Magister Scientiae Dentium - MSc(Dent) / High caries burden coupled with a lack of water and salt fluoridation make it imperative that toothpastes marketed to the South African consumer demonstrate adequate caries inhibition. It is generally accepted that an effective toothpaste contain between 1000ppm and 1500ppm total fluoride (TF) and that of this at least 1000ppm F should be in free available form. Studies conducted in other countries have demonstrated that toothpastes often do not conform to this regulation, indicating the need for quality assessments to be undertaken. Objectives: This study therefore aimed to determine total and free available (potentially bioavailable) fluoride concentrations in 28 adult, fluoridated toothpastes marketed to the South Africa consumer. Labeling practices were also assessed. Materials & Methods: Convenience samples were purchased from a major pharmaceutical and food retailer located in each of the five metropolitan areas of South Africa. Information detailed on the packaging was evaluated for compliance with national standards. Total and bioavailable fluoride concentrations were determined potentiometrically, in quadruplicate, following acid hydrolysis of the samples using a Combination Fluoride Ion Selective Electrode, calibrated with standards containing 0.0625ppm F to 6.25ppm F. Results: Although TF content on analysis was found to be statistically significantly lower than manufacturer declaration (1.2x10-7; p≤0.05), 78.6% still contained adequate free, available F levels. Relative mean available fluoride content for toothpastes formulated with a calcium-based abrasive was 85,5% as opposed to 98.7% for those containing silica. Partial alignment with national labeling statutes was observed for all toothpastes. Conclusion: Most commercially available toothpastes are adequately formulated to provide anticariogenic activity, but consumers should be advised against the use of products containing calcium. Improvements to national standards and stricter regulation of labeling practices are required.

This diploma thesis is focused on determining the physico-chemical stability of toothpastes. It is divided into theoretical and practical part. The theoretical part of the work deals with toothpastes, their short history and composition. Stability studies and methods of stability analysis are described below. In the practical part were performed long-term and accelerated stability studies on anhydrous toothpastes, on water-based toothpastes and on toothpastes based on sodium bicarbonate. The physical stability of the products was evaluated by monitoring the appearance and color visually and odor sensory, the pH value using a pH meter and the viscosity with a rotational viscometer. Chemical stability was monitored by determining the free fluorine content by ion chromatography and by ion-selective electrode, total phosphates and potassium also by ion chromatography, sodium bicarbonate by titration, soluble zinc by atomic absorption spectrometry and water activity was also monitored.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Master / Master of Dental Surgery

Thesis (M.D.S.)--University of Hong Kong, 2003. / Also available in print.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Non-carious cervical lesions (NCCLs) can be defined as the loss of dental hard tissue near the cemento-enamel junction without bacterial involvement. Abrasion, erosion and abfraction have been mentioned as common etiological factors of NCCLs. Abrasion is the loss of tooth structure due to friction by materials such as toothbrushes or abrasives in toothpaste. In contrast, dental erosion is the loss of tooth structure driven by acids. Abfraction, on the other hand, starts due to the weakening of the tooth structure in areas of concentrated stress as a result of cuspal flexure from heavy and repeated occlusal loading, which progresses to dental hard-tissue loss. Purpose: The present study focused on the abrasion aspect of NCCLs. Specifically, it aimed to investigate the influence of dentifrice abrasivity and toothbrush stiffness on the development of NCCLs in vitro Hypothesis: NCCL development is affected by both the abrasive level of the dentifrice and the stiffness of the toothbrush, as well as their interaction. Materials and Methods: A total of 288 extracted human upper first premolars, free of any dental caries and root defects, were selected. The teeth were be cleaned with a hand periodontal scaler and randomly assigned into twelve groups (total of 24 teeth/group). Specimens were brushed in an automated toothbrushing machine, using simulated toothpaste slurries of varying abrasivity and toothbrushes of varying stiffness. This study examined three experimental factors: 1. Toothpaste abrasivity, at four levels: high, medium, low, and non-abrasive slurry (as negative control); 2. Toothbrush stiffness, at three levels: soft, medium, and hard; 3. Toothbrushing cycles at three levels: baseline, 35k, and 65k strokes. Specimens were analyzed by optical profilometry at baseline and after each brushing level. The response variable was the dentin volumetric loss, in mm3. All toothbrushes caused significantly higher tooth wear when associated to the high abrasive slurry, compared to medium- and low-abrasive slurries. Medium- caused more tooth wear than low-abrasive slurry, which in turn led to more tooth wear than the control. Hard and medium toothbrushes were not significantly different, but both caused significantly higher volumetric loss than Soft toothbrushes. There were no differences among toothbrushes, when used with the non-abrasive (control) and low- abrasive slurries. Overall, 35k strokes resulted in significantly less tooth volumetric loss than 65k.

