Effect of a Single Application of CPP-ACPF Varnish on the Prevention of Erosive Tooth Wear: An AAS, AFM and SMH Study.
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The aim of this study was to investigate the in vitro effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride-containing varnish on prevention enamel erosive tooth wear.Keywords:
Amorphous calcium phosphate
Fluoride varnish
The aims of this study were (1) to assess the amount of fluoride (F) released from varnishes containing calcium glycerophosphate (CaGP) and (2) to assess the effect of the experimental varnishes on in vitro demineralization. Six test groups using 5 varnishes: base varnish (no active ingredients); Duraphat® (2.26% NaF); Duofluorid® (5.63% NaF/CaF2); experimental varnish 1 (1% CaGP/5.63% NaF/CaF2); experimental varnish 2 (5% CaGP/5.63% NaF/CaF2); and no varnish were set up. In stage 1, 60 acrylic blocks were randomly distributed into 6 groups (n = 10). Then 300 µg of each varnish was applied to each block. The blocks were immersed in deionized water, which was changed after 1, 8, 12, 24, 48 and 72 hours. Fluoride concentration in the water was analyzed using a fluoride electrode. In stage 2, 60 bovine enamel samples were distributed into 6 groups (n = 10), and treated with 300 µg of the respective varnish. After 6 h the varnish was removed and the samples were subjected to a 7-day in vitro pH cycle (6 h demineralization/18 h remineralization per day). The demineralization was measured using surface hardness. The results showed that both experimental varnishes released more fluoride than Duofluorid® and Duraphat® (p < 0.05), but Duraphat® showed the best preventive effect by decreasing enamel hardness loss (p < 0.05). Therefore, we conclude that even though (1) the experimental varnishes containing CaGP released greater amounts of F, (2) they did not increase in the preventive effect against enamel demineralization.
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The uptake of fluoride was studied in vitro after application of Duraphat varnish on dry versus wetted enamel surfaces. 30 sound premolar teeth extracted for orthodontic reasons were randomly divided into three experimental groups. Duraphat varnish was topically applied for 6 hours to the air dried surfaces of ten teeth (group 1). In group 2, 10 teeth were also treated with Duraphat but the enamel surfaces were water-wetted. In group 3, surfaces were wetted with fresh chewing-stimulated human saliva. The varnish was allowed to remain on the surfaces for 6 hours in all groups whereafter all teeth stored in synthetic saliva (37 degrees C) for one week before F-analysis performed by the acid etching method. The results indicate that the F-uptake from Duraphat varnish is increased significantly by its application to dry surfaces compared to wetted surfaces. This observation may be of clinical importance and should be further investigated.
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Aims: This study was aimed to evaluate the efficacy of self-assembling peptide, fluoride varnish, and their combination to remineralize the artificial carious lesion in vitro. Materials and methods: Sixty extracted sound premolars were randomly divided into four groups. The artificial carious lesion was created by immersion the specimens in the demineralizing solution. The enamel surface treated with: Group1: (n=15) artificial saliva alone, group2: (n=15) fluoride varnish, group3: (n=15) self-assembling peptide, group4: (n=15) self-assembling peptide + fluoride varnish. The enamel surface was assessed by Vickers surface microhardness at the baseline, after demineralization, 1-week, and 4-weeks after remineralization. Results: all four groups exhibited high statistically significant differences between the different times of test periods, In 1 and 4-weeks after remineralization, the greatest surface microhardness mean value was seen in the self-assembling peptide + fluoride varnish group followed by self-assembling peptide group then fluoride varnish group while the artificial saliva group showed the least surface microhardness mean value with a highly statistically significant difference between them. Conclusions: self-assembling peptide superior to fluoride varnish in remineralization ability and this potential is boosted when they combined together. Relating to surface microhardness, remineralization is a dynamic process that increases with time.
