Calcium lactate pre-rinse increased fluoride protection against enamel erosion in a randomized controlled in situ trial

Objectives

This in situ trial study was designed to evaluate whether calcium (Ca) pre-rinse would increase the fluoride (F) rinse protection against enamel erosion.

Methods

Fifteen volunteers participated in this split-mouth, 3-phase, crossover design study wearing a palatal appliance containing four sterilized bovine enamel slabs, for 10 days. In the 1st phase, five participants followed protocol A: daily rinse with a Ca lactate (CaL, 150 mmol/L, 1 min), followed by F (NaF 12 mmol/L, 1 min). Other five participants followed protocol B: daily rinse only with F, while the remainders followed protocol C: no rinse (negative control). Appliances were removed from the mouth and one side of the palatal appliance was exposed to a daily erosive challenge (0.05 M citric acid, 90 s); the other side served as control (deionized water – no erosion). In the 2nd phase volunteers were crossed over to other protocol and in the 3rd phase volunteers received the remaining protocol not yet assigned. Specimens were evaluated for surface loss using an optical profilometer.

Results

Repeated-measures three-way ANOVA (p = 0.009) and Tukey's test showed that CaL pre-rinse followed by NaF rinse significantly decreased surface loss of enamel when performed prior to an erosive challenge in comparison with the condition in which NaF only was used.

Conclusions

Pre-rinse with CaL may increase the protection exerted by NaF against erosive wear.     

Pronamel and tooth mousse: an initial assessment of erosion prevention in vitro

OBJECTIVES: The aim of this study was to examine whether a single topical application of proenamel or tooth mousse would prevent enamel erosion METHODS: Enamel samples were treated with either proenamel or tooth mousse applied for 15 min. The control group was placed in distilled water for 15 min. All specimens were then exposed to an erosive challenge of 0.2% citric acid for 1h. Enamel loss was determined using surfometry. RESULTS: The mean amount of enamel removed in the control group was 5.02 microm (S.D. 1.16). The mean enamel loss in the proenamel group was 2.60 microm (S.D. 0.90) and the mean enamel loss in the tooth mousse group was 3.28 microm (S.D. 1.22). The results for the proenamel group were statistically significantly different from the control group at the p<0.01 level and the results for the tooth mousse group were statistically significantly different from the control group at the p<0.05 level. CONCLUSIONS: Tooth mousse and proenamel may offer a degree of protection from erosion of permanent enamel.     

Effect of mineral supplements to citric acid on enamel erosion

The aim of this study was to evaluate the effect of mineral supplements to citric acid (1%; pH 2.21) on enamel erosion under controlled conditions in an artificial mouth. From each of 156 bovine incisors one polished enamel sample was prepared. The samples were divided among 13 experimental groups (n=12). In group 1 citric acid only was used (control). In groups 2-10 either calcium, phosphate or fluoride in various low concentrations was admixed to the citric acid. In groups 11-13 the citric acid was supplemented with a mixture of calcium, phosphate and fluoride. For demineralisation the specimens were rinsed with the respective solution for 1 min, immediately followed by a remineralisation period with artificial saliva (1 min). The specimens were cycled through this alternating procedure five times followed by rinsing for 8 h with artificial saliva. The de- and remineralisation cycle was repeated three times for each specimen interrupted by the 8 h-remineralisation periods. Before and after the experiments, the specimens were examined using microhardness testing (Knoop hardness) and laser profilometry. Hardness loss and enamel dissolution was significantly higher for the controls as compared to the remaining groups. Significantly lowest hardness loss for all groups was recorded for group 12 with admixture of calcium, phosphate and fluoride to citric acid. The significantly highest enamel loss was recorded for the controls compared to all other samples. Groups 3 and 4 revealed significantly lower and higher tissue loss compared to the remaining groups (2-13), respectively. The other groups did not differ significantly from each other. Modification of citric acid with calcium, phosphate and fluoride exerts a significant protective potential with respect to dental erosion. However, with the low concentrations applied enamel dissolution could not be completely prevented.     

