Contenido de fluoruro en dentífricos de venta en el mercado nacional / Fluoride content in toothpastes sold in the national market

Introducción: Actualmente, existe una gran variedad de pastas dentales que se pueden encontrar en el mercado nacional, para diferentes propósitos. Entre éstas se hallan las empleadas para la prevención de caries. Éstas contienen fluoruro en diversas concentraciones como agente terapéutico, y casi en su totalidad estipulan en sus marbetes un contenido de 1,000 a 1,450 partes por millón (ppm) de fluoruro. Algunos estudios han mostrado que las concentraciones de fluoruro especificadas en la etiqueta y lo encontrado en el dentífrico no coinciden. Objetivo: Evaluar la concentración de fluoruro total con base en la Norma Mexicana NMX-K-539-CNCP-2013, que establece que los dentífricos no deben contener más de 1,500 ppm de fluoruro. Así como determinar si lo declarado en el marbete de sus empaques corresponde al contenido real de fluoruro. Material y métodos: El estudio se realizó, por triplicado, en 37 pastas dentífricas. El método para determinar la concentración de fluoruro fue el de ion selectivo, descrito por la Farmacopea de los Estados Unidos Mexicanos. Resultados: El promedio de concentración de este elemento fue de 1,262 ppm F- (± 170.7). El 59% de los dentífricos analizados no contienen la cantidad estipulada en el marbete. Conclusiones: Las concentraciones de fluoruro de los dentífricos se encuentran dentro de la Norma. Las concentraciones no corresponden a lo estipulado en el empaque (AU)

Introduction: Currently, there is a wide variety of toothpastes, which can be found in the national market, for different purposes. Among these are those used for the prevention of dental caries. These, contain fluoride in various concentrations as a therapeutic agent, and almost in their entirety, stipulate in their labels a content of 1,000 to 1,450 ppm of fluoride. Some studies have shown that the fluoride concentrations specified on the label, and what is found in the toothpaste do not match. Objective: To evaluate the concentration of total fluoride based on the Mexican Standard NMX-K-539-CNCP-2013, which establishes that toothpastes should not contain more than 1,500 ppm of fluoride. As well as determining if what is stated on the label of their packaging corresponds to the actual content of fluoride. Material and methods: The study was carried out, in triplicate, on 37 toothpastes. The method for determining the fluoride concentration was that of selective ion, described by the Pharmacopoeia of the United Mexican States. Results: The average concentration of this element was 1,262 ppm F- (± 170.7). Fifty nine percent of the dentifrices analyzed do not contain the amount stipulated in the label. Conclusions: The fluoride concentrations of dentifrices are within the Standard. The concentrations do not correspond to what is stipulated in the package (AU)

Effect of iontophoresis on fluoride uptake in enamel with artificial caries lesion

Abstract: Iontophoresis is a noninvasive technique, based on the application of a constant low-intensity electric current to facilitate the release of a variety of drugs, whether ionized or not, through biological membranes. The objective of this research was to evaluate the effect of iontophoresis using different electric current intensities on the uptake of fluoride in dental enamel with artificial caries lesions. In this in vitro operator-blind experiment, bovine enamel blocks (n = 10/group) with caries-like lesions and predetermined surface hardness were randomized into 6 groups: placebo gel without fluoride applied with a current of 0.8 mA (negative control), 2% NaF gel without application of any current, and 2% NaF gel applied with currents of 0.1, 0.2, 0.4 and 0.8 mA. Cathodic iontophoresis was applied for 4 min. The concentration of loosely bound fluoride (calcium fluoride) and firmly bound fluoride (fluorapatite) was determined. The results were analyzed by the nonparametric Kruskal-Wallis and Dunn tests. Iontophoresis at 0.8 mA, combined with the application of fluoridated gel (2% NaF), increased fluoride uptake in enamel with caries-like lesions, as either calcium fluoride or fluorapatite.

A novel application of nano eggshell/titanium dioxide composite on occluding dentine tubules: an in vitro study

Abstract To synthesize Nano eggshell-titanium-dioxide (EB@TiO2) biocomposite and to evaluate its effectiveness in occluding opened dentine tubules. EB@TiO2 was synthesized and characterized using X-ray diffraction (XRD), and Transmission Electron Microscope (TEM). Sixteen simulated bovine dentine discs were prepared and randomly assigned into four groups according to the following treatment (n = 4): Group 1: No treatment; Group 2: eggshell powder; Group 3: EB@TiO2; Group 4: Sensodyne. These were then agitated in a solution of 1g powder and 40mL water for 3hours. Thereafter, each dentine discs from the respective groups were post-treated for 5 min with 2wt% citric acid to test their acid resistant characteristics. Scanning Electron Microscope (SEM) was used to observe the effectiveness of occluded dentine pre-and post-treatment. The cytotoxicity of the synthesized EB@TiO2 was tested using NIH 3T3 assay. ANOVA was used to evaluate the mean values of the occluded area ratio and the data of MTS assay. This was followed by a multi-comparison test with Bonferroni correction (α = .05). The XRD confirmed that EB@TiO2 was successfully modified through ball-milling. The TEM revealed the presence of both spherical and irregular particle shape powders. The SEM result showed that EB@TiO2 could effectively occlude open dentine tubules. Equally, the result demonstrated that EB@TiO2 exhibited the highest acid resistant stability post-treatment. NIH 3T3 assay identified that EB@TiO2 had little effect on the NIH 3T3 cell line even at the highest concentration of 100µg/ml. This study suggests that the application of EB@TiO2 effectively occluded dentine tubules and the occlusion showed a high acid resistant stability.

