Prevention of Erosion and Abrasion by a High Fluoride Concentration Gel Applied at High Frequencies

Abstract

The aim of this study was to determine maximum attainable protection of enamel from erosion and erosion abrasion using a highly fluoridated gel with and without additional fluoride from toothpaste. Thirty-six bovine enamel specimens were subjected to six erosive attacks per day (1% citric acid with pH 2.3 for 30 s), while the rest of the day the specimens were in artificial saliva. There were four treatment groups (9 specimens in each group): fluoride-free toothpaste/saliva slurry twice daily (group T0), fluoride-containing toothpaste/saliva slurry twice daily using 1,250 ppm F toothpaste (group TF), fluoride-containing toothpaste/saliva slurry twice per day plus application of a highly fluoridated gel (12,500 ppm F) twice a day for 120 s (group 2F) and a group with gel application 8 times a day (group 8F). Additionally, half of each specimen in all groups was subjected to brushing abrasion during application of the toothpaste/saliva slurry. Brushing abrasion alone led to no observable enamel loss measured with profilometry. After 14 days of cycling of erosion without toothbrushing abrasion, high-fluoride gel application 2 or 8 times daily showed significantly less enamel loss (median 24/19 µm) than with toothpaste with or without fluoride (41/45 µm). After 14 days of cycling of erosion and toothbrushing abrasion, gel application 2 or 8 times daily (33/29 µm) showed significantly less enamel loss than toothpaste with or without fluoride (57/62 µm). We conclude that a highly fluoridated acidic gel is able to protect enamel from erosion and toothbrushing abrasion while fluoridated tooth paste provides little protection.

Effect of sodium, amine and stannous fluoride at the same concentration and different pH on in vitro erosion

“…The efficacy of different fluoride compounds to decrease the progression of the erosive process has been demonstrated in several studies. 9,13 Thereby, most studies focused on fluoride compounds that have been used over years for caries prevention, such as sodium fluoride (NaF), stannous fluoride (SnF 2 ) or amine fluoride (AmF).…”

“…17 As high concentrated fluoride agents or a prolonged application time might lead to a thicker and more stable CaF 2 -precipitate, an intensive fluoridation is considered as most effective for prevention of erosive enamel loss. 4,13 While most studies focused on the impact of the fluoride concentration and the pH-value of the fluoride agent on erosion, only few studies compared the efficacy of fluorides with respect to the fluoride compound. Thereby, SnF 2 containing toothpastes and solutions showed a better protective capability against erosion-like lesions than NaF agents.…”

Effect of Different Fluoridation Regimes on the Microhardness of Bleached Enamel

“…15 Generally, the fluoridation of bleached enamel is frequently recommended for improving microhardness 7,14 and, thus, increasing the abrasion resistance of softened enamel. [16][17] However, there is no general agreement on the optimal time point of fluoridation during the bleaching regime. On one hand, the application of fluoride gels for several days prior to the bleaching treatment might be advisable, as fluoride increases the demineralization resistance of enamel and, therefore, might prevent microhardness loss during the subsequent bleaching treatment.…”

Protection of short-time enamel erosion by different tetrafluoride compounds

“…[1][2][3] Recently, research into dental erosion focused on the antierosive potential of titanium tetrafluoride (TiF 4 ), which is suggested to be more effective in inhibition of enamel erosion or carious demineralisation than sodium, stannous or amine fluoride. [4][5][6][7] Hove et al 5 reported that TiF 4 (0.5 M F) reduced enamel erosion almost completely (88%), while SnF 2 and NaF treatment resulted in only 50% or 25% protection, respectively.…”