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

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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 (ΔZB). 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 (ΔΔZE1/ΔΔZE2) were calculated between values before and after pH cycling.

Results

Mean (95%CI) ΔZB 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 ΔΔZE1 and for ΔΔZE2 (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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Acknowledgments

This study was conducted as part of the doctoral thesis of M.K.

Funding

This study was funded by the authors and their institution. Products were not provided by the manufacturers.

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Author notes

  1. Peter Tschoppe and Richard Johannes Wierichs contributed equally to this work.

Authors and Affiliations

  1. Department of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    Carolin Walther, Manana Kreibohm, Hendrik Meyer-Lueckel, Peter Tschoppe & Richard Johannes Wierichs

  2. Department of Operative Dentistry and Periodontology, University School of Dental Medicine, CharitéCentrum 3, Charité – Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany

    Sebastian Paris

  3. Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland

    Hendrik Meyer-Lueckel & Peter Tschoppe

  4. Department of Biohybrid & Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute, Forckenbeckstr. 55, 52074, Aachen, Germany

    Richard Johannes Wierichs

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  1. Carolin Walther
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Correspondence to Richard Johannes Wierichs.

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Walther, C., Kreibohm, M., Paris, S. et al. Effect of NaF, AmF, KF gels and NaF toothpaste combined with a saliva substitute on dentin lesions in vitro. Clin Oral Invest 23, 2489–2496 (2019). https://doi.org/10.1007/s00784-018-2687-4

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