Active compounds and derivatives of camellia sinensis responding to erosive attacks on dentin

Abstract This research explored the potential of Camellia sinensis-derived teas and active compounds to be used as treatments to prevent dentin wear. Human root dentin slabs were randomly assigned to 5 groups (n = 10) as follows: distilled water (DW, control), epigallocatechin-3-gallate (EGCG), theaflavin gallate derivatives (TF), commercial green tea (GT), and commercial black tea (BT). The samples were submitted to a pellicle formation and an erosive cycling model (5x/day, demineralization using 0.01 M hydrochloric acid/60 s) followed by remineralization (human stimulated saliva/60 min) for three days. The samples were treated for 5 min using the test group solutions between the erosive cycles. Dentin changes were assessed with profilometry analysis and FT-Raman spectroscopy. The data regarding wear were analyzed by ANOVA followed by Tukey's test (p < 0.05). EGCG, TF derivatives, and both regular teas significantly suppressed erosive dentin loss (38-47%, p < 0.05). No obvious changes in the Raman spectra were detected in the specimens; however, the DW group had a minor relationship of 2880/2940 cm−1. The phenolic contents in both green and black tea and the important catechins appear to have protective effects on dentin loss.

Analysis of the antimicrobial and anti-caries effects of TiF4 varnish under microcosm biofilm formed on enamel

Abstract Titanium tetrafluoride (TiF4) is known for interacting with enamel reducing demineralization. However, no information is available about its potential antimicrobial effect. Objectives This study evaluated the antimicrobial and anti-caries potential of TiF4 varnish compared to NaF varnish, chlorhexidine gel (positive control), placebo varnish and untreated (negative controls) using a dental microcosm biofilm model. Material and Methods A microcosm biofilm was produced on bovine enamel previously treated with the varnishes, using inoculum from human saliva mixed with McBain saliva, under 0.2% sucrose exposure, for 14 days. All experiments were performed in biological triplicate (n=4/group in each experiment). Factors evaluated were: bacterial viability (% dead and live bacteria); CFU counting (log10 CFU/mL); and enamel demineralization (transverse microradiography - TMR). Data were analysed using ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). Results Only chlorhexidine significantly increased the number of dead bacteria (68.8±13.1% dead bacteria) compared to untreated control (48.9±16.1% dead bacteria). No treatment reduced the CFU counting (total microorganism and total streptococci) compared to the negative controls. Only TiF4 was able to reduce enamel demineralization (ΔZ 1110.7±803.2 vol% μm) compared to both negative controls (untreated: ΔZ 4455.3±1176.4 vol% μm). Conclusions TiF4 varnish has no relevant antimicrobial effect. Nevertheless, TiF4 varnish was effective in reducing enamel demineralization under this model.

The In Situ Effect of Titanium Tetrafluoride Gel on Erosion/Abrasion Progression in Human Dentin

Abstract Erosion incidence is increasing and its control is still a challenge in clinical practice. This study evaluated 4% TiF4-gel effects on eroded human dentin subjected to in situ erosive/abrasive episodes. Seventy-two previously eroded dentin slabs (0.05 M citric acid, pH 2.3, 20 min) were allocated to 6 groups (n=12) according to the treatment to be performed during the in situ phase and number of erosive/abrasive cycles, as follows: 4% TiF4-gel applied once (TiF41), twice (TiF42) or three times (TiF43) followed by 1, 2 and 3 erosive/abrasive cycles, respectively. Gel was applied before the beginning of the next cycle. Control groups were subjected to 1 (C1), 2 (C2) and 3 (C3) erosive/abrasive cycles only. A seventh group (n=12) comprised in vitro uneroded samples (UN) subjected to 3 erosive/abrasive cycles. Each cycle corresponded to 2 days of erosive (citric acid 0.5%, pH 2.6, 6x/day) and abrasive (electric toothbrush, 10 s/sample, 1 x/day) challenges. Samples were evaluated under profilometry and environmental scanning electron microscopy (ESEM). Atomic force microscopy images (AFM) were also made (n=3). Repeated measures 2-way ANOVA and Tukey test (p<0.001) showed that TiF42, which did not differ from TiF41 and TiF43, revealed a significant reduction in surface loss compared to all control groups. TiF41 and TiF43 showed no significant difference from C1, but both groups demonstrated significantly smaller surface loss than C2 and C3. ESEM and AFM micrographs suggested alterations on treated surfaces compared to samples from control groups, showing reduced diameters of dentinal tubules lumens. Therefore, TiF4 was able to reduce the progression of erosive/abrasive lesions.

Resumo A incidência da erosão tem aumentado e o seu controle ainda é um desafio na prática clínica. Este estudo avaliou os efeitos do gel de TiF4 a 4% sobre a dentina humana erodida submetida a episódios erosivos/abrasivos in situ. Setenta e dois fragmentos de dentina previamente erodida (ácido cítrico 0,05 M, pH 2,3, 20 min) foram distribuídas em 6 grupos (n=12) de acordo com o tratamento a ser realizado durante a fase in situ e o número de ciclos erosivos/abrasivos, como descrito a seguir: gel de TiF4 a 4% aplicado uma (TiF41), duas (TiF42) ou três vezes (TiF43) seguido de 1, 2 e 3 ciclos erosivos/abrasivos, respectivamente. As aplicações dos géis foram realizadas antes do início do ciclo erosivo seguinte. Grupos controle foram submetidos a 1 (C1), 2 (C2) e 3 (C3) ciclos erosivos/abrasivos apenas. Um sétimo grupo (n=12) compreendia amostras sem erosão in vitro (UN) submetidas a 3 ciclos erosivos/abrasivos. Cada ciclo correspondia a 2 dias de desafios erosivos (ácido cítrico a 0,5%, pH 2,6, 6x/dia) e abrasivos (escova de dentes elétrica, 10 s/amostra, 1x/dia). As amostras foram avaliadas em perfilômetro e Microscopia Eletrônica de Varredura Ambiental (MEV). Imagens de microscopia de força atômica (AFM) também foram capturadas (n=3). ANOVA a 2-fatores para medidas repetidas e o teste de Tukey (p<0,001) demonstraram que TiF42, que não diferiu do TiF41 e TiF43, revelou redução significativa na perda de superfície quando comparado a todos os grupos controle. TiF41 e TiF43 não apresentaram diferença estatisticamente significativa em relação ao C1, mas ambos os grupos demonstraram perda de superfície significativamente menor que C2 e C3. Micrografias de MEV e AFM sugeriram alterações nas superfícies tratadas quando comparadas a amostras dos grupos controle, apresentando redução no diâmetro das luzes dos túbulos dentinários. Portanto, o TiF4 foi capaz de reduzir a progressão das lesões erosivas/abrasivas.