Fluoride varnish
Tooth Remineralization
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Aims: This study aimed to evaluate the efficacy of self-assembling peptide, fluoride varnish, and their combination to remineralize the artificial carious lesion in vitro. Materials and methods: Sixty extracted sound premolars were randomly divided into four groups. The artificial carious lesion was created by immersion the specimens in the demineralizing solution. The enamel surface was treated with: Group1: (n=15) artificial saliva alone, group2: (n=15) fluoride varnish, group3: (n=15) self-assembling peptide, group4: (n=15) self-assembling peptide + fluoride varnish. The enamel surface was assessed by a profilometer at the baseline, after demineralization, 1-week, and 4-weeks after remineralization. Results: all four groups exhibited high statistically significant differences between the different times of test periods, In 1 and 4 weeks after remineralization, the least surface roughness mean value was seen in the self-assembling peptide + fluoride varnish group followed by self-assembling peptide group then fluoride varnish group while the artificial saliva showed the greatest surface roughness mean value with a highly statistically significant difference between groups. Conclusions: self-assembling peptide superior to fluoride varnish in remineralization ability and this potential is boosted when they combined together.
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Changes to the features of the enamel surface submitted to induced demineralisation and subsequent remineralisation were studied. The in vitro examination was conducted on polished slices of human molar teeth, divided in four groups: the untreated control (n = 20), challenged by a demineralisation with orthophosphoric acid (H3PO4) (n = 20), and challenged by a demineralisation following remineralisation with fluoride (F) varnish containing casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP) compounds (n = 20). The specimens’ enamel surfaces were subjected to analysis of structure, molecular arrangement, mechanical features, chemical composition, and crystalline organization of apatite crystals. Specimens treated with acid showed a significant decrease in crystallinity, calcium, and phosphorus levels as well as mechanical parameters, with an increase in enamel surface roughness and degree of carbonates when compared to the control group. Treatment with fluoride CPP–ACP varnish provided great improvements in enamel arrangement, as the destroyed hydroxyapatite structure was largely rebuilt and the resulting enamel surface was characterised by greater regularity, higher molecular and structural organisation, and a smoother surface compared to the demineralised one. In conclusion, this in vitro study showed that fluoride CPP–ACP varnish, by improving enamel hardness and initiating the deposition of a new crystal layer, can be an effective remineralising agent for the treatment of damaged enamel.
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Abstract – To study the efficacy of sodium fluoride varnishes and a NaF solution in remineralization of enamel, 120 slabs of non‐carious human enamel enamel were presoftened for 6 h and randomly divided into six groups. The slabs were stored in synthetic saliva for 9 days, except for a daily 30‐min immersion in 0.1 M lactic acid‐NaOH buffer. During the 9‐day period, one group of the slabs received no treatment, and the rest were treated once or three times with 2.3% or 1.1% sodium fluoride varnish Duraphat, or nine times with a 0.1% NaF solution. Finally, the slabs were demineralized for 1 h, and the amount of dissolved Ca and F was determined. Microhardness of enamel was determined initially, after presoftening, after the 9‐ day period, and after the 1‐h demineralization. All fluoride treatments prevented enamel softening almost completely during the 9 days, but the control slabs softened markedly. Fluoride varnishes were more effective than NaF solution. Three applications of 2.3% Duraphat were slightly more effective than any of the other varnish treatments, but one treatment with 2.3% varnish was not more effective than treatments with 1.1% varnish. Enamel treated three times with 1.1% varnish showed the greatest acid resistance during the 1‐h demineralization. The results suggest that the efficacy of the varnish was not proportional to the fluoride concentration but rather to the number of applications. Fluoride uptake by enamel was greatest with the most concentrated varnish. Enamel solubility was not, however, directly proportional to the fluoride content of enamel.
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BACKGROUND: Early carious lesions are reversible, via remineralization. In recent years, newer remineralization dental varnishes based on phosphopeptides from milk protein, casein has been developed. The casein phosphopeptide-amorphous calcium phosphate complexes (CPP-ACP) interact with fluoride ions to produce an amorphous calcium fluoride phosphate, which provides calcium, fluoride and phosphate ions to promote remineralization with fluorapatite that is more resistant to future acid challenge. With this background, the present study was undertaken.