Os objetivos deste estudo foram avaliar clinicamente a alteração de cor e de rugosidade de superfície do esmalte dental e de compósitos odontológicos, submetidos à escovação com dentifrícios clareadores e a ação deles sobre a degradação das pontas das cerdas da escova dental. Foram obtidos 30 corpos-de-prova (6mm de diâmetro X 2mm de espessura) de cada compósito (Z250 e Z350, 3M ESPE e Tetric N-Ceram, Ivoclar Vivadent). Em seguida, estes foram aleatoriamente fixados na face vestibular dos primeiros molares superiores (direito e esquerdo) e de um segundo molar superior (direito ou esquerdo) de 30 participantes selecionados para o estudo, de acordo com os critérios de inclusão determinados. Após a fixação dos espécimes, os participantes receberam escovas de dentes (Oral B Classic, Procter & Gamble) e dentifrício convencional (Sorriso Dentes Brancos, Colgate-Palmolive) e foram orientados a utilizar esses produtos durante 7 dias (período pré-experimental) após o qual foram realizadas as leituras iniciais de cor (Easyshade, VITA) e de rugosidade de superfície (Rugosímetro Surfcorder SE 1700, Kosakalab) das amostras e também do esmalte dental de um dos incisivos centrais superiores dos participantes. Para as leituras de rugosidade foi realizada moldagem (Express, 3M ESPE) do incisivo central superior e dos corpos-de-prova fixados para posterior obtenção de modelos com resina de poliuretano (Axon F16, Abcol) para confecção de réplicas, sobre as quais foram realizadas as leituras. Após as leituras iniciais, os participantes foram separados em 3 grupos (n=10), conforme o dentifrício clareador utilizado: Grupo 1) Dentifrício controle (Sorriso Dentes Brancos); Grupo 2) Dentifrício clareador (Colgate Luminous White, Colgate-Palmolive); e Grupo 3) Dentifrício clareador de ação rápida (Close up White Now, Unilever). As cerdas das escovas dentais utilizadas pelos participantes foram analisadas por MEV (Microscópio XL30 Field Emission Gun, Philips), em duas regiões da escova: periférica e central. Os períodos de análise da ação dos dentifrícios clareadores foram, 7, 30 e 90 dias. Os valores das medições (antes e após os períodos de testes) foram analisados estatisticamente (3-way-ANOVA, medidas repetidas, Tukey, p<0,05) e os resultados demonstraram que não houve alteração de cor significativa dos substratos analisados independentemente do tipo de dentifrício utilizado, mas o tempo de utilização de um dentifrício sobre os compósitos foi significante para a alteração de cor. Não houve alteração de rugosidade de superfície do esmalte dental, independente do dentifrício utilizado. A alteração de rugosidade de superfície dos compósitos é material dependente, mas o tempo de escovação com esses dentifrícios não interfere nessa propriedade. Quanto maior o tempo de escovação, maior o desgaste da ponta das cerdas da escova, independente do dentifrício utilizado e da região a que ela pertence. Conclui-se que a alteração de cor e de rugosidade de superfície dos compósitos é material-dependente e tempo-dependente para a alteração de cor e para degradação das cerdas da escova. / The aims of this study were to clinically evaluated the color change and the surface roughness of enamel and dental composites submitted to brushing with whitening toothpaste and the their action over the degradation of the tips of the bristles of the toothbrush. 30 specimens were obtained (6 mm diameter X 2mm thick) of each composite (Z250 and Z350, 3M ESPE and Tetric N-Ceram, Ivoclar Vivadent). Then, the specimens were randomly bonded on the maxillary first molars buccal surfaces (right and left sides) and the one maxillary second molar (right or left sides) of 30 participants, which were selected for the study according to inclusion criteria. After specimens bonding, participants received toothbrush (Oral B Classic, Procter & Gamble) and non whitening toothpaste (Sorriso Dentes Brancos, Colgate-Palmolive) and also they were instructed to use these products for 7 days (pre-trial). After that, were realized the initial color (Easyshade, VITA) and surface roughness (Roughness Surfcorder SE 1700, KosakaLab) readings of specimens and of the enamel of the maxillary central incisors of the participants. For surface roughness readings was performed molding (Express, 3M ESPE) of the maxillary central incisor and of the specimens fixed to be retrieved later of the models with polyurethane resin (Axon F16, Abcol). Then in these replicas were made surface roughness readings. After baseline measurements, participants were divided into 3 groups (n=10), according to the whitening toothpaste used: Group 1) Control toothpaste (Sorriso Dentes Brancos); Group 2) Whitening toothpaste (Colgate Luminous White, Colgate-Palmolive); and Group 3) Whitening toothpaste with fast action (Close up White Now, Unilever). The bristles of toothbrushes used by the participants were analyzed by SEM (Field Emission Gun Microscope XL30, Philips) in two regions of the brush: peripheral and central. The periods of action analysis of whitening toothpaste were 7, 30 and 90 days. The measured values (before and after the testing periods) were statistically analyzed (3-way ANOVA, repeated measures, Tukey, p <0.05) and the results showed no significant color change of the substrates analyzed independently of the type toothpaste used, but the time of use of a dentifrice over the composites was significant for the color change. There was no surface roughness change enamel independently of the toothpaste used. The surface roughness change of composites is dependent on material, but the time of brushing with these toothpaste does not interfere in this property. The longer the time of brushing, the greater the degradation in the tips of the bristles of the toothbrush independently of the toothpaste used and the region to which it belongs. It is conclude that the color change and surface roughness of the composites is material-dependent and time-dependent to color change and to degradation of the brush bristles.

