The effect of CO2 9.3 µm short-pulsed laser irradiation in enamel erosion reduction with and without fluoride applications-a randomized, controlled in vitro study.

The aim of this in vitro study was to evaluate the protective effect of short-pulsed CO2 9.3 µm laser irradiation against erosion in human enamel without and combined with TiF4 and AmF/NaF/SnCl2 applications, respectively, as well as compared to the protective effect of these fluoride treatments alone. After polishing, ninety enamel samples (3 × 3mm) were used for 9 different treatment groups: 4% TiF4 gel (pH 1.5, 24,533 ppm F-); AmF/NaF/SnCl2 rinse (pH 4.5; 500 ppm F-, 800 ppm Sn2); CO2 laser (average power 0.58 W); CO2 laser (0.58 W) + TiF4; CO2 laser (0.58 W) + AmF/NaF/SnCl2; CO2 laser (0.69 W); CO2 laser (0.69 W) + TiF4; CO2 laser (0.69 W) + AmF/NaF/SnCl2; negative control (deionized water). TiF4 gel was brushed on only once before the first erosive cycling, while samples treated with AmF/NaF/SnCl2 were daily immersed in 5 ml of the solution before cycling. Laser treatment occurred with a CO2 laser (wavelength 9.3 µm, pulse repetition rate 100 Hz, pulse duration 14.6 µs/18 µs, average power 0.58 W/0.69 W, fluence 1.9 J/cm2/2.2 J/cm2, beam diameter 0.63 mm, irradiation time 10 s, air cooling). TiF4 was applied only once, while AmF/NaF/SnCl2 was applied once daily before the erosive challenge. Surface loss (in µm) was measured with optical profilometry immediately after treatment, and after 5 and 10 days of erosive cycling (0.5% citric acid, pH 2.3, 6 × 2 min/day). Additionally, scanning electron microscopy investigations were performed. All application measures resulted in loss of surface height immediately after treatment. After 5 days, significantly reduced surface loss was observed after applying laser irradiation (both power settings) followed by applications of TiF4 or AmF/NaF/SnCl2 solution (p < 0.05; 2-way ANOVA and Tukey test) compared to fluoride application alone. After 10 days, compared to after 5 days, a reduced tissue loss was observed in all groups treated with AmF/NaF/SnCl2 solution. This tissue gain occurred with the AmF/NaF/SnCl2 application alone and was significantly higher when the application was combined with the laser use (p < 0.05). Short-pulsed CO2 9.3 µm laser irradiation followed by additional application of AmF/NaF/SnCl2 solution significantly reduces the progression of dental enamel erosion in vitro.

Protection Against Discolouration by Two Over-the Counter Desensitising Products.

PURPOSE: To determine in vitro the protection potential against discolouration of two OTC (over-the-counter) desensitising products on enamel and dentin in comparison to a standard toothpaste and water by means of a spectrophotometer. MATERIALS AND METHODS: A total of 96 samples of bovine enamel-dentin complex and 48 of bovine dentin were alternatively immersed in red wine, tea, coffee or water after having been treated by a sodium monofluorophosphate- and calcium phosphate-based product (Curodont Protect), an amine fluoride-based toothpaste (Elmex Red), a stannous chloride-based toothpaste (Elmex Protection Erosion) or distilled water (negative control). Initial (T0) and final colour (T1, after 4 weeks of immersion in staining solutions) of each specimen were assessed by a spectrophotometer. Statistical analysis was done by means of repeated measures ANOVA followed by Fisher's LSD post-hoc test. Differences between T0 and T1 were considered stastistically significant at p ≤ 0.05. RESULTS: When enamel samples were measured over a black background, ΔE00 values (T0-T1) varied from 2.2 (SD 0.7) for amine fluoride-based product/water to 53.9 (SD 7.6) for amine fluoride-based-product/red wine. When dentin samples were measured over a black background, ΔE00 values (T0-T1) varied from 5.4 (SD 0.9) stannous chloride based product/water to 61.6 (SD 3.7) amine fluoride-based product/red wine. CONCLUSION: Specifically, the application of the sodium monofluorophosphate was able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested only on the enamel-dentin complex, while distilled water and the stannous fluoride-based product were able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested in pure dentin samples.

The future of fluorides and other protective agents in erosion prevention.

