Evaluation of the activities of toothpastes with different contents in the prevention of enamel demineralization: An in vitro study

Yıl 2023, Cilt: 33 Sayı: 1, 27 - 34, 31.01.2023

Hanife Altınışık Hhülya Erten

https://doi.org/10.54614/CRDS.2022.6199

Öz

Objective: The purpose of this study was to evaluate the efficacy of toothpastes in preventing initial caries.
Methods: Sixty extracted human molar teeth were used in the study. After the initial DIAGNOdent values of the teeth were recorded, the teeth were divided into 6 groups (n = 10) and toothpastes containing arginine + fluoride, hydroxyapatite + fluoride, bioactive glass + fluoride, fluoride, and chi- tosan were applied. After the teeth were kept in demineralization solution for 6 hours, remineral- ization solution for 16 hours, and toothpaste mixture for 2 minutes every day for a total of 14 days, final DIAGNOdent measurements were made, and the teeth were sectioned in the buccolingual direction. Then, microhardness measurement was performed. Mineral loss results were obtained from these measurements. Moreover, scanning electron microscopy images were obtained from 1 sample of every group. The data obtained were evaluated statistically and at a significance level of P < .05.
Results: Maximum increase observed in the DIAGNOdent measurements was in the control group and minimum increase was in the hydroxyapatite group (P = .000). Maximum hardness values in all the depths were in the hydroxyapatite group, while the minimum increase was in the control group. When the mineral loss results were examined, remineralization occurred in the hydroxy- apatite + fluoride, arginine + fluoride, bioactive glass + fluoride, and fluoride groups, respectively. Demineralization was detected in the chitosan and control groups. When the chitosan group was compared with the control group, however, demineralization was prevented (P = .119).
Conclusion: It is concluded that regular use of the toothpastes containing hydroxyapatite, bioac- tive glass, and arginine making synergic effect with fluoride may be useful in the prevention of the initial caries lesions.
Keywords: Demineralization, remineralization, toothpaste, DIAGNOdent Pen, cross-sectional microhardness

ÖZ
Amaç: Bu çalışmanın amacı; diş macunlarının başlangıç çürüklerini önleme etkinliklerini değerlendirmektir.
Yöntemler: Çalışmada 60 adet insan çekilmiş molar dişi kullanıldı. Dişlerin başlangıç DIAGNOdent değerleri ölçüldükten, sonra 6 gruba (n = 10) ayrıldı ve arginin+florid, hidroksiapatit+florid, biyo- aktif cam+florid, florid, kitosan içeren diş macunları uygulandı. Dişler 14 gün boyunca her gün 6 saat demineralizasyon solüsyonunda, 16 saat remineralizasyon solüsyonunda, 2 dakika da diş macunu karışımında bekletildikten sonra son DIAGNOdent ölçümleri yapılarak bukko lingual yönde kesildi ve mikrosertlik ölçümleri yapıldı. Mikrosertlik testi sonunda elde edilen değerlerden mineral kayıpları hesaplandı ve kantitatif olarak değerlendirildi. Ayrıca her gruptan birer örneğin de Taramalı Elektron Mikroskobu (SEM) görüntüleri elde edildi. Elde edilen veriler istatistiksel olarak ve anlamlılık P < ,05 düzeyinde değerlendirildi.
Bulgular: DIAGNOdent ölçümlerinde gözlenen en fazla artış kontrol uygulanılan grupta, en az artış ise hidroksiapatit grubunda gözlendi (P = ,000). Tüm derinliklerde en yüksek sertlik değerleri hidroksiapatit grubunda, en düşük artış ise kontrol grubundaydı. Mineral kaybı sonuçları incelendiğinde sırasıyla hidroksiapatit+florid, arjinin+florid, biyoaktif cam+florid, florid gurubunda reminera- lizasyon meydana geldiği belirlendi. Kitosan ve kontrol grubunda demineralizasyon olduğu saptandı. Kitosan grubu kontrol grubu ile kıyaslandığında ise demineralizasyonu engellediği sonucuna varıldı (P = ,119).
Sonuç: Başlangıç çürük lezyonlarının engellenmesinde florid ile sinerjik etki yapan hidroksiapatit, biyoaktif cam, arjinin içeren diş macunlarının düzenli olarak kullanılması faydalı olabileceği sonucuna varıldı.
Anahtar Kelimeler: Demineralizasyon, remineralizasyon, diş macunu, DIAGNOdent Pen, çapraz mikrosertlik