Os dentifrícios são veículos fundamentais para a aplicação dos fluoretos. Estudos em dentes humanos e bovinos têm mostrado que os fluoretos podem apresentar efeitos diversos na prevenção e na progressão do desgaste dentário erosivo (DDE). No entanto, pouco se sabe sobre seu efeito em dentes decíduos. Objetivo: 1) Avaliar o efeito preventivo de dentifrícios fluoretados por meio da intensidade de reflexão da superfície especular (IRS), da microdureza de superfície (MDS) e da perda da superfície calculada (PSC) utilizando um modelo inicial de erosão/abrasão; 2) avaliar por meio de perfilometria a perda de superfície (PS) em um modelo de erosão/abrasão avançado e 3) comparar esse efeito preventivo entre os dentes permanentes (DP) e dentes decíduos (dd). Material e Métodos: Amostras de esmalte de dentes permanentes (n = 100) e decíduos (n = 100) foram aleatoriamente divididos em cinco grupos (n = 20) de acordo com os dentifrícios testados: G1 – dentifrício placebo (0ppm), G2 – dentifrício com NaF (controle positivo, 1500ppm, Crest®, P & G), G3 - dentifrício anti-erosão com AmF-NaF-SnCl (1400ppm, elmex Erosion Protection®, GABA - Colgate), G4 - dentifrício com SnF (1100ppm, Sensodyne Repair&Protect®, GSK), G5 - dentifrício anti-erosão com NaF para crianças (1450ppm, Sensodyne ProNamel Junior®, GSK) Metade de cada superfície de esmalte foi coberta com resina à base de metacrilato para criar uma área hígida de referência. As amostras foram então submetidas a ciclos de erosão/abrasão, cinco no protocolo inicial e mais 25 para o protocolo avançado, totalizando 30 ciclos para este último protocolo. Em cada ciclo, as amostras foram incubadas em saliva artificial por 1h hora, submetidas ao desafio erosivo (3min; ácido cítrico 1%; pH 3.6; a 25 ° C) e à abrasão (2min de imersão no slurry; 50 movimentos de escovação; 200 g). Os efeitos das duas co-variáveis "dente" e "dentifrício" foram analisados através do teste ANOVA e as comparações entre os dentifrícios foram realizadas por meio do teste de Kruskal-Wallis e entre os tipos de dente (DP e dd) utilizando o teste de Wilcoxon, com nível de significância de 5%. Resultados: No protocolo inicial, considerando os resultados de MDS, as amostras do grupo do dentifrício placebo apresentaram valores significativamente menores para os ‘DP’ do que os outros grupos (p<0.05), no entanto sem diferença entre os dentifrícios fluoretados. Para os ‘dd’, o dentifrício placebo (G1) e o dentifrício com SnF (G4) também mostraram valores significativamente menores do que os outros grupos (p<0.05) Nos resultados de IRS, o dentifrício com SnF (G4) apresentou valores menores em ambos os tipos de dente. Além disso, os dentes decíduos apresentaram significativamente maiores valores de IRS que os dentes permanentes, exceto no grupo do dentifrício anti-erosão com AmF-NaF-SnCl (G3). Os dentes decíduos apresentaram maior PSC do que dentes permanentes, exceto no G3. No protocolo avançado de erosão/abrasão os dentes decíduos (dd) mostraram PS significativamente maior do que os dentes permanentes (DP) em todos os grupos (p <0.001). Os valores médios de PS de cada grupo foram: G1 DP 18.18μm (± 3.98), dd 25.65μm (± 9.21); G2 DP 14.76μm (± 2.82), dd 18.11μm (± 3.92); G3 DP 12.62μm (± 5.29), dd 15.61μm (± 6.70); G4 DP 17.12μm (± 2.24), dd 23.41μm (± 7.9); G5 DP 13.24μm (± 1.29), dd 18.28μm (± 8.96). Conclusões: No protocolo de erosão/abrasão inicial dentes decíduos apresentaram valores mais baixos MDS, valores de IRS mais elevados e maior PSC do que os dentes permanentes durante o experimento. O dentifrício anti-erosão com NaF para crianças apresentou os menores valores de PSC em ambos os dentes