Effectiveness of a toothpaste and a serum containing calcium silicate on protecting the enamel after interproximal reduction against demineralization.

To evaluate the effectiveness of a calcium silicate/phosphate fluoridated tooth paste and a serum compared with a toothpaste containing hydroxyapatite on protecting the enamel after interproximal reduction against demineralization. 3 sets of eleven incisors were created. The teeth underwent interproximal enamel reduction (IER) of 0.5 mm. Each set was allocated to one of three groups: (1) Brushing without toothpaste (control group); (2) Vitis toothpaste + Remin Pro; (3) Regenerate toothpaste + Regenerate Serum. The agents were applied three times a day and specimens subjected to demineralization cycles for 30 days. The weight percentages of calcium (Ca) and phosphorous (P) were quantified by X-ray microfluorescence spectroscopy. Surface microhardness measurements and electron scanning microscopy (SEM) observations were made. Ca data and the Ca/P ratio were significantly higher in Group 3 than the other groups (p < 0.017), while P was significantly lower in Group 3 (p < 0.017). No significant differences were found between Groups 1 and 2 (p > 0.017). Group 3 showed significantly higher microhardness values (p < 0.05) than Group 1. No significant differences were found for other comparisons between groups (p < 0.05). SEM images showed less demineralization in Group 3. The application of a calcium silicate/phosphate fluoridated tooth paste (Regenerate advance) and a dual serum (Regenerate advance enamel serum) protect the enamel with interproximal reduction against demineralization. Therefore, this treatment could be used to prevent the dissolution of hydroxyapatite after IER.

Gingivitis efficacy of a 0.454% w/w stannous fluoride dentifrice: a 24-week randomized controlled trial.

BACKGROUND: Plaque-induced gingivitis can be prevented and treated with regular effective oral hygiene, principally via mechanical cleaning with regular toothbrushing. To complement the mechanical plaque removal, antimicrobial ingredients can be incorporated into dentifrices to inhibit the growth of plaque. This study aimed to evaluate and compare gingivitis and the proportion of subjects moving between gingivitis severity (< 10, > 10 < 30, > 30% bleeding sites), and plaque reduction, following twice daily use of an experimental non-aqueous 0.454% weight/weight (w/w) stannous fluoride (SnF2) dentifrice, compared to a negative control dentifrice over 12 and 24 weeks. METHOD: This was a single-center, examiner-blinded, randomized, stratified, two-treatment arm, parallel group, 24-week clinical study in healthy adult volunteers with moderate gingivitis. At baseline, after abstaining from toothbrushing overnight, subjects underwent MGI (modified gingival index), BI (bleeding index) and PI (plaque index) assessments. Eligible subjects, who met the inclusion/exclusion criteria, were stratified based on gender and baseline mean MGI score (Low ≤2.00 /High > 2.00) and randomized to treatment. Following randomization, subjects underwent a thorough dental prophylaxis and flossing. After 12 and 24 weeks of twice daily brushing with their allocated treatment, subjects returned to the site (with overnight plaque, having abstained from oral hygiene procedures for 8 h prior to visit) for MGI, BI and PI assessments. Treatment effect was evaluated by comparing the MGI, BI and PI scores. RESULTS: One hundred and twenty-nine subjects were screened; 98 subjects were randomized and 90 subjects completed the study. Statistically significant differences between treatments, in favour of the 0.454% stannous fluoride dentifrice were observed, compared to the negative control dentifrice, for all outcome measures (MGI, BI, bleeding sites and PI at weeks 12 and 24 p < 0.0001). At 24 weeks, 71% of subjects in the 0.453% SnF2 treatment group demonstrated < 10% of bleeding sites. CONCLUSION: A dentifrice containing 0.454% w/w SnF2 was shown to be superior to a standard dentifrice in controlling gingivitis and supra-gingival plaque, over a 24-week period. Over two thirds of subjects in the 0.454% SnF2 treatment group demonstrated a level of bleeding sites potentially representative of "clinical periodontal health" (< 10%) following a dental prophylaxis and 24 weeks of product use. TRIAL REGISTRATION: This study was retrospectively registered at ClinicalTrials.gov, on 11th Oct. 2019 (NCT04123665).

Clinical effect of stannous fluoride and amine fluoride containing oral hygiene products: A 4-year randomized controlled pilot study.

This 4-year randomized controlled trial (RCT) aimed at investigating whether routine home use of both a SnCl2/AmF/NaF-containing mouth rinse and toothpaste has a preventive effect on oral health. Fifty-four test subjects were examined in biannual intervals. The primary endpoint "dental erosion" was determined by the Basic Erosive Wear Examination (BEWE). The secondary endpoints were "saliva pH", "dentin hypersensitivity" generated by Visual Analogue Scale (VAS), and "discoloration" measured by the Lobene Stain Index (LSI). A mixed model for repeated measures (MMRM) was used to analyze the primary endpoint "dental erosion". Primary analysis showed a significant intervention effect of the SnCl2/AmF/NaF-containing test product (p1 = 0.0242). This result was confirmed by two additional MMRM-based sensitivity analyses. Comparison of all models showed "dental erosion" values of the intervention group  below values of the control group. Discoloration of the teeth was significantly higher in the intervention than in the control group at all time points. Saliva pH and dentin hypersensitivity were not significantly different between groups over four years. In summary, this RCT is the first to indicate a possible preventive effect of SnCl2/AmF/NaF-containing oral hygiene products on dental erosion over a follow-up period of four years.