The laboratory assessment of enamel erosion: a review

Objectives. To review the various methods and techniques available to assess enamel erosion in vitro.

Data. Peer reviewed scientific articles.

Sources. Medline and Web of Science searches and manual searching.

Study selection. Laboratory based assessments only included.

Conclusions. A number of macroscopic and microscopic techniques have been used to assess enamel erosion in vitro and in situ. This review examines techniques which are either well established or comparatively novel techniques that are being explored for their potential.     

Calcium glycerophosphate supplemented to soft drinks reduces bovine enamel erosion

Objective

This in vitro study evaluated the effect of calcium glycerophosphate (CaGP) supplemented to soft drinks on bovine enamel erosion.

Material and methods

Four pH-cycles were performed, alternating demineralization by the beverage and remineralization in artificial saliva.

Results

Mean wear (±SD, µm) was 7.91±1.13, 7.39±1.01, 7.50±0.91 and 5.21±1.08 for Coca-Cola^TM without CaGP or containing CaGP at 0.1, 1.0 or 2.0 mM, respectively, while no wear was detected for CaGP at 5.0 and 10.0 mM. Corresponding figures for Sprite Zero^TM without CaGP or containing CaGP at 0.1, 1.0, 2.0, 5.0 or 10.0 mM were 8.04±1.30, 7.84±0.71, 7.47±0.80, 4.96±0.81, 3.99±0.10 and 1.87±0.12, respectively.

Conclusion

Supplementation of both beverages with CaGP seems to be an alternative to reduce their erosive potential.     

Erosion and attrition of human enamel in vitro part II: influence of time and loading

Objectives. To determine the influence of load and time on enamel wear by attrition under neutral and acid environments in vitro.

Methods. Groups of 10 enamel cusp and smooth surface specimens obtained from unerupted third molars were opposed in a wear machine under loads of 200, 400 and 600 g in citric acid at pH 3.2 and in physiological saline at 35 °C for 30 min (2280 wear cycles). The experiment was repeated with a load of 600 g for 10 and 20 min accompanied by 10 taped specimens to measure erosion only. Erosion and attrition of smooth surface specimens was determined by profilometry.

Results. At a load of 600 g attrition in saline increased with time from 7.9 μm (SD 3.7 μm) at 10 min, 10.2 μm (SD 4.8 μm) at 20–25.5 μm (SD 9.1 μm) after 30 min and combined attrition/erosion in citric acid from 1.5 μm (SD 0.4 μm) to 2.5 μm (SD 0.9 μm) to 6.0 μm (SD 3.7 μm). At a fixed time of 30 min, attrition in saline was 5.2 μm (SD 3.6 μm) at 200 g and 8.1 μm (SD 1.5 μm) at 400 g and combined attrition/erosion in citric acid 2.8 μm (SD 1.2 μm) and 3.6 μm (SD 0.7 μm). Comparison between both environments revealed significant differences at fixed load at all time points (p<0.01) and at fixed time between 400 and 600 g (p<0.01).

Conclusions. Load and time significantly influence enamel wear both in acid and neutral conditions but the effects were not linear.     

Erosion and attrition of human enamel in vitro part I: interaction effects

Objective. The aim of the study in vitro was to measure the interplay of attrition and erosion of human enamel under several different pH conditions.

Materials and methods. Cusp and smooth surface enamel specimens were prepared from unerupted human third molar teeth. Cusp and smooth surface specimens opposed each other in a wear machine under a load of 600 g. The machine simulated tooth grinding for 30 min (2280 wear cycles). Six groups of 10 specimens were worn in the following environmental conditions: saline, citric acid at pH values of 3.2, 5.5 or 7.0 and two cycling groups (pH 3.2/saline or saline/pH 3.2). Additionally, 10 smooth surface specimens were exposed to the same fluids without attrition. Tissue loss on smooth surface specimens was determined by profilometry. The worn specimen surfaces were studied by SEM.