permanentes e decíduos, com um melhor efeito preventivo. No protocolo avançado o dentifrício anti-erosão com AmF-NaF-SnCl apresentou o melhor efeito preventivo contra desgaste erosivo nos dentes permanentes. Em dentes decíduos os dentifrícios com NaF (G2), anti-erosão com AmF-NaF-SnCl (G3) e anti-erosão com NaF para crianças (G5) mostraram efeito semelhante. / Toothpastes are key vehicles for fluorides application. Studies have shown that various fluorides have different preventive effect on erosive tooth wear (ETW) progression. Little is known about their effect on deciduous teeth. Aim: 1) To evaluate the preventive effect of the toothpastes through surface specular reflection intensity (SRI), surface microhardness (SMH) and calculated surface loss (CSL) in an initial erosion/abrasion model; 2) to evaluate through profilometry the surface loss (SL) in a severe erosion/abrasion model and 3) to compare this preventive effect between permanent teeth (PT) and deciduous teeth (dt). Material and Methods: Enamel samples of permanent (n=100) and deciduous teeth (n=100) were randomly divided into five groups according to toothpastes tested (n=20). G1 – placebo toothpaste (0ppm), G2 – NaF toothpaste (positive control, 1500ppm, Crest®, P&G), G3 – AmF-NaF-SnCl antierosion toothpaste (1400ppm, elmex Erosion Protection®, GABA – Colgate), G4 – SnF toothpaste (1100ppm, Sensodyne Repair®, GSK), G5 – NaF antierosion toothpaste for children (1450ppm, Sensodyne ProNamel Junior®, GSK). Half of enamel sample surfaces were covered with methacrylate-based resin to create a sound reference area. The samples were submitted to erosion-abrasion cycles, 5 in initial protocol and more 25 in severe protocol, totalizing 30 cycles at the end. In each cycle samples were incubated in artificial saliva (1h), submitted to erosive challenge (3min; 1% citric acid; pH3.6; at 25°C) and to toothbrush abrasion (2min immersion in slurry; 50 strokes; 200g) The effects of the two covariables “tooth” and “toothpaste” were analyzed by ANOVA Comparisons among toothpastes were evaluated using Kruskal-Wallis-tests and between PT and dt using Wilcoxon’s rank sum test. Results: In initial protocol, considering the SMH results, placebo toothpaste showed significantly lower SMH values in PT than the other toothpastes (p<0.05), with no differences between the toothpastes. In dt, placebo and G4 also showed significantly different values than the other groups (p<0.05). In SRI results, SnF toothpaste (G4) showed lower erf values in both PT and dt. Deciduous teeth presented significantly higher SRI than permanent (p<0.05), except on AmF-NaF-SnCl antierosion group (G3). Deciduous teeth presented generally higher CSL than PT, except for G3. In the severe protocol deciduous teeth (dt) showed significant higher SL than permanent teeth (PT) in all groups (p<0.001). The mean values of SL of each group were: G1 PT 18.18(±3.98), dt 25.65(±9.21); G2 PT 14.76(±2.82), dt 18.11(±3.92); G3 PT 12.62(±5.29), dt 15.61(±6.70); G4 PT 17.12(±2.24), dt 23.41(±7.9); G5 PT 13.24(±1.29), dt 18.28(±8.96) Conclusions: In initial protocol deciduous teeth presented lower SMH values, higher SRI values and higher surface loss than permanent teeth during the experiment. The NaF antierosion toothpaste for children presented the lowest values of SL in both permanent and deciduous teeth, with a better preventive effect. In severe protocol, AmF-NaF-SnCl antierosion toothpaste showed the best preventive effect against erosion-abrasion cycles in permanent teeth. In deciduous teeth NaF toothpaste, AmF-NaF-SnCl antierosion toothpaste and NaF antierosion toothpaste for children showed similar effect.