The effectiveness of fluoride in caries prevention has been convincingly proven. In recent years, researchers have investigated the preventive effects of different fluoride formulations on erosive tooth wear with positive results, but their action on caries and erosion prevention must be based on different requirements, because there is no sheltered area in the erosive process as there is in the subsurface carious lesions. Thus, any protective mechanism from fluoride concerning erosion is limited to the surface or the near surface layer of enamel. However, reports on other protective agents show superior preventive results. The mechanism of action of tin-containing products is related to tin deposition onto the tooth surface, as well as the incorporation of tin into the near-surface layer of enamel. These tin-rich deposits are less susceptible to dissolution and may result in enhanced protection of the underlying tooth. Titanium tetrafluoride forms a protective layer on the tooth surface. It is believed that this layer is made up of hydrated hydrogen titanium phosphate. Products containing phosphates and/or proteins may adsorb either to the pellicle, rendering it more protective against demineralization, or directly to the dental hard tissue, probably competing with H(+) at specific sites on the tooth surface. Other substances may further enhance precipitation of calcium phosphates on the enamel surface, protecting it from additional acid impacts. Hence, the future of fluoride alone in erosion prevention looks grim, but the combination of fluoride with protective agents, such as polyvalent metal ions and some polymers, has much brighter prospects.

Erosion/abrasion-preventing potential of NaF and F/Sn/chitosan toothpastes in dentine and impact of the organic matrix.

The study investigated the erosion/abrasion-preventing potential of experimental NaF (1,400 ppm F(-)) and amine fluoride (AmF)/NaF/SnCl2/chitosan (1,400 ppm F(-), 3,500 ppm Sn(2+), 0.5% chitosan) toothpastes relative to placebo and SnF2 gel (970 ppm F(-), 3,000 ppm Sn(2+)), and the impact of the demineralised dentine matrix on toothpaste effects. The study was a cyclic erosion/intervention experiment (10 days). Samples were stored in mineral salt solution either without or with collagenase (from Clostridium histolyticum type VII; 100 U/ml) for continuous removal of the organic matrix. To produce a comparable order of tissue loss, erosion was performed 6 × 30 s/day with 0.5% citric acid in the latter and 6 × 90 s/day with 1% citric acid in the former. Intervention was toothpaste slurry immersion (2 × 2 min/day); half of the samples were additionally brushed for 15 s within this time (brushing machine, load 200 g). Tissue loss was determined profilometrically (mean ± SD; µm). Tissue loss values (without/with brushing) for placebo, NaF, AmF/NaF/SnCl2/chitosan and SnF2 gel, respectively, were 11.6 ± 3.1/12.2 ± 2.5, 12.7 ± 3.1/10.7 ± 4.5, 8.7 ± 2.1/9.7 ± 2.1 and 8.8 ± 1.8/​10.9 ± 1.8 in the presence of the organic matrix and 10.7 ± 3.2/11.9 ± 2.1, 8.2 ± 4.0/10.1 ± 4.1, 8.7 ± 2.9/9.1 ± 1.8 and 8.4 ± 1.9/7.5 ± 1.5 in the absence of the organic matrix. Relative to placebo, the NaF formulation had no significant effects; the AmF/NaF/SnCl2/chitosan formulation significantly reduced tissue loss between 20 and 25% except when applied without brushing in the absence of the organic matrix. The effects of the formulations were similar both in the presence and absence of the organic matrix. Sn(2+)/F(-)-​containing formulations have the potential to reduce erosion/abrasion even in the absence of demineralised collagen; seeking for more effective formulations is desirable.

Randomized in vivo trial evaluating plaque inhibition benefits of an advanced stannous-containing sodium fluoride dentifrice used in conjunction with power brush technology.

