Re- and demineralization characteristics of dentin depending on fluoride application and baseline characteristics in situ.

Wierichs, R.J.; Musiol, J; Erdwey, D; Esteves-Oliveira, M; Apel, C; Meyer-Lueckel, Hendrik (2020). Re- and demineralization characteristics of dentin depending on fluoride application and baseline characteristics in situ. Journal of dentistry, 94(103305), p. 103305. Elsevier Science 10.1016/j.jdent.2020.103305

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OBJECTIVES

The aim of this double-blinded, randomized, cross-over in situ study was to evaluate the re- and demineralization characteristics of sound dentin as well as highly and lowly demineralized dentin after the application of different fluoride concentrations.

METHODS

In each of four experimental legs of four weeks 20 participants wore intraoral mandibular appliances containing two (highly demineralized [EH]) bovine enamel and four (lowly and highly demineralized [DL,DH]) bovine dentin specimens (n = 480). Each specimen included one sound (ST) and one demineralized lesion area (DT). The four randomly allocated treatments included the following dentifrices: fluoride-free, zinc-carbonate-nano-hydroxyapatite [nHA0], 0 ppm F- [negative control,NaF0], 1100 ppm F- as NaF [standard therapy,NaF1100] and 5000 ppm F- as NaF [positive control,NaF5000]. Differences in integrated mineral loss (ΔΔZ) and lesion depth (ΔLD) were calculated between values before and after the in situ period using transversal microradiography.

RESULTS

After the in situ period specimens of nHA0 and NaF0 showed signs of demineralization, indicated by significantly lower ΔZ&LD values for EH and DL (only nHA0)(p ≤ 0.028), whereas specimens of NaF1100 and NaF5000 showed signs of remineralization, indicated by significantly higher ΔZ values for EH (only NaF5000), DL and DH (p ≤ 0.012). The correlation between ΔΔZDT/ΔΔZST and F- was moderate for EH(rDT = 0.497;rST = 0.463) and DL(rDT = 0.575;rST = 0.598) and strong for DH(rDH = 0.700;rST = 0.611)(p < 0.001). No significant differences for ΔΔZDT/ΔΔZST were observed between nHA0 and NaF0(p ≥ 0.333;ANCOVA).

CONCLUSION

The present in situ model was capable to reveal a fluoride dose-response on sound, lowly and highly demineralized dentin and also enamel specimens. Furthermore, both fluoride-free dentifrices, one containing nanohydroxyapatite, did not hamper demineralization.

CLINICAL SIGNIFICANCE

The present in situ model was capable to reveal a fluoride dose-response on dentin similar to the anticipated clinical efficacy. Highly demineralized specimens seem to be recommendable for measuring anti-caries effects on dentin in situ. Furthermore both fluoride-free dentifrices, one containing nanohydroxyapatite, did not hamper demineralization. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00011653).

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