Effect of fluoride on salivary immunoglobulins and sialic acid

Summary Objective: The aim of our study was to evaluate the effect of fluoride on salivary immunoglobulin and sialic acid levels in children with dental fluorosis and healthy teeth who live in places with high fluoride concentration in drinking water. Method: Fifty-one (51) healthy children between 6 and 12 years old with no caries were randomly selected from primary schools enrolled in the dental-care program operated by the Department of Pediatric Dentistry. The children were divided into two groups: group I comprised 26 children with dental fluorosis [Thylstrup-Fejerskov Dental Fluorosis Index (TFI) = 4] who lived in Isparta (2.7-2.8 ppm), and group II consisted of 25 children without dental fluorosis who were born in low-fluoride areas and had lived in Isparta for only the previous two years. Stimulated and unstimulated saliva were collected and analyzed for fluoride, salivary immunoglobulins and sialic acid levels. Results: Sialic acid level was correlated negatively with age. Levels of secretory immunoglobulin A (sIgA) and secretory immunoglobulin G (sIgG) were higher in children with dental fluorosis compared with those in group II, although these differences were not significant. Conclusion: Increased sIgA and sIgG levels may arrest the progression of caries in subjects with dental fluorosis. Given the risks of dental fluorosis, further studies of the effects of different fluoride levels in drinking water on salivary composition of children with mixed dentition are needed to confirm the results of our study and to provide data for comparison.

Proteomic analysis of liver in mice with different susceptibilities to fluorosis / Análise proteômica do fígado de camundongos com diferentes suscetibilidades à fluorose

Fluoride (F) is a potent anti-cariogenic element, but only an appropriate dose is effective to have therapeutic action, else systemic toxicity may be observed. Additionally, two factors, amount of F and time of exposure, drive its action. Surprisingly, the susceptibility to toxic effects of F is genetically determined. The present study identified the effects of F on the liver proteome of mice susceptible (A/J) or resistant (129P3/J) to the effects of F. Weanling male A/J (n=6) and 129P3/J mice (n=6) were housed in pairs and assigned to three groups given low-F diet and drinking water containing 0, 15 or 50 ppm F for 7 weeks. Liver proteome profiles were examined using nano-LC-ESI-MS/MS. Protein function was classified by GO biological process (Cluego v2.0.7 + Clupedia v1.0.8). Difference in expression among the groups was determined using the PLGS software. In the control group (0 ppm F), most proteins with fold change were increased in A/J mice. Precisely the proteins related to energy flux and oxidative stress were quite significant in this context, suggesting the high susceptibility of these mice to the effects of F, since the exposure also induces oxidative stress. Treatment with the lower F concentration provoked more pronounced alterations in fold change in liver proteins in comparison to the treatment with the higher F concentration. Strikingly, most of the proteins with fold change upon following 15 ppm F treatment, were increased in the A/J mice compared with their 129P3/J counterparts, thus suggesting attempt of the former to fight against the toxic effects of F. With respect to 50 ppm F, most proteins with fold change were decreased in the A/J mice compared with their 129P3/J counterparts, especially proteins related to oxidative stress and protein folding, which might be related to the higher susceptibility of the A/J animals to the deleterious effects of F. Our findings can provide new insights into the molecular mechanisms underlying genetic susceptibility to fluorosis by indicating key protein players which need to be better addressed in future experimental studies.(AU)

O Fluoreto (F) é um potente elemento anti-cariogênico, mas é somente efetivo terapeuticamente em uma dose apropriada. Por outro lado, doses acima das recomendadas levam a toxicidade sistêmica. Em adição, dois fatores decidem sua efetividade de ação: quantidade de F e tempo de exposição. A suscetibilidade aos efeitos tóxicos do F é determinada geneticamente. O presente estudo avaliou os efeitos do F no proteoma do fígado de camundongos suscetíveis (A/J) ou resistentes (129P3/J) aos efeitos do F. Camundongos machos desmamados A/J (n=6) e 129P3/J (n=6) foram alojados em pares e divididos em três grupos tratados com ração com baixo teor de F e água contendo 0, 15, ou 50 ppm de F por 7 semanas. Perfis proteômicos do fígado foram examinados usando nano-LC-ESI-MS/MS. A função de proteínas foi classificada pelo processamento biológico GO (Cluego v2.0.7 + Clupedia v1.0.8). A diferença de expressão entre os grupos foi determinada usando o software PLGS. No grupo controle (0 ppm F), a expressão da maioria das proteínas foi aumentada nos camundongos A/J e precisamente as proteínas relacionadas ao fluxo de energia e estresse oxidativo foram significativas neste contexto, sugerindo portanto, a alta sucetibilidade destes camundongos aos efeitos do F, já que a exposição também induz o estresse oxidativo. O tratamento com baixa concentração de F provocou alterações mais pronunciadas em proteínas do fígado comparado ao tratamento com alta concentração de F. Notadamente, a maioria das proteínas encontradas no fígado dos animais tratados com 15 ppm de F foi aumentada em camundongos A/J comparados aos camundongos 129P3/J, demonstrando portanto, uma tentativa dos A/J de neutralizar os efeitos tóxicos do F. Já nos animais tratados com 50 ppm de F, a maioria das proteínas foi diminuída nos camundongos comparados aos seus pares 129P3/J, especialmente proteínas relacionadas ao estresse oxidativo e enovelamento de proteínas, o que pode estar relacionado à alta suscetibilidade dos animais A/J aos efeitos deletérios do F. Nossos achados podem fornecer novos insights que podem contribuir para a interpretação os mecanismos moleculares relacionados à suscetibilidade genética à fluorose, indicando proteínas chaves que precisam ser melhor estudadas em estudos futuros.(AU)

