This in vitro study compared the effect of TiF4 varnish with that of NaF varnish, applied on pre-eroded bovine dentin samples, with respect to the progression of erosive loss, in the presence or absence of the demineralized organic matrix (DOM). One hundred and sixty bovine dentin samples were pre-eroded (0.1% citric acid, pH 2.5, 30 min). Half of the samples were subjected to the DOM removal (collagenase solution, 5 days). Samples with and without the DOM were treated according to the groups (n = 20 with DOM and 20 without DOM/group): TiF4 varnish (2.45% F), NaF varnish (2.45% F), placebo varnish (without fluoride) and control (no treatment). Thereafter, the treated samples were submitted to erosive challenges 4 × 90 s/day (0.1% citric acid, pH 2.5) during 7 days. Between the challenges, the samples were immersed in artificial saliva. The dentin erosive loss was measured using contact profilometry (µm, n = 15). Five dentin samples per group were prepared for energy-dispersive X-ray spectroscopy analysis. Data were compared using 2-way ANOVA/Bonferroni test (p < 0.05). Both fluoride varnishes were effective in reducing the erosive loss progression regardless of the dentin condition when compared to placebo varnish and control groups. Despite the fact that the TiF4 varnish was more effective than the NaF varnish for both dentin conditions (p < 0.001), its effect was significantly reduced in the absence of DOM (p < 0.05). It can be concluded that the TiF4 varnish is the best treatment in reducing the progression of dentin erosive loss (100%) in vitro, but its protective effect is more pronounced in the presence of DOM.

1.
Aguiar YP, dos Santos FG, Moura EF, da Costa FC, Auad SM, de Paiva SM, Cavalcanti AL: Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study. Sci World J 2014;2014:818167.
2.
Buzalaf MA, Hannas AR, Kato MT: Saliva and dental erosion. J Appl Oral Sci 2012a;20:493-502.
3.
Buzalaf MA, Kato MT, Hannas AR: The role of matrix metalloproteinases in dental erosion. Adv Dent Res 2012b;24:72-76.
4.
Comar LP, Cardoso C de A, Charone S, Grizzo LT, Buzalaf MA, Magalhães AC: TiF4 and NaF varnishes as anti-erosive agents on enamel and dentin erosion progression in vitro. J Appl Oral Sci 2015;23:14-18.
5.
Comar LP, Souza BM, Grizzo LT, Buzalaf MAR, Magalhães AC: Sound and demineralised enamel treated with TiF4 in vitro: KOH-soluble fluoride deposition and SEM-EDXS analysis; in 60th Congress of the European Organisation for Caries Research 2013, Liverpool. Caries Res 2013;47:516.
6.
Flury S, Koch T, Peutzfeldt A, Lussi A, Ganss C: The effect of a tin-containing fluoride mouth rinse on the bond between resin composite and erosively demineralised dentin. Clin Oral Investig 2013;17:217-225.
7.
Ganss C, Hardt M, Blazek D, Klimek J, Schlueter N: Effects of toothbrushing force on the mineral content and demineralized organic matrix of eroded dentine. Eur J Oral Sci 2009;117:255-260.
8.
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 2010a;118:376-384.
9.
Ganss C, Klimek J, Schlueter N: Erosion/abrasion-preventing potential of NaF and F/Sn/chitosan toothpastes in dentine and impact of the organic matrix. Caries Res 2014;48:163-169.
10.
Ganss C, Klimek J, Starck C: Quantitative analysis of the impact of the organic matrix on the fluoride effect on erosion progression in human dentine using longitudinal microradiography. Arch Oral Biol 2004;49:931-935.
11.
Ganss C, Neutard L, von Hinckeldey J, Klimek J, Schlueter N: Efficacy of a tin/fluoride rinse: a randomized in situ trial on erosion. J Dent Res 2010b;89:1214-1218.
12.
Ganss C, Schlueter N, Klimek J: Retention of KOH-soluble fluoride on enamel and dentine under erosive conditions - a comparison of in vitro and in situ results. Arch Oral Biol 2007;52:9-14.
13.
Ganss C, Schulze K, Schlueter N: Toothpaste and erosion. Monogr Oral Sci 2013;23:88-99.
14.
Hove L, Holme B, Øgaard B, Willumsen T, Tveit AB: The protective effect of TiF4, SnF2 and NaF on erosion of enamel by hydrochloric acid in vitro measured by white light interferometry. Caries Res 2006;40:440-443.
