Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
J Dent. 2024 Jun;145:104966. doi: 10.1016/j.jdent.2024.104966. Epub 2024 Mar 29.
The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population.
This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001).
The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001).
The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F.
This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.
龋齿的减少归因于氟化物（F）的广泛使用。氟化物牙膏（FT）和漱口水（MW）是两种常见的应用形式，被广泛应用于人群中。
本研究旨在评估 FT 和 MW 联合应用的效果，无论是补充还是不补充三聚磷酸钠（TMP），对牙釉质脱矿的影响。根据初始表面硬度（SHi）选择牛牙釉质块（n = 60），并将其分为 5 个实验组（n = 12）：I）安慰剂牙膏（无 F/TMP）；II）1100 ppm F 牙膏（FT）；III）与 100 ppm F 的 MW 联合应用（FT + MW 100F）；IV）与 225 ppm F 的 MW 联合应用（FT + MW 250F）；V）与 100 ppm F 的 MW 联合应用，补充 0.4% TMP（FT + MW 100F-TMP）。这些块每天处理两次，在 7 天内进行 5 个 pH 循环。因此，确定了表面硬度百分比变化（%SH）、表面下硬度损失积分（ΔKHN）以及釉质中氟、磷（P）和钙（Ca）的浓度。数据经方差分析和 Student-Newman-Keuls 检验（p < 0.001）。
1100F 组在%SH、ΔKHN 以及釉质中 P 和 Ca 的浓度方面明显低于与 MW 联合应用的组（p < 0.001）。与其他组相比，用 FT + MW 225F 和 FT + MW 100F-TMP 处理的块的%SH 明显更低（p < 0.001）。FT + MW 100F-TMP 组的釉质矿物损失深度最低（ΔKHN），P 浓度最高（p < 0.001）。
MW 与 FT 联合应用对抑制牙釉质脱矿具有更大的保护作用，而 MW 中补充 TMP 比 225F 的 MW 具有更好的效果。
这种联合治疗可以被视为几种替代氟化物补充剂之一，用于那些患龋风险较高的患者。