AIM AND OBJECTIVE: To evaluate the remineralization potential of fluoride varnish containing 5% sodium fluoride with casein phosphopeptide- amorphous calcium phosphate and to compare it with that of 5% sodium fluoride varnish on artificial enamel caries-like lesions in human primary and permanent teeth, using polarized light microscopy.
MATERIALS AND METHODS: Twenty permanent and ten primary sound anterior teeth were coated with nail varnish, leaving three 1x1 mm windows before being immersed in demineralizing solution for four days, following which the testing varnishes were randomly applied to the incisal and cervical windows and nail varnish applied to the middle window. Samples were subjected to pH cycling and longitudinally sectioned and examined under polarized light microscopy. Lesion depth was measured using computerized
method with Image-Pro Plus Program. Data was statistically analysed using paired sample t test and independent sample t test.
RESULTS: Both varnishes produced significant reduction in lesion depth in both primary and permanent teeth (p=0.000).* The fluoride varnish containing 5% sodium fluoride with casein phosphopeptide-amorphous calcium phosphate had enhanced remineralization potential than that of 5% sodium fluoride varnish alone in both primary (p=0.009)* and permanent teeth (p=0.019).*
CONCLUSION: There was significant reduction in depth of carious lesions in primary and permanent teeth after treatment with both varnishes; however, the fluoride varnish containing 5% sodium fluoride with casein phosphopeptide-amorphous calcium phosphate had increased remineralization potential than that of 5% sodium fluoride varnish both in primary and permanent teeth.
Fluoride varnish
Amorphous calcium phosphate
Fluorapatite
Sodium fluoride
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This study aimed at evaluating the effect of 1 and 4% titanium tetrafluoride (TiF4) gels, amine fluoride (AmF) 1 and 0.25% and a fluoride varnish (FP) on the prevention of dental erosion. Two experimental groups served as controls, one with no pretreatment and another one pretreated with a fluoride-free varnish (FP-blanco). Dental erosion was modelled using bovine enamel samples submitted to alternate cycles of acid exposure in citric acid and remineralization in artificial saliva. Calcium loss of all samples involved in the study was quantified by atomic absorption spectroscopy and erosion depths were estimated. Two samples of each experimental group were also analyzed by white light confocal microscopy. The cumulative erosion depth (in mum) after 72 min was: TiF4 gel 1% 8.29 +/- 0.39; TiF4 gel 4% 8.27 +/- 0.55; AmF 1% 8.69 +/- 0.66; AmF 0.25% 8.86 +/- 0.33; FP 3.43 +/- 1.07; FP-blanco 14.86 +/- 1.59 and control 9.77 +/- 0.49. A statistically significant protective effect (p < or = 0.001) was found only for the group pretreated with the fluoride varnish. Within the limitations of an in vitro study it may be concluded that topical applications of the fluoride varnish tested have a protective effect on the prevention of dental erosion.
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Tooth Remineralization
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The analysis of remineralization effect in fluoride varnish using confocal laser scanning microscope
It is well established that fluoride products play an important role in the prevention and remineralization of carious lesion. Fluoride varnish is a concentrated topical fluoride and varnishes adhere to tooth surface, permitting prolonged fluoride exposure and uptake. In this study, the artificial initial enamel caries was caused on the sound human enamel and divided 60 specimens into three groups. Group 1 and group 2 were treated with the topical application of fluoride varnish and stored in artificial saliva for 1 and 2 weeks. Group 3 was stored in artificial saliva for 2 weeks, which acted as control group. Changes in mineral contents were analysed with the confocal laser scanning microscope. The following results were obtained: 1. In group 1 and group 2, the total fluorescence of the lesion(TFL) was reduced in remineralized area compared to in demineralized area(p
Fluoride varnish
Tooth Remineralization
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Abstract Introduction The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro . Methods MI varnish containing casein phosphopeptide–amorphous calcium phosphate (CPP‐ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model. Results Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish ( P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%). Conclusion Varnish containing fluoride and CPP‐ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.
Fluoride varnish
Tooth Remineralization
Amorphous calcium phosphate
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