School of Dentistry, Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), Rua José Bonifácio, 1193, Aracatuba, SP, 16015-050, Brazil.
Department of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, Avenida Costábile Romano, 2201, Ribeirao Preto, SP, 14096-900, Brazil.
Clin Oral Investig. 2021 Mar;25(3):883-889. doi: 10.1007/s00784-020-03375-5. Epub 2020 Jun 1.
This study evaluated the effects of calcium gluconate (CaGlu), sodium fluoride (NaF), sodium trimetaphosphate (TMP), and NaF/TMP added to a 35% hydrogen peroxide (HP) bleaching gel for the reduction in enamel demineralization in vitro, with and without the use of a fluoridated dentifrice.
Enamel blocks (n = 100) were obtained from bovine incisors (n = 200) after flattening and subjected to initial surface hardness (SH) analysis. The blocks were divided according to the bleaching gel (35% HP; 35% HP + 0.05% NaF; 35% HP + 0.25% TMP; 35% HP + 0.05% NaF + 0.25% TMP; 35% HP + 2% CaGlu) and were treated with ether non-fluoridated or fluoridated (1100 ppm) dentifrice. The bleaching gels were applied thrice (40 min/session) at the intervals of 7 days between each application. After 21 days, the final SH for the calculation of the percentage of SH loss (%SH) and cross-sectional hardness for the evaluation of the integrated hardness area (IH) were determined.
Bleaching containing HP + NaF + TMP presented lowest %SH (p < 0.001), regardless of the dentifrice used. HP + NaF + TMP bleaching gel led to lower subsurface enamel mineral loss (IH) compared to the other groups (p < 0.001), and these did not differ from each other (p > 0.05). Daily use of fluoride dentifrice led to higher IH values (p < 0.001), regardless of the bleaching gels.
The addition of NaF/TMP to a 35% HP bleaching gel remarkably reduced the mineral loss compared to the cases of the other bleaching gels, regardless of dentifrice.
The association of TMP/NaF can be used as a strategy for reducing mineral loss during the bleaching procedure, even without the daily use of fluoride dentifrice.
本研究评估了葡萄糖酸钙（CaGlu）、氟化钠（NaF）、三聚磷酸钠（TMP）以及添加到 35%过氧化氢（HP）漂白凝胶中的 NaF/TMP 对体外减少牙釉质脱矿的影响，同时评估了使用含氟牙膏与不使用含氟牙膏的效果。
从牛切牙（n=200）中获得牙釉质块（n=100），并对其进行初始表面硬度（SH）分析。根据漂白凝胶（35% HP；35% HP+0.05% NaF；35% HP+0.25% TMP；35% HP+0.05% NaF+0.25% TMP；35% HP+2% CaGlu）和是否使用醚非氟化或氟化（1100 ppm）牙膏对牙釉质块进行分组。将漂白凝胶应用于牙釉质块，每 40 分钟（每次 40 分钟）处理一次，每次处理间隔 7 天。21 天后，确定最终 SH 值以计算 SH 值损失百分比（%SH）和进行整体硬度区域（IH）评估的横截面硬度。
无论使用何种牙膏，含 HP+NaF+TMP 的漂白凝胶的%SH 最低（p<0.001）。与其他组相比，HP+NaF+TMP 漂白凝胶导致的釉下牙本质矿物质损失（IH）更低（p<0.001），且彼此之间无差异（p>0.05）。无论使用何种漂白凝胶，每天使用含氟牙膏均可导致 IH 值更高（p<0.001）。
与其他漂白凝胶相比，35% HP 漂白凝胶中添加 NaF/TMP 可显著减少矿物质损失，而与牙膏无关。
TMP/NaF 的联合应用可作为减少漂白过程中矿物质损失的策略，即使不每天使用含氟牙膏也有效。
