Comparison of the remineralisation potential of five toothpastes on eroded human
enamel produced by a soft drink
Alhamdan M, McDonald A, Knowles J
UCL Eastman Dental Institute
256 Gray’s Inn Road, London. WC1X 8LD | www.ucl.ac.uk/eastman
Introduction
Results:
Erosion of dental tissues refers to the irreversible chemical and chemical-mechanical processes
that involves dissolution of dental hard tissues by acid s with no inclusion of any bacterial action
All data was analysed using SPSS (Statistical Package for the Social Sciences) for Windows.
(Hemingway et al., 2006, Poggio et al., 2013, Barbour and Rees, 2004). Those acids can be either
Levene’s test was used to assess the normality of the data. One-way ANOVA was used to compare
intrinsic as hydrochloric acid from gastrointestinal refluxes, or extrinsic as soft drinks and fruit
the percentage of SMH change between groups. The mean pre and post treatment VHN of all
juices.
groups are plotted in Table 2.
Published data has established the protective as well as therapeutic action of fluoride in the repair
It is observed from Table 2 and fig.1 that the PC group showed the highest SMH loss of all groups
of demineralised enamel (Ganss et al., 2011, Cassimiro-Silva et al., 2016). Studies have shown
(55% loss from baseline with145 VHN units change) with statistically significant differences
fluoride to reduce enamel loss after acidic challenges (Ganss et al., 2013, Hornby et al., 2014). A
registered only against SP and TM which showed the lowest alteration in SMH (14%, 22%) and 47,
calcium silicate and sodium phosphate salts toothpaste and a dual phase booster gel has also been
61 VHN units change respectively. No significance was found between the other treatment groups,
developed to provide additional enamel remineralisation benefits. The toothpaste has been shown
where R, R+, and D, had similar reduction outcome (30%, 32%, and 35% loss) and SMH reduction
to form hydroxyapatite on enamel surface by depositing calcium silicate. Casein phosphopeptides
by 77, 78,102 VHN units respectively.
(CPP)-amorphous calcium phosphate (ACP) has also been used to mitigate dental erosion. This
compound seems to cause the formation of a layer that fills the enamel interprism cavities
Table 2. Mean pre- and post-treatment SMH (VHN)± standard deviation, mean SMH reduction and
(Cassimiro-Silva et al., 2016, Poggio et al., 2009).
percentage loss obtained in six groups:
Aims
The aim of the present in vitro study was to compare the remineralisation potential of 5 toothpastes
(Sensodyne Pronamel, Regenerate, Regenerate with boosting serum, Tooth mousse, and Duraphat
5000) on repairing enamel erosion produced by a soft drink (Coca Cola).
Materials and methods
Thirty human enamel specimens from the buccal surface of maxillary third molars were used for
this study. Teeth were randomly allocated into 6 groups (n=6). Positive Control (PC), Sensodyne
Pronamel (SP), Regenerate (R), Regenerate with Booster serum (R+), Tooth mousse (TM), and
80
Colgate Duraphat 5000 (CD). The toothpastes used with their active ingredients are listed in Table1.
70
Specifix resin was used to embed the teeth exposing the buccal surface of the crown. The enamel
60
surfaces were ground flat with water-cooled silicon carbide discs (220, 500,1200 and 2000 grade
55
50
microhardness was tested for all samples. The Wallace microindentation tester (H. W. Wallace &
Co. LTD. Croydon, England) was used to apply 250g load for 15 sec. Each indentation was
repeated 6 times, with a distance interval of 100 µ, starting at a point 200µ from the edge of the
% SMH loss
papers) then polished with felt paper wet by diamond spray. Before any treatment, surface
40
35
30
32
30
22
20
14
sample.
10
All specimens were eroded twice daily in a cola drink (Coca Cola, CC; pH = 2.7; Coca Cola, UK)
0
PC
for 4 intervals of 2 min at 0, 12, 24, 36, 48, and 60 h, then rinsed with distilled water for 10 sec using
SP
R
R+
TM
CD
Treatment
a squeeze bottle. In treatment groups, toothpaste slurries were applied after each erosive challenge
for 3 min. Toothpaste slurries were prepared by dilution in distilled water (2:1 w/w) (TM was applied
Fig1. Percentage of microhardness change among 6 groups
as is without dilution into a slurry according to the manufacturer’s recommendation). Between tests,
the specimens were rinsed with distilled water for 10 sec then stored in paraffin-wax-stimulated
saliva from one donor. A second SMH registration of all samples was made after the end of the
erosive-remineralization cycles.
Conclusions
Eroded enamel demonstrated a reduction in SMH. There was a trend towards increased surface
hardness when all toothpastes were used on eroded surfaces. Only SP and TM showed statistically
significant difference from the control group.
Table 1. Tested toothpastes and their active ingredients:
References
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