Remineralization and inactivation of carious lesions treated with silver fluoride in Brazilian children with special healthcare needs.

Introduction: Providing conventional, restorative dental care to children with special healthcare needs (CSHCN) often requires sedation using general anesthesia. Saliva consistency, diet, and oral hygiene practice are different for CSHCN, and limited evidence is available on the efficacy of silver fluoride (SF) for the management of carious lesions for this vulnerable population. Methods: Parents of CSHCN were educated about silver fluoride as a treatment option for caries. In total, 550 carious lesions from 100 participants were identified and scored according to the Nyvad Caries criteria. A total of 100 lesions with Nyvad scores 1, 2, and 3 were treated with a single application of silver fluoride and observed postoperatively at 1, 3, and 6 weeks. Result: The results indicate statistically significant (p < 0.05) differences in lesion remineralization over the 6-week follow-up period. At the 6-week follow-up, more than 85% of all lesions were remineralized across all children, regardless of condition or original Nyvad score of 1, 2, or 3. Conclusion: A single application of silver fluoride has demonstrated effectiveness in remineralization and inactivation of carious lesions over 6 weeks among Brazilian CSHCN. Silver fluoride should be considered an option for the management of carious lesions among CSHCN. Further studies are recommended, including larger sample sizes, longer follow-up times, a second application of SF, and different special needs conditions.

Fluoride Exposure and Salivary Glands: How Is Glandular Morphology Susceptible to Long-Term Exposure? A Preclinical Study.

Despite a strong body of evidence attesting to the effectiveness of fluoride (F) in preventing and controlling caries, some studies have sought to investigate the influence of F exposure on the salivary glands, organs that are essential for the maintenance of cavity homeostasis through salivary production, finding that exposure to F can cause biochemical and proteomic changes. Thus, this study aimed to investigate the morphological effects of prolonged exposure to F on the salivary glands of mice, at concentrations that would correspond to optimally fluoridated water (suitable for human consumption) and to fluorosis-endemic regions. Twenty-four male mice (Mus musculus) were divided into three groups, according to F levels in the drinking water: 0 (control), 10, or 50 mg F/L, with an exposure period of 60 days. The glands were morphometrically analyzed for the total acinar area, parenchyma area, and stromal area, as well as for the immunohistochemical analysis of myoepithelial cells. The results showed that prolonged exposure to F at 10 mg F/L did not promote significant changes in the morphometry of the salivary glands of mice, which reinforces the safety of the chronic use of F in low doses.

Maternal Fluoride Exposure Exerts Different Toxicity Patterns in Parotid and Submandibular Glands of Offspring Rats.

There is currently a controversial and heated debate about the safety and ethical aspects of fluoride (F) used for human consumption. Thus, this study assessed the effects of prenatal and postnatal F exposure of rats on the salivary glands of their offspring. Pregnant rats were exposed to 0, 10, or 50 mg F/L from the drinking water, from the first day of gestation until offspring weaning (42 days). The offspring rats were euthanized for the collection of the parotid (PA) and submandibular (SM) glands, to assess the oxidative biochemistry and to perform morphometric and immunohistochemical analyses. F exposure was associated with a decrease in the antioxidant competence of PA in the 10 mg F/L group, contrasting with the increase observed in the 50 mg F/L group. On the other hand, the antioxidant competence of the SM glands was decreased at both concentrations. Moreover, both 10 and 50 mg F/L groups showed lower anti-α-smooth muscle actin immunostaining area in SM, while exposure to 50 mg F/L was associated with changes in gland morphometry by increasing the duct area in both glands. These findings demonstrate a greater susceptibility of the SM glands of the offspring to F at high concentration in comparison to PA, reinforcing the need to adhere to the optimum F levels recommended by the regulatory agencies. Such findings must be interpreted with caution, especially considering their translational meaning.

Evaluation of genetic polymorphisms in MMP2, MMP9 and MMP20 in Brazilian children with dental fluorosis.

Recent studies suggested that genetics contribute to differences in dental fluorosis (DF) susceptibility among individuals having the same environmental exposure. This study evaluated if MMP2, MMP9 and MMP20 are expressed during enamel development and assessed the association between polymorphisms in these genes with DF. Mice susceptible and resistant to DF were used to evaluate if MMPs were candidate genes for DF. The animals received fluoride and their enamels were used for immunohistochemistry. Additionally, 481 subjects from a city with fluoridation of public water supplies were recruited. Genotyping was performed using real time PCR. Allele/genotype frequencies were compared between groups. MMP2, MMP9 and MMP20 immunostaining was detected in both animal groups. DF was observed in 22.4% of the subjects. A borderline association was observed in MMP2 (rs243865), MMP9 (rs17576) and in MMP20 (rs1784418) (p = 0.06, p = 0.08 and p = 0.06 respectively). Briefly, MMPs were expressed during enamel maturation and genetic polymorphisms were not associated with DF.