Identification and Analysis of the Fluoride Concentration in Toothpastes Intended for Children

Objective: To identify the commercially available toothpastes intended for children and their total soluble fluoride concentrations (TSF). Material and Methods: Twelve brands of toothpastes intended for children marketed in supermarkets and pharmacies were found and analyzed: Bitufo®; Colgate Smile®; Lilica Ripilica®; Even Baby®; Turma da Mônica Baby®; Loney Tunes®; Loney Tunes Baby®; Malvatrikds Baby®; Oral B Stages®; Sanifil Kids®; Tandy®; Tra-lálá Baby®. Duplicate samples of each toothpaste were weighed (+/- 90 to 110 mg) and diluted in 10 mL of distilled water under stirring. To evaluate soluble fluoride, duplicate aliquots of supernatant suspensions were evaluated on specific ion fluoride electrode calibrated with fluoride standard solutions and results expressed in ppm F according to established protocol. Results: According to information provided by manufacturers, 5 non-fluoridated toothpastes, 3 toothpastes with less than 1000 ppm F and 4 toothpastes with conventional fluoride concentration (1100 ppm F) were identified. After analysis of soluble fluoride of fluoridated toothpastes, only 02 presented TSF concentration equal to or greater than 1000 ppm F. The TSF concentration (mean ± SD) for all samples ranged from 8.2 ± 0.1 to 1065.9 ± 24.7 ppm F. Conclusion: Few toothpastes intended for children presented soluble fluoride concentrations capable of preventing dental caries. Additionally, regulatory measures need to be implemented for the marketing of toothpastes intended for children with at least 1000 ppm of soluble fluoride, especially in locations without other sources of fluoride (fluoridated water) for the population.

Is plaque regrowth inhibited by dentifrice?: A systematic review and meta-analysis with trial sequential analysis.

OBJECTIVES: The aim of this systematic review was to establish in studies with human participants the effect of a regular fluoride dentifrice compared to water or saline on dental plaque inhibition. METHODS: MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched, up to April 2018. The inclusion criteria were controlled clinical trials among participants aged ≥18 years with good general health. Papers that evaluated the effect of dentifrice slurry compared with water or saline on plaque regrowth during a 4-day nonbrushing period were included. Data were extracted from the eligible studies, the risk of bias was assessed, and a meta-analysis was performed where feasible. RESULT: The search retrieved eight eligible publications including 25 comparisons. The estimated potential risk of bias was low for all studies. Based on three different indices, overall plaque regrowth was significantly (P < 0.01) inhibited for 0.25 or more by the use of a dentifrice slurry as compared to water. All subanalysis on specific dentifrice ingredients and the overall descriptive analysis supported these findings. CONCLUSION: The results of this review demonstrate moderate-quality evidence for a weak inhibitory effect on plaque regrowth in favour of the use of a dentifrice intended for daily use.

Qual é o nível de alfabetismo em saúde bucal necessário para escolher e quantificar apropriadamente o dentifrício fluoretado para crianças? / What level of oral health literacy is necessary to choose and quantify properly the fluoride toothpaste for children?

Dentifrícios fluoretados são os principais veículos para o flúor, e o seu uso adequado pode ajudar no equilíbrio do processo de des-remineralização, mantendo baixo o risco de fluorose. O nível de Alfabetismo em Saúde Bucal (ASB) de pais interfere nos desfechos de saúde de suas crianças. Este estudo objetivou avaliar qual o nível de alfabetismo necessário para selecionar e aplicar a quantidade adequada de dentifrício fluoretado indicado para crianças. Participaram do estudo 171 pais/responsáveis alfabetizados de crianças de 0 a 10 anos de idade atendidas no Ambulatório de Criança de Risco do HC-UFMG que possuíam português como língua materna e não haviam recebido orientação sobre uso de dentifrício. O ASB foi mensurado através do BREALD-30 (adequado 26-30) e da versão brasileira do OHLAQ (adequado 14-17). As tarefas que servem para categorizar cada nível de habilidade são aquelas realizadas corretamente por 75% das pessoas naquela faixa de alfabetismo. Os pais/responsáveis receberam orientações padronizadas sobre quantidade de dentifrício a ser dispensada na escova (0,03g) e concentração ideal de Flúor (1100 ppm). Em seguida, os participantes foram convidados a quantificar um dentifrício em uma escova infantil e a escolher dentre quatro dentifrícios para crianças(com diferentes concentrações de flúor) os que estivessem de acordo com a orientação recebida. A porcentagem de pais/responsáveis com nível de ASB adequado pelo BREALD-30 foi 34%, destes 45,8% acertaram a quantidade e 78% escolheram corretamente o dentifrício. Utilizando o OHL-AQ, 30% dos pais obtiveram nível adequado de ASB, destes 54,9% quantificaram e 70,6% escolheram o dentifrício corretamente. Houve associação do nível de ASB medido pelo OHL-AQ com a quantificação do dentifrício: os pais/responsáveis que acertaram a quantificação apresentaram escores do OHL-AQ mais altos do que os que erraram (p = 0,034, teste de Mann Whitney).Pais/responsáveis com nível adequado de ASB tiveram dificuldade de dispensar a quantidade adequada, porém escolheram corretamente o dentifrício. Os demais pais/responsáveis não demonstraram habilidade para desempenhar nenhuma das duas tarefas. Não houve associação do desempenho dos pais/ responsáveis na quantificação e na escolha do dentifrício com as variáveis socioeconômicas e demográficas nem com a capacidade de reconhecimento de palavras da área odontológica.