Results. Attrition depth in saline and pH 7.0 citric acid was 25.5 μm. At pH 3.2 and 5.5 attrition depths were 6.0 and 4.3 μm, respectively. Cycling in saline/citric acid and vice versa produced attrition depths of 9.2 and 7.9 μm, respectively. In the erosion only specimens lesion depths were 3.0, 1.2 and 0 μm at pH 3.2, 5.5 and 7.0 and saline, respectively. Attrition specimens at pH 7.0 and in saline showed very rough surfaces. At low pH enamel surfaces appeared flat and smooth.

Conclusions. Enamel wear in neutral conditions is significantly higher than in acidic conditions (p<0.05), apparently due to a smoothing effect of erosion on contacting surfaces.     

Effect of an iron mouthrinse on enamel and dentine erosion subjected or not to abrasion: an in situ/ex vivo study

OBJECTIVES: This in situ/ex vivo study evaluated whether a rinse with an iron solution could reduce wear and the percentage of microhardness change of human enamel and dentine submitted to erosion followed by brushing after 1 or 30min. DESIGN: During 2 experimental 5-day crossover phases (wash-out period of 10 days), 10 volunteers wore intraoral palatal devices, with 12 specimens (6 of enamel and 6 of dentine) arranged in 3 horizontal rows (4 specimens each). In one phase, the volunteers immersed the device for 5min in 150mL of cola drink, 4 times a day. Immediately after immersion, no treatment was performed in one row. The other row was brushed after 1min using a fluoride dentifrice and the device was replaced into mouth. After 30min, the remaining row was brushed. In the other phase, the procedures were repeated, but after immersion the volunteers rinsed for 1min with 10mL of a 10mM ferrous sulphate solution. Changes in surface microhardness (%SMH) and wear (profilometry) of enamel and dentine were measured. Data were tested using ANOVA and Tukey's tests (p<0.05). RESULTS: The enamel presented more wear than dentine, under all experimental conditions. The iron solution caused a significant reduction on the %SMH in enamel, and a significant reduction on the wear in dentine, regardless the other conditions. CONCLUSIONS: Rinsing with an iron solution after an erosive attack, followed or not by an abrasive episode, may be a viable alternative to reduce the loss of dental structure.     

Acids with an equivalent taste lead to different erosion of human dental enamel

Objectives

The consumption of acidic soft drinks may lead to demineralization and softening of human dental enamel, known as dental erosion. The aims of this in vitro study were to determine: (i) if different acids with a similar sensorial acidic taste lead to different hardness loss of enamel and (ii) if the fruit acids tartaric, malic, lactic or ascorbic acid lead to less hardness loss of enamel than citric or phosphoric acid when their concentration in solution is based on an equivalent sensorial acidic taste.

Methods

Enamel samples of non-erupted human third molars were treated with acidic solutions of tartaric (TA), malic (MA), lactic (LA), ascorbic (AA), phosphoric (PA) and citric (CA) acids with a concentration that gave an equivalent sensorial acidic taste. The acidic solutions were characterized by pH value and titratable acidity. Atomic force microscopy (AFM) based nanoindentation was used to study the nano mechanical properties and scanning electron microscopy (SEM) was used to study the morphology of the treated enamel samples and the untreated control areas, respectively.

Results

The investigated acids fell into two groups. The nano hardnesses of MA, TA and CA treated enamel samples (group I) were statistically significantly greater (p < 0.05) than the nano hardnesses of PA, AA and LA treated enamel samples (group II). Within each group the nano hardness was not statistically significantly different (p > 0.05). The SEM micrographs showed different etch prism morphologies depending on the acid used.

Significance

In vitro, the acids investigated led to different erosion effects on human dental enamel, despite their equivalent sensorial acidic taste. This has not been reported previously.     

