Erosion protection with hydroxylapatite –

remineralization of tooth enamel defects

introduction

Tooth erosion is the acid-induced breakdown of tooth enamel. The acids here do not come from microorganisms, but either extrinsically from food or, in patients with bulimia or reflux disease, from the stomach. In both cases, permanent exposure of the teeth to these acids leads to an increased breakdown of the tooth enamel. The saliva is no longer able to repair these defects, the equilibrium is shifted towards demineralization. The buffering effect of the saliva is also eliminated, so that the tooth enamel is gradually lost. This often results in exposed tooth necks and consequently hypersensitive teeth. In addition to a change in diet, a dental and oral care product that supports the saliva is recommended.

Question

How good is the erosion protection and the remineralization potential of a hydroxyapatite toothpaste in comparison with commercially available products?

material and methods

For this in vitroStudy, 50 tooth enamel samples were divided into a total of five groups: (i) erosion, without toothpaste, (ii) erosion, fluoride-free toothpaste, (iii) erosion, fluoride toothpaste, (vi) erosion, hydroxyapatite toothpaste, (v) erosion, hydroxyapatite toothpaste with zinc PCA. The erosion was induced with cola for 2 min. The erosion was induced a total of four times, namely after 0, 8, 24 and 32 hours. The dental care products were applied to the enamel samples after the acid treatment. These were left on the teeth for 3 minutes and then washed off with distilled water. Between the treatments, the teeth were stored in artificial saliva. The surface hardness (Vickers hardness) of the samples was measured at the beginning (0 hours) and after the end of the series of samples (32 hours).

Results

The Vickers hardness is a measure of the remineralization of the tooth enamel. The greatest increase after erosion was seen in (iv) hydroxyapatite toothpaste and (v) hydroxyapatite toothpaste with zinc PCA. The fluoride toothpaste (iii) and toothpaste without fluoride (ii) followed in order. The differences were not statistically significant. Conclusion Hydroxyapatite toothpastes remineralize the teeth and harden the tooth enamel after acid erosion better than the other dental care products tested.

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Figure: Etched tooth enamel and tooth enamel after application with Nordic Smile (a protective layer can be seen)

conclusion

Hydroxyapatite toothpastes remineralize the teeth and harden the tooth enamel after acid erosion better than the other dental care products tested.