Objective: To evaluate the remineralizing potential of a conventional toothpaste (1,100 ppm F) supplemented with nano-sized sodium hexametaphosphate (HMPnano) in artificial caries lesions in situ. Design: This double-blinded crossed study was performed in 4 phases of 3 days each. Twelve subjects used palatal appliances containing 4 bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned into the following treatment groups: no F/HMP/HMPnano (Placebo); 1,100 ppm F (1100F); 1100F plus 0.5% micrometric HMP (1100F/HMP) and 1100F plus 0.5% nano-sized HMP (1100F/HMPnano). Volunteers were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), so that blocks were treated with natural slurries of toothpastes. After each phase, surface hardness post-remineralization (SH2), integrated recovery of subsurface hardness (ΔIHR), integrated mineral recovery (ΔIMR) and enamel F concentration were determined. Data were submitted to analysis of variance and Student-Newman-Keuls’ test (p < 0.001). Results: Enamel surface became 42% harder when treated with 1100F/HMPnano in comparison with 1100F (p < 0.001). Treatment with 1100F/HMP and 1100F/HMPnano promoted an increase of ∼23 and ∼87%, respectively, in ΔIHR when compared to 1100F (p < 0.001). In addition, ΔIMR for the 1100F/HMPnano was ∼75 and ∼33% higher when compared to 1100F and 1100F/HMP respectively (p < 0.001). Enamel F uptake was similar among all groups except for the placebo (p < 0.001). Conclusion: The addition of 0.5% HMPnano to a conventional fluoride toothpaste was able to promote an additional remineralizing effect of artificial caries lesions.

Keywords:
Dental enamel, Phosphate, Remineralization, Toothpaste, Nano-sized
1.
Afonso RL, Pessan JP, Igreja BB, Cantagallo CF, Danelon M, Delbem AC: In situ protocol for the determination of dose response effect of low-fluoride dentifrices on enamel remineralization. J App Oral Sci 2013; 21: 525–532.
2.
Akabane S, Delbem AC, Pessan J, Garcia L, Emerenciano N, Gonçalves DF, Danelon M: In situ effect of the combination of fluoridated toothpaste and fluoridated gel containing sodium trimetaphosphate on enamel demineralization. J Dent 2018; 68: 59–65.
3.
Alves KM, Pessan JP, Brighenti FL, Franco KS, Oliveira FAL, Buzalaf MAR, Sassaki KT, Delbem AC: In vitro evaluation of the effectiveness of acidic fluoride dentifricies. Caries Res 2007; 41: 263–267.
4.
Bratthal D, Hansel-Petersson G, Sundberg H: Reasons for the caries decline: what do the experts believe?. Eur J Oral Sci 1996; 104: 416–422.
5.
Carey CM: Focus on fluorides: update on the use of fluoride for the prevention of dental caries. J Evid Based Dent Pract 2014; 14: 95–102.
6.
Cochrane NJ, Saranathan S, Cai F, Cross KJ, Reynolds EC: Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride. Caries Research 2008; 42: 88–97.
7.
da Camara DM, Miyasaki ML, Danelon M, Sassaki KT, Delbem AC: Effect of low-fluoride toothpastes combined with hexametaphosphate on in vitro enamel demineralization. J Dent 2014; 42: 256–262.
8.
da Camara DM, Pessan JP, Francati TM, Santos Souza JA, Danelon M, Delbem AC: Synergistic effect of fluoride and sodium hexametaphosphate in toothpaste on enamel demineralization in situ. J Dent 2015; 43: 1249–1254.
9.
da Camara DM, Pessan JP, Francati TM, Souza JA, Danelon M, Delbem AC: Fluoride toothpaste supplemented with sodium hexametaphosphate reduces enamel demineralization in vitro. Clin Oral Investig 2016; 20: 1981–1985.
10.
Dalpaquale G, Delbem AC, Pessan JP, Nunes GP, Gorup LF, Neto FN, de Camargo ER, Danelon M: Effect of the addition of nano-sized sodium hexametaphosphate to fluoride toothpastes on tooth demineralization: an in vitro study. Clin Oral Invest 2017; 21: 1821–1827.
