In Vitro Comparison of the Fluoride Ion Release from the First- and Second-Generation Fluoride Varnishes

Fluoride varnishes, both the first and the second generations, are effective in inhibiting caries, especially in children and adolescents, by reducing it on average by 43% for permanent teeth and 37% for deciduous teeth. The aim of this study was to evaluate the dynamics of in vitro fluoride ion release from first(Duraphat) and second-generation (MI Varnish and Embrace Varnish) fluoride varnishes and the impact of the type of varnish, the time from its application and the pH of the environment on this process. Materials and methods: The test material (90 specimens), prepared from extracted human teeth, were divided into nine groups of 10 specimens each. Measured amounts of the examined varnishes were applied onto specimens and the levels of fluoride release were assessed at the baseline and after 1, 2, 24, 48 and 168 h from the application with the use of an ion-specific electrode. The specimens were immersed into artificial saliva with pH adjusted to 4, 5 and 7. The highest cumulative release of fluoride was obtained by MI Varnish (11.52 ppm/mg), regardless of the pH of the environment, whereas the lowest released fluoride concentration was achieved by Embrace Varnish (4.82 ppm/mg). In the acidic environment, the release of fluoride was significantly higher than in the neutral environment for all investigated varnishes, with no change in the overall fluoride release profile and with maximum fluoride release in the first two hours after application. The findings of this study indicate that all examined fluoride varnishes released the maximum amount of fluoride within the first hours after application and that it was related to the acidity of the immersion medium.

[1]  Wojciech Zakrzewski,et al.  The Safety of Fluoride Compounds and Their Effect on the Human Body—A Narrative Review , 2023, Materials.

[2]  A. El-Housseiny,et al.  Fluoride Varnishes for Preventing Occlusal Dental Caries: A Review , 2021, Dentistry journal.

[3]  S. C. Möhlhenrich,et al.  Fluoride Ion Release Characteristics of Fluoride-Containing Varnishes—An In Vitro Study , 2021, Applied Sciences.

[4]  M. Erkmen Almaz,et al.  Antibacterial activity of fluoride varnishes containing different agents in children with severe early childhood caries: a randomised controlled trial , 2020, Clinical Oral Investigations.

[5]  J. Simmer,et al.  How Fluoride Protects Dental Enamel from Demineralization , 2020, Journal of International Society of Preventive & Community Dentistry.

[6]  A. Tappuni,et al.  A comparative evaluation of ion release characteristics of three different dental varnishes containing fluoride either with CPP-ACP or bioactive glass. , 2019, Dental materials : official publication of the Academy of Dental Materials.

[7]  K. Siralertmukul,et al.  Fluoride varnish containing chitosan demonstrated sustained fluoride release. , 2019, Dental materials journal.

[8]  Yuxing Bai,et al.  Effects of Fluoride and Calcium Phosphate Materials on Remineralization of Mild and Severe White Spot Lesions , 2019, BioMed research international.

[9]  T. Jackowska,et al.  Individualised caries prevention with fluoride in children and adolescents – recommendations of Polish experts , 2019, Nowa Stomatologia.

[10]  M. Pithon,et al.  Effectiveness of casein phosphopeptide-amorphous calcium phosphate-containing products in the prevention and treatment of white spot lesions in orthodontic patients: A systematic review. , 2019, Journal of investigative and clinical dentistry.

[11]  M. El Tantawi,et al.  Comparison of remineralization by fluoride varnishes with and without casein phosphopeptide amorphous calcium phosphate in primary teeth , 2018, Acta odontologica Scandinavica.

[12]  S. Hekmatfar,et al.  In vitro Comparison of Antimicrobial Activity of Conventional Fluoride Varnishes Containing Xylitol and Casein Phosphopeptide-Amorphous Calcium Phosphate , 2018, Journal of International Society of Preventive & Community Dentistry.

[13]  KL Girish Babu,et al.  Remineralization potential of varnish containing casein phosphopeptides-amorphous calcium phosphate with fluoride and varnish containing only fluoride: A comparative study , 2018 .

[14]  U. Kaczmarek,et al.  Fluoride release from fluoride varnish under in vitro and in vivo conditions , 2017 .

[15]  C. Yiu,et al.  Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions , 2017, International journal of paediatric dentistry.