OBJECTIVE: To compare the plaque inhibition efficacy of a novel stannous-containing sodium fluoride test dentifrice to a standard anticavity negative control dentifrice, when both were used in conjunction with an advanced oscillating-rotating (O/R) power toothbrush. METHODS: This was a randomized, two-treatment, three-period, double-blind crossover study conducted in a population using an O/R power brush. Subjects brushed twice per day with their assigned dentifrice during the three-treatment periods, each lasting for 17 consecutive days. Each period was separated by a 4-day washout period during which subjects continued to use their O/R power toothbrush. Plaque levels were assessed and averaged amongst three assessments taken on days 15, 16 and 17 at the end of each treatment period using digital plaque imaging analysis. Assessments were carried out on the facial anterior tooth surfaces in the morning before brushing (A.M. prebrush) following whole-mouth brushing (30 s per quadrant) with the assigned dentifrice (A.M. post-brush) and in the afternoon (P.M.). RESULTS: Twenty-seven subjects were randomized and completed the study. During the 17-day usage period, the stannous-containing test NaF dentifrice demonstrated a statistically significant lower mean plaque area versus the negative control dentifrice at each assessment timepoint; overnight A.M. prebrush was 33.8% lower (P < 0.0001), A.M. post-brush was 21.8% lower (P < 0.01), and P.M. was 29.2% lower (P < 0.0001). CONCLUSION: A population of O/R power toothbrush users had significantly less plaque coverage for all three measurements when using a stannous-containing NaF dentifrice than when using a negative control (fluoride) dentifrice.

Experimental toothpastes containing ß-TCP nanoparticles functionalized with fluoride and tin to prevent Erosive Tooth Wear.

OBJECTIVES: The present study aimed to synthesize toothpastes containing Beta- TriCalcium Phosphate (ß-TCP) nanoparticles, functionalized with fluoride and tin, and test their ability to reduce erosive tooth wear (ETW). METHODS: Toothpastes were synthesized with the following active ingredients: 1100 ppm of fluoride (as sodium fluoride, F-), 3500 ppm of tin (as stannous chloride, Sn2+), and 800 ppm of ß-TCP (Sizes a - 20 nm; and b - 100 nm). Enamel specimens were randomly assigned into the following groups (n = 10): 1. Commercial toothpaste; 2. Placebo; 3 F-; 4. F- + ß-TCPa; 5. F- + ß-TCPb; 6. F- + Sn2+; 7. F- + Sn2+ + ß-TCPa and 8. F- + Sn2+ + ß-TCPb. Specimens were subjected to erosion-abrasion cycling. Surface loss (in µm) was measured by optical profilometry. Toothpastes pH and available F- were also assessed. RESULTS: Brushing with placebo toothpaste resulted in higher surface loss than brushing with F- (p = 0.005) and F- + ß-TCPb (p = 0.007); however, there was no difference between F- and F- + ß-TCPb (p = 1.00). Commercial toothpaste showed no difference from Placebo (p = 0.279). The groups F-, F- + ß-TCPa, F- + ß-TCPb, F- + Sn2+, F- + Sn2+ + ß-TCPa and F- + Sn2+ + ß-TCPb were not different from the commercial toothpaste (p > 0.05). Overall, the addition of ß-TCP reduced the amount of available fluoride in the experimental toothpastes. The pH of toothpastes ranged from 4.97 to 6.49. CONCLUSIONS: Although toothpaste containing ß-TCP nanoparticles protected enamel against dental erosion-abrasion, this effect was not superior to the standard fluoride toothpaste (commercial). In addition, the functionalization of ß-TCP nanoparticles with fluoride and tin did not enhance their protective effect. CLINICAL SIGNIFICANCE: Although ß-TCP nanoparticles have some potential to control Erosive Tooth Wear, their incorporation into an experimental toothpaste appears to have a protective effect that is similar to a commercial fluoride toothpaste.

Silver diamine fluoride in preventing enamel erosion: An in vitro study with salivary pellicle.

