Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial

Dental products containing calcium phosphate and fluoride are claimed to enhance enamel remineralization over fluoride products.

Objectives

To compare remineralization of enamel subsurface lesions by dental products with added calcium phosphate in a double-blind, randomized, cross-over in situ study.

Methods

Human enamel specimens with subsurface lesions were prepared and inserted into intra-oral appliances worn by volunteers. A slurry (1 g product plus 4 ml H₂O) of each product was rinsed for 60 s, 4 times per day for 10 days. Six products were tested (i) placebo, (ii) 1000 ppm F, (iii) 5000 ppm F, (iv) Tooth Mousse (TM), (v) TM plus 900 ppm F (TMP) and (vi) Clinpro with 950 ppm F. Calcium, inorganic phosphate and fluoride levels were measured in post-rinse/saliva samples using ion chromatography. Mineral content was measured using transverse microradiography.

Results

Only TM and TMP significantly increased salivary calcium and phosphate levels. The products produced remineralization in the following order from lowest to highest: placebo < 1000 ppm F = Clinpro < 5000 ppm F < TM < TMP.

Conclusion

Clinpro was not significantly different to 1000 ppm F whereas TM and TMP were superior to 5000 ppm F with TMP producing the highest level of enamel lesion remineralization.