Analysis of Polymorphisms in Genes Differentially Expressed in the Enamel of Mice with Different Genetic Susceptibilities to Dental Fluorosis.

Genes expressed during amelogenesis are candidates to increase the risk of dental fluorosis (DF). Thus, this study aimed to evaluate the association between polymorphisms in enamel development genes and susceptibility to DF in mice. Mice of both sexes, representing strains 129P3/J (n = 20; resistant to DF) and A/J (n = 20; susceptible to DF), were divided into 2 groups. Each strain received a diet with a low concentration of fluoride (F) and drinking water containing 0 or 50 mg/L of F for 6 weeks. Clinical evaluation and analysis of Vickers enamel microhardness of the incisors were performed. Livers were collected for genomic DNA extraction. Seventeen genetic polymorphisms in Amelx, Ambn, Ambn, Col14a1, Col1a1, Col5a2, Enam, Fam20a, Fam83h, Foxo1, Klk4, Mmp20, Serpinf1, Serpinh1, Smad3, Tuft1, and Wdr72 were genotyped by real-time PCR using Taqman chemistry. Overrepresentation of alleles and genotypes in DF was evaluated using the χ2 test with an alpha of 5%. The clinical aspects of the enamel and the surface enamel microhardness confirmed the DF condition. In the polymorphisms rs29569969, rs13482592, and rs13480057 in Ambn, Col14a1, and Mmp20, respectively, genotype and allele distributions were statistically significantly different between A/J and 129P3/J strains (p < 0.05). In conclusion, polymorphisms in Ambn, Col14a1, and Mmp20 are associated with the susceptibility to DF.

Proteomic Mapping of Dental Enamel Matrix from Inbred Mouse Strains: Unraveling Potential New Players in Enamel.

Enamel formation is a complex 2-step process by which proteins are secreted to form an extracellular matrix, followed by massive protein degradation and subsequent mineralization. Excessive systemic exposure to fluoride can disrupt this process and lead to a condition known as dental fluorosis. The genetic background influences the responses of mineralized tissues to fluoride, such as dental fluorosis, observed in A/J and 129P3/J mice. The aim of the present study was to map the protein profile of enamel matrix from A/J and 129P3/J strains. Enamel matrix samples were obtained from A/J and 129P3/J mice and analyzed by 2-dimensional electrophoresis and liquid chromatography coupled with mass spectrometry. A total of 120 proteins were identified, and 7 of them were classified as putative uncharacterized proteins and analyzed in silico for structural and functional characterization. An interesting finding was the possibility of the uncharacterized sequence Q8BIS2 being an enzyme involved in the degradation of matrix proteins. Thus, the results provide a comprehensive view of the structure and function for putative uncharacterized proteins found in the enamel matrix that could help to elucidate the mechanisms involved in enamel biomineralization and genetic susceptibility to dental fluorosis.

Oxidative Biochemistry Disbalance and Changes on Proteomic Profile in Salivary Glands of Rats Induced by Chronic Exposure to Methylmercury.

Methylmercury (MeHg) is one of the most toxic mercury species, which can cause many systemic damages, but little is known about its effect in the salivary glands. This study aimed to analyze the mercury levels, oxidative stress, and proteomic profile in parotid, submandibular, and sublingual salivary glands of rats, after chronic MeHg intoxication. Two groups of twenty male Wistar rats (90 days of age) were used on the experiment. MeHg group was intoxicated by intragastric gavage with MeHg at a dose of 0.04 mg/kg/day for 60 days, while the control group received only oil. After the period of intoxication, the glands were collected for evaluation of total mercury levels, proteomic profile, and oxidative balance by analyzing the antioxidant capacity against peroxyl radicals (ACAP), lipid peroxidation (LPO), and nitrite levels. Our results have showed that mercury levels were significant in all three glands compared to the respective control. It also showed lower levels of ACAP, as well as higher LPO and nitrite levels. The proteomic profile presented impairments on structural components of cytoskeleton, metabolic pathways, and oxidative biochemistry. Thus, the exposure to MeHg was able to generate oxidative stress that could be associated with changes in the proteomic profile of salivary glands.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study.