OBJECTIVES: To compare the prevention of enamel erosion and discolouring effect with a single and two weekly topical applications of silver diamine fluoride (SDF) solution. METHODS: Human enamel blocks were divided into four groups. Group 1 (SDF2) received two weekly applications of SDF solution (Advantage Arrest: 260,000 ppm Ag, 44,300 ppm F, pH 9.1). Group 2 (SDF1) received a single application of SDF solution. Group 3 (SNF, Positive Control) received daily application of stannous-chloride/amine-fluoride/sodium-fluoride solution (Elmex® Enamel professional: 800 ppm Sn(II), 500 ppm F, pH 4.5). Group 4 (DW, Negative Control) received daily application of deionised water. The treated blocks were subjected to a 14-day erosive challenge. Crystal characteristics, elemental composition, surface morphology, percentage of surface microhardness loss (%SMHL), surface loss, and total colour change (ΔE) of the blocks were investigated using X-ray diffraction (XRD), energy-dispersive spectrometry (EDS) and scanning electron microscopy (SEM), Vickers' hardness testing, non-contact profilometry, and digital spectrophotometry, respectively. RESULTS: XRD and EDS revealed precipitates of silver for SDF2 and SDF1 and tin for SNF. SEM showed prominent etched enamel pattern on DW than the other three groups. The%SMHL (%) of SDF2, SDF1, SNF, and DW were 26.6 ± 2.9, 33.6 ± 2.8, 38.9 ± 2.9, and 50.5 ± 2.8 (SDF2SDF1=SNF>DW, p < 0.05). CONCLUSION: Two weekly applications was more effective than a single application of SDF in preventing enamel erosion, though it caused more discolouration. CLINICAL SIGNIFICANCE: Topical application of 38 % SDF with two weekly applications protocol is effective in preventing enamel erosion.

Patient-specific dosimetry for intracavitary 32P-chromic phosphate colloid therapy of cystic brain tumours.

PURPOSE: (32)P-chromic phosphate colloid treatments of astrocytoma and craniopharyngioma cystic brain tumours in paediatric patients are conventionally based on a sphere model under the assumption of uniform uptake. The aims of this study were to determine the distribution of the absorbed dose delivered by (32)P on a patient-specific basis and to evaluate the accuracy with which this can be predicted from a pretherapy administration of (99m)Tc-Sn colloid. METHODS: Three patients were treated with (32)P-chromic phosphate colloid following (99m)Tc-Sn colloid administrations. Convolution dosimetry was performed using pretherapy and posttherapy sequential SPECT imaging, and verified with EGSnrc Monte Carlo radiation transport simulations. Mean absorbed doses to the cyst wall and dose-volume histograms were also calculated and compared with those obtained by the sphere model approach. RESULTS: Highly nonuniform uptake distributions of both the (99m)Tc and (32)P colloids were observed and characterized by dose-volume histograms to the cyst wall. Mean absorbed doses delivered to the cyst wall, obtained with the convolution method, were on average 21 % (SD 18 %) and 50 % (SD 30 %) lower than those predicted by the (99m)Tc distribution and the uniform assumption of the sphere model, respectively. CONCLUSION: Absorbed doses delivered to the cyst wall by (32)P are more accurately predicted from image-based patient-specific convolution dosimetry than from simple sphere models. These results indicate the necessity to perform personalized treatment planning and verification for intracavitary irradiation of cystic brain tumours treated with radiocolloids. Patient-specific dosimetry can be used to guide the frequency and levels of repeated administrations and would facilitate data collection and comparison to support the multicentre trials necessary to progress this therapy.

Randomised in situ study on the efficacy of a tin/chitosan toothpaste on erosive-abrasive enamel loss.

Tin is a notable anti-erosive agent, and the biopolymer chitosan has also shown demineralisation-inhibiting properties. Therefore, the anti-erosive/anti-abrasive efficacy of the combination of both compounds was tested under in situ conditions. Twenty-seven volunteers were included in a randomised, double-blind, three-cell crossover in situ trial. Enamel specimens were recessed on the buccal aspects of mandibular appliances, extraorally demineralised (6 × 2 min/day) and intraorally treated with toothpaste slurries (2 × 2 min/day). Within the slurry treatment time, one-half of the specimens received additional intraoral brushing (5 s, 2.5 N). The tested toothpastes included a placebo toothpaste, an experimental NaF toothpaste (1,400 ppm F(-)) and an experimental F/Sn/chitosan toothpaste (1,400 ppm F(-), 3,500 ppm Sn(2+), 0.5% chitosan). The percentage reduction of tissue loss (slurry exposure/slurry exposure + brushing) compared to placebo was 19.0 ± 47.3/21.3 ± 22.4 after use of NaF and 52.5 ± 30.9/50.2 ± 34.3 after use of F/Sn/chitosan. F/Sn/chitosan was significantly more effective than NaF (p ≤ 0.001) and showed good efficacy against erosive and erosive-abrasive tissue loss. This study suggests that the F/Sn/chitosan toothpaste could provide good protection for patients who frequently consume acidic foodstuffs.

