São Paulo State University (Unesp), School of Dentistry, Araçatuba Department of Pediatric Dentistry and Public Health, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil.
São Paulo State University (Unesp), School of Dentistry, Araçatuba Department of Pediatric Dentistry and Public Health, Rua José Bonifácio 1193, Araçatuba, SP, Cep 16015-050, Brazil.
J Dent. 2018 Jan;68:59-65. doi: 10.1016/j.jdent.2017.10.013. Epub 2017 Oct 31.
This in situ study evaluated the effect of the association of low-F (4500μg F/g) gel containing TMP and FT (1100μg F/g) on enamel demineralization.
This crossover and double-blind study consisted of five phases of seven days each. Volunteers (n=12) wore palatal appliances containing four enamel blocks. The cariogenic challenge was performed with 30% sucrose solution (six times/day). Treatments were: placebo toothpaste (PT, no fluoride/TMP); 1100μg F/g toothpaste (FT); FT+4500μg F/g+5%TMP gel (FT+TMP gel); FT+9000μg F/g gel (FT+9000 gel) and FT+12,300μg F/g (FT+Acid gel). After topical application of treatments for one min, two blocks were removed for analysis of loosely bound fluoride (CaF), calcium (Ca), phosphorus (P) and firmly bound fluoride (FA) formed in enamel. After the seven-day experimental periods, the percentage of surface hardness loss (%SH), integrated subsurface hardness loss (ΔKHN), CaF, Ca, P and FA retained were determined. Moreover, the biofilms formed on the blocks were analyzed for F, Ca, P and insoluble extracellular polysaccharide (EPS) concentrations.
FT+TMP gel promoted the lowest%SH and ΔKHN (p<0.001). The highest concentration of CaF formed was observed for the FT+Acid gel (p<0.001), followed by FT+9000 gel > FT+TMP gel > FT > PT. CaF retained on the blocks was reduced across all groups (p<0.001). Similar values were observed for the Ca/P/F and EPS in enamel and biofilm for all fluoride groups.
The association of FT+TMP gel significantly reduced enamel demineralization in situ.
The association of treatments may be an alternative for patients with high caries risk.
本原位研究评估了低 F（4500μg F/g）含 TMP 和 FT（1100μg F/g）凝胶联合应用对牙釉质脱矿的影响。
本交叉双盲研究包括五个为期七天的阶段。志愿者（n=12）佩戴含有四个牙釉质块的腭部器械。采用 30%蔗糖溶液（每天 6 次）进行致龋挑战。处理方法如下：安慰剂牙膏（PT，无氟/TMP）；1100μg F/g 牙膏（FT）；FT+4500μg F/g+5%TMP 凝胶（FT+TMP 凝胶）；FT+9000μg F/g 凝胶（FT+9000 凝胶）和 FT+12300μg F/g（FT+酸凝胶）。处理剂涂敷一分钟后，取出两个牙釉质块，分析牙釉质中形成的松散结合氟（CaF）、钙（Ca）、磷（P）和牢固结合氟（FA）。在七个实验期后，测定表面硬度损失百分比（%SH）、综合表面下硬度损失（ΔKHN）、CaF、Ca、P 和 FA 的保留率。此外，还分析了牙釉质块上形成的生物膜中 F、Ca、P 和不可溶细胞外多糖（EPS）的浓度。
FT+TMP 凝胶组的%SH 和 ΔKHN 最低（p<0.001）。FT+酸凝胶组形成的 CaF 浓度最高（p<0.001），其次是 FT+9000 凝胶>FT+TMP 凝胶>FT>PT。各组牙釉质块上的 CaF 保留率均降低（p<0.001）。所有氟化物组牙釉质和生物膜中 Ca/F/P 和 EPS 的比值相似。
FT+TMP 凝胶联合应用显著减少了原位牙釉质脱矿。
该处理方法的联合应用可能是高龋风险患者的一种选择。