OBJECTIVES: This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. MATERIAL AND METHODS: Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. RESULTS: TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. CONCLUSION: Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.

Role of Candida species from HIV infected children in enamel caries lesions: an in vitro study

Abstract Objectives This study analyzed the capacity of Candida spp. from dental biofilm of HIV infected (HIV+) children to demineralize primary molar enamel in vitro by Transversal Microhardness (TMH), Polarized Light Microscopy (PLM) and the quantity of calcium ions (Ca2+) released from the enamel. Material and Methods Candida spp. samples were isolated from the supragingival biofilm of HIV+ children. A hundred and forty (140) enamel blocks were randomly assigned to six groups: biofilm formed by C. albicans (Group 1); mixed biofilm formed by C. albicans and C. tropicalis (Group 2); mixed biofilm formed by C. albicans and C. parapsilosis (Group 3); mixed biofilm formed by C. albicans, C. parapsilosis and C. glabrata (Group 4); biofilm formed by C. albicans ATCC (Group 5) and medium without Candida (Group 6). Enamel blocks from each group were removed on days 3, 5, 8 and 15 after biofilm formation to evaluate the TMH and images of enamel were analyzed by PLM. The quantity of Ca2+ released, from Groups 1 and 6, was determined using an Atomic Absorption Spectrophotometer. The SPSS program was used for statistical analysis and the significance level was 5%. Results TMH showed a gradual reduction in enamel hardness (p<0.05) from the 1st to 15th day, but mainly five days after biofilm formation in all groups. The PLM showed superficial lesions indicating an increase in porosity. C. albicans caused the release of Ca2+ into suspension during biofilm formation. Conclusion Candida species from dental biofilm of HIV+ children can cause demineralization of primary enamel in vitro.

Polymorphisms in genes involved in enamel development are associated with dental fluorosis.

OBJECTIVE: To evaluate the association between polymorphisms in DLX1, DLX2, MMP13, TIMP1 and TIMP2 genes with dental fluorosis (DF) phenotype. DESIGN: Four hundred and eighty one subjects (108 with DF and 373 DF free) from 6 to 18 years of age were recruited. This population lived in Rio de Janeiro, a city with fluoridation of public water supplies. DF was assessed using the Deans index modified. Only erupted permanent teeth were assessed. Genetic polymorphisms in DLX1, DLX2, MMP13, TIMP1 and TIMP2 were analyzed by real-time PCR from genomic DNA. Association between DF, genotype, and allele distribution were evaluated using chi-square and logistic regression analyses with an alpha level of 5%. RESULTS: DF was more prevalent in Afro-descendants than in Caucasians (p=0.08; OR=1.83; CI 95%=1.18-2.82). Logistic regression analysis adjusted by the ethnicity demonstrated a statistical difference for TIMP1 genotype (p=0.033; OR=2.93, 95%CI, 1.09-7.90). When only the severer cases of DF were analyzed, polymorphisms in DLX1 and DLX2 were associated with DF (p<0.05). CONCLUSION: Our results provided evidence that polymorphisms in TIMP1, DLX1 and DLX2 genes may be associated with DF phenotypes.

Liver proteome of mice with different genetic susceptibilities to the effects of fluoride.

OBJECTIVE: In this study, we investigated the differential pattern of protein expression in the liver of these mice to provide insights on why they have different responses to F. MATERIAL AND METHODS: Weanling male A/J and 129P3/J mice (n=10 from each strain) were pared and housed in metabolic cages with ad libitum access to low-F food and deionized water for 42 days. Liver proteome profiles were examined using nLC-MS/MS. Protein function was classified by GO biological process (Cluego v2.0.7 + Clupedia v1.0.8) and protein-protein interaction network was constructed (PSICQUIC, Cytoscape). RESULTS: Most proteins with fold change were increased in A/J mice. The functional category with the highest percentage of altered genes was oxidation-reduction process (20%). Subnetwork analysis revealed that proteins with fold change interacted with Disks large homolog 4 and Calcium-activated potassium channel subunit alpha-1. A/J mice had an increase in proteins related to energy flux and oxidative stress. CONCLUSION: This could be a possible explanation for the high susceptibility of these mice to the effects of F, since the exposure also induces oxidative stress.