[16]  N. J. Coleman,et al.  A 12-Week Assessment of the Treatment of White Spot Lesions with CPP-ACP Paste and/or Fluoride Varnish , 2016, BioMed research international.

[17]  F. Ozer,et al.  Effect of fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate on the acid resistance of the primary enamel , 2016, BMC oral health.

[18]  E. Reynolds,et al.  Effect of calcium phosphate addition to fluoride containing dental varnishes on enamel demineralization. , 2016, Australian dental journal.

[19]  Shalin Shah,et al.  Comparative evaluation of application of different fluoride varnishes on artificial early enamel lesion: An in vitro study , 2016, Indian journal of dental research : official publication of Indian Society for Dental Research.

[20]  E. Martinez-Mier,et al.  The effect of fluoride varnishes on caries lesions: an in vitro investigation , 2016, Clinical Oral Investigations.

[21]  P. Poornima,et al.  Comparative Evaluation of Longevity of Fluoride Release From three Different Fluoride Varnishes - An Invitro Study. , 2016, Journal of clinical and diagnostic research : JCDR.

[22]  S. Angelova,et al.  Clinical Study Remineralization Effect of Mineralization Varnish , 2016 .

[23]  M. Lennon,et al.  Fluoride and Oral Health. , 2016, Community dental health.

[24]  J. Clarkson,et al.  Fluoride Varnish for Caries Prevention: Efficacy and Implementation , 2016, Caries Research.

[25]  M. Borysewicz-Lewicka,et al.  Consensus statement of Polish experts on individual caries prevention with fluoride in children and adolescents , 2016 .

[26]  M. Mei,et al.  Caries remineralisation and arresting effect in children by professionally applied fluoride treatment – a systematic review , 2016, BMC oral health.

[27]  Lori E Henrichs,et al.  Substantive Fluoride Release from a New Fluoride Varnish Containing CXP , 2015 .

[28]  C. Llena,et al.  CPP-ACP and CPP-ACFP versus fluoride varnish in remineralisation of early caries lesions. A prospective study. , 2015, European journal of paediatric dentistry.

[29]  E. Kidd,et al.  Dental Caries: The Disease and its Clinical Management , 2015 .

[30]  M. Vossoughi,et al.  Efficacy of Fluoride Varnish and Casein Phosphopeptide-Amorphous Calcium Phosphate for Remineralization of Primary Teeth: A Randomized Clinical Trial , 2015, Medical Principles and Practice.

[31]  F. Lippert Fluoride release from fluoride varnishes under acidic conditions. , 2014, The Journal of clinical pediatric dentistry.

[32]  C. Carey Focus on fluorides: update on the use of fluoride for the prevention of dental caries. , 2014, The journal of evidence-based dental practice.

[33]  M. Buzalaf,et al.  Evaluation of fluoride release from experimental TiF4 and NaF varnishes in vitro , 2014, Journal of applied oral science : revista FOB.

[34]  D. Elkassas,et al.  Remineralizing efficacy of different calcium-phosphate and fluoride based delivery vehicles on artificial caries like enamel lesions. , 2014, Journal of dentistry.

[35]  E. Reynolds,et al.  Ion release from calcium and fluoride containing dental varnishes. , 2014, Australian dental journal.

[36]  H. Worthington,et al.  Fluoride varnishes for preventing dental caries in children and adolescents. , 2013, The Cochrane database of systematic reviews.

[37]  Agnieszka Mielczarek,et al.  The effect of selected fluoride products on microstructure of early caries lesions , 2013 .

[38]  N. Vimala,et al.  Protective potential of casein phosphopeptide amorphous calcium phosphate containing paste on enamel surfaces , 2013, Journal of conservative dentistry : JCD.

[39]  Tao Xu,et al.  Fluoride release and anti-erosive effects of dentifrices containing PVM/MA copolymers. , 2013, Journal of dentistry.

[40]  J. Hagan,et al.  Evaluation of short-term fluoride release from fluoride varnishes. , 2012, The Journal of clinical pediatric dentistry.

[41]  Xuedong Zhou,et al.  Remineralization effects of casein phosphopeptide-amorphous calcium phosphate crème on artificial early enamel lesions of primary teeth. , 2011, International journal of paediatric dentistry.

