Department of Operative Dentistry, Periodontology, and Preventive Dentistry, RWTH Aachen University, Aachen, Germany.
Caries Res. 2018;52(3):199-211. doi: 10.1159/000484483. Epub 2018 Jan 17.
The aim of this study was to compare the caries-preventive effect of different fluoride varnishes on sound dentin as well as on artificial dentin caries-like lesions. Bovine dentin specimens (n = 220) with one sound surface (ST) and one artificial caries lesion (DT) were prepared and randomly allocated to 11 groups. The interventions before pH cycling were as follows: application of a varnish containing NaF (22,600 ppm F-; Duraphat [NaF0/NaF1]), NaF plus tricalcium phosphate (22,600 ppm F-; Clinpro White Varnish Mint [TCP0/TCP1]), NaF plus casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP; 22,600 ppm F-; MI Varnish [CPP0/CPP1]), or silver diamine fluoride (SDF; 35,400 ppm F-; Cariestop 30% [SDF0/SDF1]) and no intervention (NNB/N0/N1). During pH cycling (14 days, 6 × 120 min demineralization/day) half of the specimens in each group were brushed (10 s; 2 times/day) with either fluoride-free ("0"; e.g., TCP0) or 1,100 ppm F- ("1"; e.g., TCP1) dentifrice slurry. In another subgroup, the specimens were pH cycled but not brushed (NNB). Differences in integrated mineral loss (ΔΔZ), lesion depth (ΔLD), and colorimetric values (ΔΔE) were calculated between the values after initial demineralization and those after pH cycling, using transversal microradiography and photographic images. After pH cycling, no discoloration could be observed. Furthermore, NNB, N0, and N1 showed significantly increased ΔZDT/LDDT and ΔZST/LDST values, indicating further demineralization. In contrast, CPP0, CPP1, SDF0, and SDF1 showed significantly decreased ΔZDT/LDDT values, indicating remineralization (p ≤ 0.004; paired t test). CPP0, CPP1, SDF0, and SDF1 showed significantly higher changes in ΔΔZDT/ΔLDDT and ΔΔZST/ΔLDST than NNB, N0, and N1 (p < 0.001; Bonferroni post hoc test). In conclusion, under the conditions chosen, all fluoride varnishes prevented further demineralization. However, only NaF plus CPP-ACP and SDF could remineralize artificial dentin caries-like lesions under net-demineralizing conditions, thereby indicating that NaF plus CPP-ACP and SDF may be helpful to high-caries-risk patients.
本研究旨在比较不同氟化物涂料在正常牙本质和人工牙本质龋损上的防龋效果。制备 220 个具有一个正常表面（ST）和一个人工龋损（DT）的牛牙本质标本，并随机分配到 11 个组。在 pH 循环前的干预措施如下：应用含有 NaF（22600ppm F-；Duraphat[NaF0/NaF1]）、NaF 加磷酸三钙（22600ppm F-；Clinpro White Varnish Mint[TCP0/TCP1]）、NaF 加酪蛋白磷酸肽稳定的无定形磷酸钙复合物（CPP-ACP；22600ppm F-；MI Varnish[CPP0/CPP1]）或银胺氟化氢（SDF；35400ppm F-；Cariestop 30%[SDF0/SDF1]）的涂料，以及不干预（NNB/N0/N1）。在 pH 循环（14 天，每天 6 次×120min 脱矿）期间，每组一半的标本用含氟或无氟（“0”；例如，TCP0）的牙膏糊剂（10s；每天 2 次）刷牙。在另一个亚组中，标本进行 pH 循环但不刷牙（NNB）。使用横切显微放射摄影术和摄影图像，计算初始脱矿化后与 pH 循环后之间的积分矿物损失（ΔΔZ）、病变深度（ΔLD）和比色值（ΔΔE）的差异。pH 循环后，未观察到变色。此外，NNB、N0 和 N1 的 ΔZDT/LDDT 和 ΔZST/LDST 值显著增加，表明进一步脱矿。相比之下，CPP0、CPP1、SDF0 和 SDF1 的 ΔZDT/LDDT 值显著降低，表明再矿化（p≤0.004；配对 t 检验）。CPP0、CPP1、SDF0 和 SDF1 的 ΔΔZDT/ΔLDDT 和 ΔΔZST/ΔLDST 变化显著高于 NNB、N0 和 N1（p<0.001；Bonferroni 事后检验）。综上所述，在所选择的条件下，所有氟化物涂料均可预防进一步脱矿。然而，只有 NaF 加 CPP-ACP 和 SDF 可以在净脱矿条件下再矿化人工牙本质龋损，表明 NaF 加 CPP-ACP 和 SDF 可能对高龋风险患者有帮助。
