The Role of Fluoride and Casein Phosphopeptide/Amorphous Calcium Phosphate in the Prevention of Erosive/Abrasive Wear in an in vitro Model Using Hydrochloric Acid

Abstract

Objective: To investigate the effect of various fluoride compounds and casein phosphopeptide/amorphous calcium phosphate (CPP-ACP) on the reduction of erosive/abrasive tooth wear. Methods: Forty enamel samples were prepared from bovine lower incisors, stratified and allocated to 4 groups (1–4). Samples in group 1 remained untreated and served as negative controls. The test samples were treated for 2 min/day as follows: group 2 amine/sodium fluoride gel (pH 4.8; 12,500 ppm), group 3 sodium fluoride gel (pH 7.1; 12,500 ppm) and group 4 CPP-ACP-containing mousse. De- and remineralization cycling was performed for 20 days with 6 erosive attacks for 20 s with HCl (pH 3.0) per day. Samples were stored in artificial saliva between cycles and overnight. Toothbrushing (15 s; 60 strokes/min; load 2.5 N) with a toothpaste slurry was performed each day before the first and 1 h after the last erosive exposure. Tooth wear was measured by comparing baseline surface profiles with the corresponding posttreatment profiles. Results: Tooth wear was significantly reduced in groups 2 and 3 compared with group 1, while the enamel loss of group 4 was not significantly lower compared to the negative control group 1. Between the fluoride groups 2 and 3, no significant difference in tooth wear was recorded. Conclusion: Erosive/abrasive tooth wear under the conditions used could be reduced significantly by the daily application of fluoride gels, irrespective of the fluoride compound, while the application of CPP-ACP-containing mousse was less effective.

Durability of the anti-erosive effect of surfaces sealants under erosive abrasive conditions

“…The results of studies [36,37] using pepsin admixture to hydrochloric acid for erosion simulation are inconclusive. Therefore, in the present study, the erosive attack was performed with pure hydrochloric acid, as performed in numerous other studies [12,14,19,24,38,39].…”

“…In the recent years, studies testing new products or active ingredients, namely stannous chloride [9], cerium chloride [10] or CPP-ACP containing pastes [11], intended to prevent erosion associated dental hard tissue loss or softening, have been published. However, the effectiveness of reducing or preventing erosive tooth wear by fluoride or CPP-ACP is discussed controversially in the literature [12][13][14].…”

Biofunctional Properties of Caseinophosphopeptides in the Oral Cavity

“…Bovine teeth are a good model as they have been reported to be similar to human teeth in terms of physical and compositional characteristics [Wu et al, 2010;Wegehaupt et al, 2011]. Bovine teeth are easier to obtain than human teeth and can be sourced from the same geographical area, reducing inter-variability that can be caused by environmental and nutritional factors [Wegehaupt and Attin, 2010]. Additionally, they are normally not in contact with fluorides and do not present caries [Wegehaupt and Attin, 2010].…”

“…In recent times while there appears to be a decline in dental caries prevalence [Borges et al, 2011], more attention is now being given to dental erosion [Tantbirojn et al, 2008] as an increase in its prevalence has been observed [Ranjitkar et al, 2009a;Wang et al, 2011]. Erosion is the consequence of the contact of teeth with low pH solutions (pH 1-3), which occurs during the consumption of acidic foods and fluids, or when gastric fluids get into the oral cavity [ten Cate, 1999;Lussi, 2009;Panisch and Poolthong, 2009;Hannig and Hannig, 2010;Wegehaupt and Attin, 2010;Barbour et al, 2011]. In a recent review, Barbour et al [2011] described low pH as the main factor in erosion and values below pH 5.0 have been reported as the threshold pH for erosion detection.…”

“…Erosion can also be associated with parameters such as abrasive conditions during teeth cleaning or physiological deficiencies such as low saliva flow [Lussi, 2009]. Enhancement of the extent of tooth remineralisation has been proposed as a means to prevent dental erosion [Wegehaupt and Attin, 2010].…”