Interplay between experimental dental pellicles and stannous-containing toothpaste on dental erosion-abrasion.

The interaction between stannous-containing dentifrice slurry and experimentally formed pellicles was investigated on enamel and root dentin using an erosion-remineralization-abrasion cycling model. The remineralizing solutions contained no proteins (negative control), mucin, casein, mucin + casein or albumin, for experimental pellicle formation. Toothbrushing was performed with fluoride toothpaste, with (TP + Sn) and without (TP) 3,500 ppm Sn. TP + Sn reduced surface loss for both enamel and root dentin (p < 0.05). The association between TP + Sn and albumin resulted in a significantly lower enamel surface loss (p < 0.05), suggesting positive interaction of stannous ion and albumin on dental erosion-abrasion protection. A similar trend was observed for root dentin, although less pronounced.

Conventional and anti-erosion fluoride toothpastes: effect on enamel erosion and erosion-abrasion.

New toothpastes with anti-erosion claims are marketed, but little is known about their effectiveness. This study investigates these products in comparison with various conventional NaF toothpastes and tin-containing products with respect to their erosion protection/abrasion prevention properties. In experiment 1, samples were demineralised (10 days, 6 × 2 min/day; citric acid, pH 2.4), exposed to toothpaste slurries (2 × 2 min/day) and intermittently stored in a mineral salt solution. In experiment 2, samples were additionally brushed for 15 s during the slurry immersion time. Study products were 8 conventional NaF toothpastes (1,400-1,490 ppm F), 4 formulations with anti-erosion claims (2 F toothpastes: NaF + KNO(3) and NaF + hydroxyapatite; and 2 F-free toothpastes: zinc-carbonate-hydroxyapatite, and chitosan) and 2 Sn-containing products (toothpaste: 3,436 ppm Sn, 1,450 ppm F as SnF(2)/NaF; gel: 970 ppm F, 3,030 ppm Sn as SnF(2)). A mouth rinse (500 ppm F as AmF/NaF, 800 ppm Sn as SnCl(2)) was the positive control. Tissue loss was quantified profilometrically. In experiment 1, most NaF toothpastes and 1 F-free formulation reduced tissue loss significantly (between 19 and 42%); the Sn-containing formulations were the most effective (toothpaste and gel 55 and 78% reduction, respectively). In experiment 2, only 4 NaF toothpastes revealed significant effects compared to the F-free control (reduction between 29 and 37%); the F-free special preparations and the Sn toothpaste had no significant effect. The Sn gel (reduction 75%) revealed the best result. Conventional NaF toothpastes reduced the erosive tissue loss, but had limited efficacy regarding the prevention of brushing abrasion. The special formulations were not superior, or were even less effective.

Efficacy of tin-containing solutions on erosive mineral loss in enamel and dentine in situ.

The addition of tin to mouth rinses is, at least in vitro, a promising strategy for symptomatic therapy of dental erosion. The aim of this study was to evaluate the in situ efficacy of an experimental tin-containing fluoride solution on erosive tissue loss in human enamel and dentine. The study was a three-cell (7 days each) crossover design involving eight healthy participants. Samples were mounted on buccal shields of mandibular mouth appliances, which were worn for 24 h except during meals and drinks. Specimens were demineralised extraorally with 0.05 M citric acid (pH 2.3) for 6 × 5 min daily and were treated with test solutions intraorally once per day for 30 s after the first demineralisation. Three solutions were used: placebo (negative control), a commercially available tin- and fluoride-containing (SnF(2)) mouth rinse (positive control, 409 ppm Sn(2+), 250 ppm F(-), pH 4.2) and an experimental solution (pH 4.5) containing 1,900 ppm Sn(2+) (SnCl(2)) and 1,000 ppm F(-) (AmF/NaF). Tissue loss (micrometre) was determined profilometrically. In enamel, tissue loss was 54.8 ± 8.6 in the placebo, 24.5 ± 14.4 in the positive control and 9.7 ± 4.1 in the experimental solution group. The respective values for dentine were 48.5 ± 13.0 in the placebo, 32.8 ± 9.6 in the positive control and 26.2 ± 6.7 in the experimental solution group. The experimental solution was notably effective for enamel but was less effective for dentine. The positive control solution was less effective than the experimental solution; its effects for enamel and dentine were similar.