Anahtar Kelimeler

Demineralization, remineralization, toothpaste, DIAGNOdent Pen

Kaynakça

• 1. Vyavhare S, Sharma DS, Kulkarni VK. Effect of three different pastes on remineralization of initial enamel lesion: An in vitro study. J Clin Pediatr Dent. 2015;39(2):149-160. [CrossRef]
• 2. Featherstone JD. Prevention and reversal of dental caries: Role of low level fluoride. Community Dent Oral Epidemiol. 1999;27(1):31-40. [CrossRef]
• 3. Kariper E, Akin EGG, Alici O. Remineralization agents on early stage of caries comparison with different diagnostic methods and evaluate surface hardness of remineralization area. Curr Res Dent Sci. 2019; 29(2):229-237.
• 4. Heymann GC, Grauer D. A contemporary review of white spot lesions in orthodontics. J Esthet Restor Dent. 2013;25(2):85-95. [CrossRef]
• 5. Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res. 1990;69:601-606. [CrossRef]
• 6. Malekafzali B, Ekrami M, Mirfasihi A, Abdolazimi Z. Remineralizing effect of child formula dentifrices on artificial enamel caries using a pH cycling model. J Dent (Tehran). 2015;12(1):11-17.
• 7. Cheng X, Xu P, Zhou X, et al. Arginine promotes fluoride uptake into artificial carious lesions in vitro. Aust Dent J. 2015;60(1):104-111. [CrossRef]
• 8. Alhussain AM, Alhaddad AA, Ghazwi MM, Farooq I. Remineralization of artificial carious lesions using a novel fluoride incorporated bio- active glass dentifrice. Dent Med Probl. 2018;55(4):379-382. [CrossRef]
• 9. Amaechi BT, Phillips TS, Evans V, et al. The potential of hydroxyapa- tite toothpaste to prevent root caries: A pH-cycling study. Clin Cos- met Investig Dent. 2021;13:315-324. [CrossRef]
• 10. Kim M, Kwon H, Choi CH, Kim B. Combined effects of nano- hydroxyapatite and NaF on remineralization of early caries lesion. Paper presented at. Key Eng Mater. 2007;330-332 II:1347-1350.
• 11. Ekambaram M, Itthagarun A, King NM. Comparison of the remineral- izing potential of child formula dentifrices. Int J Paediatr Dent. 2011;21(2):132-140. [CrossRef]
• 12. De Carvalho M, Stamford TCM, Dos Santos E, Tenorio P, Sampaio F. Chitosan as an oral antimicrobial agent. Formatex. 2011;2012(1):13.
• 13. Arnaud TM, de Barros Neto B, Diniz FB. Chitosan effect on dental enamel de-remineralization: An in vitro evaluation. J Dent. 2010; 38(11):848-852. [CrossRef]
• 14. Wang Z, Jiang T, Sauro S, et al. The dentine remineralization activity of a desensitizing bioactive glass-containing toothpaste: An in vitro study. Aust Dent J. 2011;56(4):372-381. [CrossRef]
• 15. Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent. 2011;39(6):430-437. [CrossRef]
• 16. ten Cate JM, Duijsters PP. Alternating demineralization and remin- eralization of artificial enamel lesions. Caries Res. 1982;16(3):201-210. [CrossRef]
• 17. Stookey GK, Featherstone JD, Rapozo-Hilo M, et al. The Feather- stone laboratory pH cycling model: A prospective, multi-site valida- tion exercise. Am J Dent. 2011;24(5):322-328.
• 18. Purdell-Lewis DJ, Groeneveld A, Arends J. Microhardness and densi- tometric measurements of the effect of 4% SnF2 solution on artificial white spot lesions. Caries Res. 1976;10(3):216-226. [CrossRef]
• 19. Chedid SJ, Cury JA. Effect of 0.02% NaF solution on enamel demin- eralization and fluoride uptake by deciduous teeth in vitro. Braz Oral Res. 2004;18(1):18-22. [CrossRef]
• 20. Featherstone JD, Ten Cate JM, Shariati M, Arends J. Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profiles. Caries Res. 1983;17(5):385-391. [CrossRef]
• 21. White DJ, Faller RV, Bowman WD. Demineralization and reminerali- zation evaluation techniques—added considerations. J Dent Res. 1992;71(3):929-933. [CrossRef]
• 22. Featherstone JD, ten Cate JM, Shariati M, Arends J. Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profiles. Caries Res. 1983;17(5):385-391. [CrossRef]
• 23. U.S. Department of Health and Human Services Oral Health Coordi- nating Committee. U.S. Department of Health and Human Services Oral Health strategic framework, 2014-2017. Public Health Rep. 2016;131(2):242-257. [CrossRef]
• 24. Gunsolley JC. Clinical efficacy of antimicrobial mouthrinses. J Dent. 2010;38(suppl 1):S6-S10. [CrossRef] 25. ten Cate JM, Zaura E. The numerous microbial species in oral bio- films: How could antibacterial therapy be effective? Adv Dent Res. 2012;24(2):108-111. [CrossRef]