15.
Hove LH, Holme B, Young A, Tveit AB: The protective effect of TiF4, SnF2 and NaF against erosion-like lesions in situ. Caries Res 2008;42:68-72.
16.
Kato MT, Leite AL, Hannas AR, Calabria MP, Magalhães AC, Pereira JC, Buzalaf MA: Impact of protease inhibitors on dentin matrix degradation by collagenase. J Dent Res 2012;91:1119-1123.
17.
Klimek J, Hellwig E, Ahrens G: Fluoride taken up by plaque, by the underlying enamel and by clean enamel from three fluoride compounds in vitro. Caries Res 1982;16:156-161.
18.
Levy FM, Magalhães AC, Gomes MF, Comar LP, Rios D, Buzalaf MA: The erosion and abrasion-inhibiting effect of TiF(4) and NaF varnishes and solutions on enamel in vitro. Int J Paediatr Dent 2012;22:11-16.
19.
Lussi A, Carvalho TS: The future of fluorides and other protective agents in erosion prevention. Caries Res 2015;49(suppl 1):18-29.
20.
Magalhães AC, Comar LP, Al-Ahj LP, Silva TL, Buzalaf MAR: Synthesis and characterization of hydroxyapatite treated with TiF4 in vitro; in 60th Congress of the European Organisation for Caries Research, 2013, Liverpool. Caries Res 2013;47:515.
21.
Magalhães AC, Kato MT, Rios D, Wiegand A, Attin T, Buzalaf MAR: The effect of an experimental 4% TiF4 varnish compared to NaF varnishes and 4% TiF4 solution on dental erosion in vitro. Caries Res 2008;42:269-274.
22.
Magalhães AC, Levy FM, Rios D, Buzalaf MA: Effect of a single application of TiF4 and NaF varnishes and solutions on dentin erosion in vitro. J Dent 2010;38:153-157.
23.
Magalhães AC, Levy FM, Rizzante FA, Rios D, Buzalaf MA: Effect of NaF and TiF(4) varnish and solution on bovine dentin erosion plus abrasion in vitro. Acta Odontol Scand 2012;70:160-164.
24.
Magalhães AC, Silva MG, Comar LP, Buzalaf MA, Ganss C, Schlueter N: Effect of a single application of TiF4 varnish versus a daily use of low-concentrated TiF4/NaF solution on tooth erosion prevention in vitro. Caries Res 2016;50:462-470.
25.
Magalhães AC, Wiegand A, Rios D, Buzalaf MA, Lussi A: Fluoride in dental erosion. Monogr Oral Sci 2011;22:158-170.
26.
Salas MM, Nascimento GG, Huysmans MC, Demarco FF: Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis. J Dent 2015a;43:42-50.
27.
Salas MM, Nascimento GG, Vargas-Ferreira F, Tarquinio SB, Huysmans MC, Demarco FF: Diet influenced tooth erosion prevalence in children and adolescents: results of a meta-analysis and meta-regression. J Dent 2015b;43:865-875.
28.
Schlueter N, Ganss C, Hardt M, Schegietz D, Klimek J: Effect of pepsin on erosive tissue loss and the efficacy of fluoridation measures in dentine in vitro. Acta Odontol Scand 2007;65:298-305.
29.
Schlueter N, Hara A, Shellis RP, Ganss C: Methods for the measurement and characterization of erosion in enamel and dentine. Caries Res 2011;45(suppl 1):13-23.
30.
Souza BM, Lima LL, Comar LP, Buzalaf MA, Magalhães AC: Effect of experimental mouthrinses containing the combination of NaF and TiF4 on enamel erosive wear in vitro. Arch Oral Biol 2014;59:621-624.
31.
Wiegand A, Attin T: Influence of fluoride on the prevention of erosive lesions - a review. Oral Health Prev Dent 2003;1:245-253.
32.
Wiegand A, Schneider S, Sener B, Roos M, Attin T: Stability against brushing abrasion and the erosion-protective effect of different fluoride compounds. Caries Res 2014;48:154-162.
33.
Zarella BL, Cardoso CA, Pelá VT, Kato MT, Tjäderhane L, Buzalaf MA: The role of matrix metalloproteinases and cysteine-cathepsins on the progression of dentine erosion. Arch Oral Biol 2015;60:1340-1345.
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.