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

Autor: Creeth J; Haleon PLC, St George's Avenue, Weybridge, KT13 0DE, UK. Jon.e.creeth@haleon.com., Smith G; Haleon PLC, St George's Avenue, Weybridge, KT13 0DE, UK., Franks B; Haleon PLC, St George's Avenue, Weybridge, KT13 0DE, UK., Hara A; Oral Health Research Institute, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis, IN, 46202-2876, USA., Zero D; Oral Health Research Institute, Indiana University School of Dentistry, 415 Lansing Street, Indianapolis, IN, 46202-2876, USA.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2024 Dec 26; Vol. 29 (1), pp. 28. Date of Electronic Publication: 2024 Dec 26.
DOI: 10.1007/s00784-024-06107-1
Abstrakt: 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.
Competing Interests: Declarations. Competing interests: J.C., G.S. and B.F. are employees of Haleon plc, the manufacturers of the Pronamel and Aquafresh products tested in this work. The studies included in this manuscript were sponsored and funded by Haleon plc, formerly GlaxoSmithKline Consumer Healthcare. A.H. and D.Z. are faculty at the Indiana University School of Dentistry, Oral Health Research Institute, which has received funding from Haleon/GlaxoSmithKline Consumer Healthcare. A.H. and D.Z. have received compensation from Haleon/GSK Consumer Healthcare as consultants in the past. Conflict of interest: J.C., G.S. and B.F. are employees of Haleon plc, the manufacturers of the Pronamel and Aquafresh products that were tested in this work. The studies included in this manuscript were sponsored and funded by Haleon plc, formerly GlaxoSmithKline Consumer Healthcare. A.H. and D.Z. are faculty at the Indiana University School of Dentistry, Oral Health Research Institute, which has received funding from Haleon/GlaxoSmithKline Consumer Healthcare. A.H. and D.Z. have received compensation from Haleon/GSK Consumer Healthcare as consultants in the past. Ethics approval: All studies except one were performed at the Oral Health Research Institute at the Indiana University School of Dentistry. These studies obtained ethical approval from the Indiana University Institutional Review Board. The remaining study (code name RH02535, see Table 1) was performed at Intertek Clinical Research Services Ltd, Ellesmere Port, UK. This study obtained ethical approval from the North West-Liverpool Central Research Ethics Committee. Consent: All participants in all studies included in this meta-analysis freely gave written informed consent to take part in the study/studies in which they participated. Consent for publication is not applicable.
(© 2024. The Author(s).)
Databáze: MEDLINE
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