In situ effect of titanium tetrafluoride varnish on enamel demineralization

Abstract The effect of a 4% titanium tetrafluoride (TiF 4 ) varnish on enamel demineralization was evaluated. Twelve volunteers participated in this double-blind, randomized crossover study. Six enamel specimens were positioned in intraoral appliances throughout four treatment stages: 4% TiF 4 varnish (experimental varnish), 5% sodium fluoride (NaF) varnish (Duraphat ® ), placebo varnish, and negative control (deionized water). After 24 h, the varnishes were removed and plaques were allowed to accumulate. A 20% sucrose solution was dripped onto enamel blocks (10x/day). Enamel alterations were analyzed by surface microhardness (SMH), percentage of surface loss (%SML), cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy dispersive X-ray spectrometry (EDS). Student's paired t-test was used for SMH analysis and repeated-measures analysis of variance (ANOVA) for %SML and CSMH (∆Z) analyses (p-value=0.05). The TiF 4 varnish group had lower %SML than the placebo and control groups (p=0.044 and p=0.003, respectively), thus showing its capacity to inhibit surface demineralization. TiF 4 and NaF varnishes demonstrated a protective effect against mineral loss on the enamel subsurface. Both were statistically different from the control group when CSMH was analyzed (p=0.000). A titanium dioxide film was observed on enamel surfaces of the TiF 4 group SEM images. EDS confirmed the presence of titanium in all TiF 4 samples. The 4% TiF 4 varnish is a promising compound capable of reacting with enamel to protect it against surface and subsurface demineralization.

Effect of Fluoride and Simplified Adhesive Systems on the Bond Strength of Primary Molars and Incisors

The aim of this study was evaluate in vitro the influence of simplified adhesive systems (etch-and-rinse and self-etching) and 1.23% acidulated phosphate fluoride (APF) on the microshear bond strength (μ-SBS) of composite resins on primary molars and incisors. Forty primary molars and forty incisors vestibular enamel was treated with either the self-etching Clearfil SE Bond (CSE, Kuraray) or etch-and-rinse Adper Single Bond 2 (SB2, 3M/ESPE) adhesive system. Each group was subdivided based on the prior treatment of the enamel with or without the topical application of 1.23% APF. Thereafter, matrices were positioned and filled with composite resin and light cured. After storage in distilled water at 37±1°C for 24 h, the specimens were submitted to μ-SBS in a universal testing machine. Kruskal-Wallis and Mann-Whitney tests (p<0.05) showed that the prior application of 1.23% APF led to a significant reduction in bond strength. The type of adhesive exerted no significant influence bond strength. In the inter-group analysis, however, significantly bond strength reduction was found for the incisors when CSE was employed with APF. Adhesive failure was the most common type of fracture. The bond strength was affected by the prior application of 1.23% APF and type of tooth.

O objetivo deste estudo foi avaliar a influência dos sistemas adesivos simplificados (condicionamento ácido total e auto-condicionante) e fluorfosfato acidulado a 1,23% (FFA) na resistência de união ao microcisalhamento (μ-RUC) de resinas compostas em molares e incisivos decíduos. O esmalte vestibular de quarenta molares e quarenta incisivos decíduos foi tratado com Clearfil SE Bond (CSE, Kuraray) ou Adper Single Bond 2 (SB2, 3M/ESPE). Cada grupo foi subdividido com base no tratamento prévio do esmalte com ou sem aplicação tópica de FFA a 1,23%. Em seguida, matrizes foram posicionadas e preenchidas com resina composta e posterior fotopolimerização. Depois da armazenagem em água destilada a 37±1 °C por 24 h, os espécimes foram submetidos ao μ-RUC em uma máquina de ensaio universal. Teste Kruskal-Wallis e Mann-Whitney (p<0,05) mostraram que a aplicação prévia de FFA a 1,23% levou a uma redução significativa na resistência de união. O tipo de adesivo não exerceu influência significativa na resistência de união. Na análise intergrupos, entretanto, redução significativa na resistência de união foi encontrada para os incisivos quando CSE foi empregado sem FFA. Falha adesiva foi o tipo de fratura mais comum. A resistência de união foi afetada pela aplicação de FFA a 1,23% e tipo de dente.

Revisión Sistemática sobre los Efectos Adversos de la Fluoración del Agua / Systematic Review of the Adverse Effects of Water Fluoridation

Durante las últimas décadas, una considerable atención científica ha sido puesta en la seguridad de los fluoruros, dada la amplia variedad de fuentes de ingestión a la que la población se encuentra expuesta y los riesgos a la salud de las personas que esto puede acarrear. El objetivo de esta investigación fue determinar si la fluoración del agua a concentraciones de 0,6 a 1 ppm se asocian a una mayor proporción de efectos adversos en la población general al compararlo con concentraciones subóptimas. Se realizó una revisión sistemática de la literatura en MEDLINE, EMBASE, COCHRANE, SCIELO, LILACS, CRD, BBO, PAHO y WHOLIS, limitada desde el 2002 al 2012. Se incluyeron estudios primarios y secundarios en español, inglés y portugués con al menos dos poblaciones comparadas, una con niveles óptimos de flúor en agua (0,6­1 ppm) y otra sin fluoración del agua (<0,3 ppm) o con niveles subóptimos (>0,3 < 0,6 ppm). Dos investigadores de forma independiente realizaron evaluación de la calidad de los artículos seleccionados y que cumplieron los criterios de inclusión. La búsqueda arrojó 1024 artículos de los cuales 24 cumplieron los criterios de inclusión y 10 fueron incluidos como evidencia. Con excepción de fluorosis dental, no hay asociación entre fluoración del agua con fracturas óseas, cáncer u otro efecto adverso. A pesar de la mayor prevalencia de fluorosis en zonas fluoradas, esta fue principalmente del tipo cuestionable a leve y la proporción de fluorosis con daño estético no difiere significativamente de la presente en zonas sin fluoración del agua.

