Pharmacokinetic aspects of topical fluorides

Pharmacokinetic studies have revealed quantitative information about the bioavailability, rate of absorption, distribution, and clearance of fluoride following the use of fluoride-containing dentifrices, gels, varnishes, and solutions. It is concluded that following the use of topical fluoride products, variable amounts of fluoride are swallowed and absorbed into the systemic circulation--amounts which may be sufficient to produce acute or chronic side-effects. Pharmacokinetic data should, therefore, form part of the basis for the optimal and safe use of fluoride products. In addition, there is a need for future research to determine the kinetics of fluoride in the oral fluids after the application of topical fluoride agents and to determine the associated changes in the composition of the mineral components of the oral fluids.     

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本文主要对专业人员使用的局部用氟措施的适应证、应用方法和频率、临床效果进行回顾。专业人员使用的局部用氟措施通常在口腔临床和社区口腔健康项目中应用,其主要适用于高龋危险性的儿童、青少年和成年人。应用频率取决于个体对龋的敏感性,一般推荐每半年应用1次。氟化凝胶、泡沫和含氟涂料都能有效预防儿童乳、恒牙龋的发生,但对6岁以下儿童不推荐使用氟化凝胶。另外高浓度含氟涂料还具有明显抗牙本质敏感的作用。     

Comparison of preferences in lip position using computer animated imaging.

The objectives of this study were to examine the esthetic preferences of lip position in males and females, and to compare them with each other and with a common orthodontic standard using a custom computer animation program. The sample consisted of 53 young adult subjects, 25 males and 28 females. The sample was divided into orthodontically treated and untreated subjects. ANOVA and Scheffé tests were carried out to determine differences between the responses of the various groups. Also, t-tests were used to compare subjects' responses to a commonly used orthodontic standard (Ricketts' E-line). The results indicated a sex-effect, with females preferring fuller lips than males. Significant differences were also found between orthodontically treated subjects and untreated subjects, with untreated subjects preferring fuller lips. Differences were significant at p<0.05. Furthermore, both males and females preferred lip fullness greater than the Ricketts' values.     

Current status of professionally applied topical fluorides

Abstract – The literature was reviewed to establish the current effectiveness of professionally applied topical fluorides in the prevention of dental caries and to determine the risk of chronic and acute fluoride ingestion from their use. Use of professionally applied topical fluorides by moderate to high risk children and adults is supported by existing research. Although many of the studies are dated, there is sufficient evidence to support their continued use. Professionally applied topical fluorides are not a risk factor for dental fluorosis. though they have been implicated in acute reactions. The precautions needed to minimize fluoride intake are discussed.     

Use of professionally administered topical fluorides in Asia

Professionally applied topical fluoride varnish, gel, and solution have been shown to be effective in preventing and in arresting dental caries. Their use in different countries in Asia varies greatly and may not correlate with the dental caries situation of the populations in the countries. In the higher-income countries, use of fluoride varnish and gel is common among dental professionals. In contrast, the use of professionally administered topical fluorides is not common in the lower-income countries. Fluoride varnish, being easy to apply and safe, has been the preferred agent for the prevention of early childhood caries, which is prevalent in many developing countries in Asia. The relatively high cost of professionally administered fluoride agents and the shortage of a dental workforce, especially in lower income countries, have hampered the widespread adoption of these effective caries prevention methods in the private and public dental services. Government health policies should be pursued to lower the cost of treatment, either through incentives for local production and/or elimination of taxes and tariffs on imported fluoride products.     

In vitro effect of topical fluorides on sealant materials.

