Machado Alana, Sakae Leticia, Niemeyer Samira Helena, Carvalho Thiago Saads, Amaechi Bennett, Scaramucci Taís
Department of Restorative Dentistry, University of São Paulo School of Dentistry. Av. Prof Lineu Prestes 2227, São Paulo 05508-000, SP, Brazil.
Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7 CH-3010, Bern, Switzerland.
J Dent. 2020 Oct;101:103450. doi: 10.1016/j.jdent.2020.103450. Epub 2020 Aug 13.
To evaluate the impact of the application of a F/Sn-containing mouthrinse before or after toothbrushing with a F/Sn/chitosan toothpaste on the progression of erosion/abrasion on enamel and dentin.
This crossover in situ study had five arms: Control (toothbrushing without toothpaste), Brushing (toothbrushing with toothpaste), Brushing + Rinsing, Rinsing + Brushing, and Rinsing (without toothbrushing). Fifteen subjects used removable mandibular appliances containing 3 enamel and 3 dentin specimens, which were subjected to erosion-abrasion cycling of 60 min salivary pellicle formation followed by 5 min extra-oral erosion with 1% citric acid (4x/day for 5 days). Treatments were performed in situ after first and last erosive challenges with rinse (10 ml; 30 s) and/or toothbrushing with/without toothpaste (with electric toothbrush; 5 s per specimen; total 2 min contact with slurry). Surface loss (SL) was evaluated with an optical profilometer. Data were analyzed by two-way repeated measures ANOVA and Tukey tests (α = 0.05).
The Control showed the highest SL (mean ± SD for enamel: 24.58 ± 11.32; dentin: 32.32 ± 10.10; all μm). Rinsing alone resulted in significantly lower SL value (enamel: 8.30 ± 4.96; dentin: 16.15 ± 8.29) compared with arms that applied toothpaste, except Brushing + Rinsing. None of the arms that underwent toothbrushing with the toothpaste differed from each other (p > 0.05). Dentin specimens showed significantly higher SL values than enamel (p < 0.001).
The order of treatment applications had no influence on their anti-erosive effect; however, toothbrushing with F/Sn/chitosan toothpaste reduced enamel surface loss. Additional rinsing with F/Sn mouthrinse did not offer improved protection.
The use of fluoride- and stannous- containing toothpastes and mouthrinses is an important approach in the prevention of erosive tooth wear. Further evidence is needed to support the benefit of combining these products against this condition.
评估在使用含氟/锡/壳聚糖牙膏刷牙之前或之后应用含氟/锡漱口水对牙釉质和牙本质侵蚀/磨损进展的影响。
这项交叉原位研究有五个组：对照组（不使用牙膏刷牙）、刷牙组（使用牙膏刷牙）、刷牙+漱口组、漱口+刷牙组和漱口组（不刷牙）。15名受试者使用含有3个牙釉质和3个牙本质标本的可摘下颌矫治器，这些标本先进行60分钟的唾液薄膜形成，然后用1%柠檬酸进行5分钟的口外侵蚀（每天4次，共5天），进行侵蚀-磨损循环。在第一次和最后一次侵蚀挑战后，在原位进行治疗，使用漱口水（10毫升；30秒）和/或使用或不使用牙膏刷牙（使用电动牙刷；每个标本5秒；与牙膏糊剂总接触2分钟）。用光学轮廓仪评估表面损失（SL）。数据通过双向重复测量方差分析和Tukey检验进行分析（α=0.05）。
对照组的表面损失最高（牙釉质的平均值±标准差：24.58±11.32；牙本质：32.32±10.10；单位均为微米）。与使用牙膏的组相比，单独漱口导致的表面损失值显著更低（牙釉质：8.30±4.96；牙本质：16.15±8.29），刷牙+漱口组除外。使用牙膏刷牙的组之间没有差异（p>0.05）。牙本质标本的表面损失值显著高于牙釉质（p<0.001）。
治疗应用的顺序对其抗侵蚀效果没有影响；然而，使用含氟/锡/壳聚糖牙膏刷牙可减少牙釉质表面损失。额外使用含氟/锡漱口水并不能提供更好的保护。
使用含氟和含锡的牙膏和漱口水是预防侵蚀性牙齿磨损的重要方法。需要进一步的证据来支持联合使用这些产品对抗这种情况的益处。