During the last decades, considerable scientific attention has been paid to the safety of fluoride, given the wide variety of sources of intake at which the population is exposed and the risks to the health of people this may produce. The aim was to determine whether water fluoridation at concentrations from 0.6 to 1 ppm is associated with a higher proportion of adverse effects in the general population when comparing them to suboptimal concentrations. A systematic review was conducted of the literature in MEDLINE, EMBASE, COCHRANE, SCIELO, LILACS, CRD, BBO, PAHO and WHOLIS, limited to 2002 to 2012. Included were primary and secondary studies in Spanish, English and Portuguese with at least two compared populations, one with optimal fluoride levels in the water (0.6­1 ppm) and another without water fluoridation (<0.3 ppm) or with suboptimal levels (>0.3 < 0.6ppm). Two researchers independently evaluated the quality of the articles selected and which met the inclusion criteria. The search revealed 1024 articles, of which 24 met the inclusion criteria and 10 were included as evidence. With the exception of dental fluorosis, there is no association between any other adverse effect and water fluoridation. Despite the greater prevalence of fluorosis in fluoride than in non-fluoride zones, this was mainly questionable to slight and the proportion of fluorosis with esthetic damage does not differ significantly from this in zones without water fluoridation.

TiF4 and NaF varnishes as anti-erosive agents on enamel and dentin erosion progression in vitro

Objective This study assessed the effect of fluoride varnishes on the progression of tooth erosion in vitro. Material and Methods: Forty-eight enamel and 60 root dentin samples were previously demineralized (0.1% citric acid, pH 2.5, 30 min), leading to a baseline and erosive wear of 12.9 and 11.4 µm, respectively. The samples were randomly treated (6 h) with a 4% TiF4 varnish (2.45%F-, pH 1.0), a 5.42% NaF varnish (2.45%F-, pH 5.0), a placebo varnish and no varnish (control). The samples were then subjected to erosive pH cycles (4x90 s/day in 0.1% citric acid, intercalated with artificial saliva) for 5 days. The increment of the erosive tooth wear was calculated. In the case of dentin, this final measurement was done with and without the demineralized organic matrix (DOM). Enamel and dentin data were analyzed using ANOVA/Tukey’s and Kruskal-Wallis/Dunn tests, respectively (p<0.05). Results The TiF4 (mean±s.d: 1.5±1.1 µm) and NaF (2.1±1.7 µm) varnishes significantly reduced enamel wear progression compared to the placebo varnish (3.9±1.1 µm) and control (4.5±0.9 µm). The same differences were found for dentin in the presence and absence of the DOM, respectively: TiF4 (average: 0.97/1.87 µm), NaF (1.03/2.13 µm), placebo varnish (3.53/4.47 µm) and control (3.53/4.36 µm). Conclusion The TiF4 and NaF varnishes were equally effective in reducing the progression of tooth erosion in vitro. .

In Situ Effect of Titanium Tetrafluoride and Sodium Fluoride on Artificially Decayed Human Enamel

This study compared in situ the application of 4% titanium tetrafluoride (TiF4) solution and 2% sodium fluoride (NaF) gel on artificial white-spot lesions in human enamel. A crossover, double-blind study using in situ caries models was carried out. Eleven volunteers used an intraoral appliance containing five demineralized human enamel blocks. The blocks (n=170) were randomly divided according to treatment into the following groups: TiF4 (n=55), NaF (n=55), positive control (n=55). A negative control group was composed of demineralized specimens (n=5). The microhardness test was performed using a Knoop penetrator. Energy dispersive spectrometer (EDS) was used to analyze the concentration of titanium, calcium, phosphate and oxygen. The enamel microhardness at different depths for TiF4, NaF and positive control samples was not statistically different (p>0.05). The samples from these three groups had statistically higher microhardness values than the negative control samples (p<0.05). EDS analysis did not provide conclusive results about the penetration of titanium in the TiF4 samples. While in some fragments it had substantial penetration, in other fragments it only had superficial penetration. It was possible to conclude that, under in situ conditions, 4% TiF4 solution and 2% NaF gel were able to remineralize artificial white-spot lesions in human enamel. However, the magnitude of the remineralization did not differ between groups.

Este estudo comparou in situ a aplicação de uma solução de tetrafluoreto de titânio (TiF4) a 4% e um gel de fluoreto de sódio (NaF) sobre lesões de mancha branca artificiais em esmalte dentário humano. Foi realizado um estudo cruzado, duplo-cego utilizando um modelo in situ de cárie. Onze voluntários usaram um aparelho intraoral contendo cinco blocos de esmalte humanos desmineralizados. Os blocos (n = 170) foram divididos aleatoriamente de acordo com o tratamento nos seguintes grupos: TiF4 (n = 55) , NaF (n = 55) , controle positivo (n = 55). Um grupo controle negativo foi composto de espécimes desmineralizados (n = 5). O teste de microdureza foi realizado utilizando um penetrador Knoop. Espectrômetro de energia dispersiva (EDS) foi utilizado para analisar a concentração de titânio, cálcio, fosfato e oxigênio. A microdureza do esmalte em diferentes profundidades para as amostras dos grupos TiF4, NaF e controle positivo não diferiram estatisticamente (p>0,05). As amostras destes três grupos apresentaram valores de microdureza estatisticamente maiores do que as amostras do controle negativo (p<0,05). A análise EDS não forneceu resultados conclusivos sobre a penetração de titânio nas amostras de TiF4. Apesar de apresentar, em alguns fragmentos, uma penetração substancial, em outros fragmentos apresentou apenas penetração superficial. Foi possível concluir que, sob as condições do estudo in situ, a solução de TiF4 a 4% e o gel de NaF a 2% foram capazes de remineralizar lesões de mancha branca em esmalte humano. No entanto, a magnitude da remineralização não diferiu entre os grupos.

