in vitro study, Siqueira et al 17 found that a varnish containing xylitol had a significantly higher remineralization capacity compared to non-xylitol varnishes. 18…”