Martins Tamires Passadori, Báez-Quintero Liliana Carolina, Gomes Isabela Maria Passarela, Wiegand Annette, Delbem Alberto Carlos Botazzo, Pessan Juliano Pelim
Department of Pediatric Dentistry and Public Health, School of Dentistry, Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen/Georg August University, Göttingen, NI, Germany.
J Dent. 2025 Jul 8;162:105964. doi: 10.1016/j.jdent.2025.105964.
This study evaluated the effect of fluoride gels supplemented with nano-sized sodium trimetaphosphate (TMP) on remineralization of artificial caries lesions in situ.
Bovine enamel blocks (n = 160) with chemically-induced caries-like lesions were randomly distributed into four groups: Placebo (without F and TMP - negative control), 9000 µg F/g (9000F - positive control), 4500 µg F/g + 5 % micrometric TMP (4500F+5 % TMPmicro), and 4500 µg F/g + 5 % nano-sized TMP (4500F+5 %TMPnano). Ten volunteers used palatal devices containing 4 demineralized enamel blocks for 3 days, following a double-blind and crossover protocol. Two enamel blocks were removed immediately after gel application to determine calcium fluoride (CaF) formed. After each phase, the samples were analyzed for the percentage of surface hardness recovery (%SHR), cross-sectional hardness (ΔKHN), and CaF retained on enamel. The data were submitted to one-way (%SHR and ΔKHN) or two-way (CaF), repeated-measures ANOVA, followed by Student-Newman-Keuls test (p < 0.05).
The highest %SHR was observed for 4500F+5 %TMPnano gel, followed by 4500F+5 %TPMmicro, 9000F, and Placebo, with significant differences among all groups. An inverse pattern was verified for ΔKHN, with the highest and lowest values achieved by the Placebo and 4500+5 %TMPnano groups, respectively. Regarding CaF formed, the highest concentration was observed in the 9000F group. For CaF retained, no significant differences were observed among all fluoride-containing gels.
The low-fluoride gel containing TMP led to significantly higher remineralization rates than a conventional gel containing twice as much fluoride; nano-sized TMP resulted in enhanced remineralization compared with micrometric particles.
The experimental formulation significantly outperformed the conventional fluoride gel in promoting enamel remineralization. These findings suggest a promising and safer alternative to current topical fluoride therapies, with important implications for caries prevention, both for private practice and in public health programs.
本研究评估了添加纳米级三聚偏磷酸钠（TMP）的氟凝胶对原位人工龋损再矿化的影响。
将具有化学诱导的类龋损的牛牙釉质块（n = 160）随机分为四组：安慰剂组（不含氟和TMP - 阴性对照）、9000 μg F/g（9000F - 阳性对照）、4500 μg F/g + 5%微米级TMP（4500F + 5% TMPmicro）和4500 μg F/g + 5%纳米级TMP（4500F + 5% TMPnano）。10名志愿者按照双盲交叉方案，使用含有4个脱矿牙釉质块的腭部装置3天。凝胶应用后立即取出2个牙釉质块以测定形成的氟化钙（CaF）。每个阶段后，分析样品的表面硬度恢复百分比（%SHR）、横截面硬度（ΔKHN）以及牙釉质上保留的CaF。数据进行单向（%SHR和ΔKHN）或双向（CaF）重复测量方差分析，随后进行Student - Newman - Keuls检验（p < 0.05）。
4500F + 5% TMPnano凝胶的%SHR最高，其次是4500F + 5% TPMmicro、9000F和安慰剂组，所有组之间存在显著差异。ΔKHN呈现相反模式，安慰剂组和4500 + 5% TMPnano组分别达到最高值和最低值。关于形成的CaF，9000F组中观察到最高浓度。对于保留的CaF，所有含氟凝胶之间未观察到显著差异。
含TMP的低氟凝胶导致的再矿化率显著高于含氟量为其两倍的传统凝胶；与微米级颗粒相比，纳米级TMP导致再矿化增强。
实验配方在促进牙釉质再矿化方面明显优于传统氟凝胶。这些发现表明，对于当前的局部氟治疗，这是一种有前景且更安全的替代方法，对私人执业和公共卫生项目中的龋齿预防具有重要意义。