In situ protocol for the determination of dose-response effect of low-fluoride dentifrices on enamel remineralization

No in situ protocol has assessed the dose-response effects of fluoride dentifrices involving low-fluoride formulations. Objective: To assess the ability of an in situ remineralization model in determining dose-response effects of dentifrices containing low fluoride concentrations ([F]) on bovine enamel. Material and Methods: Volunteers wore palatal appliances containing demineralized enamel blocks and brushed their teeth and devices with the dentifrices supplied (double-blind, crossover protocol) separately for 3 and 7 days. Surface hardness (SH), integrated subsurface hardness (ΔKHN) and [F] in enamel were determined. Data were analyzed by ANOVA, Tukey's test and Pearson's correlation (p<0.05). Results: Dose-response relationships were verified between [F] in dentifrices and SH, ΔKHN and enamel [F]. Higher correlation coefficients between enamel [F] and SH and ΔKHN were obtained for the 3-day period. Significant differences in SH and ΔKHN were observed among all groups for the 3-day period, but not between 0-275, 275-550, and 550-1,100 µg F/g dentifrices for the 7-day period, nor between 3- and 7-day periods for the 1,100 µg F/g groups. Conclusions: Considering that the peak remineralization capacity of the conventional dentifrice (1,100 µg F/g) was achieved in 3 days, this experimental period could be used in future studies assessing new dentifrice formulations, especially at low-fluoride concentrations. .

In Vitro Enamel Remineralization by Low-Fluoride Toothpaste with Calcium Citrate and Sodium Trimetaphosphate

The objective of this study was to evaluate in vitro the effect of a low fluoride toothpaste (450 µgF/g, NaF) combined with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel remineralization. Bovine enamel blocks had the enamel surface polished sequentially to determine the surface hardness. After production of artificial carious lesions, the blocks selected by their surface hardness were submitted to remineralization pH cycling and daily treatment with dentifrice suspensions (diluted in deionized water or artificial saliva): placebo, 275, 450, 550 and 1,100 µgF/g and commercial dentifrice (positive control, 1,100 µgF/g). Finally, the surface and cross-section hardness was determined for calculating the change of surface hardness (%SH) and mineral content (%∆Z). Fluoride in enamel was also determined. The data from %SH, %∆Z and fluoride were subjected to two-way analysis of variance followed by Student-Newman-Keuls's test (p<0.05). The mineral gain (%SH and %∆Z) was higher for toothpastes diluted in saliva (p<0.05), except for the 450 µgF/g dentifrice with Cacit/TMP (p>0.05). The 450 Cacit/TMP toothpaste and the positive control showed similar results (p>0.05) when diluted in water. A dose-response was observed between fluoride concentration in toothpastes and fluoride present in enamel, regardless of dilution. It was concluded that it is possible to enhance the remineralization capacity of low F concentration toothpaste by of organic (Cacit) and inorganic (TMP) compounds with affinity to hydroxyapatite.

O objetivo do presente trabalho foi avaliar in vitro o efeito de um dentifrício com reduzida concentração de fluoreto (450 µgF/g, NaF) associado ao citrato de cálcio (Cacit) e trimetafosfato de sódio (TMP) na remineralização do esmalte. Blocos de esmalte bovino tiveram sua superfície de esmalte polida seqüencialmente para determinação da dureza de superfície. Após o desenvolvimento de lesões artificiais de cárie, os blocos selecionados através da dureza de superfície foram submetidos a ciclagem de remineralização e tratamento diário com suspensões de dentifrícios (diluição em água deionizada ou saliva artificial): placebo, 275, 450, 550 e 1.100 µgF/g e com dentifrício comercial (controle positivo, 1.100 µgF/g). Ao término, determinou-se a dureza de superfície e em secção longitudinal, para cálculo da variação da dureza de superfície (%SH) e do conteúdo mineral (%∆Z). O fluoreto presente no esmalte também foi determinado. Os dados de %SH, %∆Z e fluoreto foram submetidos a análise de variância a dois critérios seguido pelo teste de Student-Newman-Keuls (p<0,05). O ganho mineral (%SH e %∆Z) foi maior para os dentifrícios diluídos em saliva (p<0,05), exceto para os dentifrícios 450 µg F/g com Cacit/TMP (p>0,05). Os dentifrícios 450 Cacit/TMP e controle positivo apresentaram resultados semelhantes (p>0,05) quando diluídos em água. Uma relação dose-resposta foi observada entre a concentração de fluoreto nos dentifrícios e o fluoreto presente no esmalte, independente da diluição. Concluiu-se que é possível melhorar a capacidade de remineralização de dentifrícios com reduzida concentração de fluoreto pela adição de compostos orgânico (Cacit) e inorgânico (TMP) com afinidade a hidroxiapatita.

Effect of Fluoride-Treated Enamel on Indirect Cytotoxicity of a 16% Carbamide Peroxide Bleaching Gel to Pulp Cells

The aim of this study was to evaluate the possibility of fluoride solutions applied to enamel to protect pulp cells against the trans-enamel and transdentinal cytotoxicity of a 16% carbamide peroxide (CP) bleaching gel. The CP gel was applied to enamel/dentin discs adapted to aicial pulp chambers (8 h/day) during 1, 7 or 14 days, followed by fluoride (0.05% or 0.2%) application for 1 min. The extracts (culture medium in contact with dentin) were applied to MDPC-23 cells for 1 h, and cell metabolism (MTT assay), alkaline phosphatase (ALP) activity and cell membrane damage (flow cytometry) were analyzed. Knoop microhardness of enamel was also evaluated. Data were analyzed statistically by ANOVA and Kruskal-Wallis tests (α=0.05). For the MTT assay and ALP activity, significant reductions between the control and the bleached groups were observed (p<0.05). No statistically significant difference occurred among bleached groups (p>0.05), regardless of fluoride application or treatment days. Flow cytometry analysis demonstrated 30% of cell membrane damage in all bleached groups. After 14 days of treatment, the fluoride-treated enamel presented significantly higher microhardness values than the bleached-only group (p<0.05). It was concluded that, regardless of the increase in enamel hardness due to the application of fluoride solutions, the treated enamel surface did not prevent the toxic effects caused by the 16% CP gel to odontoblast-like cells.