Fluoride toothpaste are the major carriers for fluoride, and their proper use can help balance the de-remineralization process while keeping the risk of fluorosis low. The level of Oral Health Literacy (OHL) of parents interferes in the health outcomes of their children. This study aimed to evaluate the level of literacy required to select and apply the appropriate amount of fluoride toothpaste indicated for children. A total of 171 literate parents/caregivers of children aged 0 to 10 years-old who were attended at the HC-UFMG Children's in risk Outpatient Clinic, had Portuguese as their mother language and had not received guidance on the use of dentifrice participated in the study. OHL was measured using BREALD-30 (adequate 26-30) and the Brazilian version of OHL-AQ (adequate 14-17). The tasks that serve to categorize each skill level are those performed correctly by 75% of the people in that literacy level. Parents/caregivers received standardized guidelines on the amount of toothpaste to be dispensed at the toothbrush (0.03g) and ideal concentration of fluorine (1100 ppm). Then, they were asked to quantify a toothpaste in a children's toothbrush and to choose from four toothpastes for children (with different concentrations of fluoride) which were in accordance with the orientation received. The percentage of parents/caregivers with adequate OHL level measured withBREALD-30 was 34%, of these 45.8% matched the amount and 78% correctly chose the toothpaste. Using OHL-AQ, 30% of the parents/caregivers had an adequate level of OHL, of these 54.9% quantified and 70.6% chose the toothpaste correctly. There was an association between the OHL level measured by the OHL-AQ and the toothpaste quantification: the parents/caregivers who correctly quantified had higher OHL-AQ scores than those who did it wrong (p = 0.034, Mann Whitney test). Parents/caregivers with an adequate OHL level had difficulty dispensing the adequate amount, but correctly chose the toothpaste. The other parents did not demonstrate ability to perform either of the tasks. There was no association between the performance of the parents/ guardians in the quantification and the choice of the toothpaste with the socioeconomic and demographic variables nor with the ability to recognize words in the dental area.

Avaliação do perfil de prescrição de dentifrícios fluoretados por cirurgiões dentistas em crianças menores de 6 anos / Evaluation of the prescription profile of fluoridated dentifrices by dentists in children under the age of six years

Introdução: A escovação com dentifrício fluoretado é o melhor meio para prevenir a cárie dentária, independente da idade. Objetivo: Avaliar o perfil de prescrição de dentifrício fluoretado por cirurgiões dentistas em crianças menores de 06 anos. Métodos: Foram entrevistados 62 odontólogos da rede pública do município de Cascavel ­ PR, e entregue um questionário com seis questões específicas. Resultados: Os cirurgiões dentistas relataram prescrever dentifrício fluoretado (64,5%), e orientam a quantidade a ser colocada na escova (93,5%), também conhecem sobre toxicidade do flúor e as causas da fluorose. Quanto a idade indicada para início da escovação com dentifrício fluoretado as prescrições foram a partir dos 6 anos de idade (24,2%) ou quando a criança soubesse cuspir (17,7%). Conclusão: Os entrevistados prescrevem dentifrício fluoretado para crianças menores de 6 anos de idade. Porém grande parte diferiu sobre a concentração ideal de flúor que deve ser utilizada, além da idade inicial que deve ser prescrito o creme dental fluoretado.

Introduction: Flossing with fluoride dentifrice is the best way to prevent tooth decay, regardless of age. Objective: To evaluate the prescription profile of fluoridated dentifrice by dentists in children under 06 years of age. Methods: We interviewed 62 dentists from the public service of the county of Cascavel - PR, and delivered a questionnaire with six specific questions. Results: Dentists reported prescribing fluoride dentifrice (64.5%), guide the amount to be placed on the toothbrush (93.5%), also know about fluorine toxicity and the causes of fluorosis. As to the age indicated for the beginning toothbrushing with fluoridated dentifrice the prescriptions were from the age of six years (24.2%) or when the child knew how to spit (17.7%). Conclusion: Interviewees prescribe fluoridated toothpaste for children under 6 years of age. However much of it differed on the ideal concentration of fluoride that should be used in addition to the initial age that should be prescribed fluoride toothpaste.

A randomised clinical evaluation of a fluoride mouthrinse and dentifrice in an in situ caries model.

