Scientific Article Review:
The Potential of Hydroxyapatite Toothpaste to Prevent Root Caries – A pH-Cycling Study
Published In: Clinical, Cosmetic, and Investigational Dentistry
Publication Year: 2021
Study Design
This study utilized an in vitro pH-cycling model, a well-established method for simulating alternating demineralization and remineralization cycles in tooth tissues.
Funding Sources
The study was funded and supported by Dr. Kurt Wolff GmbH & Co. KG, a manufacturer of one of the tested hydroxyapatite-based toothpastes.
PICO Framework - what was studied and how?
Population
Human dentin blocks derived from the roots of extracted teeth.
Intervention
Treatment with 10% hydroxyapatite (HAP) toothpaste.
Comparison
1450 ppm fluoride toothpaste and artificial saliva as control.
Outcomes
Reduction in mineral loss (ΔZ) and percentage inhibition of demineralization.
In Paragraph Form:
This study assessed the effectiveness of 10% hydroxyapatite toothpaste compared to 1450 ppm fluoride toothpaste and artificial saliva in reducing mineral loss in human dentin blocks. The outcomes measured were mineral loss and the percentage inhibition of demineralization, using transverse microradiography.
Inclusion and Exclusion Criteria
Inclusion Criteria
- Extracted human teeth free from structural damage.
- Teeth extracted for orthodontic or impaction reasons.
Exclusion Criteria
- Teeth with visible defects or cracks.
- Teeth showing signs of decay prior to the experiment.
Demographics and Study Design
- Sample Size: 60 dentin blocks (20 per group).
- Intervention Group: 10% hydroxyapatite toothpaste.
- Comparison Groups: 1450 ppm fluoride toothpaste and artificial saliva.
- Regimen: A daily cycle including two 2-minute toothpaste applications, 6 hours of acid exposure, and storage in remineralizing solution for 7 days.
Primary Outcome Variables and Results
Mineral Loss (ΔZ) ± SD (vol%.μm):
- Artificial saliva (control): 1406 ± 223
- Hydroxyapatite toothpaste: 1117 ± 366
- Fluoride toothpaste: 1392 ± 334
Percentage Inhibition of Demineralization (Relative to Control):
- Hydroxyapatite toothpaste: 21%
- Fluoride toothpaste: 6%
Statistical Analysis:
- No statistically significant differences in mineral loss among the groups (ANOVA, Tukey’s HSD).
- Hydroxyapatite toothpaste numerically outperformed fluoride in demineralization inhibition.
Conclusions
Hydroxyapatite toothpaste demonstrated effectiveness in reducing root tissue demineralization and was slightly more effective than 1450 ppm fluoride toothpaste. The findings suggest hydroxyapatite could be a viable fluoride alternative for managing root caries, but further clinical trials are necessary.
Discussion
Strengths
- Employed a standardized pH-cycling model, widely regarded as a reliable in vitro test for evaluating caries prevention strategies.
- Use of transverse microradiography for accurate measurement of mineral loss.
Limitations
- Lack of clinical conditions, such as biofilm presence, limits real-world applicability.
- The study's aggressive acid exposure is not reflective of typical oral environments.
- Limited duration (7 days) for treatment evaluation.
Visual Aids
Simple Chart: Mineral Loss and Inhibition of Demineralization
Treatment Group | Mineral Loss (ΔZ ± SD) | Inhibition (%) |
---|---|---|
Artificial Saliva | 1406 ± 223 | - |
Hydroxyapatite | 1117 ± 366 | 21% |
Fluoride Toothpaste | 1392 ± 334 | 6% |
Citation
Amaechi BT, et al. The Potential of Hydroxyapatite Toothpaste to Prevent Root Caries: A pH-Cycling Study. Clin Cosmet Investig Dent. 2021;13:315-324. https://pubmed.ncbi.nlm.nih.gov/.