Role of titanium tetrafluoride (TiF₄) in conservative dentistry: A systematic review

Abstract

The role of fluoride to reduce demineralization and enhance remineralization of dental hard tissue has been well documented. Different forms of fluoride solutions have been topically used in dentistry as prophylactic agents against tooth decay. In the recent past, metal fluorides, especially titanium tetrafluoride, have become popular in the fraternity of dental research due to their unique interaction with dental hard tissue. Many studies on titanium tetrafluoride, with positive and negative conclusions, have been published in many research journals. This gives the reader a plethora of inconclusive results with one study neutralizing the outcome of other, which confuses us regarding the present status of titanium tetrafluoride in the field of dentistry. This is an endeavor to organize and present the various studies of this unique compound, to provide us with a lucid overall review of its versatile potential application in dentistry, along with its fallacy/drawbacks. We have discussed its role as a cariostatic agent, pit and fissure sealant, tooth desensitizer, against dental erosion, as a root canal irrigant and others.

The In Situ Effect of Titanium Tetrafluoride Gel on Erosion/Abrasion Progression in Human Dentin

“…5A, 5C, 5E and 5G) and, despite that tubules remained open, they appeared partially obliterated and in reduced amount. Furthermore, the rough appearance of the samples without treatment was decreased by TiF 4 .…”

“…TiF 4 has a peculiar mechanism of action and a significant potential in reducing erosion progression (3), however, there is still no consensus on the ideal formulation for this fluoride's clinical use (2,9). The present study investigated the possible anti-erosive effects produced by 4% TiF 4 gel, under in situ conditions, with a simulated high incidence of erosive/abrasive episodes. In case of positive results regarding the control of erosion progression, it could give professionals an effective alternative for erosive lesions' in-office treatment.…”

“…The independent variables were "volunteer" and "treatment" at seven levels: three control groups subjected to 1 (C1), 2 (C2) and 3 (C3) erosive/ abrasive cycles solely; an extra control group comprising in vitro uneroded samples (UN) subjected to 3 erosive/abrasive cycles and three experimental groups, in which 4% TiF 4 gel was applied once (TiF 4 1), twice (TiF 4 2) or three times (TiF 4 3) followed by 1, 2 and 3 erosive/abrasive cycles, respectively. The dependent variable was surface loss, measured by profilometry (in µm).…”

“…In fact, fluoride products commonly used for caries prevention, as sodium fluoride, amine fluoride and acidulated phosphate fluoride, have proven to be partially effective in controlling erosive lesions (2,3), as they promote the precipitation of minerals like calcium fluoride (CaF 2 ) on the eroded surface (4). They form a layer that acts as a physical barrier to the action of acids, apart from acting as a mineral reservoir, which under erosive challenge is able to release calcium and fluoride (5).…”

“…Currently, fluoride compounds of polyvalent metal ions, especially titanium tetrafluoride (TiF 4 ), have been studied due to their unique interaction with the tooth structure, leading to the formation of an acid-resistant glaze-like layer capable of adhering strongly to the tooth surface (6). Among the existing theories to explain its action, one is that titanium is capable of reacting with the oxygen atoms of the phosphate groups of the dental tissue, forming stable titanium oxides (7) or organometallic complexes that can act as a diffusion barrier (8).…”