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.

Keywords:
Remineralization, Caries, Enamel, Fluoride, Stannous ion, Demineralization
1.
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.
2.
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.
3.
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.
4.
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.
5.
Dénès G, Lazanas G: Oxidation of SnF2 stannous fluoride in aqueous solutions. Hyperfine Interact 1994;90:435-439.
6.
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.
7.
Ekstrand J: Fluoride in plaque fluid and saliva after NaF or MFF rinses. Eur J Oral Sci 1997;105:478-484.
8.
Ellingsen JE, Rölla G: Treatment of dentin with stannous fluoride - SEM and electron microprobe study. Scand J Dent Res 1987;95:281-286.
9.
Faller RV, Eversole SL, Yan J: Anticaries potential of a stabilized stannous-containing sodium fluoride dentifrice. Am J Dent 2010;23:32B-38B.
10.
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.
11.
Gelhard TBFM, ten Cate JM, Arends J: Rehardening of artificial enamel lesions in vivo. Caries Res 1979;13:80-83.
12.
Ingram GS, Silverstone LM: A chemical and histological study of artificial caries in human dental enamel in vitro. Caries Res 1981;15:393-398.
13.
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.
14.
Lippert F: Dose-response effects of zinc and fluoride on caries lesion remineralization. Caries Res 2012;46:62-68.
15.
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.
16.
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.
17.
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.
18.
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.
19.
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.
20.
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.
21.
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.
22.
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.
23.
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.
24.
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.
25.
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.
26.
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.
27.
White DJ: Use of synthetic polymer gels for artificial carious lesion preparation. Caries Res 1987;21:228-242.
28.
White DJ: A ‘return' to stannous fluoride dentifrices. J Clin Dent 1995;6:29-36.
29.
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.
30.
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.
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2016
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