Influence of enamel matrix derivative (Emdogain((R))) and sodium fluoride on the healing process in delayed tooth replantation: histologic and histometric analysis in rats

Although it has already been shown that enamel matrix derivative (Emdogain((R))) promotes periodontal regeneration in the treatment of intrabony periodontal defects, there is little information concerning its regenerative capacity in cases of delayed tooth replantation. To evaluate the alterations in the periodontal healing of replanted teeth after use of Emdogain((R)), the central incisors of 24 Wistar rats (Rattus norvegicus albinus) were extracted and left on the bench for 6 h. Thereafter, the dental papilla and the enamel organ of each tooth were sectioned for pulp removal by a retrograde way and the canal was irrigated with 1% sodium hypochlorite. The teeth were assigned to two groups:in group I, root surface was treated with 1% sodium hypochlorite for 10 min (changing the solution every 5 min), rinsed with saline for 10 min and immersed in 2% acidulated-phosphate sodium fluoride for 10 min; in group II, root surfaces were treated in the same way as described above, except for the application of Emdogain((R)) instead of sodium fluoride. The teeth were filled with calcium hydroxide (in group II right before Emdogain((R)) was applied) and replanted. All animals received antibiotic therapy. The rats were killed by anesthetic overdose 10 and 60 days after replantation. The pieces containing the replanted teeth were removed, fixated, decalcified and paraffin-embedded. Semi-serial 6-mu m-thick sections were obtained and stained with hematoxylin and eosin for histologic and histometric analyses. The use of 2% acidulated-phosphate sodium fluoride provided more areas of replacement resorption. The use of Emdogain((R)) resulted in more areas of ankylosis and was therefore not able to avoid dentoalveolar ankylosis. It may be concluded that neither 2% acidulated-phosphate sodium fluoride nor Emdogain((R)) were able to prevent root resorption in delayed tooth replantation in rats.

Influence of 0.05% sodium fluoride solutions on microhardness of resin-modified glass ionomer cements

This study aimed to evaluate the influence of fluoride-containing mouthrinse solutions (Fluorgard and Oral B) on the superficial microhardness of two resin-modified glass ionomer cements (Vitremer and Fuji II LC). Fifteen discs-shaped specimens of each glass ionomer cement (0 10 mm; 2 mm thick) were prepared, thereby forming two groups. After 24-hour storage in artificial saliva, the microhardness was measure and the data were recorded. Next, each group was divided into three subgroups (n = 5), according to the solution to be immersed in. Control specimens were kept in artificial saliva along the whole experiment. The test specimens were kept in mouthrinse solution for 30 days. Vickers surface microhardness was analyzed at predetermined evaluation periods: 24 h, 48 h, 7, 14, 21 and 30 days after specimens' preparation. Data were subjected to three-way ANOVA and to Tukey test (p < 0.05). A better behavior of Fuji II LC was observed and Fluorgard affected most the characteristics of the tested materials. It may be concluded that fluoride-containing solutions influenced the tested characteristics of materials, mainly of Vitremer.

Immediate replantation of maxillary incisors in rats: effects of tooth immersion in sodium fluoride and subsequent removal of the periodontal ligament.

The advantages and disadvantages of maintaining the periodontal ligament (PDL) in immediate replantation as well as chemical treatment of the root surface have been a matter of discussion because the vitality of such tissue in surgery is always questioned. This study evaluated the effects of conserving the tooth in sodium fluoride and the removal of the PDL before replantation of incisors in rats. There was more cementum-dentin resorption in the group with the PDL. The group without the PDL showed more discreet resorption, repair occurred through the newly formed bone tissue in the PDL space and ankylosis was more extensive than in the group with the PDL.

Delayed tooth replantation after root surface treatment with sodium hypochlorite and sodium fluoride: Histomorphometric analysis in rats

In cases of delayed tooth replantation, non-vital periodontal ligament remnants have been removed with sodium hypochlorite in an attempt to control root resorption. Nevertheless, reports of its irritating potential in contact with the alveolar connective tissue have been described. Therefore, this study evaluated the healing process on delayed replantation of rat teeth, after periodontal ligament removal by different treatment modalities. Twenty-four rats, assigned to 3 groups (n=8), had their upper right incisor extracted and left on the workbench for desiccation during 60 min. Afterwards, the teeth in group I were immersed in saline for 2 min. In group II, root surfaces were scrubbed with gauze soaked in saline for 2 min; and in group III, scrubbing was done with gauze soaked in 1% sodium hypochlorite solution. Thereafter, root surfaces were etched with 37% phosphoric acid and immersed in 2% acidulate-phosphate sodium fluoride solution, at pH 5.5. Root canals were filled with a calcium hydroxide-based paste and the teeth were replanted. The animals were sacrificed 60 days postoperatively and the pieces containing the replanted teeth were processed and paraffin- embedded. Semi-serial transversally sections were obtained from the middle third of the root and stained with hematoxylin and eosin for histomorphometric analysis. Data were analyzed statistically using Kruskal-Wallis and Dunn's tests. The results showed that root structure and cementum extension were more affected by resorption in group III (p<0.05). All groups were affected by root resorption but the treatment performed in group III was the least effective for its control. The treatment accomplished in groups I and II yielded similar results to each other.