Liver proteome of mice with different genetic susceptibilities to the effects of fluoride

ABSTRACT A/J and 129P3/J mice strains have been widely studied over the last few years because they respond quite differently to fluoride (F) exposure. 129P3/J mice are remarkably resistant to the development of dental fluorosis, despite excreting less F in urine and having higher circulating F levels. These two strains also present different characteristics regardless of F exposure. Objective In this study, we investigated the differential pattern of protein expression in the liver of these mice to provide insights on why they have different responses to F. Material and Methods Weanling male A/J and 129P3/J mice (n=10 from each strain) were pared and housed in metabolic cages with ad libitum access to low-F food and deionized water for 42 days. Liver proteome profiles were examined using nLC-MS/MS. Protein function was classified by GO biological process (Cluego v2.0.7 + Clupedia v1.0.8) and protein-protein interaction network was constructed (PSICQUIC, Cytoscape). Results Most proteins with fold change were increased in A/J mice. The functional category with the highest percentage of altered genes was oxidation-reduction process (20%). Subnetwork analysis revealed that proteins with fold change interacted with Disks large homolog 4 and Calcium-activated potassium channel subunit alpha-1. A/J mice had an increase in proteins related to energy flux and oxidative stress. Conclusion This could be a possible explanation for the high susceptibility of these mice to the effects of F, since the exposure also induces oxidative stress.

Protective Effect of Whole and Fat-Free Fluoridated Milk, Applied before or after Acid Challenge, against Dental Erosion.

This study analysed in vitro the effect of milk against dental erosion, considering three factors: the type of milk (bovine whole/fat-free), the presence of different fluoride concentrations and the time of application (before/after erosive challenge). Bovine enamel (n = 15/group) and root dentine (n = 12/group) specimens were submitted to the following treatments: after the first erosive challenge - 0.9% NaCl solution (negative control), whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control); before the first erosive challenge - whole milk with 0, 2.5, 5.0 and 10.0 ppm F, fat-free milk with 0, 2.5, 5.0 and 10.0 ppm F, and 0.05% NaF solution (positive control). Specimens were submitted to demineralisation-remineralisation regimes 4 times/day for 5 days. The response variables were enamel and dentine loss (in micrometres). Data were analysed using Kruskal-Wallis/Dunn's test (p < 0.05). For enamel, whole milk containing 10 ppm F, applied before the erosive challenge, was the most protective treatment, but with no significant difference compared with the same treatment carried out after the erosive challenge. For dentine, whole fluoridated milk (all concentrations, after), fat-free 10 ppm F milk (after, before) and whole milk with or without F (except 2.5 ppm F, all before) significantly reduced dentine erosion. It seems that the presence of fluoride, especially at 10 ppm, is the most important factor in reducing dental erosion.

Proteomics of Secretory-Stage and Maturation-Stage Enamel of Genetically Distinct Mice.

The mechanisms by which excessive ingestion of fluoride (F) during amelogenesis leads to dental fluorosis (DF) are still not precisely known. Inbred strains of mice vary in their susceptibility to develop DF, and therefore permit the investigation of underlying molecular events influencing DF severity. We employed a proteomic approach to characterize and evaluate changes in protein expression from secretory-stage and maturation-stage enamel in 2 strains of mice with different susceptibilities to DF (A/J, i.e. 'susceptible' and 129P3/J, i.e. 'resistant'). Weanling male and female susceptible and resistant mice fed a low-F diet were divided into 2 F-water treatment groups. They received water containing 0 (control) or 50 mg F/l for 6 weeks. Plasma and incisor enamel was analyzed for F content. For proteomic analysis, the enamel proteins extracted for each group were separated by 2-dimensional electrophoresis and subsequently characterized by liquid-chromatography electrospray-ionization quadrupole time-of-flight mass spectrometry. F data were analyzed by 2-way ANOVA and Bonferroni's test (p < 0.05). Resistant mice had significantly higher plasma and enamel F concentrations when compared with susceptible mice in the F-treated groups. The proteomic results for mice treated with 0 mg F/l revealed that during the secretory stage, resistant mice had a higher abundance of proteins than their susceptible counterparts, but this was reversed during the maturation stage. Treatment with F greatly increased the number of protein spots detected in both stages. Many proteins not previously described in enamel (e.g. type 1 collagen) as well as some uncharacterized proteins were identified. Our findings reveal new insights regarding amelogenesis and how genetic background and F affect this process.

Association of Candida Species Isolated From the Dental Plaque of HIV-infected Children and Prevalence of Early Carious Lesions.