Resumo O objetivo do presente estudo foi avaliar o possível efeito protetor de soluções fluoretadas aplicadas sobre o esmalte dentário frente à citotoxicidade trans-amelodentinária de um gel clareador com 16% de peróxido de carbamida (PC). O gel de PC foi aplicado sobre discos de esmalte/dentina adaptados a câmaras pulpares aiciais (8 h/dia) durante períodos de 1, 7 ou 14 dias, seguido de aplicação de soluções fluoretadas (0,05% ou 0,2%) durante 1 min. Os extratos (meio de cultura em contato com a dentina) foram aplicados sobre células MDPC-23 durante 1 h, seguido de análise do metabolismo celular (teste do MTT), atividade de fosfatase alcalina (ALP) e danos à membrana celular (citometria de fluxo). A microdureza Knoop do esmalte dental foi avaliada. Os dados foram analisados pelos testes de ANOVA e Kruskal-Wallis. Para o teste do MTT e atividade de ALP, redução significante entre os grupos controle e clareados foram observados (p<0,05). Nenhuma diferença entre os grupos clareados foi observada (p>0,05), independente da aplicação das soluções fluoretadas ou tempo de tratamento. A análise por citometria de fluxo demonstrou lesão à membrana celular em torno de 30% para todos os grupos clareados. Após 14 dias de tratamento, os espécimes clareados e fluoretados apresentaram aumento significante na microdureza do esmalte (p<0,05). Pôde-se concluir que apesar do aumento na dureza do esmalte decorrente da aplicação das soluções fluoretadas, este tratamento não preveniu os efeitos tóxicos causados pelo gel com 16% de PC sobre as células odontoblastóides. .

Effects of fluoride and ethanol administration on lipid peroxidation systems in rat brain.

Exposure to fluoride and excessive ethanol consumption has been identified as a serious public health problem in many parts of the world, including India. Thus, the effect of co-exposure to fluoride and ethanol for 3-6 weeks was studied on lipid peroxidation (LPO) and oxidative stress related parameters in the rat brain. After 3 weeks, co-treated animals showed 95% increase in LPO levels compared to control. However, the levels of reduced glutathione, total and protein thiols were decreased. These changes were accompanied by a decrease in the activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase. Rats exposed to fluoride together with ethanol for 6 weeks resulted in 130% increase in LPO and decrease in the reduced glutathione levels. The activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase were reduced under these conditions. Brain histology revealed excessive lymphocytes, edema and spongeosis in the cortical region after six weeks of fluoride and ethanol treatment. These results suggest that exposure to fluoride together with ethanol enhances lipid peroxidation by affecting antioxidant defence systems in the rat brain.

Anticaries effect of dentifrices with calcium citrate and sodium trimetaphosphate

Because of the growing concerns regarding fluoride ingestion by young children and dental fluorosis, it is necessary to develop new dentifrices. OBJECTIVE: The aim of this study was to evaluate the effect of dentifrices with calcium citrate (Cacit) and sodium trimetaphosphate (TMP) on enamel demineralization. MATERIAL AND METHODS: Enamel blocks (n=70), previously selected through surface hardness analysis, were submitted to daily treatment with dentifrices diluted in artificial saliva and to a pH-cycling model. The fluoride concentration in dentifrices was 0, 250, 450, 550, 1,000 and 1,100 µg F/g. CrestTM was used as a positive control (1,100 mg F/g). Cacit (0.25 percent) and TMP (0.25 percent) were added to dentifrices with 450 and 1,000 µg F/g. Surface hardness was measured again and integrated loss of subsurface hardness and fluoride concentration in enamel were calculated. Parametric and correlation tests were used to determine difference (p<0.05) and dose-response relationship between treatments. RESULTS: The addition of Cacit and TMP did not provide a higher fluoride concentration in enamel, however it reduced (p<0.05) mineral loss when compared to other dentifrices; the dentifrice with Cacit and TMP and a low fluoride concentration presented similar results when compared to a dentifrice with 1,100 mg F/g (p>0.05). CONCLUSIONS: Dentifrices with 450 and 1,000 µg F/g, Cacit and TMP were as effective as a gold standard one.

Efeito do fluoreto no osso de camundongos com diferentes susceptibilidades genéticas à fluorose: uma análise proteômica / Effect of fluoride on bone of mice with different genetic susceptibilities to fluorosis: a proteomic analysis

Tem sido demonstrado que fatores genéticos influenciam a resposta do osso e esmalte ao fluoreto (F), mas os mecanismos moleculares envolvidos não estão bem definidos. No presente estudo, foi empregada uma abordagem proteômica livre de marcadores para identificar e avaliar alterações na expressão de proteínas ósseas em duas linhagens de camundongos com diferentes susceptibilidades à fluorose (A/J susceptível e 129P3/J resistente). Camundongos machos das linhagens 129P3/J e A/J foram distribuídos em três grupos para cada linhagem, que receberam ração com baixa concentração de F e água de beber contendo 0, 10 e 50 ppm F por 8 semanas. A concentração de F foi analisada no plasma e fêmur. A atividade da fosfatase alcalina foi dosada no plasma. Fêmur, tíbia e vértebra lombar foram submetidos à análise por micro-CT. A taxa de aposição mineral (MAR) também foi avaliada no osso cortical dos camundongos. Em adição, eletroforese unidimensional e cromatografia líquida - espectrometria de massas sequencial (LC-ESI-MS/MS) foram utilizadas para identificar e caracterizar as proteínas de fêmur da linhagem 129P3/J. Para análise proteômica quantitativa, proteínas ósseas foram extraídas para cada grupo empregando quatro diferentes etapas: (a) tampão PBS (pH 7,4) por 24h, (b) tampão de Guanidina HCl 4 M / Tris HCl 50 mM (pH 7,4) por 96 h, (c) tampão EDTA 0,5 M / Tris HCl 50 mM (pH 7,4) por 96 h, e por último (d) tampão de Guanidina HCl 4 M / Tris HCl 50 mM (pH 7,4) por 96 h. As proteínas ósseas extraídas para cada grupo foram separadamente submetidas ao LC-ESI-MS/MS, seguido da análise semi-quantitativa de diferença de expressão proteica livre de marcadores. Foram identificadas várias proteínas ósseas com alteração na abundância entre os 3 tratamentos com F para cada linhagem e entre as duas linhagens para cada tratamento com F (razão 1,5 or 0,5, respectivamente). O F promoveu alterações na expressão de proteínas envolvidas na osteogênese e osteoclastogênese de maneira distinta...