• 26. Axelsson P, Lindhe J, Wäseby J. The effect of various plaque control measures on gingivitis and caries in schoolchildren. Community Dent Oral Epidemiol. 1976;4(6):232-239. [CrossRef]
• 27. Jeong S, Jang S, Kim KN, Kwon H, Park YD, Kim B. Remineralization potential of new toothpaste containing nano-hydroxyapatite. Paper presented at. Key Eng Mater. 2006;309:537-540.
• 28. Yin W, Hu DY, Li X, et al. The anti-caries efficacy of a dentifrice con- taining 1.5% arginine and 1450 ppm fluoride as sodium monofluoro- phosphate assessed using Quantitative Light-induced Fluorescence (QLF). J Dent. 2013;41(suppl 2):S22-S28. [CrossRef]
• 29. Rodrigues E, Delbem AC, Pedrini D, Cavassan L. Enamel reminerali- zation by fluoride-releasing materials: Proposal of a pH-cycling model. Braz Dent J. 2010;21(5):446-451. [CrossRef]
• 30. White DJ. The application of in vitro models to research on demin- eralization and remineralization of the teeth. Adv Dent Res. 1995; 9(3):175-194. [CrossRef]
• 31. Lynch RJ, Mony U, ten Cate JM. Effect of lesion characteristics and mineralizing solution type on enamel remineralization in vitro. Caries Res. 2007;41(4):257-262. [CrossRef]
• 32. Narayana SS, Deepa VK, Ahamed S, Sathish ES, Meyappan R, Satheesh Kumar KS. Remineralization efficiency of bioactive glass on artificially induced carious lesion an in-vitro study. J Indian Soc Pedod Prev Dent. 2014;32(1):19-25. [CrossRef]
• 33. Patil VH, Anegundi RT. An in vitro assessment of fluoride uptake by tooth enamel from four different fluoride dentifrices. Eur Arch Pae- diatr Dent. 2014;15(5):347-351. [CrossRef]
• 34. Moriyama CM, Rodrigues JA, Lussi A, Diniz MB. Effectiveness of fluorescence-based methods to detect in situ demineralization and remineralization on smooth surfaces. Caries Res. 2014;48(6): 507-514. [CrossRef]
• 35. Reis A, Mendes FM, Angnes V, Angnes G, Grande RH, Loguercio AD. Performance of methods of occlusal caries detection in permanent teeth under clinical and laboratory conditions. J Dent. 2006;34(2): 89-96. [CrossRef]
• 36. Uysal T, Akkurt MD, Amasyali M, et al. Does a chitosan-containing dentifrice prevent demineralization around orthodontic brackets? Angle Orthod. 2011;81(2):319-325. [CrossRef]
• 37. Marsillac M, Delbem ACB, Vieira R. Effect of time in hardness test on artificially demineralized human dental enamel. Braz J Oral Sci. 2008:1507-1511.
• 38. Kraivaphan P, Amornchat C, Triratana T, et al. Two-year caries clinical study of the efficacy of novel dentifrices containing 1.5% arginine, an insoluble calcium compound and 1,450 ppm fluoride. Caries Res. 2013;47(6):582-590. [CrossRef]
• 39. Cantore R, Petrou I, Lavender S, et al. In situ clinical effects of new dentifrices containing 1.5% arginine and fluoride on enamel de- and remineralization and plaque metabolism. J Clin Dent. 2013;24(Spec no A):A32-A44.
• 40. Hornby K, Evans M, Long M, Joiner A, Laucello M, Salvaderi A. Enamel benefits of a new hydroxyapatite containing fluoride toothpaste. Int Dent J. 2009;59(6):325-331. [CrossRef]
• 41. de Carvalho FG, Vieira BR, Santos RLD, Carlo HL, Lopes PQ, de Lima B. In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions. Pediatr Dent. 2014;36(3):85-89.
• 42. Swarup JS, Rao A. Enamel surface remineralization: Using syn- thetic nanohydroxyapatite. Contemp Clin Dent. 2012;3(4):433-436. [CrossRef]
• 43. Comar LP, Souza BM, Gracindo LF, Buzalaf MA, Magalhães AC. Impact of experimental Nano-HAP pastes on bovine enamel and dentin submitted to a pH cycling model. Braz Dent J. 2013;24(3):273-278. [CrossRef]
• 44. Yli-Urpo H, Närhi T, Söderling E. Antimicrobial effects of glass ionomer cements containing bioactive glass (S53P4) on oral micro- organisms in vitro. Acta Odontol Scand. 2003;61(4):241-246. [CrossRef] 45. Gjorgievska E, Nicholson JW. Prevention of enamel demineralization after tooth bleaching by bioactive glass incorporated into tooth- paste. Aust Dent J. 2011;56(2):193-200. [CrossRef]
• 46. Fujiwara M, Hayashi Y, Ohara N. Inhibitory effect of water-soluble chitosan on growth of Streptococcus mutans. New Microbiol. 2004; 27(1):83-86. 47. Svensson O, Lindh L, Cárdenas M, Arnebrant T. Layer-by-layer assem- bly of mucin and chitosan--Influence of surface properties, concen- tration andtype ofmucin. J Colloid Interface Sci. 2006;299(2):608-616. [CrossRef]