Clinical comparison of plaque inhibition effects of a novel stabilized stannous fluoride dentifrice and a chlorhexidine digluconate dentifrice using digital plaque imaging.

OBJECTIVE: To compare the plaque inhibition efficacy of a novel 0.454% stannous fluoride (SnF2) test dentifrice with sodium hexametaphosphate and stannous chloride to a chlorhexidine digluconate (0.05%), aluminium lactate (0.8%), and aluminium fluoride marketed control dentifrice (Lacalut Aktiv or AlF3/Chx). METHODS: This was a randomized, two-treatment, two-period, double-blind crossover study that compared the SnF2 test dentifrice to the AlF3/Chx control dentifrice. Each of the two treatment periods lasted for 17 consecutive days of product use, during which subjects were required to brush twice per day with their assigned dentifrice using a standard manual toothbrush (Oral-B P35 Indicator). The two periods of the crossover were separated by a four-day washout period. Plaque levels on the facial anterior tooth surfaces were evaluated and averaged among three assessment days at the end of each treatment period using digital plaque imaging analysis (DPIA). The evening prior to assessments, subjects only brushed lingual surfaces. Assessment time points were carried out in the morning following no morning brushing (A.M. pre-brush), following 40 seconds of brushing with the assigned dentifrice (A.M. post-brush), and in the afternoon (P.M.). The DPIA captured images were used to calculate and analyze visible plaque coverage. RESULTS: Twenty-eight subjects were randomized and completed the study. At each assessment time point, the SnF2 test dentifrice demonstrated a statistically significant lower plaque level compared to the AlF3/Chx dentifrice: A.M. mean pre-brush 15.9% lower, p < 0.05; A.M. mean post-brush 22.2% lower, p < 0.05; P.M. mean 24.3% lower, p < 0.005. CONCLUSION: Compared to the AlF3/Chx control dentifrice, the novel SnF2 test dentifrice significantly inhibited plaque regrowth overnight and during the day. Immediately after brushing there was also significantly less plaque coverage with the SnF2 test dentifrice.

Anticaries potential of a stabilized stannous-containing sodium fluoride dentifrice.

PURPOSE: To evaluate the anticaries potential of a stabilized stannous-containing sodium fluoride dentifrice relative to appropriate control products. METHODS: A series of in vitro studies was conducted using the following standard anticaries efficacy measures: (1) fluoride uptake; (2) pH cycling remineralization/inhibition of demineralization; and (3) surface microhardness. In each study, the stannous-containing sodium fluoride test dentifrice (1450 ppm F) was compared to a negative control dentifrice (0 ppm F) and a positive control fluoride dentifrice (either 1100 ppm F or 1450 ppm F). RESULTS: Fluoride uptake: The mean fluoride uptake from both the test dentifrice and the positive control dentifrice was significantly greater than the negative control. There was no statistically significant difference between the two fluoride dentifrices, although the test dentifrice was directionally higher. pH cycling: The remineralization measured with the test dentifrice was directionally higher though not significantly different from the positive control dentifrice. Remineralization by both fluoride-containing dentifrices was significantly greater versus the negative control. Surface microhardness: The percent increase in surface microhardness measured on enamel surfaces after treatments with the test dentifrice was found to be significantly higher than that measured for the positive control and the negative control.

The desensitizing efficacy of a novel stannous-containing sodium fluoride dentifrice: an 8-week randomized and controlled clinical trial.

PURPOSE: To assess the efficacy of a novel stannous-containing dentifrice in the reduction of dentin hypersensitivity when compared to a marketed positive control dentifrice. METHODS: An 8-week, single-center, randomized, parallel group, two-treatment, double-blind clinical study was conducted in a generally healthy adult population with moderate thermal and tactile dentin hypersensitivity. A total of 60 adults were enrolled into the study. Participants were stratified at baseline by age, gender, and cold air sensitivity scores, and randomly assigned to either an experimental stannous-containing sodium fluoride dentifrice or a marketed potassium nitrate positive control. Brushing was supervised on site after baseline and Week 4 examinations. All other product usage was unsupervised. Subjects brushed 2 minutes twice daily. At baseline, Week 4 and Week 8, efficacy outcomes were assessed for tactile sensitivity via the Yeaple Probe, and for thermal sensitivity with air-blast/SchiffAir Index. RESULTS: Fifty-eight subjects completed all evaluations. Both the experimental stannous-containing and positive control dentifrices provided significant (P< 0.05) reductions in both tactile and thermal dentin hypersensitivity compared to baseline at both Weeks 4 and 8. There were no significant differences in Yeaple Probe or Schiff Air Index results between the dentifrices with either efficacy measurement at Week 4 and Week 8 (P > or = 0.5375).