PURPOSE: The purposes of this study were to: (1) quantify and identify Candida species (spp.) in the dental plaque of children infected with the human immunodeficiency virus (HIV) and compare with noninfected children; and (2) determine the association of Candida spp. with the presence of caries. METHODS: Seventy HIV-infected and 55 non-HIV-infected three- to 12-year-old children were examined to determine caries prevalence. After a visual inspection, supragingival plaque was collected from the cervical region using standard dental curettes. The material was transferred to microtubes and submitted for analysis to identify and quantify the presence of Candida spp. RESULTS: Candida spp. were more prevalent in the HIV-infected group (72.9 percent) than in the control group (20 percent), and the most prevalent specie was Candida albicans. Caries was found in 72.9 percent of the HIV-infected group and in 58.2 percent of the control group, but a significant difference was only found in the presence of active white spot lesions between the groups. CONCLUSIONS: The dental plaque of HIV-infected children was colonized by Candida species to a much greater extent than that of non-HIV-infected children, and this colonization was significantly associated with the prevalence of early carious lesions in enamel.

Role of host-derived proteinases in dentine caries and erosion.

Demineralization in dentinal caries and erosion exposes dentine organic matrix. This exposed matrix, containing type I collagen and non-collagenous proteins, is then degraded by host collagenolytic enzymes, matrix metalloproteinases (MMPs) and cysteine cathepsins. The knowledge of the identities and function of these enzymes in dentine has accumulated only within the last 15 years, but has already formed a field of research called 'dentine degradomics'. This research has demonstrated the role of endogenous collagenolytic enzymes in caries and erosion development. In demineralized dentine, the enzymes degrade triple-helical collagen molecules, leading to the gradual loss of collagen matrix. Even before that, they can cleave off the terminal non-helical ends of collagen molecules called telopeptides, leading to the structural changes at the intramolecular gap areas, which may affect or even prevent intrafibrillar remineralization, which is considered essential in restoring the dentine's mechanical properties. They may also cause the loss of non-collagenous proteins that could serve as nucleation sites for remineralization. Here we review the findings demonstrating that inhibition of salivary or dentine endogenous MMPs and cysteine cathepsins may provide preventive means against the progression of caries or erosion. Furthermore, we also suggest the future directions for the new experimental preventive research to gain more knowledge of the enzymes and their function during and after dentine demineralization, and the pathways to find the clinically acceptable means to prevent the functional activity of these enzymes.

TiF4 and NaF varnishes as anti-erosive agents on enamel and dentin erosion progression in vitro.

OBJECTIVE: This study assessed the effect of fluoride varnishes on the progression of tooth erosion in vitro. MATERIAL AND METHODS: Forty-eight enamel and 60 root dentin samples were previously demineralized (0.1% citric acid, pH 2.5, 30 min), leading to a baseline and erosive wear of 12.9 and 11.4 µm, respectively. The samples were randomly treated (6 h) with a 4% TiF4 varnish (2.45%F-, pH 1.0), a 5.42% NaF varnish (2.45%F-, pH 5.0), a placebo varnish and no varnish (control). The samples were then subjected to erosive pH cycles (4x90 s/day in 0.1% citric acid, intercalated with artificial saliva) for 5 days. The increment of the erosive tooth wear was calculated. In the case of dentin, this final measurement was done with and without the demineralized organic matrix (DOM). Enamel and dentin data were analyzed using ANOVA/Tukey's and Kruskal-Wallis/Dunn tests, respectively (p<0.05). RESULTS: The TiF4 (mean±s.d: 1.5±1.1 µm) and NaF (2.1±1.7 µm) varnishes significantly reduced enamel wear progression compared to the placebo varnish (3.9±1.1 µm) and control (4.5±0.9 µm). The same differences were found for dentin in the presence and absence of the DOM, respectively: TiF4 (average: 0.97/1.87 µm), NaF (1.03/2.13 µm), placebo varnish (3.53/4.47 µm) and control (3.53/4.36 µm). CONCLUSION: The TiF4 and NaF varnishes were equally effective in reducing the progression of tooth erosion in vitro.

