Remineralisation of enamel erosive lesions by daily-use fluoride treatments: network meta-analysis of an in situ study set

Date
2024-12-26
Language
American English
Embargo Lift Date
Committee Members
Degree
Degree Year
Department
Grantor
Journal Title
Journal ISSN
Volume Title
Found At
Springer
Can't use the file because of accessibility barriers? Contact us with the title of the item, permanent link, and specifics of your accommodation need.
Abstract

Objectives: Daily-use fluoride products are first-line protection against enamel wear from dietary-acid exposure (DAE). This study aimed to understand effects of fluoride concentration, fluoride salt, product form and ingredients in daily-use products on remineralisation and demineralisation, via network meta-analysis (NMA) of 14 studies using one well-established in-situ model. Remineralisation (surface-microhardness recovery, SHMR) after treatment, and protection against subsequent demineralisation (acid-resistance ratio, ARR) were measured.

Materials and methods: Healthy participants, wearing intra-oral palatal appliances holding enamel specimens eroded with standardised DAE, used test products once. Enamel hardness was assessed (Knoop microhardness probe) pre-DAE; post-DAE; after 4 h intra-oral remineralisation; and after post-remineralisation DAE. NMA was performed using a mixed-models approach on subject-level data to estimate and compare means.

Results: There was a dose-response for fluoride ion in toothpastes (0-1426ppm F; p < 0.001 for SMHR and ARR). One toothpaste (silica-based, 1150ppm F as NaF) showed a benefit for SMHR versus placebo [mean(standard error)]: 8.8%(0.6%) (33.0% vs. 24.2%; p < 0.001); for ARR: 0.27(0.03) (0.43 vs. 0.15; p < 0.001; 9 mutual studies). Use of fluoride mouthwash after fluoride toothpaste increased SMHR [2.4%(1.1%); p = 0.043; 3 studies]; the effect on ARR [0.08(0.05)] was not significant (p = 0.164). Negative effects of polyvalent metal ions and polyphosphates on SMHR (p < 0.05) were observed.

Conclusions: NMA proved effective in discriminating between fluoride-based treatments in this in-situ study, highlighting the importance of fluoride ion to enamel protection and showing formulation ingredients can affect its performance.

Clinical relevance: Daily-use fluoride products can protect enamel against dietary acids, but careful formulation is required for optimal performance.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Creeth J, Smith G, Franks B, Hara A, Zero D. Remineralisation of enamel erosive lesions by daily-use fluoride treatments: network meta-analysis of an in situ study set. Clin Oral Investig. 2024;29(1):28. Published 2024 Dec 26. doi:10.1007/s00784-024-06107-1
ISSN
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
Clinical Oral Investigations
Source
PMC
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Final published version
Full Text Available at
This item is under embargo {{howLong}}