Sodium fluoride effect on erosion-abrasion under hyposalivatory simulating conditions

Objectives: To investigate the effect of fluoride (0, 275 and 1250 ppm F; NaF) in combination with normal and low salivary flow rates on enamel surface loss and fluoride uptake using an erosion-remineralization-abrasion cycling model. Design: Enamel specimens were randomly assigned to 6 experimental groups (n = 8). Specimens were individually placed in custom made devices, creating a sealed chamber on the enamel surface, connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min followed by artificial saliva at 0.5 (normal flow) or 0.05 (low flow) ml/min, for 60 min. This cycle was repeated 4×/day, for 5 days. Toothbrushing with abrasive suspensions containing fluoride was performed for 2 min (15 s of actual brushing) 2×/day. Surface loss was measured by optical profilometry. KOH-soluble fluoride and enamel fluoride uptake were determined after the cycling phase. Data were analysed by two-way ANOVA. Results: No significant interactions between fluoride concentration and salivary flow were observed for any tested variable. Low caused more surface loss than normal flow rate (p < 0.01). At both flow rates, surface loss for 0 was higher than for 275, which did not differ from 1250 ppm F. KOH-soluble and structurally-bound enamel fluoride uptake were significantly different between fluoride concentrations with 1250 > 275 > 0 ppm F (p < 0.01). Conclusions: Sodium fluoride reduced enamel erosion/abrasion, although no additional protection was provided by the higher concentration. Higher erosion progression was observed in low salivary flow rates. Fluoride was not able to compensate for the differences in surface loss between flow rates. © 2013 Elsevier Ltd. All rights reserved.

Erosion Protection by Calcium Lactate/Sodium Fluoride Rinses under Different Salivary Flows in vitro

This study investigated the effect of a calcium lactate pre-rinse on sodium fluoride protection in an in vitro erosion-remineralization model simulating two different salivary flow rates. Enamel and dentin specimens were randomly assigned to 6 groups (n = 8), according to the combination between rinse treatments - deionized water (DIW), 12 mm NaF (NaF) or 150 mm calcium lactate followed by NaF (CaL + NaF) and unstimulated salivary flow rates - 0.5 or 0.05 ml/min simulating normal and low salivary flow rates, respectively. The specimens were placed into custom-made devices, creating a sealed chamber on the specimen surface connected to a peristaltic pump. Citric acid was injected into the chamber for 2 min, followed by artificial saliva (0.5 or 0.05 ml/min) for 60 min. This cycle was repeated 4x/day for 3 days. Rinse treatments were performed daily 30 min after the 1st and 4th erosive challenges, for 1 min each time. Surface loss was determined by optical profilometry. KOH-soluble fluoride and structurally bound fluoride were determined in specimens at the end of the experiment. Data were analyzed by 2-way ANOVA and Tukey tests (alpha = 0.05). NaF and CaL + NaF exhibited significantly lower enamel and dentin loss than DIW, with no difference between them for normal flow conditions. The low salivary flow rate increased enamel and dentin loss, except for CaL + NaF, which presented overall higher KOH-soluble and structurally bound fluoride levels. The results suggest that the NaF rinse was able to reduce erosion progression. Although the CaL prerinse considerably increased F availability, it enhanced NaF protection against dentin erosion only under hyposalivatory conditions. (C) 2014 S. Karger AG, Basel

Effect of resin composites with sodium trimetaphosphate with or without fluoride on hardness, ion release and enamel demineralization

Purpose: To evaluate the effect of the addition of sodium trimetaphosphate (TMP) with or without fluoride on enamel demineralization, and the hardness and release of fluoride and TMP of resin composites. Methods: Bovine enamel slabs (4x3x3 mm) were prepared and selected based on initial surface hardness (n= 96). Eight experimental resin composites were formulated, according to the combination of TMP and sodium fluoride (NaF): TMP/NaF-free (control), 1.6% sodium fluoride (NaF), and 1.5%, 14.1% and 36.8% TMP with and without 1.6% NaF. Resin composite specimens (n= 24) were attached to the enamel slabs with wax and the sets were subjected to pH cycling. Next, surface and cross-sectional hardness and fluoride content of enamel as well as fluoride and TNT release and hardness of the materials were evaluated. Data were statistically analyzed using ANOVA (P< 0.05). Results: The presence of fluoride in enamel was similar in fluoridated resin composites (P> 0.05), but higher than in the other materials (P< 0.05). The combination of 14.1% TMP and fluoride resulted in less demineralization, especially on lesion surface (P< 0.05). The presence of TMP increased fluoride release from the materials and reduced their hardness.