TiF4 and NaF varnishes as anti-erosive agents on enamel and dentin erosion progression in vitro

Objective This study assessed the effect of fluoride varnishes on the progression of tooth erosion in vitro. Material and Methods: Forty-eight enamel and 60 root dentin samples were previously demineralized (0.1% citric acid, pH 2.5, 30 min), leading to a baseline and erosive wear of 12.9 and 11.4 µm, respectively. The samples were randomly treated (6 h) with a 4% TiF4 varnish (2.45%F-, pH 1.0), a 5.42% NaF varnish (2.45%F-, pH 5.0), a placebo varnish and no varnish (control). The samples were then subjected to erosive pH cycles (4x90 s/day in 0.1% citric acid, intercalated with artificial saliva) for 5 days. The increment of the erosive tooth wear was calculated. In the case of dentin, this final measurement was done with and without the demineralized organic matrix (DOM). Enamel and dentin data were analyzed using ANOVA/Tukey’s and Kruskal-Wallis/Dunn tests, respectively (p<0.05). Results The TiF4 (mean±s.d: 1.5±1.1 µm) and NaF (2.1±1.7 µm) varnishes significantly reduced enamel wear progression compared to the placebo varnish (3.9±1.1 µm) and control (4.5±0.9 µm). The same differences were found for dentin in the presence and absence of the DOM, respectively: TiF4 (average: 0.97/1.87 µm), NaF (1.03/2.13 µm), placebo varnish (3.53/4.47 µm) and control (3.53/4.36 µm). Conclusion The TiF4 and NaF varnishes were equally effective in reducing the progression of tooth erosion in vitro. .

Mechanisms of action of fluoridated acidic liquid dentifrices against dental caries.

OBJECTIVE: This study attempted to clarify the mechanisms of action of fluoridated acidic liquid dentifrices against dental caries. DESIGN: In the in vitro leg, enamel specimens were submitted to a pH-cycling model, treated with distinct dentifrices (0, 550 µgF/g pH 4.5 and pH 7.0, 1100 or 5000 µgF/g pH 7.0) and analyzed using hardness. Alkali-soluble fluoride (F) deposition was quantified on pre-demineralized specimens treated with the dentifrices. In the clinical leg, 2-to-4-year-old children who had been using liquid dentifrices for 6 months (550 µgF/g pH 4.5 or pH 7.0 or 1100 µgF/g pH 7.0) had their plaque samples collected 5 and 60 min after the last brushing. Fluoride uptake in whole plaque was evaluated. RESULTS: The reduction of the pH had a partial preventive effect on subsurface hardness loss only. [F] had a significant influence on the deposition of fluoride, surface and subsurface hardness loss. In vivo, the reduction of the pH was able to significantly increase plaque F uptake, leading to similar levels as those found for the neutral dentifrice containing twice [F]. CONCLUSION: The results obtained from in vitro studies whose design does not include the presence of dental plaque should be interpreted with caution.

The effect of mouthwashes containing biguanides on the progression of erosion in dentin.

BACKGROUND: Dental erosion is caused by frequent exposure to acids without the involvement of microorganism. This study analyzed the effect of biguanides (polyhexamethylene biguanide - PHMB and chlorhexidine - CHX) on dentin erosion due to their possible influence on the enzymatic degradation of the demineralized organic matrix. METHOD: Sixty bovine dentin specimens were prepared. On both sides of their surface, nail varnish was applied to maintain the reference surfaces for the determination of dentin loss. Samples were cyclically de- and remineralized for 6 days. Demineralization was performed with a 0.87 M citric acid solution (6×5 min daily). Thereafter, samples were treated with distilled water (negative control), 0.12% CHX (positive control), 0.07% PHMB, Sanifill Perio Premium™ (0.07% PHMB plus 0.05% NaF), or F solution (0.05% NaF) for 1 min and then subjected to enzymatic challenge for 10 min using a bacterial collagenase (Clostridium hystoliticum, 100 µg/ml). Dentin loss was assessed using profilometry (µm) daily. Data were analyzed using 2-way repeated measures-ANOVA and Bonferroni's test (p < 0.05). RESULTS: Dentin loss progressed significantly for all groups during the 6 days. After the 3rd day, Sanifill Premium™, CHX, and PHMB significantly reduced dentin erosion compared to control. On the 6th day, the lowest mean (±SD) dentin loss was observed for Sanifill Perio Premium™ (94.4 ± 3.9 µm). PHMB and CHX led to intermediate dentin loss (129.9 ± 41.2 and 135.3 ± 33.5 µm, respectively) that was significantly lower than those found for negative control (168.2 ± 6.2 µm). F (157.4 ± 6.1 µm) did not significantly differ from negative control. CONCLUSIONS: Sanifill Perio Premium™ mouthwash has a good potential to reduce dentin loss, which might be associated with the presence of PHMB.