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      AmF/NaF/SnCl2 solution reduces in situ enamel erosion – profilometry and cross-sectional nanoindentation analysis

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          Abstract

          Abstract This in situ study aimed to investigate the effect of a tin-containing fluoride solution in preventing enamel erosion. Also, its effects on the partly demineralized zone were assessed for the first time. Thirteen volunteers participated in this 2-phase study, wearing removable intra-oral appliances containing four sterilized bovine enamel slabs, for 8 days, where 2 treatment protocols were tested using samples in replicas (n = 13): CO - no treatment (negative control) and FL - AmF/NaF/SnCl2 solution (500 ppm F-, 800 ppm Sn2+, pH = 4.5). Samples were daily exposed to an erosive challenge (0.65% citric acid, pH 3.6, 4 min, 2x/day). In the 2nd phase, volunteers switched to the other treatment protocol. Samples were evaluated for surface loss using a profilometer (n = 13) and a cross-sectional nanohardness (CSNH) test (n = 13) was carried out in order to determine how deep the partly demineralized zone reaches below the erosive lesion. The data were statistically analyzed by two-way ANOVA. Erosive challenges lead to smaller enamel surface loss (p < 0.001) in the FL group when compared to group CO. Data from CSNH showed that there was no significant difference in demineralized enamel zone underneath erosion lesions between the groups. An amorphous layer could be observed on the surface of enamel treated with tin-containing solution alone. Under the experimental conditions of this in situ study, it can be concluded that AmF/NaF/SnCl2 solution prevents enamel surface loss but does not change the hardness of the partly demineralized zone near-surface enamel.

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          Most cited references38

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          In situ caries models.

          D. Zero (1995)
          By using in situ models, we have the potential to study both fundamental aspects of the caries process as well as more applied research problems such as the effect of food on dental caries and the role of fluoride in caries prevention in human subjects without actually causing caries in the natural dentition. The key experimental parameters that need to be considered in the development of an in situ model are the characteristics of the subject panel, the physical design of the model, the type of hard tissue substrate and the method of assessing mineral status, and the study design and clinical protocol. Each parameter must be carefully considered in relation to the objectives of the research, study design requirements, ethical considerations, impact on clinical relevance, and impact on the control of variation. The major source of variation associated with in situ models should be of biological and not experimental origin. The design and conduct of proper in situ model studies require a clear understanding of the caries process, sound analytical support, and a knowledge of how to work with research subjects to achieve a high level of compliance. Given the complex nature of caries, a combination of hard tissue substrates--including sound, surface-softened lesions and subsurface lesions--may be necessary to model all aspects of caries progression and prevention successfully. Internal validation of in situ models using fluoride dose-response controls is considered to be necessary for studies evaluating the efficacy of new fluoride dentifrice formulations.
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            Tin-containing fluoride solutions as anti-erosive agents in enamel: an in vitro tin-uptake, tissue-loss, and scanning electron micrograph study.

            Tin-containing fluoride solutions can reduce erosive tissue loss, but the effects of the reaction between tin and enamel are still not clear. During a 10-d period, enamel specimens were cyclically demineralized (0.05 M citric acid, pH 2.3, 6 x 5 min d(-1)) and remineralized (between the demineralization cycles and overnight). In the negative-control group, no further treatment was performed. Three groups were treated (2 x 2 min d(-1)) with tin-containing fluoride solutions (400, 1,400 or 2,100 ppm Sn2+, all 1,500 ppm F-, pH 4.5). Three additional groups were treated with test solutions twice daily, but without demineralization. Tissue loss was determined profilometrically. Energy-dispersive X-ray spectroscopy was used to measure the tin content on and within three layers (10 mum each) beneath the surface. In addition, scanning electron microscopy was conducted. All test preparations significantly reduced tissue loss. Deposition of tin on surfaces was higher without erosion than with erosion, but no incorporation of tin into enamel was found without demineralization. Under erosive conditions, both highly concentrated solutions led to the incorporation of tin up to a depth of 20 mum; the less-concentrated solution led to small amounts of tin in the outer 10 mum. The efficacy of tin-containing solutions seems to depend mainly on the incorporation of tin into enamel.
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              Efficacy of a tin/fluoride rinse: a randomized in situ trial on erosion.

              Concentrated tin- and fluoride-containing mouthrinses are effective erosion inhibitors in enamel and dentin. To test whether this is also true for solutions with lower concentrations, we conducted a randomized double-blind three-cell crossover in situ study with extra-orally performed erosive impacts (citric acid, 6 x 5 min/day) and an intra-oral rinsing protocol (1 x 30 sec/day) in 24 volunteers. The mouthrinses were a placebo, a NaF (500 ppm F⁻), and an amine fluoride (AmF)/NaF/SnCl₂ mouthrinse (500 ppm F⁻, 800 ppm Sn(2+)). Compared with the placebo, the NaF mouthrinse reduced substance loss by 19% in enamel and 23% in dentin (p ≤ 0.01 each); the AmF/NaF/SnCl₂ mouthrinse reduced this parameter by 67% in enamel and 47% in dentin (p ≤ 0.001 each). AmF/NaF/SnCl₂ was significantly more effective than NaF in both tissues (p ≤ 0.01). The mouthrinse containing Sn and F exhibited good efficacy, even under severe erosive conditions.
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                Author and article information

                Journal
                bor
                Brazilian Oral Research
                Braz. oral res.
                Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )
                1806-8324
                1807-3107
                2017
                : 31
                : e20
                Affiliations
                [2] Campinas SP orgnameSão Leopoldo Mandic Institute orgdiv1Dental Research Center orgdiv2Department of Restorative Dentistry Brazil
                [1] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1School of Dentistry orgdiv2Department of Restorative Dentistry Brazil
                [3] São Francisco CA orgnameUniversity of California San Francisco orgdiv1School of Dentistry orgdiv2Department of Preventive and Restorative Dental Sciences United States
                Article
                S1806-83242017000100218 S1806-8324(17)03100000218
                10.1590/1807-3107bor-2017.vol31.0020
                28273206
                fd4a4076-6766-44df-b15b-a4d871d82386

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 23 February 2016
                : 24 January 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Research

                Dental Enamel,Fluorides,Tooth Erosion
                Dental Enamel, Fluorides, Tooth Erosion

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