Protective effect of calcium nanophosphate and CPP-ACP agents on enamel erosion

Abstract

The aim of this study was to assess the effect of different remineralizing agents on enamel microhardness (KHN) and surface topography after an erosive challenge. Forty-eight human enamel specimens (4 × 4 mm) were randomly assigned to 4 groups: control (no treatment), fluoride varnish, calcium nanophosphate paste and casein phosphopeptide-amorphous calcium phosphate paste (CPP-ACP). Both pastes were applied for 5 minutes, and fluoride varnish, for 24 h. Four daily erosive cycles of 5 minutes of immersion in a cola drink and 2 h in artificial saliva were conducted for 5 days. KHN readings were performed at baseline and after 5 days. The percentage of enamel hardness change (%KHN) was obtained after erosion. The surface topography was evaluated by atomic force microscopy (AFM). The data were tested using ANOVA, Tukey's and paired-T tests (p < 0.05). After an erosive challenge, there was no statistically significant difference between the control (96.8 ± 11.4 KHN / 72.4 ± 3.0 %KHN) and the varnish (91.7 ± 14.1 KHN / 73.4 ± 5.5 %KHN) groups. The nanophosphate group showed lower enamel hardness loss (187.2 ± 27.9 / 49.0 ± 7.9 %KHN), compared with the CPP-ACP group (141.8 ± 16.5 / 60.6 ± 4.0 %KHN), and both were statistically different from the varnish and the control groups. AFM images showed a rough surface for the control and the varnish groups, a non-homogeneous layer with globular irregularities for CPP-ACP, and a thick homogeneous layer for the nanophosphate group. None of the agents provided protection against the development of erosion; however, nanophosphate paste was able to reduce enamel surface softening after the erosive challenge.

Thickness and nanomechanical properties of protective layer formed by TiF4 varnish on enamel after erosion

“…The specimens were immersed in artificial saliva for 6 h for clinical simulation of the contact time of the varnish with the tooth surface. 11,14 Thereafter, the varnishes were carefully removed from the surface with acetone using a scalpel blade. 9,11,14 Total removal of the layer was checked microscopically.…”

“…11,14 Thereafter, the varnishes were carefully removed from the surface with acetone using a scalpel blade. 9,11,14 Total removal of the layer was checked microscopically. The varnishes were removed to evaluate their chemical effect rather than their mechanical protection, and also to simulate the clinical situation in which varnishes might be removed post-application through regular toothbrushing and mastication.…”

“…6 The antierosive effect of TiF 4 varnish compared to conventional varnishes, such as sodium fluoride (NaF), is still contradictory. 11,12,13,14 In order to explain these contradictory results, recent speculations have been made about the deposition and thickness of the layer formed by TiF 4 varnish application, 4,15 but there is a paucity of data on the thickness and properties of the protective layer formed by TiF 4 varnish after an erosive challenge.…”

Utilização de pastas contendo fosfopeptídeo de caseína-fosfato de cálcio amorfo com e sem fluoreto na prevenção da erosão dentária: uma revisão da literatura

“…Vários estudos avaliaram o poder preventivo das pastas de CPP-ACP aplicadas no esmalte previamente ao desafio erosivo, associadas ou não ao fluoreto, comparadas a diversos outros agentes protetores, utilizando protocolos de estudo distintos e enquanto alguns 3,5,40 obtiveram resultados positivos, outros 25,27,42,44,[47][48][49][50] encontraram resultados pouco favoráveis.…”

Treatment Protocol for Dentin Hypersensitivity

“…[12][13][14][15] Nowadays, many doubts still exist in relation to the different desensitizing protocols and about the best agent that obliterates the dentinal tubules and protects the exposed dentin in the presence of intrinsic acids and extrinsic challenges. Therefore, we propose a DH treatment protocol using new desensitizing agents availed in the market, i.e., replicable in research groups as well as by dental practices.…”