In vitro enamel remineralization capacity of composite resins containing sodium trimetaphosphate and fluoride

This study evaluated the in vitro enamel remineralization capacity of experimental composite resins containing sodium trimetaphosphate (TMP) combined or not with fluoride (F). Bovine enamel slabs were selected upon analysis of initial surface hardness (SH1) and after induction of artificial carious lesions (SH2). Experimental resins were as follows: resin C (control-no sodium fluoride (NaF) or TMP), resin F (with 1.6 % NaF), resin TMP (with 14.1 % TMP), and resin TMP/F (with NaF and TMP). Resin samples were made and attached to enamel slabs (n = 12 slabs per material). Those specimens (resin/enamel slab) were subjected to pH cycling to promote remineralization, and then final surface hardness (SH3) was measured to calculate the percentage of surface hardness recovery (%SH). The integrated recovery of subsurface hardness (ΔKHN) and F concentration in enamel were also determined. Data was analyzed by ANOVA and Student-Newman-Keuls test (p < 0.05). Resins F and TMP/F showed similar SH3 values (p = 0.478) and %SH (p = 0.336) and differed significantly from the other resins (p < 0.001). Considering ΔKHN values, resin TMP/F presented the lowest area of lesion (p < 0.001). The presence of F on enamel was different among the fluoridated resins (p = 0.042), but higher than in the other resins (p < 0.001). The addition of TMP to a fluoridated composite resin enhanced its capacity for remineralization of enamel in vitro. The combination of two agents with action on enamel favored remineralization, suggesting that composite resins containing sodium trimetaphosphate and fluoride could be indicated for clinical procedures in situations with higher cariogenic challenges.

Lack of effect of prior treatment with fluoride on genotoxicity of two chemical agents in vitro

The goal of this study was to investigate the ability of fluoride to modulate the genotoxic effects induced by the oxidative agent hydrogen peroxide (H2O2) and the alkylating agent methyl methanesulfonate (MMS) in vitro by the single-cell gel ( comet) assay. Chinese hamster ovary cells were exposed in culture for 1 h at 37 degrees C to sodium fluoride at 7-100 mu g/ml. NaF-treated and control cells were then incubated with 0-10 mu M MMS in phosphate-buffered saline (PBS) for 15 min at 37 degrees C, or 7-100 mu M H2O2 in distilled water for 5 min on ice. Negative control cells were treated with PBS for 1 h at 37 degrees C. Clear concentration-related effects were observed for the two genotoxins. Increase of DNA damage induced by either MMS or H2O2 was not significantly altered by pretreatment with NaF. The data indicate that NaF does not modulate alkylation-induced genotoxicity or oxidative DNA damage as measured by the single-cell gel ( comet) assay. Copyright (c) 2007 S. Karger AG, Basel

No relationship between subchronic fluoride intake and DNA damage in Wistar rats

Fluoride has been widely used in dentistry because it is an effective caries prophylactic agent. However, excess fluoride may represent a hazard to human health, especially by causing injury on the genetic apparatus. Genotoxicity tests form an important part of cancer research and risk assessment of potential carcinogens. In the current study, the potential DNA damage associated with exposure to fluoride was assessed by the single cell gel ( comet) assay in peripheral blood, oral mucosa and brain cells in vivo. Male Wistar rats were exposed to sodium fluoride (NaF) at a 0, 7 and 100 ppm dose for drinking water during 6 weeks. The results pointed out that NaF did not contribute to the DNA damage in all cellular types evaluated as depicted by the mean tail moment and tail intensity. These findings are clinically important since they represent an important contribution to the correct evaluation of the potential health risk associated with dental agents exposure. Copyright (C) 2004 S. Karger AG, Basel.

Absence of DNA damage in multiple organs (blood, liver, kidney, thyroid gland and urinary bladder) after acute fluoride exposure in rats

Fluoride has been widely used in dentistry as a caries prophylactic agent. However, there has been some speculation that excess fluoride could cause an impact on genome integrity. In the current study, the potential DNA damage associated with exposure to fluoride was assessed in cells of blood, liver, kidney, thyroid gland and urinary bladder by the single cell gel (comet) assay. Male Wistar rats aging 75 days were distributed into seven groups: Groups 1 (control), 2, 3, 4, 5, 6 and 7 received 0 (deionized water), 10, 20, 40, 60, 80 and 100 mgF/Kg body weight from sodium fluoride (NaF), respectively, by gastrogavage. These groups were killed at 2 h after the administration of the fluoride doses. The level of DNA strand breaks did not increase in all organs evaluated and at all doses of NaF tested, as depicted by the mean tail moment. Taken together, our results suggest that oral exposure to NaF did not result in systemic genotoxic effect in multiple organs related to fluoride toxicity. Since DNA damage is an important step in events leading to carcinogenesis, this study represents a relevant contribution to the correct evaluation of the potential health risk associated with chemical exposure.

Effect of root surface treatment with propolis and fluoride in delayed tooth replantation in rats

Replantation is an acceptable option for treatment of an avulsed permanent tooth. Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I - teeth immersed in 20 ml of physiologic saline; Group II - teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III - teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation.