Two mechanistic, laboratory, factorial design studies were conducted to investigate the effect of the stannous ion (Sn2+) in the absence or presence of fluoride on caries lesion de- and remineralization. Study I was concerned with determining changes in mineral distribution of subsurface lesions, whereas study II investigated changes in surface hardness of surface-softened lesions as a function of pH. Study I showed that Sn2+ modulates the effects of fluoride by preventing lamination. Study II revealed that the effect of Sn2+ on rehardening is pH dependent. Neither study demonstrated synergy between Sn2+ and fluoride, yet interactions were observed. Sn2+ does interfere with remineralization to some extent although it provided acid resistance. The role of Sn2+ in the caries process is complex.

Angmar B, Carlström D, Glas JE: Studies on the ultrastructure of dental enamel. IV. The mineralization of normal tooth enamel. J Ultrastruct Res 1963;8:12-23.
Beiswanger BB, Gish CW, Mallatt ME: A three-year study of the effect of a sodium fluoride-silica abrasive dentifrice on dental caries. Pharmacol Ther Dent 1981;6:9-16.
Collins R, Nebergall W, Langer H: A study of the reactions of various tin(II) compounds with calcium hydroxylapatite. J Am Chem Soc 1961;83:3724-3725.
de Josselin de Jong E, ten Bosch JJ, Noordmans J: Optimised microcomputer-guided quantitative microradiography on dental mineralised tissue slices. Phys Med Biol 1987;32:887-899.
Dénès G, Lazanas G: Oxidation of SnF2 stannous fluoride in aqueous solutions. Hyperfine Interact 1994;90:435-439.
Dénès G, Muntasar A, Kozak KM, Baig AA, White DJ: Mössbauer studies of stannous fluoride reactivity with synthetic tooth enamel - a model for the tooth cavity protection actions of novel dentifrices. Hyperfine Interact 2002;141/142:255-260.
Ekstrand J: Fluoride in plaque fluid and saliva after NaF or MFF rinses. Eur J Oral Sci 1997;105:478-484.
Ellingsen JE, Rölla G: Treatment of dentin with stannous fluoride - SEM and electron microprobe study. Scand J Dent Res 1987;95:281-286.
Faller RV, Eversole SL, Yan J: Anticaries potential of a stabilized stannous-containing sodium fluoride dentifrice. Am J Dent 2010;23:32B-38B.
Ganss C, Hardt M, Lussi A, Cocks AK, Klimek J, Schlueter N: Mechanism of action of tin-containing fluoride solutions as anti-erosive agents in dentine - an in vitro tin-uptake, tissue loss, and scanning electron microscopy study. Eur J Oral Sci 2010;118:376-384.
Gelhard TBFM, ten Cate JM, Arends J: Rehardening of artificial enamel lesions in vivo. Caries Res 1979;13:80-83.
Ingram GS, Silverstone LM: A chemical and histological study of artificial caries in human dental enamel in vitro. Caries Res 1981;15:393-398.
Katsuri R, White DJ, Lanzalaco AC, Macksood D, Cox ER, Bacca L, Liang K, Baker R: Effects of nine weeks' use of a new stabilized stannous fluoride dentifrice on intrinsic plaque virulence expressed as acidogenicity and regrowth: a modified PGRM study. J Clin Dent 1995;6:71-79.
Lippert F: Dose-response effects of zinc and fluoride on caries lesion remineralization. Caries Res 2012;46:62-68.
Lippert F, Newby EE, Lynch RJ, Chauhan VK, Schemehorn BR: Laboratory assessment of the anticaries potential of a new dentifrice. J Clin Dent 2009;20:45-49.
Lynch RJ, Churchley D, Butler A, Kearns S, Thomas GV, Badrock TC, Cooper L, Higham SM: Effects of zinc and fluoride on the remineralisation of artificial carious lesions under simulated plaque fluid conditions. Caries Res 2011;45:313-322.
Meyer JL, Nancollas GH: Effect of stannous and fluoride ions on the rate of crystal growth of hydroxyapatite. J Dent Res 1972;51:1443-1450.
Meyer-Lueckel H, Wierichs RJ, Gninka B, Heldmann P, Dörfer CE, Paris S: The effect of various model parameters on enamel caries lesions in a dose-response model in situ. J Dent 2015;43:1261-1267.
Muhler JC, Radike AW, Nebergall WH, Day HG: The effect of a stannous fluoride-containing dentifrice on caries reduction in children. J Dent Res 1954;33:606-612.
Muhler JC, Radike AW, Nebergall WH, Day HG: The effect of a stannous fluoride-containing dentifrice on dental caries in adults. J Dent Res 1956;35:49-53.
Newby EE, Martinez-Mier EA, Zero DT, Kelly SA, Fleming N, North M, Bosma ML: A randomised clinical study to evaluate the effect of brushing duration on fluoride levels in dental biofilm fluid and saliva in children aged 4-5 years. Int Dent J 2013;63(suppl 2):39-47.
Oppermann RV, Johansen JR: The effect of fluoride and non-fluoride salts of copper, silver and tin on the acidogenicity of dental plague in vivo. Scand J Dent Res 1980;88:476-480.
Rykke M, Ellingsen JE, Sönju T: Chemical analysis and scanning electron microscopy of acquired pellicle formed in vivo on stannous fluoride treated enamel. Scand J Dent Res 1991;99:205-211.
Scott DC, Coggan JW, Cruze CA, He T, Johnson RD: Topical oral cavity pharmacokinetic modeling of a stannous fluoride dentifrice: an unusual two compartment model. J Pharm Sci 2009;98:3862-3870.
Stookey GK, Mau MS, Isaacs RL, Gonzalez-Gierbolini C, Bartizek RD, Biesbrock AR: The relative anticaries effectiveness of three fluoride-containing dentifrices in Puerto Rico. Caries Res 2004;38:542-550.
ten Cate JM, Dundon KA, Vernon PG, Damato FA, Huntington E, Exterkate RAM, Wefel JS, Jordan T, Stephen KW, Roberts AJ: Preparation and measurement of artificial enamel lesions, a four-laboratory ring test. Caries Res 1996;30:400-407.
White DJ: Use of synthetic polymer gels for artificial carious lesion preparation. Caries Res 1987;21:228-242.
White DJ: A ‘return' to stannous fluoride dentifrices. J Clin Dent 1995;6:29-36.
Wierichs RJ, Zelck H, Doerfer CE, Appel P, Paris S, Esteves-Oliveira M, Meyer-Lueckel H: Effects of dentifrices differing in fluoride compounds on artificial enamel caries lesions in vitro. Odontology 2016, Epub ahead of print.
Zacherl WA: A three-year clinical caries evaluation of the effect of a sodium fluoride-silica abrasive dentifrice. Pharmacol Ther Dent 1981;6:1-7.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.