11.
Danelon M, Takeshita EM, Sassaki KT, Delbem AC: In situ evaluation of a low fluoride concentration gel with sodium trimetaphosphate in enamel re-mineralization. Am J Dent 2013; 26: 15–20.
12.
Danelon M, Pessan JP, Neto FN, de Camargo ER, Delbem AC: Effect of toothpaste with nano-sized trimetaphosphate on dental caries: in situ study. J Dent 2015; 43: 806–813.
13.
Danelon M, Pessan JP, Souza-Neto FN, Camargo ER, Delbem AC: Effect of fluoride toothpaste with nano-sized trimetaphosphate on enamel demineralization: an in vitro study. Arch Oral Biol 2017; 78: 82–87.
14.
Delbem AC, Carvalho LP, Morihisa RK, Cury JA: Effect of rinsing with water immediately after APF gel application on enamel demineralization in situ. Caries Res 2005; 39: 258–260.
15.
Delbem ACB, Sassaki KT, Vieira AE, Rodrigues E, Bergamaschi M, Stock SR, et al: Comparison of methods for evaluating mineral loss: hardness versus synchrotron microcomputed tomography. Caries Res 2009; 43: 359–365.
16.
do Amaral JG, Sassaki KT, Martinhon CC, Delbem AC: Effect of low-fluoride dentifrices supplemented with calcium glycerophosphate on enamel deminetalization in situ. Am J Dent 2013; 26: 75–80.
17.
Dowker SE, Elliott JC, Davis GR, Wassif HS: Longitudinal study of the three-dimensional development of subsurface enamel lesions during in vitro demineralization. Caries Res 2003; 37: 237–245.
18.
Dowker SE, Elliott JC, Davis GR, Wilson RM, Cloetens P: Synchrotron X-ray microtomographic investigation of mineral concentrations at micrometer scale in sound and carious enamel. Caries Res 2004; 38: 514–522.
19.
Lynch RJM, Mony U, ten Cate JM: Effect of lesion characteristics and mineralizing solution type on enamel remineralization in vitro. Caries Res 2007; 41: 257–262.
20.
Mellberg JR: Relationship of original mineral loss in carieslike lesions to mineral changes in situ. Caries Res 1991; 25: 459–461.
21.
Queiroz CS, Hara AT, Leme FP, Cury JA: pH-cycling models to evaluate the effect of low fluoride dentifrice on enamel de- and remineralization. Braz Dent J 2008; 19: 21–27.
22.
Rios D, Honorio HM, Magalhaes AC, Delbem AC, Machado MA, Silva SM, Buzalaf MA: Effect of salivary stimulation on erosion of human and bovine enamel subjected or not to subsequent abrasion: an in situ/ex vivo study. Caries Res 2006; 40: 218–223.
23.
Rølla G, Ogaard B, Cruz RA: Clinical effect and mechanism cariostact action of fluoride-containing toothpastes: a review. Int Dent J 1991; 41: 171–174.
24.
Takeshita EM, Castro LP, Sassaki KT, Delbem AC: In vitro evaluation of dentifrice with low fluoride content supplemented with trimetaphosphate. Caries Re 2009; 43: 50–56.
25.
Takeshita EM, Danelon M, Castro LP, Sassaki KT, Delbem AC: Effectiveness of a Toothpaste with low fluoride content combined with trimetaphosphate on dental biofilm and enamel demineralization in situ. Caries Res 2015; 49: 394–400.
26.
van Wazer JR, Campanella DA: Structure and properties of the condensed phosphates. IV. Complex ion formation in polyphosphate solutions. J Am Chem Soc 1950; 72: 655–663.
27.
Weatherell JA, Robinson C, Strong M, Nakagaki, H: Micro-sampling by abrasion. Caries Res 1985; 19: 97–102.
28.
Xu HH, Weir MD, Sun L, Moreau JL, Takagi S, Chow LC, et al: Strong nanocomposites with Ca, PO4 and F release for caries inhibition. J Dent Res 2010; 89: 19–28.
© 2018 S. Karger AG, Basel
2018
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.