Protection of short-time enamel erosion by different tetrafluoride compounds

OBJECTIVE: This in vitro study aimed to analyse the protective effect of differently concentrated titanium (TiF(4)), zirconium (ZrF(4)) and hafnium (HfF(4)) tetrafluoride on enamel erosion. METHODS: Polished enamel surfaces of 36 bovine crowns were covered with tape leaving 4 enamel windows each 3mm in diameter exposed. The crowns were randomly assigned to six groups (each n=6) and pretreated with 4% TiF(4), 10% TiF(4), 4% ZrF(4), 10% ZrF(4), 4% HfF(4) or 10% HfF(4) for 4 min (first window), 10 min (second window) or 15 min (third window). The fourth window of each crown was not pretreated and served as control. Erosion was performed stepwise with 1% HCl (pH 2) in five consecutive intervals of each 15 s (total 75 s). Enamel dissolution was quantified by colorimetric determination of phosphate release into the acid. For each tooth, cumulative phosphate loss of enamel pretreated with one of the tetrafluoride compounds was calculated as percentage of the respective control and statistically analysed using two-way ANOVA. RESULTS: Enamel erosion was significantly reduced by TiF(4), ZrF(4) and HfF(4) application. Cumulative phosphate loss (mean % of control, 75s erosion) after 4-15 min application was significantly lower for 4% ZrF(4) (7-11%), 10% ZrF(4) (2-6%), 4% HfF(4) (11-9%) and 10% HfF(4) (12-16%) compared to 4% TiF(4) (42-27%) and 10% TiF(4) (54-33%). Only for 4% and 10% TiF(4), phosphate loss decreased with increasing duration of application, but also increased with increasing acid intervals. CONCLUSION: TiF(4), ZrF(4) and HfF(4) might protect enamel against short-time erosion, but protection was more enhanced by ZrF(4) and HfF(4) compared to TiF(4) application overtime.     

Towards quantitative analysis of enamel erosion by focused ion beam tomography

Objectives

The purpose of this work is a proof of concept to introduce a new quantitative 3D-analysis of dental erosion obtained by focused ion beam (FIB) tomography associated with silver nitrate penetration into porosities in etched enamel.

Adhesion to eroded enamel and dentin: systematic review and meta-analysis

ObjectiveThe aim of this systematic review and meta-analysis was to compare the bond strength between eroded and sound permanent enamel and dentin and to assess whether bonding performance (immediate and after aging) differs between etch&rinse and self-etch adhesives and can be improved by surface pretreatment prior to bonding.MethodsElectronic databases (PubMed, Scopus, Embase, Web of Science, CENTRAL, LILACS, BBO) were searched by two reviewers. Random-effect meta-analyses were performed to compare bond strength to sound and eroded dental hard tissues without and with surface pretreatment prior to bonding, respectively. The effect of adhesive mode (etch&rinse vs. self-etch) and aging (immediate vs. aged) was compared using subgroup analyses. Statistical heterogeneity was assessed using Cochran’s Q and I²-statistic. Funnel plots and Egger’s regression intercept tests were used to evaluate publication bias. Quality and risk of bias of included studies were also assessed.ResultsFourty-seven studies (45 in vitro, 2 in situ) were included in the systematic review and meta-analyses. Erosion impairs bond strength to dentin (p < 0.001; mean difference: −10.2 MPa [95%CI: −11.9 to −8.6 MPa]), but not to enamel (p = 0.260). Surface pretreatment measures removing or stabilizing the collagenous matrix can improve dentin bond strength (maximum mean difference: +12.4 MPa). Etch&rinse and self-etch adhesives did not perform significantly different on eroded enamel (p = 0.208) and dentin (p = 0.353). The majority of studies (32 of 47) presented a medium risk of bias.SignificanceData from in vitro and in situ studies showed that erosion impairs dentin bonding of etch&rinse and self-etch adhesives and makes surface pretreatment prior to bonding of composite restorations necessary.     