OBJECTIVES: Fluoride mouthrinses provide advantages for fluoride delivery by maintaining elevated intra-oral fluoride concentrations following fluoride dentifrice use. This in situ caries study investigated potential anti-caries efficacy of a 220 ppm fluoride mouthrinse. METHODS: This was an analyst-blinded, four-treatment, randomised, crossover study using partially demineralised, gauze-wrapped, human enamel samples mounted in a mandibular partial denture. Participants brushed twice daily for 14 days with either a 1150 ppm fluoride or a fluoride-free placebo dentifrice and either rinsed once daily with the 220 ppm fluoride mouthrinse or not. Following each treatment period, percent surface microhardness recovery (%SMHR) and enamel fluoride uptake (EFU) were assessed. RESULTS: Fifty three participants completed the study. Compared with the placebo dentifrice/no rinse treatment, the fluoride-containing regimens demonstrated greater enamel remineralisation (%SMHR) and fluoridation (EFU): fluoride dentifrice/fluoride rinse (%SMHR difference: 21.55 [95% CI: 15.78,27.32]; EFU difference 8.35 [7.21,9.29]); fluoride dentifrice/no rinse: 19.48 [13.81,25.15]; 6.47 [5.35,7.60]; placebo dentifrice/fluoride rinse: 16.76 [11.06,22.45]; 5.87 [4.72,7.00] (all P < .0001). There were no significant differences in%SMHR between fluoride regimens. The fluoride dentifrice/fluoride rinse regimen was associated with higher EFU than the fluoride dentifrice/no rinse (1.88 [0.75,3.01], P = .0013) and placebo dentifrice/fluoride rinse regimens (2.48 [1.34,3.62], P < .0001). Treatments were generally well-tolerated. CONCLUSIONS: The in situ caries model demonstrated that the fluoride mouthrinse is effective in promoting enamel caries lesion remineralisation and fluoridation whether used following a fluoride or non-fluoride dentifrice. Additive (potential) anti-caries benefits of a fluoride rinse after a fluoride dentifrice were confined to enhancements in lesion fluoridation (EFU). CLINICAL SIGNIFICANCE: In conjunction with a fluoride dentifrice, fluoride mouthrinses enhance enamel fluoridation, which may be useful in caries prevention.

Can Coloured Fluoride Gel Stain Demineralised Enamel?

PURPOSE: This study evaluated the colour changes of demineralized enamel after treatment with coloured fluoride gel. MATERIALS AND METHODS: Enamel blocks obtained from bovine incisors were submitted to artificial caries induction by pH cycling followed by fluoride gel applications (2% sodium fluoride, pH 6.8) using a colourless gel (control group), pink or blue gels. The enamel optical properties were evaluated by spectrophotometry, using the CIE L*a*b* system at baseline (sound enamel), after artificial caries induction (demineralised enamel) and after each of the five fluoride gel applications (weekly intervals). Changes in enamel optical properties (ΔE) were analysed by two-way ANOVA and Tukey's test (α = 0.05). RESULTS: No significant differences were found among fluoride gels (p = 0.476) regardless of the presence of pigments in the gel. ΔE values were significantly different (p < 0.001) between baseline evaluation and treated enamel (after fluoride gel application). CONCLUSION: This in vitro study demonstrated that colour changes in enamel do not occur during fluoride gel treatment, regardless of the presence or absence of coloured pigments in the gel.

Knowledge of Brazilian Dental Students about the Use of Conventional Fluoride Dentifrices for Preschool Children from Zero to Six Years Old

Objective: To verify the knowledge of dental students about the correct use of fluoride dentifrices above 1000 pmm fluorine for children aged 0-6 years old. Material and Methods: This is a cross-sectional study in which self-administered questionnaires were administered to 355 dental students from sixth to ninth or tenth graduation period. The questionnaires included questions regarding knowledge of the need to use, concentration, amount, frequency and potential adverse effects of the use of conventional fluoride dentifrices above 1000 ppm of fluorine by children up to six years of age, as well as the mechanism of action and the method of using fluorides that has the most scientific evidence. A descriptive analysis of data was performed. Results: 83.1% of students reported receiving content on the use of fluoride dentifrices in early childhood. Most students consider the use of fluoride dentifrice as important for the age group from zero to three years (73.8%) and from three to six years (96.4%). Only 17.7% would indicate fluoride toothpaste above 1000 ppm fluoride for children from zero to three years and 40.6% for three to six years. 76.9% believe that the amount of ideal refers to a grain of rice (0-3 years) and 61.7% of pea grain (3-6 years). 43.4% of students believe that fluoride dentifrices as an adverse effect the potential to cause fluorosis independent of concentration. Conclusion: The students evaluated were misleading about the fluoride concentration of the dentifrices indicated for children up to six years of age; on the toxicity of fluorine; action mechanism of fluorides and the scientific method of greater scientific evidence on caries disease. Failures in training and need to update fluoride contents to be taught to future dentistry professionals are evident.

Effect of fluoride dentifrice and casein phosphopeptide-amorphous calcium phosphate cream with and without fluoride in preventing enamel demineralization in a pH cyclic study.

