Effects of zinc and fluoride on the remineralisation of artificial carious lesions under simulated plaque fluid conditions.

The aim was to study the effects of zinc (Zn) and fluoride (F) on remineralisation at plaque fluid concentrations. Artificial carious lesions were created in 2 acid-gel demineralising systems (initially infinitely undersaturated and partially saturated with respect to enamel) giving lesions with different mineral distribution characteristics (high and low R values, respectively) but similar integrated mineral loss values. Lesions of both types were assigned to 1 of 4 groups and remineralised for 5 days at 37°C. Zn and F were added, based on plaque fluid concentrations 1 h after application, to give 4 treatments: 231 µmol/l Zn, 10.5 µmol/l F, Zn/F combined and an unmodified control solution (non-F/non-Zn). Subsequently remineralisation was measured using microradiography. High-R lesions were analysed for calcium, phosphorus, F and Zn using electron probe micro-analysis. All lesions underwent statistically significant remineralisation. For low-R lesions, remineralisation was in the order F(a) < non-F/non-Zn(a) < Zn(a, b) < Zn/F(b), and for high-R lesions F(a) < non-F/non-Zn(b) < Zn(b) < Zn/F(c) (treatments with the same superscript letter not significantly different, at p < 0.05). Qualitatively, remineralisation occurred throughout non-F/non-Zn and Zn groups, predominantly at the surface zone (F) and within the lesion body (Zn/F). Electron probe micro-analysis revealed Zn in relatively large amounts in the outer regions (Zn, Zn/F). F was abundant not only at the surface (F), but also in the lesion body (Zn/F). Calcium:phosphate ratios were similar to hydroxyapatite (all). To conclude, under static remineralising conditions simulating plaque fluid, Zn/F treatment gave significantly greater remineralisation than did F treatment, possibly because Zn in the Zn/F group maintained greater surface zone porosity compared with F, facilitating greater lesion body remineralisation.

Inhibition of erosive dissolution by sodium fluoride: evidence for a dose-response.

OBJECTIVES: The aim of this study was to investigate the protective effects of sodium fluoride solutions and commercial mouthrinses on hydroxyapatite (HA) dissolution in citric acid in vitro, with and without a salivary pellicle. METHODS: A rapid-throughput HA solubility-reduction model was employed in which HA dissolution was quantified using ion chromatography. Two HA substrates were selected, a high-resolution powder and 80 µm diameter beads, and studied in the presence and absence of a salivary pellicle (pooled human saliva, 2 h). Immediately prior to acid exposure, substrates were exposed to one of a number of pre-treatments that included aqueous fluoride (F(-)) solutions and commercially available mouthrinses with F(-) concentrations of 0-450 µg/g (as NaF). Dissolution reduction was calculated relative to a deionised water negative control. RESULTS: For aqueous solutions and mouthrinses, a fluoride dose-response was observed with a plateau around 100 µg/g F(-) for both HA substrates, with or without pellicle. Concentrations as low as 10 µg/g F(-) significantly reduced HA dissolution. The HA substrate had little impact on the fluoride dose-response, and the fluoride was equally effective in the presence of a pellicle as in its absence. CONCLUSIONS: Fluoride significantly reduced HA dissolution at concentrations of 10 µg/g and higher. A fluoride dose-response was seen at low concentrations. This study illustrates the use of a powerful rapid-throughput HA solubility-reduction model for investigating HA dissolution in citric acid in the presence of dissolution inhibitors. CLINICAL SIGNIFICANCE: A single exposure to fluoride solutions with fluoride concentrations and exposure time representative of brushing or rinsing with mainstream oral care products was shown to significantly inhibit HA dissolution under conditions relevant to dental erosion. A similar efficacy was observed in the presence and absence of salivary pellicle.