In situ effect of sodium fluoride or titanium tetrafluoride varnish and solution on carious demineralization of enamel

Abstract

This study evaluated the effect of titanium tetrafluoride (TiF(4)) formulations on enamel carious demineralization in situ. Thirteen subjects took part in this cross-over, split-mouth, double-blind study performed in three phases of 14 d each. In each subject, two sound and two predemineralized specimens of bovine enamel were worn intra-orally and plaque accumulation was allowed. One sound and one predemineralized specimen in each subject was treated once with sodium fluoride (NaF) varnish or solution (Treatment A); TiF(4) varnish or solution (Treatment B); or placebo varnish or no treatment (Treatment C). The initially sound enamel specimens were exposed to severe cariogenic challenge (20% sucrose, eight times daily for 5 min each time), whereas the predemineralized specimens were not. Eleven subjects were able to finish all experimental phases. The enamel alterations were quantified by surface hardness and transversal microradiography. Demineralization of previously sound enamel was reduced by all test formulations except for the NaF solution, while both TiF(4) formulations were as effective as NaF varnish. For the predemineralized specimens, enamel surface hardness was increased only by TiF(4) formulations, while subsurface mineral remineralization could not be seen in any group. Within the experimental protocol, TiF(4) was able to decrease enamel demineralization to a similar degree as NaF varnish under severe cariogenic challenges, while only TiF(4) formulations remineralized the enamel surface.

Effect of enamel pretreatment on the fluoride remineralization of artificial white spot lesions

“…The main difference in the protocol of the present study is the no renew of the solutions during the cycling as pilot tests performed before this study demonstrated that there were no differences in the enamel lesions features obtained with or without these changes. The %SHL after the DE-RE cycling was greater than 90% and the values were similar to the obtained in a previous study [15], which also used this pH cycling model. Furthermore, the validation trough TMR performed in the present study also attested the creation of subsurface lesions.…”

“…In attempt to increase the fluoride retention, different strategies were described in previous studies [14,15,17,18]. Among these strategies, the use of phosphoric acid [17] and aluminum [16,18] was associated in this study as a pre-treatment of the enamel, aiming enhance the fluoride potential of remineralization based on these two interesting methods.…”

“…The increase of the retention of this material has been shown between its association with other metals or materials [14][15][16]18]. Thus, this study aimed to investigate the role of two previously preconized methods in association: APF with phosphoric acid and aluminum nitrate to treat white spot lesions targeting to a well-reactive surface to interact with fluoride.…”

“…Investigations look for more stable complexes, aiming to improve the retention of fluoride in tooth structure and therefore, some different strategies are investigated [12][13][14][15][16]. Among them, the etching of the enamel with phosphoric acid and the application of aluminum nitrate were suggested [16][17][18].…”

Fluoride dose-response of human and bovine enamel artificial caries lesions under pH-cycling conditions

“…Among those techniques are the 'gold standard' transverse microradiography (TMR), Knoop and Vickers microhardness either used perpendicular (K-SMH, V-SMH) or parallel to the hard tissue surface, polarized light and confocal laser scanning microscopy (both used parallel to the surface), and quantitative light-induced fluorescence (used perpendicular to the surface). Researchers have either shown good [4,21,22] or poor correlations [23,24] between TMR and SMH, depending on the extent of demineralization and lesion mineral distribution. However, previous 5 laboratories approximately monthly; however, determinations of origin, exact age and other characteristics of the donor (human or animal) are impossible due to the large number of teeth received.…”