OBJECTIVE: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) complexes are anticariogenic and capable of remineralizing the early stages of enamel lesions. The use of fluoride prevents dental decay and the association of CPP-ACP with fluoride can increase remineralization. To evaluate the effect of CPP-ACP and CPP-ACPF creams associated with a fluoride dentifrice to prevent enamel demineralization in a pH cyclic model. MATERIAL AND METHODS: Previously selected by surface microhardness (SH) analysis, human enamel blocks (n = 56) were submitted to daily treatment with dentifrice in a pH-cycling model. The enamel blocks were divided into four groups; G1: Crest™ Cavity Protection - Procter & Gamble (1,100 ppmF of NaF); G2: Crest™ +MI Paste (MP) - Recaldent™ GC Corporation Tokyo, Japan); G3: Crest™ + MI Paste Plus (MPP) - Recaldent™ 900 ppm as NaF, GC Corporation Tokyo, Japan), and G4: control, saliva. Specimens were soaked alternatively in a demineralizing solution and in artificial saliva for 5 d. The fluoride dentifrice, with proportion of 1:3 (w/w), was applied three times for 60 s after the remineralization period. The undiluted MP and MPP creams were applied for 3 m/d. After cycling, SH was re-measured and cross section microhardness measurements were taken. RESULTS: The SH values observed for the groups G3 (257±70), G1 (205±70), and G2 (208±84) differed from the G4 group (98±110) (one-way ANOVA and Tukey's post hoc test). There were no differences between the groups G1xG2, G2xG3, and G1xG3 for demineralization inhibition. The percentage of volume mineral showed that, when applied with fluoride dentifrice, MPP was the most effective in preventing enamel demineralization at 50 µ from the outer enamel surface (Kruskal-Wallis and Mann Whitney p<0.05). CONCLUSION: Fluoride dentifrice associated with CPP-ACPF inhibited subsurface enamel demineralization.

Fluoride concentration and amount of dentifrice influence enamel demineralization in situ.

OBJECTIVES: This study evaluated the effect of conventional (CD, 1100ppm F) and low-fluoride (LFD, 550ppm F) dentifrices, applied in different quantities, on enamel demineralization, and on fluoride (F) concentrations in the dental biofilm formed in situ. METHODS: Five combinations of dentifrices and quantities were tested: placebo (P-F-free) applied on all brush bristles; LFD applied by the transversal technique (0.3g-T1) or on all bristles (0.6g-T2); and CD applied in a pea-sized amount (0.15g-T3) or by the transversal technique (0.3g-T4), in order to produce comparable intensities (F concentration in the dentifrice×amount applied to the brush). Volunteers (n=13, 20-36 years old) wore palatal devices containing 4 bovine enamel blocks, and performed cariogenic challenges (30% sucrose solution) 6×/day, and brushing 3×/day, following a double-blind, cross-over and randomized protocol. On the 8th day, biofilm was collected 5 and 60min after brushing. The percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN) and biofilm F concentrations (solid and fluid phases) were determined. Data were analyzed by repeated-measures ANOVA, Student-Newman-Keuls test, and Pearson's correlation coefficient (p<0.05). RESULTS: Significantly lower ΔKHN was observed for treatments with higher intensity (T2 and T4) in comparison with the lower intensity (T1 and T3). A strong correlation was observed between ΔKHN and F concentrations in total biofilm (r=-0.71) and biofilm fluid (r=-0.72) 5min after brushing. CONCLUSIONS: The treatment intensity has a significant influence on the development of caries lesions in situ. CLINICAL SIGNIFICANCE: The intensity of treatment (amount of dentifrice×concentration) during brushing seems to be a more relevant parameter of clinical efficacy than simply observing the F concentration of the product. The use of a small amount of CD significantly reduced the protective effects against enamel demineralization.

A randomised exploratory clinical evaluation of dentifrices used as controls in dentinal hypersensitivity studies.

OBJECTIVES: To explore relative efficacy of six negative-control dentifrices utilised as controls in clinical studies compared with two dentine hypersensitivity (DH)-relief dentifrices used 2×/day for 8 weeks. METHODS: Six control dentifrices differing in terms of fluoride source (sodium fluoride/sodium monofluorophosphate), abrasive base (silica/dicalcium phosphate), relative dentine abrasivity (RDA) (∼17 to ∼180) and colour (white/blue/multicoloured stripes) were compared with a depolarising dentifrice (5% KNO3; RDA ∼70-97; 'Test 1') and an occlusion-technology dentifrice (0.454% SnF2; RDA ∼160-180; 'Test 2'). DH was assessed using tactile and evaporative (air) (measured by Schiff Sensitivity Scale and a visual rating scale [VRS]) stimuli. RESULTS: In total 249 subjects were randomized. All dentifrices yielded statistically significant improvements from baseline on all endpoints. The two DH-relief dentifrices ranked highest in terms of improvement in scores over the control dentifrices. While there was a clear differentiation between Test 1 and control dentifrices on both measures at 4/8 weeks, for Test 2, statistically significant improvements in Schiff scores were observed over all controls at Week 4 but only over three at Week 8. At Week 4 none of the controls separated from Test 2 on tactile threshold; all separated by Week 8. VRS scores did not separate test and control dentifrices. Dentifrices were generally well-tolerated. CONCLUSIONS: The six negative-control dentifrices can be used to assess dentifrices considered to be effective in reducing DH. Although response ranges for commercially available negative controls varied, these results may begin to set acceptable performance ranges for control dentifrices in DH trials.

