Effect of the Mixture of Coffee or Chocolate to Milk in the Progression of Des-Remineralization of Tooth Enamel -An in Vitro Study

Objective:To evaluate if there is any interference when adding coffee or chocolate to cow milk in the enamel des-remineralization process (orange juice/saliva).Material and Methods:48 specimens of human enamel (4x4 mm) were included in acrylic resin, ground flat, polished and randomly divided into the following experimental groups (n = 8): G1-saliva, G2-orange juice, G3 orange juice / milk; G4-Orange Juice / Chocolate, G5-Orange Juice / Coffee + milk and G6-milk. Each group was immersed for 60 seconds on each solution proposed and then immersed for 30 minutes in saliva. This cycle was repeated 4 times. Prior to these cycles, the Knoop microhardness average of each specimen was obtained. After the challenges proposed, the final microhardness average was calculated. The values obtained from the difference between the initial and final microhardness were subjected to ANOVA followed by Tukey test (p <0,05).Results:The orange juice had the highest change in microhardness and statistically different from all other groups. The microhardness change was statistically similar in the groups submitted to orange juice followed by immersion in milk, in chocolate and in the mixture milk + coffee. The pure milk and saliva caused no change in surface hardness of enamel.Conclusion:Milk or the addition of chocolate and coffee to milk was able to produce aprotective effect of the enamel surface against an erosive challenge

Effect of mouthrinses with different active agents in the prevention of initial dental erosion.

Introduction: Hydrochloric acid (HCl) from the gastric juice is the only source of intrinsic acid, which can reach the oral cavity in cases of gastroesophageal reflux or chronic vomiting, enhancing the risk of dental erosion. Aim: Compare the effects of mouthrinses with different active agents in the prevention of initial dental erosion caused by HCl. Subjects and Methods: Casein (CAS at 0.2%), sodium hexametaphosphate (HMP at 0.02%), titanium tetrafluoride (TiF4 at 0.34%), and stannous fluoride (SnF2 at 0.87%) were individually added to an experimental mouthrinse. The mouthrinse without additives was used as the negative control (C) and a commercially available mouthrinse for erosion (ELM – Elmex®) as the reference product. Enamel specimens were exposed to human saliva and randomly assigned to 6 experimental groups (n = 8). Specimens were submitted to erosion in HCl for 10 s, followed by to the experimental mouthrinses for 30 s, and artificial saliva for 60 min. This cycle was repeated 3 times. The total amounts of calcium and phosphorus released by the specimens in the 2nd and 3rd erosive challenges were evaluated by atomic emission spectrometry. Statistical analysis used Shapiro–Wilks and Hartley tests, followed by one‑way ANOVA and Tukey tests. Results: When compared with C, ELM and HMP presented significantly less calcium in solution, with no difference between them. All the groups showed similar and significantly less phosphorus than C, except CAS. Conclusions: HMP was the only agent that could match the protection against initial erosion of the commercially available mouthrinse in both analyses.

Comparação da ação de princípios ativos incorporados a um enxaguatório bucal na prevenção/controle da erosão dental / Comparison of action of an oral rinse embedded with active principles to prevention/control of dental erosion

O objetivo deste estudo foi comparar, in vitro, empregando diferentes métodos de análise, a ação de superfície de alguns enxaguatórios bucais experimentais para a prevenção/controle da erosão dental causada por ácido clorídrico incorporando-se diferentes princípios ativos. Um enxaguatório bucal experimental sem aditivos, um enxaguatório para erosão disponível comercialmente, Elmex Erosion® (AmF/NaF/SnCl2) (ELM), e um enxaguatórios acrescidos de 4 diferentes aditivos foram testados quanto a sua capacidade de proteção contra erosão em um modelo de erosão-remineralização, onde as variáveis resposta foram a alteração da micro e da nanodureza e as quantidades de cálcio e fosfato liberadas em solução, determinadas por espectrometria de emissão óptica. Os aditivos utilizados foram: Caseína (CAS 5 g/L), Hexametafosfato de sódio (HMP 0,2 g/L), Tetrafluoreto de titânio (TiF4 3,4g/L) e Fluoreto estanhoso (SnF2 8,7g/L). Espécimes de esmalte bovino foram incluídos em resina acrílica e polidos. Esses foram distribuídos nos grupos (n=8) e ciclados da seguinte forma: (1) Imersão em 20 ml de ácido clorídrico (HCl) a 0,01M pH = 2,4 por 10 s, (2) imersão em 20 ml de saliva artificial por 60 s, (3) imersão em 20 ml de solução teste por 30 s e (4) imersão em 20 ml de saliva artificial por 60 s

