Evaluation of the protective effect of fluoride associated to bioadhesive polymer Carbopol in the erosive wear

Author(s)

Daniele Mara da Silva Ávila Nogueira

• Document type: Doctoral Thesis
• Press: São José dos Campos. 2018-08-16.
• Institution: Universidade Estadual Paulista (Unesp). Instituto de Ciência e Tecnologia. São José dos Campos
• Defense date: 2018-07-02
• Advisor: Alessandra Bühler Borges; Tais Scaramucci

Abstract

The protective effect of fluoride against erosion has been related mainly to the formation of calcium fluoride deposits and the adsorption of fluoride ions on the dental surface, so it was hypothesized that the incorporation to the Carbopol 980 polymer could potentiate the protective effect of fluoride solutions in the control of the enamel erosive wear with the formation of a protective film. The proposal was divided in two stages. The first stage consisted of an in vitro study in which the association of Carbopol polymer to sodium fluoride (NaF) and sodium fluoride with tin chloride (NaF + Sn) was tested in the presence of acquired pellicle. The ph stat test was used to test the protective potential of these components isolated or associated, in relation to the dissolution of hydroxyapatite, thus predicting the protective potential of the solutions tested. The remineralizing and protective effect against initial erosion measured by microhardness was investigated. Cylindrical polished bovine enamel specimens (3 mm diameter) was prepared and demineralized with 0.3% citric acid (pH 2.6) for 2 minutes (n=15). The specimens were immersed in human saliva for 2 hours to allow acquired pellicle formation and then, treatment with experimental solutions for 2 minutes were performed [NaF (500 ppm F), NaF + Carbopol (0,1%), NaF + Sn (500 ppm F + 800 ppm Sn), NaF + Sn + Carbopol], deionized water (negative control) and comercial mouthrinse (Elmex – positive control). A new immersion in human saliva (2 h) for remineralization and then new acid challenge were performed. The Knoop microhardness was measured at different times: baseline, after the first acid challenge, after treatments (remineralization potential), and after second acid challenge (protective potential). Additionally, a new immersion in test solutions was conducted for the measurement of alkali-soluble fluoride on enamel surface. ANOVA and Tukey tests were applied (5%). It was observed that the dissolution of hydroxyapatite was lower in the groups treated with NaF + Sn + Carbopol compared to the other groups. This result was also observed with the remineralizing and protective potentials, measured by microhardness. The measurement of alkali-soluble fluoride on enamel surface was also higher to the NaF + Sn + Carbopol association group compared to the other groups. The second stage was an in situ study carried out with the experimental solutions that present the greatest protective potential in the previous in vitro study. For this, polished enamel specimens were divided into three groups (n = 60): NaF + Sn (positive control), NaF + Sn + Carbopol, and deionized water (negative control). An in situ model with three stages was tested. Fifteen volunteers participated in the study. In each phase, volunteers used a palatal appliance containing 4 specimens each, in which two were submitted to an erosion and remineralization cycle for 5 days. This cycle consisted of using the appliance for 2 hours for pellicle formation, followed by extra oral immersion in 1% citric acid (pH 2.3 - 5 minutes - 4x/day) with intervals of 1 hour of in situ saliva exposure between challenges and treatment with the solutions 2x/day for 1 minute. The other two specimens were subjected to erosion/abrasion/remineralization cycle, in which abrasion was performed 2x/day - 15 seconds, with active electric toothbrush, before the daily treatment with the solutions, and erosion/remineralization as previously described. At the end of the experiment, enamel surface loss (µm) was evaluated by profilometry and the data were analyzed by two-way ANOVA and Tukey tests (5%). There were differences between the challenges (erosion and erosion + abrasion), as well as treatments with fluoride solutions were able to protect the enamel against erosive wear, significantly different from the negative control. It can be concluded that for both the in vitro and the in situ study, the association of NaF to Sn, and these to Carbopol, presented promising results reducing the development of erosive wear. (AU)

• FAPESP's process: 15/19585-4 - Evaluation of the protective effect of fluoride associated to bioadhesive polymer carbopol in the development of erosive wear
• Grantee: Daniele Mara da Silva Ávila Nogueira
• Support Opportunities: Scholarships in Brazil - Doctorate