Eficacia de un dentífrico con dióxido de silicio obliterante en pacientes con hiperestesia dentinaria / Efficacy of a toothpaste containing precipitated silica particles in patients with dentin hyperesthesia

Introducción: la hiperestesia dentinaria se caracteriza por un dolor intenso y breve asociado a la exposición de estímulos térmicos, táctiles, osmóticos o químicos. De prevalencia creciente, reduce la calidad de vida del paciente. Objetivo: evaluar la eficacia, aceptabilidad y tolerancia de un dentífrico con dióxido de silicio obliterante, nitrato potásico y monofluorofosfato sódico en pacientes con hiperestesia dentinaria. Métodos: estudio observacional y longitudinal (n= 22) en el que se aplicó el dentífrico 3 veces/día durante 28 días. Se realizó una evaluación clínica, antes y después de la aplicación, a las 48 horas, a las 96 horas y los días 7, 14, 21 y 28 del estudio. Se evaluó su eficacia en términos de reducción de la hipersensibilidad dental determinada mediante técnica táctil (escala de calificación verbal) y de chorro de aire (escala de Schiff). En cada visita se valoró la tolerancia del producto. Los pacientes valoraron el grado de hipersensibilidad y su percepción del producto mediante un cuestionario de evaluación subjetiva. El estudio se realizó bajo los principios de Buena Práctica Clínica. Resultados: la hipersensibilidad dental se redujo en todos los puntos temporales del estudio y fue significativa (p< 0,05) a partir del día 5. Esta mejoría fue sostenida y aumentó a medida que avanzó el tratamiento. El día 29 la hipersensibilidad media se redujo en un 85 por ciento respecto al valor basal en todos los pacientes. El 91 por ciento de los participantes opinó que el dentífrico había cumplido sus expectativas. No se observó ninguna reacción adversa derivada del uso del producto. Conclusiones: el dentífrico, administrado 3 veces/día, consiguió una reducción de la hipersensibilidad dental, significativa a partir del día 5, que fue aumentando con el tiempo. El producto presentó muy buena aceptabilidad y tolerancia(AU)

Introduction: dentin hypersensitivity is characterized by sharp pain of short duration associated with exposure to thermal, tactile, osmotic or chemical stimuli. Dentin hypersensitivity is a disorder of growing prevalence which reduces the quality of life of patients. Objective: evaluate the efficacy, acceptability and tolerance of a toothpaste with precipitated silica, potassium nitrate and sodium monofluorophosphate in patients with dentin hypersensitivity. Methods: an observational longitudinal study was conducted (n= 22) in which the toothpaste was applied 3 times a day for 28 days. Clinical assessment was performed before and after the application, at 48 hours, at 96 hours and on days 7, 14, 21 and 28 of the study. Efficacy was evaluated in terms of dental hypersensitivity reduction as determined by tactile (Verbal Rating Scale) and air jet (Schiff scale) techniques. Tolerance to the product was assessed in every visit. Patients ranked the degree of hypersensitivity and their perception of the product by means of a subjective assessment questionnaire. The study complied with Good Clinical Practice principles. Results: areduction was observed in dental hypersensitivity at all time points throughout the study, and it was significant (p< 0,05) as of day 5. This improvement was sustained and increased as treatment progressed. On day 29 mean hypersensitivity had reduced 85 percent with respect to baseline value in all patients. 91 percent of the patients stated that the toothpaste had met their expectations. No adverse reaction attributable to the product was observed. Conclusions: applied 3 times/day, the toothpaste obtained a reduction in dental hypersensitivity, which was significant as of day 5. This improvement increased over time. The product had very good acceptability and tolerance(AU)

Eficacia de un dentífrico con dióxido de silicio obliterante en pacientes con hiperestesia dentinaria / Efficacy of a toothpaste containing precipitated silica particles in patients with dentin hyperesthesia

Introducción: la hiperestesia dentinaria se caracteriza por un dolor intenso y breve asociado a la exposición de estímulos térmicos, táctiles, osmóticos o químicos. De prevalencia creciente, reduce la calidad de vida del paciente. Objetivo: evaluar la eficacia, aceptabilidad y tolerancia de un dentífrico con dióxido de silicio obliterante, nitrato potásico y monofluorofosfato sódico en pacientes con hiperestesia dentinaria. Métodos: estudio observacional y longitudinal (n= 22) en el que se aplicó el dentífrico 3 veces/día durante 28 días. Se realizó una evaluación clínica, antes y después de la aplicación, a las 48 horas, a las 96 horas y los días 7, 14, 21 y 28 del estudio. Se evaluó su eficacia en términos de reducción de la hipersensibilidad dental determinada mediante técnica táctil (escala de calificación verbal) y de chorro de aire (escala de Schiff). En cada visita se valoró la tolerancia del producto. Los pacientes valoraron el grado de hipersensibilidad y su percepción del producto mediante un cuestionario de evaluación subjetiva. El estudio se realizó bajo los principios de Buena Práctica Clínica. Resultados: la hipersensibilidad dental se redujo en todos los puntos temporales del estudio y fue significativa (p< 0,05) a partir del día 5. Esta mejoría fue sostenida y aumentó a medida que avanzó el tratamiento. El día 29 la hipersensibilidad media se redujo en un 85 por ciento respecto al valor basal en todos los pacientes. El 91 por ciento de los participantes opinó que el dentífrico había cumplido sus expectativas. No se observó ninguna reacción adversa derivada del uso del producto. Conclusiones: el dentífrico, administrado 3 veces/día, consiguió una reducción de la hipersensibilidad dental, significativa a partir del día 5, que fue aumentando con el tiempo. El producto presentó muy buena aceptabilidad y tolerancia(AU)