Effect of fluoride varnish supplemented with sodium trimetaphosphate on enamel erosion and abrasion: An in situ/ex vivo study

Objective

To evaluate the effect of fluoride (F) varnishes supplemented or not with sodium trimetaphosphate (TMP) on enamel erosive wear followed or not by abrasion in situ.

Methods

Ten volunteers were selected and randomly divided into four groups, according to the varnishes tested: placebo (no F or TMP), 5% NaF (positive control), 2.5% NaF and 2.5% NaF/5% TMP. Enamel blocks (n = 4) were mounted in palatal devices and received an application of each test varnish, following a double-blind, crossover protocol. After 6 h, varnishes were completely removed and the blocks were subjected to erosive challenges by ex vivo immersion in citric acid (5 min, 4×/dia, 5 days). Following, half of the blocks were subjected to abrasion by brushing with a placebo dentifrice slurry for 15 s. Enamel wear (μm), surface hardness (SH_f) and cross-sectional hardness (ΔKHN) were assessed after each experimental period. Results were analyzed by ANOVA, Student–Newman–Keuls's test and Pearson correlation coefficient (p < 0.05).

Results

The fluoride varnish supplemented with TMP promoted significantly lower wear and ΔKHN when compared to the other groups after erosive challenges, followed or not by abrasion (p < 0.05). As for (SH_f) the fluoride varnish supplemented with TMP promoted similar results to the 5% NaF product, being significantly higher than the remaining groups after erosive and erosive + abrasive challenges (p < 0.05).

Conclusion

TMP significantly enhanced the effects of F on enamel wear after erosive challenges, followed or not by abrasion.     

Dental erosion in archaeological human remains: A critical review of literature and proposal of a differential diagnosis protocol

ObjectiveAlthough studies of dental wear on archaeological human remains have largely focused on mechanical wear (attrition and abrasion) in the past, chemical wear (erosion) is being increasingly identified as a separate form of wear. This paper aims to review the current state of research and to develop a protocol that may be universally used by biorchaeologists to specifically identify dental erosion.Design and resultsA critical review of literature has been done in order to highlight the issues related to diagnosis of dental erosion in archaeological human remains. The bodies of work based on the analysis of both modern and archaeological dentitions raise their separate problems. In addition to a need to re-evaluate symptoms of dental erosion, notably dentin ‘cupping’, it is apparent that no specific protocol is adapted from medical to archaeological sciences. Authors rather rely on tooth wear indices and photographs of modern clinical cases for diagnosis. Furthermore, the diagenetic chemical alternation has rarely been considered as a bias.ConclusionsHere we suggest a three-step protocol: the primary method is the microscopic identification of dental erosion by SEM, followed by the exclusion of taphonomic aetiology on surrounding bone and soil pH analysis. Archaeologists should also explore possible causative agents of wear using archaeological and historic knowledge about the population being analyzed.     

Effect of sodium,amine and stannous fluoride at the same concentration and different pH on in vitro erosion

Objective

This study aimed to compare the effects 0.5% and 1% sodium, amine and stannous fluoride at different pH on enamel erosion in vitro.

Methods

Bovine enamel samples were submitted to a cyclic de- and remineralisation for 3 days. Each day, the samples were exposed for 120 min to pooled human saliva and subsequently treated with one of the fluoride solutions for 3 min: amine fluoride (AmF, 0.5% and 1% F⁻), sodium fluoride (NaF, 0.5% and 1% F⁻), each at pH 3.9 and 7.0, and stannous fluoride (SnF₂, 0.5% and 1% F⁻), at pH: 3.9. Additionally, two groups were treated with fluoride-free placebo solutions (pH: 3.9 and 7.0) and one group served as control (no fluoridation). Ten specimens each group were inserted in a so-called artificial mouth and eroded six times daily with hydrochloric acid (pH 2.6) for 90 s each intermitted by exposure to artificial saliva (1 h). After 3 days, enamel loss was analyzed profilometrically and evaluated statistically by ANOVA.