Este ciclo foi repetido por 3 vezes por um dia e as soluções utilizadas foram armazenadas para posterior avaliação. Para microdureza, os espécimes tratados com ELM e SnF2 apresentaram os maiores valores de dureza, os quais foram significantemente diferentes de TiF4, que apresentou o menor valor. O ELM, SnF2, CAS e HMP foram semelhantes estatisticamente ao C. Para nanodureza, o TiF4 apresentou menor valor médio de dureza e significantemente diferente do C. O SnF2, ELM, CAS e HMP apresentaram-se estatisticamente semelhantes ao C. Na análise de perda de cálcio da ciclagem final, ELM e HMP resultaram em menor perda de cálcio e estatisticamente diferentes do C. Na primeira imersão, todos os grupos testados, exceto a caseína, mostraram significantemente menor perda que o C e, na segunda, não foi constatada diferença estatística significante. Na análise de perda de fosfato da ciclagem final, ELM e TiF4 apresentaram as menores perdas de íons, sendo significantemente diferente do C. Na primeira e segunda imersões, somente ELM mostrou-se estatisticamente diferente do C. Conclui-se que o ELM, o HMP e o TiF4 protegeram a superfície de esmalte quanto a perda de íons porém os testes de dureza não detectaram essa proteção.

The objective of this study was to compare, in vitro, using different methods of analysis, the effect on surface of an experimental mouthrinse modified with different active ingredients for the prevention / control of dental erosion caused by hydrochloric acid. An experimental mouthrinse without additives, a commercially available mouthwash for erosion Elmex Erosion ® (AmF/NaF/SnCl2) (ELM) and four mouthrinses added 4 different additives were tested for their ability to protect against erosion in a model of erosion-remineralization, where the response variables were the change of micro-and nanohardness and the quantities of released calcium and phosphate in solution, determined by optic emission spectrometry. The additives used were: casein (CAS 5 g/L), sodium hexametaphosphate (HMP 0.2 g/L), titanium tetrafluoride (TiF4 3.4 g/L) and stannous fluoride (SnF2 8.7 g/L). Bovine enamel specimens were embedded in acrylic resin and polished. They were ramdomily distributed in groups (n=8) and submitted to the following cycle: (1) immersion in 20 ml of 0,01M hydrochloric acid (HCl), pH = 2.4 10 s, (2) immersion in 20 ml of saliva artificial for 60 s, (3) immersion in 20 ml of test solution for 30 seconds and (4) immersion in 20 ml of artificial saliva for 60 s. This cycle was repeated three times during the same day and the solutions were stored for later evaluation.

For microhardness, the specimens treated with ELM and SnF2 showed the highest values of hardness, being significant different from TiF4 solution, which presented the lowest value. The ELM, SnF2, CAS and HMP were statistically similar to C. For nanohardness, the TiF4 had the lowest value of hardness, being significant different from C. The SnF2, ELM, CAS and HMP were statistically similar to C. In the calcium analysis after the last cycle, ELM and HMP resulted in less calcium loss, which was significantly different from C. After the first immersion, all groups tested, except casein, showed statistically lower calcium loss when compared to group C and there was no difference in statistical analysis of loss of phosphate in the second. In analysis of phosphate loss after the final cycle, ELM TiF4 showed the lowest losses being significant different from C. After the first and the second cycles, only ELM was statistically different from C. It can be concluded that the ELM, HMP and TiF4 protect the enamel surface against ions loss but the hardness tests could not detect this protection.