Introduction: dentin hypersensitivity is characterized by sharp pain of short duration associated with exposure to thermal, tactile, osmotic or chemical stimuli. Dentin hypersensitivity is a disorder of growing prevalence which reduces the quality of life of patients. Objective: evaluate the efficacy, acceptability and tolerance of a toothpaste with precipitated silica, potassium nitrate and sodium monofluorophosphate in patients with dentin hypersensitivity. Methods: an observational longitudinal study was conducted (n= 22) in which the toothpaste was applied 3 times a day for 28 days. Clinical assessment was performed before and after the application, at 48 hours, at 96 hours and on days 7, 14, 21 and 28 of the study. Efficacy was evaluated in terms of dental hypersensitivity reduction as determined by tactile (Verbal Rating Scale) and air jet (Schiff scale) techniques. Tolerance to the product was assessed in every visit. Patients ranked the degree of hypersensitivity and their perception of the product by means of a subjective assessment questionnaire. The study complied with Good Clinical Practice principles. Results: areduction was observed in dental hypersensitivity at all time points throughout the study, and it was significant (p< 0,05) as of day 5. This improvement was sustained and increased as treatment progressed. On day 29 mean hypersensitivity had reduced 85 percent with respect to baseline value in all patients. 91 percent of the patients stated that the toothpaste had met their expectations. No adverse reaction attributable to the product was observed. Conclusions: applied 3 times/day, the toothpaste obtained a reduction in dental hypersensitivity, which was significant as of day 5. This improvement increased over time. The product had very good acceptability and tolerance(AU)

Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness

Abstract The aim of this study was to evaluate the influence of an extended use of desensitizing toothpastes (DTs) on dentin bonding, microhardness and roughness. One hundred and twenty bovine incisor teeth were randomly divided into four groups: G1, distilled water (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-Relief (CSPR); and G4, Sensodyne Repair ?αμπ; Protect (SRP). Dentin surfaces were etched with 17% EDTA and 2 years of simulated tooth brushing (20,000 cycles) was performed on their surfaces. Knoop microhardness, surface roughness and scanning electron microscopy (SEM) were performed before and after the simulated tooth brushing. For microshear bonding test, a 2-step self-etching adhesive system (Clearfil SE Bond) was used and 0.8 mm diameter composite resin (Filtek Z350 XT) cylinders were built. Microshear test was performed with an orthodontic wire and with a crosshead speed of 0.5 mm/min. The data were analyzed for: 1) bond strength (one-way ANOVA), 2) microhardness intra-group (Student's test) and inter-group (one-way ANOVA/Tukey's test) comparisons, 3) roughness intra-group (Student's test/Wilcoxon's test) and inter-group (Kruskal-Wallis/Student-Newman-Keuls test) comparisons. The extended use of both dentifrices (conventional and for sensitive teeth) did not affect the bond strength and produced a significant increase in microhardness and roughness of the dentin, except for the microhardness of the SRP group. The simulated tooth brushing technique with water produced an increase in roughness, without reducing significantly the dentin microhardness.

Resumo O objetivo deste estudo foi avaliar a influência do uso prolongado de dentifrícios dessensibilizantes (DTs) na adesão, microdureza e rugosidade da dentina. Cento e vinte dentes incisivos bovinos foram divididos aleatoriamente em quatro grupos: G1, água destilada (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-alívio (CSPR); e G4, Sensodyne Repair ?αμπ; Protect (SRP). As superfícies dentinárias foram condicionadas com EDTA a 17% e foram realizados 2 anos de escovação dental simulada (20.000 ciclos) em suas superfícies. A microdureza Knoop, rugosidade de superfície e microscopia eletrônica de varredura (MEV) foram realizadas antes e após escovação dental simulada. Para o teste de adesão por microcisalhamento, foi aplicado um sistema adesivo auto condicionante de 2 passos (Clearfil SE Bond) e foram construídos cilindros de resina composta (Filtek Z350 XT) de 0,8 mm de diâmetro. O teste de microcisalhamento foi realizado com um fio ortodôntico e com velocidade de 0,5mm/min. Os dados foram analisados para: 1) resistência de união (ANOVA 1 fator), 2) comparações de microdureza intra grupo (teste t de Student) e inter grupo (ANOVA 1 fator / teste de Tukey), 3) comparações de rugosidade intra grupo (teste t de Student / teste de Wilcoxon) e inter grupo (Kruskal Wallis / teste de Student-Newman-Keuls). O uso prolongado de ambos dentifrícios (convencional e para dentes sensíveis) não interferiu na resistência de união e produziu um aumento significativo na microdureza e rugosidade da dentina, exceto para a microdureza do grupo SRP. A técnica de escovação dental simulada com água promoveu aumento na rugosidade, sem reduzir significativamente a microdureza da dentina.