Results

Only the acidic 0.5% and 1% SnF₂ and 1% AmF solutions were able to reduce erosive enamel loss significantly, while all other solutions and placebos did not differ significantly from the control. Between the acidic SnF₂ and the 1% AmF solutions no significant differences could be detected.

Conclusion

At the same concentrations, acidic SnF₂ and AmF may be more effective than NaF to protect enamel against erosion.     

Effect of TiF4, ZrF4, HfF4 and AmF on erosion and erosion/abrasion of enamel and dentin in situ

Objective

This in situ study aimed to analyse the impact of different tetrafluorides (TiF₄, ZrF₄ and HfF₄) and AmF on erosion and erosion plus abrasion of enamel and dentin.

Design

Ten volunteers took part in this crossover and double-blind study performed in 8 phases of each 3 days. In each phase, 2 bovine enamel and 2 dentin specimens were fixed in intraoral appliances. One enamel and one dentin sample were pretreated once with TiF₄, ZrF₄, HfF₄ or AmF (all 0.5 M F) for 60 s, while the other samples remained unfluoridated and served as control. Then, all samples were subjected to either erosion only (4 times/day, 90 s) or to erosion and abrasion (2 times/day, 30 s/sample). Toothbrushing abrasion was performed 90 min after the first and last erosion with an electrical toothbrush and fluoridated toothpaste at 1.2 N. After 3 days, enamel and dentin loss was assessed by profilometry (μm) and analysed by repeated measures ANOVA and paired t-test (p < 0.05).

Results

All fluoride solutions reduced enamel and dentin loss significantly compared to the controls. Generally, eroded samples showed less wear than eroded and abraded samples. The protective potential of the fluorides was not significantly different and was only slightly, but mostly not significantly, decreased by abrasion. The protective effect of the fluoride solutions was similar in enamel and dentin.

Conclusion

Tetrafluorides and AmF are able to reduce erosion and erosion plus abrasion in situ and are almost equally effective.     

Suitability of a malachite green procedure to detect minimal amounts of phosphate dissolved in acidic solutions

The study describes the suitability of a colorimetric method (malachite green procedure) for detection of minimal amounts of phosphate (7.3–29.1 mol/L) in different acidic solutions (hydrochloric acid, oxalic acid, maleic acid, perchloric acid, tartaric acid, citric acid, lactic acid and acetic acid) adjusted to pH 2.0. A mixture of the respective phosphate concentrations with distilled water served as control. The experiments were run with ten repeats in series. Assessment of intra- and interassay coefficient of variation and lower limit of quantification revealed that depending on the acid used, the applied method is a reliable and suitable tool to detect and quantify minimal phosphate contents in small samples of acidic solutions that have the potential to cause erosive dental lesions.     

The effect of increasing sodium fluoride concentrations on erosion and attrition of enamel and dentine in vitro

Objectives

To investigate the effect of an aqueous sodium fluoride solution of increasing concentration on erosion and attrition of enamel and dentine in vitro.

Methods

Enamel and dentine sections from caries-free human third molars were polished flat and taped (exposing a 3 mm × 3 mm area) before being randomly allocated to 1 of 5 groups per substrate (n = 10/gp): G1 (distilled water control); G2 (225 ppm NaF); G3 (1450 ppm NaF); G4 (5000 ppm NaF); G5 (19,000 ppm NaF). All specimens were subjected to 5, 10 and 15 cycles of experimental wear [1 cycle = artificial saliva (2 h, pH 7.0) + erosion (0.3% citric acid, pH 3.2, 5 min) + fluoride/control (5 min) + attrition (60 linear strokes in artificial saliva from enamel antagonists loaded to 300 g)]. Following tape removal, step height (SH) in μm was measured using optical profilometry.

