Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
Caries Res. 2012;46(1):31-7. doi: 10.1159/000335125. Epub 2012 Jan 12.
Although the effect of acidulated phosphate fluoride gel (APF gel) on caries reduction in permanent teeth is based on evidence, the relevance of the clinical application time is still under debate. Also, the effect of 4- versus 1-min application has not been evaluated in deciduous enamel. In a blind, crossover, in situ study of 14 days, 16 adult volunteers wore palatal appliances containing slabs of human permanent and deciduous enamel. At the beginning of each phase, the slabs were submitted to one of the following treatments: no APF application (negative control); APF gel (1.23% F) application for 1 or 4 min. Biofilm accumulation on the slab surface was allowed and the slabs were subjected eight times a day to 20% sucrose, simulating a high cariogenic challenge condition. On the 15th day of each phase, fluoride retained as CaF(2) and fluorapatite (FAp) was determined on the enamel of the slabs and demineralization was assessed by cross-sectional microhardness. Fluoride as CaF(2) and FAp, formed by APF gel application on the enamel slabs not subjected to the cariogenic challenge, was also determined. APF gel reduced demineralization in both enamel types (p < 0.05), but the difference between 1 and 4 min was not statistically significant (p > 0.05). CaF(2) and FAp formed and retained on deciduous and permanent enamel was significantly higher in APF gel groups (p < 0.05), but no significant difference was found between 1 and 4 min (p > 0.05). The findings suggest that 1 min of APF gel application provides a similar effect on inhibition of demineralization as 4 min, for both permanent and deciduous enamel.
尽管酸化膦氟凝胶(APF 凝胶)对恒牙龋减少的效果有证据支持,但临床应用时间的相关性仍存在争议。此外,4 分钟与 1 分钟应用在乳牙釉质上的效果尚未得到评估。在一项为期 14 天的盲法、交叉、原位研究中,16 名成年志愿者佩戴了含有人类恒牙和乳牙釉质板的腭架。在每个阶段开始时,将这些板片进行以下处理之一:不进行 APF 应用(阴性对照);APF 凝胶(1.23%F)应用 1 分钟或 4 分钟。允许生物膜在板片表面堆积,每天 8 次将 20%蔗糖施加到板片上,模拟高致龋挑战条件。在每个阶段的第 15 天,用氟化物保留作为 CaF₂和氟磷灰石(FAp)来确定板片釉质上的氟化物,并通过横截面显微硬度来评估脱矿质。还确定了未受致龋挑战的釉质板片上应用 APF 凝胶形成的氟化物作为 CaF₂和 FAp。APF 凝胶减少了两种釉质类型的脱矿质(p<0.05),但 1 分钟与 4 分钟之间的差异无统计学意义(p>0.05)。在 APF 凝胶组中,形成和保留在乳牙和恒牙釉质上的 CaF₂和 FAp 明显更高(p<0.05),但 1 分钟与 4 分钟之间无显著差异(p>0.05)。这些发现表明,1 分钟的 APF 凝胶应用在抑制脱矿质方面与 4 分钟一样,对恒牙和乳牙均有相似效果。