An exploratory clinical trial to evaluate the efficacy of an experimental dentifrice formulation in the relief of dentine hypersensitivity.

OBJECTIVES: This study aimed to investigate whether addition of an octadecene/maleic anhydride copolymer (O/MA) to a potassium nitrate (KNO3) dentifrice could facilitate delivery of potassium to dentine and enhance its efficacy in dentine hypersensitivity relief. METHODS: This was a randomised, examiner-blind, controlled, parallel group study in 139 healthy subjects with at ≥2 sensitive teeth. Assessment of dentine hypersensitivity to tactile (Yeaple probe) and evaporative (air) stimuli (Schiff Sensitivity Scale, visual analogue scale [VAS]) was carried out at baseline and after 1, 2, 4 and 8 weeks twice daily treatment with an experimental 5% KNO3/3% O/MA dentifrice, a comparator 5% KNO3 dentifrice (active comparator), a 0% KNO3/3% O/MA dentifrice (placebo) and a regular fluoride dentifrice (negative control). This study was not powered to detect statistically significant differences between treatments. RESULTS: Across the treatment period an improvement in sensitivity to evaporative air stimulus was observed for all products and to a tactile stimulus for the potassium-containing treatments, with the greatest reductions for the experimental dentifrice (5% KNO3/3% O/MA). Reductions in sensitivity observed for the potassium-containing dentifrices compared to the placebo and negative control dentifrices were statistically significantly for Schiff sensitivity score and tactile threshold at all time-points and for VAS at Weeks 4 and 8. Trends in the study data also favoured the experimental dentifrice, compared to the active comparator dentifrice, for all clinical measures. Study treatments were generally well tolerated. CONCLUSION: This study provides initial clinical evidence to suggest that addition of a polymer excipient may enhance the anti-sensitivity efficacy of potassium-containing dentifrices. CLINICAL SIGNIFICANCE: Daily use potassium-containing dentifrices are established as efficacious for the relief of dentine hypersensitivity. Inclusion of a polymer excipient in such formulations may facilitate delivery of potassium to the dentine surface and so enhance clinical efficacy. Further clinical studies are required to confirm this hypothesis.

Remineralizing potential of a 60-s in vitro application of Tooth Mousse Plus.

BACKGROUND: No published studies exist on the remineralizing potential of Tooth Mousse Plus® (TMP) when applied for less than 3 min. AIM: To evaluate (i) the remineralizing potential of TMP on artificial carious lesions, when applied thrice daily for 60 s, and (ii) the benefit of using a fluoridated dentifrice prior to TMP application. DESIGN: Carious lesions, 120-200 µm deep, were produced by placing molars in demineralizing solution for 96 h, and sections 100-150 µm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or 1000 ppm F dentifrice (Group B), or TMP (Group C), or a 1000 ppm F dentifrice followed by TMP application (Group D), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography. RESULTS: Post-treatment maximum mineral content at the surface zone (Vmax ) was significantly increased and lesion depth (LD) significantly decreased in Group C, while only the Vmax increased in Group D. Increase in LD was observed in Group B; however, no significant differences were noted in percentage LD changes between groups B, C, and D (P > 0.05). CONCLUSIONS: TMP applied for 60 s significantly remineralized the artificial carious lesions. No additional benefit was evident when TMP was preceded by treatment with 1000 ppm F dentifrice.

Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness.

The aim of this study was to evaluate the influence of an extended use of desensitizing toothpastes (DTs) on dentin bonding, microhardness and roughness. One hundred and twenty bovine incisor teeth were randomly divided into four groups: G1, distilled water (WATER); G2, Colgate Total 12 (CT12); G3, Colgate Sensitive Pro-Relief (CSPR); and G4, Sensodyne Repair ?αµπ; Protect (SRP). Dentin surfaces were etched with 17% EDTA and 2 years of simulated tooth brushing (20,000 cycles) was performed on their surfaces. Knoop microhardness, surface roughness and scanning electron microscopy (SEM) were performed before and after the simulated tooth brushing. For microshear bonding test, a 2-step self-etching adhesive system (Clearfil SE Bond) was used and 0.8 mm diameter composite resin (Filtek Z350 XT) cylinders were built. Microshear test was performed with an orthodontic wire and with a crosshead speed of 0.5 mm/min. The data were analyzed for: 1) bond strength (one-way ANOVA), 2) microhardness intra-group (Student's test) and inter-group (one-way ANOVA/Tukey's test) comparisons, 3) roughness intra-group (Student's test/Wilcoxon's test) and inter-group (Kruskal-Wallis/Student-Newman-Keuls test) comparisons. The extended use of both dentifrices (conventional and for sensitive teeth) did not affect the bond strength and produced a significant increase in microhardness and roughness of the dentin, except for the microhardness of the SRP group. The simulated tooth brushing technique with water produced an increase in roughness, without reducing significantly the dentin microhardness.

A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish.

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.