Results

When the number of cycles increased the amount of tooth surface loss increased significantly in enamel and dentine after attrition and erosion and for dentine after attrition. Attrition and erosion resulted in greater surface loss than attrition alone after 15 cycles of experimental wear of enamel. 5000 ppm and 19,000 ppm sodium fluoride solutions had a protective effect on erosive and attritional enamel tooth wear in vitro, however no other groups showed significant differences.

Conclusions

The more intensive the fluoride regime the more protection was afforded to enamel from attrition and erosion. However, in this study no such protective effect was demonstrated for dentine.     

Inhibition of tooth erosion by milk containing different fluoride concentrations: An in vitro study

Objectives

This in vitro study assessed the effect of milk containing different fluoride concentrations on tooth erosion.

Methods

Bovine enamel and root dentine specimens were treated with: (1) bovine whole milk with 0 ppm F; (2) 2.5 ppm F; (3) 5 ppm F; (4) 10 ppm F (all after erosion); (5) whole milk with 0 ppm F (before erosion); (6) NaF (0.05% F, positive control, after erosion) or (7) 0.9% NaCl (negative control, after erosion). The specimens were submitted to pH cycles (4× 90 s in soft drink) and treatments for 5 days. The specimens were immersed in the treatment solutions for 1 min (only at the first cycle each day) with further exposition to 1:1 milk:saliva slurry for 10 min. The tooth loss was measured using a contact profilometer and statistically analysed (p < 0.05).

Results

Rinsing with milk before erosive challenge significantly reduced tooth loss compared to negative control (67% and 24% reduction in dentine and enamel loss, respectively) and to milk after erosive challenge, only for dentine. The addition of fluoride to milk also reduced tooth loss compared to negative control, but with no significant differences among fluoride concentrations for enamel and dentine (μm), respectively: 0 ppm (3.63 ± 0.04 and 2.51 ± 0.53), 2.5 ppm F (2.86 ± 0.42 and 1.96 ± 0.47), 5 ppm F (2.81 ± 0.27 and 1.77 ± 0.44), 10 ppm F (2.03 ± 0.49 and 1.68 ± 0.59). There was a negative and significant correlation between [F] and the tooth loss.

Conclusions

Daily rinse with milk containing F is able to reduce both enamel and dentine erosion in vitro.

Clinical significance

Since the prevalence of dental erosion is steadily increasing, rinse with milk or its derivate might be an important strategy to reduce the progression of tooth erosion.     

Erosive cola-based drinks affect the bonding to enamel surface: an in vitro study

Objective

This study aimed to assess the impact of in vitro erosion provoked by different cola-based drinks (Coke types), associated or not with toothbrushing, to bonding to enamel.

Material and Methods

Fifty-six bovine enamel specimens were prepared and randomly assigned into seven groups (N=8): C- Control (neither eroded nor abraded), ERO-RC: 3x/1-minute immersion in Regular Coke (RC), ERO-LC: 3x/1-minute immersion in Light Coke (LC), ERO-ZC: 3x/1-minute immersion in Zero Coke (ZC) and three other eroded groups, subsequently abraded for 1-minute toothbrushing (EROAB-RC, EROAB-LC and EROAB-ZC, respectively). After challenges, they were stored overnight in artificial saliva for a total of 24 hours and restored with Adper Single Bond 2/Filtek Z350. Buildup coronal surfaces were cut in 1 mm² -specimens and subjected to a microtensile test. Data were statistically analyzed by two-way ANOVA/Bonferroni tests (α=0.05). Failure modes were assessed by optical microscopy (X40). The interface of the restorations were observed using Confocal Laser Scanning Microscopy (CLSM).

Results

All tested cola-based drinks significantly reduced the bond strength, which was also observed in the analyses of interfaces. Toothbrushing did not have any impact on the bond strength. CLSM showed that except for Zero Coke, all eroded specimens resulted in irregular hybrid layer formation.

Conclusions

All cola-based drinks reduced the bond strength. Different patterns of hybrid layers were obtained revealing their impact, except for ZC.