Genetic factors have been shown to influence bone and enamel responses to fluoride (F), but the molecular mechanisms involved remain unclear. In this study, a label-free proteomics approach was employed to identify and evaluate changes in bone protein expression of two mouse strains with different susceptibilities to fluorosis (A/J a susceptible strain, 129P3/J a resistant strain). Male 129P3/J and A/J mice were assigned to three groups given low-F food and water containing 0, 10 or 50 ppmF for 8 weeks. Plasma and femur were analyzed for F levels. Plasma was also evaluated for alkaline phosphatase activity. Femurs, tibiae and lumbar vertebrae were subjected to micro-CT analysis. Mineral apposition rate (MAR) was also measured in mice cortical bone. In addition, unidimensional electrophoresis and liquid chromatography/Tandem mass spectrometry (LC-ESI-MS/MS) was used to identify and characterize the femur protein profile from 129P3/J mouse strain. For quantitative proteomic analysis, bone proteins were extracted using four different steps: (a) PBS buffer (pH 7.4) for 24h, (b) 4 M Guanidine HCl/50 mM Tris HCl buffer (pH 7.4) for 96 h, (c) 0.5 M EDTA/50 mM Tris HCl buffer (pH 7.4) for 96 h, followed by (d) 4 M Guanidine HCl/50 mM Tris HCl buffer (pH 7.4) for 96 h. Bone proteins extracted from each group were separately subjected to LC-ESI-MS/MS, followed by label-free semi-quantitative differential expression analysis. Changes in many bone proteins abundance were found among the F treatment groups for each mouse strain and between the strains for each F treatment group (ratio 1.5 or 0.5, respectively). F led to alterations in expression of proteins involved in osteogenesis and osteoclatogenesis in a different way for each strain. Although F treatment had no significant effects on BMD and histomorphometric measurements for both strains, mineral apposition rate (MAR) was higher in 129P3/J mice treated...

Efeito do fluoreto no osso de camundongos com diferentes susceptibilidades genéticas à fluorose: uma análise proteômica / Effect of fluoride on bone of mice with different genetic susceptibilities to fluorosis: a proteomic analysis

Tem sido demonstrado que fatores genéticos influenciam a resposta do osso e esmalte ao fluoreto (F), mas os mecanismos moleculares envolvidos não estão bem definidos. No presente estudo, foi empregada uma abordagem proteômica livre de marcadores para identificar e avaliar alterações na expressão de proteínas ósseas em duas linhagens de camundongos com diferentes susceptibilidades à fluorose (A/J susceptível e 129P3/J resistente). Camundongos machos das linhagens 129P3/J e A/J foram distribuídos em três grupos para cada linhagem, que receberam ração com baixa concentração de F e água de beber contendo 0, 10 e 50 ppm F por 8 semanas. A concentração de F foi analisada no plasma e fêmur. A atividade da fosfatase alcalina foi dosada no plasma. Fêmur, tíbia e vértebra lombar foram submetidos à análise por micro-CT. A taxa de aposição mineral (MAR) também foi avaliada no osso cortical dos camundongos. Em adição, eletroforese unidimensional e cromatografia líquida - espectrometria de massas sequencial (LC-ESI-MS/MS) foram utilizadas para identificar e caracterizar as proteínas de fêmur da linhagem 129P3/J. Para análise proteômica quantitativa, proteínas ósseas foram extraídas para cada grupo empregando quatro diferentes etapas: (a) tampão PBS (pH 7,4) por 24h, (b) tampão de Guanidina HCl 4 M / Tris HCl 50 mM (pH 7,4) por 96 h, (c) tampão EDTA 0,5 M / Tris HCl 50 mM (pH 7,4) por 96 h, e por último (d) tampão de Guanidina HCl 4 M / Tris HCl 50 mM (pH 7,4) por 96 h. As proteínas ósseas extraídas para cada grupo foram separadamente submetidas ao LC-ESI-MS/MS, seguido da análise semi-quantitativa de diferença de expressão proteica livre de marcadores. Foram identificadas várias proteínas ósseas com alteração na abundância entre os 3 tratamentos com F para cada linhagem e entre as duas linhagens para cada tratamento com F (razão 1,5 or 0,5, respectivamente). O F promoveu alterações na expressão de proteínas envolvidas na osteogênese e osteoclastogênese de maneira distinta...

Genetic factors have been shown to influence bone and enamel responses to fluoride (F), but the molecular mechanisms involved remain unclear. In this study, a label-free proteomics approach was employed to identify and evaluate changes in bone protein expression of two mouse strains with different susceptibilities to fluorosis (A/J a susceptible strain, 129P3/J a resistant strain). Male 129P3/J and A/J mice were assigned to three groups given low-F food and water containing 0, 10 or 50 ppmF for 8 weeks. Plasma and femur were analyzed for F levels. Plasma was also evaluated for alkaline phosphatase activity. Femurs, tibiae and lumbar vertebrae were subjected to micro-CT analysis. Mineral apposition rate (MAR) was also measured in mice cortical bone. In addition, unidimensional electrophoresis and liquid chromatography/Tandem mass spectrometry (LC-ESI-MS/MS) was used to identify and characterize the femur protein profile from 129P3/J mouse strain. For quantitative proteomic analysis, bone proteins were extracted using four different steps: (a) PBS buffer (pH 7.4) for 24h, (b) 4 M Guanidine HCl/50 mM Tris HCl buffer (pH 7.4) for 96 h, (c) 0.5 M EDTA/50 mM Tris HCl buffer (pH 7.4) for 96 h, followed by (d) 4 M Guanidine HCl/50 mM Tris HCl buffer (pH 7.4) for 96 h. Bone proteins extracted from each group were separately subjected to LC-ESI-MS/MS, followed by label-free semi-quantitative differential expression analysis. Changes in many bone proteins abundance were found among the F treatment groups for each mouse strain and between the strains for each F treatment group (ratio 1.5 or 0.5, respectively). F led to alterations in expression of proteins involved in osteogenesis and osteoclatogenesis in a different way for each strain. Although F treatment had no significant effects on BMD and histomorphometric measurements for both strains, mineral apposition rate (MAR) was higher in 129P3/J mice treated...