The anti-plaque efficacy of a novel stannous-containing sodium fluoride dentifrice: a randomized and controlled clinical trial.

PURPOSE: To evaluate the anti-plaque efficacy of a novel stannous-containing sodium fluoride dentifrice compared to a negative control regular anti-caries dentifrice and a positive control marketed triclosan-containing dentifrice. METHODS: This was a randomized and controlled, single-center, double-blind, three-treatment, three-period, crossover clinical trial in generally healthy adults. A prophylaxis was followed by three 4-day treatment periods of limited brushing, each separated by an approximate 7-day washout phase. Subjects used the test dentifrice on Days 0-3 of each period according to their randomly assigned sequence; either Crest Cavity Protection (negative control); an experimental stannous-containing sodium fluoride dentifrice; or a marketed triclosan positive control (Colgate Total). A dental polishing was given at Day 0 of each treatment period, and subjects brushed the lingual surfaces only and then swished the entire dentition with a dentifrice slurry twice daily under supervision through Day 3. At baseline and Day 4 of each treatment period, plaque levels were assessed via the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI). RESULTS: Twenty-eight fully evaluable subjects completed the trial. Both the experimental and positive control dentifrices provided significantly lower mean whole mouth TMQHPI plaque scores after treatment compared to the negative control: 11.4% lower for the experimental stannous-containing dentifrice and 8.4% for Colgate Total (P< 0.0001). The experimental stannous-containing dentifrice group resulted in directionally lower whole mouth plaque scores when compared to Colgate Total (P= 0.07). The experimental stannous-containing dentifrice had significantly lower mean plaque scores post-treatment at lingual sites compared with Total (P= 0.0355). All dentifrices were well-tolerated.

A randomized clinical study to assess the extrinsic staining profiles of stannous- and triclosan-containing dentifrices.

PURPOSE: To evaluate the extrinsic stain profiles of two experimental stannous-containing dentifrice prototypes compared to two marketed control dentifrices. METHODS: This was a 5-week, randomized, four-treatment, parallel group, double-blind clinical trial of healthy adults. Following a baseline Lobene Stain Index evaluation, subjects received a prophylaxis limited to the 12 anterior teeth to remove surface stain and calculus. They were randomly assigned based on stain scores to one of the four treatment groups: one of two experimental stannous-containing sodium fluoride dentifrices; a non-staining marketed triclosan dentifrice (Colgate Total); or a 0.454% stannous fluoride dentifrice (Crest Gum Care). Subjects brushed for 1 minute twice daily at home with their assigned dentifrice. Stain examinations were repeated at Week 3 and Week 5 to assess treatment differences. RESULTS: For the 96 subjects completing the study, Lobene stain composite mean scores--as well as extent (area) and intensity average scores--were significantly lower in the two experimental stannous-containing dentifrice groups and the Colgate Total group when compared to Crest Gum Care (P < 0.0001) at both Weeks 3 and 5. There were no statistically significant differences (P > 0.145) in stain accumulation at either time point between the experimental stannous groups and the Colgate Total group by any Lobene stain measure (composite, extent, intensity). All dentifrices were well-tolerated.

Breath malodor reduction with use of a stannous-containing sodium fluoride dentifrice: a meta-analysis of four randomized and controlled clinical trials.