The purpose of this study was to determine by visual inspection and by scanning electron microscopy (SEM) whether commercially available, topical, acidulated phosphate fluoride (APF) and neutral sodium fluoride (NaF) agents cause surface roughening of five sealant materials: two unfilled resins, two filled resins, and one glass-ionomer material. In addition, the effect of treatment with 1.23% APF and sonification on weight of an unfilled and a filled sealant was compared to treatment with controls. Unfilled sealants exhibited no surface changes visually or on micrographs following any treatment. Filled sealants and the glass-ionomer sealant exhibited visually apparent changes depending on the treatment. SEM inspection of filled sealants with visually apparent changes showed loss of filler particles whereas the glass-ionomer sealant exhibited apparent destruction both of the matrix and the filler particle. No significant differences in weight were found between sonicated and unsonicated specimens. However, significant loss of weight was found with filled sealant specimens, but not unfilled sealant specimens, treated with 1.23% APF gel as compared with the specimens treated with water. The results of this in vitro study indicate that preventive therapies that combine use of topical fluorides and sealants may cause deterioration of filled sealants and glass-ionomer sealant material, but not unfilled sealants.     

Brushing abrasion of eroded bovine enamel pretreated with topical fluorides

Topical fluorides have been proposed for the prevention of erosive dental wear. This study evaluated the in vitro effect of a single professional application of 4% titanium tetrafluoride (TiF4), 1% amine fluoride (AmF) and 0.1% difluorosilane varnish (FV) in preventing wear due to combined erosion and brushing abrasion. One hundred and eight bovine enamel samples were used. Control groups were not pretreated with any product (C), pretreated with a fluoride-free varnish (FV-bl) or pretreated with fluoride varnish and subsequently submitted to varnish removal (FV-r). Wear was modeled by submitting the fluoride-treated and control groups to 3 cycles of the following regimens: erosion/remineralization (er/remin), abrasion/remineralization (abr/remin) or erosion/abrasion/remineralization (er/abr/remin). Erosion was simulated by immersion of the samples for 10 min in citric acid 50 mM (pH 3). Abrasion was carried out for 1 min (200 strokes, load 150 g) in a wear device. Remineralization (2 h artificial saliva) took place between the cycles. Two-way ANOVA showed that there was a significant interaction (p相似文献   

A community-based caries control program for pre-school children using topical fluorides: 18-month results.

Dental caries in Chinese pre-school children is common, and restorative treatment is not readily available. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. We divided 375 children (aged 3-5 yrs) with carious upper anterior teeth into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). NaF varnish (22,600 ppm F) was applied every three months onto the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. We followed 341 children for 18 months. The mean numbers of new caries surfaces in the five groups were 0.4, 0.4, 0.8, 0.6, and 1.2, respectively (p = 0.001). The respective mean numbers of arrested carious tooth surfaces were 2.8, 3.0, 1.7, 1.5, and 1.0 (p < 0.001).     

Effect of topical fluorides and citric acid on heat-pressed all-ceramic material

The effects of citric acid and acidulated phosphate fluoride on the surface roughness of autoglazed and overglazed all-ceramic IPS Empress materials were analyzed. Atomic force microscopy was used to measure the roughness. Citric acid solution (2.00%) was applied for 8 hours, simulating 2 years of exposure. Acidulated phosphate fluoride gel (1.23%) was applied for 32 minutes, simulating 2 years of fluoride therapy. Acidulated phosphate fluoride caused a significant roughening effect on both autoglazed and overglazed specimens.     

Dentist use patterns for pit and fissure sealants and topical fluorides

A survey of 2,800 general dentists from six licensing regions was conducted to determine the current rate of pit and fissure sealants and topical fluoride use. The response rate was 56 percent. Seventy percent of general dentists used sealants on newly erupted secondary teeth and 20 percent of general dentists had never used sealants. Sixty-five percent of general dentists used topical fluorides on pedodontic patients at six-months intervals and 25 percent used them at one-year intervals. Dentists with more frequent use of sealants tended to be recent graduates who used new procedures, spent more practice time in pedodontics, came from the central region, had a hygienist in their practice, and belonged to the Academy of General Dentistry. Dentists with more frequent use of topical fluorides tended to perform frequent recall examinations. Those who performed frequent recall examinations were more likely to come from Florida and the Southeast, to believe caries spread rapidly, to be recent graduates, and to have a greater percentage of patients with insurance.