[42]  E. Reynolds,et al.  New Approaches to Enhanced Remineralization of Tooth Enamel , 2010, Journal of dental research.

[43]  V. Marinho Cochrane reviews of randomized trials of fluoride therapies for preventing dental caries , 2009, European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry.

[44]  E. Reynolds,et al.  Casein Phosphopeptide-Amorphous Calcium Phosphate: The Scientific Evidence , 2009, Advances in dental research.

[45]  Lucineide de Melo Santos,et al.  In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth. , 2009, Brazilian oral research.

[46]  E. Reynolds,et al.  Calcium phosphate-based remineralization systems: scientific evidence? , 2008, Australian dental journal.

[47]  A. Azarpazhooh,et al.  Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review. , 2008, Journal.

[48]  K. Cross,et al.  Casein phosphopeptides in oral health--chemistry and clinical applications. , 2007, Current pharmaceutical design.

[49]  얀-페터 미트볼렌,et al.  Pharmaceutical formulation for producing rapidly disintegrating tablets , 2006 .

[50]  T. Attin,et al.  Deposition of fluoride on enamel surfaces released from varnishes is limited to vicinity of fluoridation site , 2006, Clinical Oral Investigations.

[51]  J. Featherstone,et al.  Salivary fluoride levels following application of fluoride varnish or fluoride rinse. , 2004, Community dentistry and oral epidemiology.

[52]  P. Milgrom,et al.  Fluoride release from varnishes in two in vitro protocols. , 2004, Journal of the American Dental Association.

[53]  A. Banerjee Dental Caries. The Disease and its Clinical Management , 2004, British Dental Journal.

[54]  K. Donly Fluoride varnishes. , 2003, Journal of the California Dental Association.

[55]  Carol Dixon Hatrick Dental Materials: Clinical Applications for Dental Assistants and Dental Hygienists , 2002 .

[56]  S. Adair,et al.  Plaque Fluoride Concentrations Are Dependent on Plaque Calcium Concentrations , 2002, Caries Research.

[57]  Chiayi Shen,et al.  Assessing fluoride concentration uniformity and fluoride release from three varnishes. , 2002, Journal of the American Dental Association.

[58]  E. Kharasch,et al.  Evaluation of fluoride release from commercially available fluoride varnishes. , 2001, Journal of the American Dental Association.

[59]  S. Twetman,et al.  Fluoride concentration in whole saliva and separate gland secretions after topical treatment with three different fluoride varnishes. , 1999, Acta odontologica Scandinavica.

[60]  C. Yiu,et al.  A Review of Enamel Remineralisation Potential of Calcium- and Phosphate-based Remineralisation Systems. , 2017, Oral health & preventive dentistry.

[61]  M. Buzalaf,et al.  Fluoride varnishes with calcium glycerophosphate: fluoride release and effect on in vitro enamel demineralization. , 2015, Brazilian oral research.

[62]  L. Tenuta,et al.  Insoluble NaF in Duraphat® may prolong fluoride reactivity of varnish retained on dental surfaces. , 2014, Brazilian dental journal.

[63]  S. Tracy,et al.  Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review. , 2013, Journal of the American Dental Association.

[64]  E. Martinez-Mier Fluoride Its Metabolism, Toxicity, and Role in Dental Health , 2012 .

[65]  K. Vandewalle,et al.  Fluoride release from newly marketed fluoride varnishes. , 2012, Quintessence international.

[66]  G. Vogel Oral fluoride reservoirs and the prevention of dental caries. , 2011, Monographs in oral science.

[67]  Jaime Aparecido Cury,et al.  Enamel remineralization: controlling the caries disease or treating early caries lesions? , 2009, Brazilian oral research.

[68]  C. Longbottom,et al.  Novel preventive treatment options. , 2009, Monographs in oral science.

[69]  Professionally applied topical fluoride: evidence-based clinical recommendations. , 2006, Journal of the American Dental Association.

[70]  I. Lin Current Concept on the Anticaries Fluoride Mechanism of the Action , 2003 .

[71]  B. Ogaard CaF(2) formation: cariostatic properties and factors of enhancing the effect. , 2001, Caries research.

[72]  B R Schemehorn,et al.  Remineralization by fluoride enhanced with calcium and phosphate ingredients. , 1999, The Journal of clinical dentistry.