PURPOSE: To determine the effectiveness of a novel stannous-containing sodium fluoride dentifrice in reducing malodor-causing volatile sulfur compound (VSC) levels versus a standard marketed fluoride (negative control) anti-caries dentifrice using pooled data from independent clinical trials. METHODS: Four randomized and controlled, evaluator-blinded, 3- or 4-period, 2-treatment crossover clinical studies were conducted at four separate centers in Asia and the United States in subjects with a baseline VSC score of > 100 ppb. Following a week-long acclimation period, subjects were randomly assigned to a treatment sequence specifying the order of use of a stannous-containing sodium fluoride dentifrice and a negative control dentifrice (Crest Cavity Protection). VSC levels were assessed at four time points using a Halimeter during each treatment period: (1) baseline prior to treatment; (2) 3-4 hours after baseline and a single brushing; (3) 24 hours post-baseline and after two total brushings ("overnight"/"morning breath"); and (4) 27-28 hours post-baseline following three total product uses. Brushing instructions were standardized and required two minutes of timed toothbrushing with the assigned dentifrice. Washout periods of at least 2 days separated the treatment periods. RESULTS: A total of 100 subjects were included in the meta-analysis. The stannous-containing dentifrice showed statistically significantly greater breath benefits via VSC reduction compared to the negative control dentifrice (P < 0.047) at all three time points. The stannous-containing dentifrice provided increasingly greater superior relative breath protection benefits of 7.7% at Hour 3-4 post-baseline, 10.6% after 24 hours ("overnight"/"morning breath"), and 24.5% at Hour 27-28. Similar malodor reduction benefits in favor of the stannous-containing dentifrice relative to the negative control were observed for each individual study.

Tin and fluoride as anti-erosive agents in enamel and dentine in vitro.

OBJECTIVE: To investigate the efficacy of an experimental tin- and fluoride-containing mouth rinse on progression of erosion in enamel and dentine in vitro. MATERIAL AND METHODS: Human enamel and dentine specimens were subjected to a cyclic demineralization and remineralization procedure for 10 days, with six 5-min demineralization periods per day. Erosive demineralization was performed with 0.05 M citric acid (pH 2.3). Except in the negative control group, the specimens were treated for 2 min with mouth rinses after the first and sixth demineralizations. An experimental tin-containing fluoride mouth rinse [125 mg/kg F(-) (amine fluoride), 375 mg/kg F(-) (NaF), 800 mg/kg Sn(2+) (SnCl(2))] and an experimental sodium fluoride mouth rinse (500 mg/kg F(-)) were used (both pH 4.5). A commercially available, tin-containing mouth rinse served as a positive control (pH 4.2, 409 mg/kg Sn(2+), 250 mg/kg F(-)). Tissue loss was determined profilometrically. RESULTS: The highest tissue loss was found in the negative control group, in both enamel and dentine. In enamel, the NaF solution showed almost no effect. Both tin-containing solutions significantly reduced tissue loss (positive control: 65%; 800 mg/kg Sn(2+): 78%; both p ≤ 0.001 compared to negative control). In dentine all mouth rinses significantly reduced tissue loss (positive control: 43%; 800 mg/kg Sn(2+): 53%; NaF: 40%; all p ≤ 0.001 compared to negative control). CONCLUSIONS: In enamel, the efficacy of mouth rinses depended on the compound used; tin-containing preparations were notably effective. In dentine, however, reduction of substance loss was nearly the same in all treatment groups.

A clinical assessment of the efficacy of a stannous-containing sodium fluoride dentifrice on dentinal hypersensitivity.

AIM: To measure the desensitizing benefits of an experimental stannous-containing sodium fluoride dentifrice versus a regular sodium fluoride negative control. METHODS AND MATERIALS: This study was a randomized, double-blind, parallel group, four-week clinical trial. Subjects reporting dentinal hypersensitivity were enrolled and randomized to the experimental dentifrice or the control dentifrice to use twice daily for four weeks. Efficacy assessments (Air Blast) were performed at baseline and weeks two and four. Separate analyses were performed for the two most sensitive teeth at baseline and for all 12 teeth. Results for weeks two and four combined also were analyzed. RESULTS: Thirty-one subjects were included in the analyses. For the two most sensitive teeth, the experimental dentifrice showed statistically significantly less sensitivity (p<0.05) versus the control at weeks two and four and for weeks two and four combined. The sensitivity reduction ranged from 24.9% to 28.4% over the control. For all 12 teeth, the experimental group had statistically significantly (p<0.03) lower sensitivity scores versus the control group at week two and weeks two and four combined. CONCLUSION: The experimental dentifrice demonstrated significant desensitizing advantages versus the control. CLINICAL SIGNIFICANCE: This stannous-containing sodium fluoride dentifrice provides an effective treatment for patients with dentinal hypersensitivity, significantly reducing sensitivity versus a negative control in this four-week trial.