The effect of different strontium concentrations on the efficacy of chlorhexidine-fluoride-strontium gel in preventing enamel softening in vitro.

The effects were compared of strontium concentrations of 0, 15, 50 and 250 parts/10(6) in chlorhexidine(0.20%)-fluoride(0.16%) gel in preventing the softening of bovine enamel during bacterial fermentation. Fresh Streptococcus sobrinus cells were suspended in a buffer solution (pH 6.0) with 3.3% sucrose and centrifuged as a plaque-like layer on the top of enamel slabs covered with 10 microliters gel. AFter 24 h incubation, the pH fall of the fluid was significantly smaller in all test groups than in the placebo group. Strontium seemed to have an inhibitory effect on the pH fall. All test gels significantly prevented softening and dissolution of enamel during bacterial fermentation, which was directly related to strontium concentration. The amounts of calcium and phosphorus in the cells and fluid after incubation were the smallest in the group with 250 parts/10(6) strontium. In a second experiment without bacteria, new enamel slabs were covered with 10 microliters gel containing chlorhexidine and NaF with 0 and 250 parts/10(6) strontium to study the protective effect of strontium. After 24 h gel treatment, each enamel slab was dissolved in 1 ml 0.1 M lactic acid, pH 5.0, for 2 h. Significantly less calcium and phosphorus were dissolved from the enamel in both test groups than in the control and placebo groups. However, the placebo gel also prevented calcium and phosphorus dissolution significantly. These results suggest that the addition of strontium to chlorhexidine-fluoride gel improves the ability of this combination to prevent caries-like enamel softening. The inhibition of bacterial acid production by the strontium-containing gel may explain this enhanced protection of enamel.