Eficácia de dentifrício com tecnologia inovadora para remineralização de lesões iniciais de cárie e erosão: abordagem in vitro e in vivo

Abstract

Objective: To evaluate the effectiveness of dentifrices with innovative technology for remineralization of initial carious lesions and erosion in vitro, and for the ability to retain fluoride in vivo in exposure biomarkers. Materials and methods: For the in vitro model, 60 blocks of bovine enamel were artificially decayed by pH cycling for 6 days, interspersed with exposure to dentifrices: G1- Negative control (NC); G2- Positive control (PC); G3- Daily Regenerator Dentalclean (RDC); G4- Regenerate Enamel Science (RES) and G5- Sensodyne Repair & Protect (SRP). The specimens were subjected to surface microhardness analysis, quantitative analysis of light-induced fluorescence (QLF), to calculate the percentage of surface remineralization (% SMHR) and the percentage of mineral recovery (ΔFRE). The surface morphology of the samples was evaluated using scanning electron microscopy (SEM) and dispersive energy spectroscopy (EDS). The data were analyzed using ANOVA test followed by Tukey, ANOVA of repeated measures and Pearson's correlation (α = 5%). Soon after, some of these enamel blocks (n = 5), were subjected to an erosive challenge, being immersed in 50% citric acid for 2 minutes and evaluated in SEM and EDS. In the randomized crossover clinical trial, 15 subjects used the following toothpaste for one week: G1- Daily Regenerator Dentalclean Neutral (RDCN); G2- Sensodyne Repair & Protect (SRP); G3- Daily Regenerator Dentalclean Acid (RDCA); G4 Colgate Total Daily Repair (CTDR). On the seventh day of use of the toothpaste, the biofilm was collected at 1 and 12 h, and saliva was collected up to 60 min and 12 h after the last brushing. F concentrations were determined using using the facilitated diffusion technique. Saliva results were analyzed by the repeated measures ANOVA test followed by Bonferroni (α= 5%). Area under the curve (AUC) after 1 hour of using the toothpaste was calculated for the saliva data. For biofilm, Wilcoxon test, Friedman test and Bonferroni post-test (α = 5%) were applied. Results: For dental caries (in vitro), the% SMHR values ranged from: 1.8 to 22.8. In ΔFRE, they were in the range of -6.6 to 11.9. The RDC obtained the highest values in both measurements (p<0,05). The morphological analysis showed the formation of a thick mineral layer on the surface of the samples treated with this group. After the erosion challenge, the RDC presented the smoothest surface. In the in vivo study, the highest values of AUC in saliva were for G3, G4, G1 and G2, respectively. For biofilm, in the xii evaluation between the groups and at the same collection time, the G3 group (RDCA) was the one with the highest median values in 1 and 12 hours: 452.90 and 373.60 ppm, respectively; and different from placebo (p <0.05). Conclusion: It is concluded that the Daily Regenerator Dentalclean was the most effective (in vitro) for for remineralization of the carious lesion and protection against erosive challenges. The results of the in vivo model corroborate these findings for the initial lesions of dental caries.