Effect of NaF, AmF, KF gels and NaF toothpaste combined with a saliva substitute on dentin lesions in vitro

Abstract

Objective

The aim of the present in vitro study was to evaluate the remineralizing effects of NaF, AmF, KF gels and NaF toothpaste in combination with a potentially demineralizing saliva substitute (Glandosane; pH = 5.1) being widely used in Germany.

Methods

In each of 120 dentin specimens, three artificial lesions were created. One lesion was covered for analysis of pre-demineralization (ΔZ_B). Treatments during pH cycling (3 × 1 h demineralization/day [pH = 5.0] and 3 × 3 h Glandosane/day; 12 h 100%humidity) were as follows: no treatment (NT), application (5 min,2×/day) of 12.500 ppm F⁻ [pH = 6.04] (NaF-gel₁), 12.500 ppm F⁻ [pH = 7.34] (NaF-gel₂), 12.500 ppm F⁻ [pH = 5.82] (AmF-gel), 1450 ppm F⁻ [pH = 7.35] (KF-gel), and 5000 ppm F⁻ [pH = 8.14]; (NaF-TP) for 7 days (E1). Subsequently, from each specimen, one lesion was covered, while the remaining lesion was cycled for another 7 days (E2). Differences in integrated mineral loss (ΔΔZ_E1/ΔΔZ_E2) were calculated between values before and after pH cycling.

Results

Mean (95%CI) ΔZ_B was 3851 (3762;3939) vol% × μm. Except for NaF-gel₂ and NaF-TP, specimens of all other groups further demineralized. Only NaF-gel₂ induced a significant gain in mineral content (p ≤ 0.004; paired t test). Significant differences in the change of mineral loss were found between NT and all fluoride groups for both ΔΔZ_E1 and for ΔΔZ_E2 (p < 0.05, Bonferroni post hoc test). However, only NaF-gel₂ and NaF-TP induced remineralization.

Conclusion

Under the in vitro conditions chosen, all fluoride agents could significantly hamper the adverse effects of a demineralizing saliva substitute.

Clinical significance

In combination with a demineralizing saliva substitute, slight mineral gain was only observed for neutral NaF-gel₂ and 5000 ppm F⁻ toothpaste.

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