Os objetivos deste estudo foram avaliar clinicamente a alteração de cor e de rugosidade de superfície do esmalte dental e de compósitos odontológicos, submetidos à escovação com dentifrícios clareadores e a ação deles sobre a degradação das pontas das cerdas da escova dental. Foram obtidos 30 corpos-de-prova (6mm de diâmetro X 2mm de espessura) de cada compósito (Z250 e Z350, 3M ESPE e Tetric N-Ceram, Ivoclar Vivadent). Em seguida, estes foram aleatoriamente fixados na face vestibular dos primeiros molares superiores (direito e esquerdo) e de um segundo molar superior (direito ou esquerdo) de 30 participantes selecionados para o estudo, de acordo com os critérios de inclusão determinados. Após a fixação dos espécimes, os participantes receberam escovas de dentes (Oral B Classic, Procter & Gamble) e dentifrício convencional (Sorriso Dentes Brancos, Colgate-Palmolive) e foram orientados a utilizar esses produtos durante 7 dias (período pré-experimental) após o qual foram realizadas as leituras iniciais de cor (Easyshade, VITA) e de rugosidade de superfície (Rugosímetro Surfcorder SE 1700, Kosakalab) das amostras e também do esmalte dental de um dos incisivos centrais superiores dos participantes. Para as leituras de rugosidade foi realizada moldagem (Express, 3M ESPE) do incisivo central superior e dos corpos-de-prova fixados para posterior obtenção de modelos com resina de poliuretano (Axon F16, Abcol) para confecção de réplicas, sobre as quais foram realizadas as leituras. Após as leituras iniciais, os participantes foram separados em 3 grupos (n=10), conforme o dentifrício clareador utilizado: Grupo 1) Dentifrício controle (Sorriso Dentes Brancos); Grupo 2) Dentifrício clareador (Colgate Luminous White, Colgate-Palmolive); e Grupo 3) Dentifrício clareador de ação rápida (Close up White Now, Unilever). As cerdas das escovas dentais utilizadas pelos participantes foram analisadas por MEV (Microscópio XL30 Field Emission Gun, Philips), em duas regiões da escova: periférica e central. Os períodos de análise da ação dos dentifrícios clareadores foram, 7, 30 e 90 dias. Os valores das medições (antes e após os períodos de testes) foram analisados estatisticamente (3-way-ANOVA, medidas repetidas, Tukey, p<0,05) e os resultados demonstraram que não houve alteração de cor significativa dos substratos analisados independentemente do tipo de dentifrício utilizado, mas o tempo de utilização de um dentifrício sobre os compósitos foi significante para a alteração de cor. Não houve alteração de rugosidade de superfície do esmalte dental, independente do dentifrício utilizado. A alteração de rugosidade de superfície dos compósitos é material dependente, mas o tempo de escovação com esses dentifrícios não interfere nessa propriedade. Quanto maior o tempo de escovação, maior o desgaste da ponta das cerdas da escova, independente do dentifrício utilizado e da região a que ela pertence. Conclui-se que a alteração de cor e de rugosidade de superfície dos compósitos é material-dependente e tempo-dependente para a alteração de cor e para degradação das cerdas da escova. / The aims of this study were to clinically evaluated the color change and the surface roughness of enamel and dental composites submitted to brushing with whitening toothpaste and the their action over the degradation of the tips of the bristles of the toothbrush. 30 specimens were obtained (6 mm diameter X 2mm thick) of each composite (Z250 and Z350, 3M ESPE and Tetric N-Ceram, Ivoclar Vivadent). Then, the specimens were randomly bonded on the maxillary first molars buccal surfaces (right and left sides) and the one maxillary second molar (right or left sides) of 30 participants, which were selected for the study according to inclusion criteria. After specimens bonding, participants received toothbrush (Oral B Classic, Procter & Gamble) and non whitening toothpaste (Sorriso Dentes Brancos, Colgate-Palmolive) and also they were instructed to use these products for 7 days (pre-trial). After that, were realized the initial color (Easyshade, VITA) and surface roughness (Roughness Surfcorder SE 1700, KosakaLab) readings of specimens and of the enamel of the maxillary central incisors of the participants. For surface roughness readings was performed molding (Express, 3M ESPE) of the maxillary central incisor and of the specimens fixed to be retrieved later of the models with polyurethane resin (Axon F16, Abcol). Then in these replicas were made surface roughness readings. After baseline measurements, participants were divided into 3 groups (n=10), according to the whitening toothpaste used: Group 1) Control toothpaste (Sorriso Dentes Brancos); Group 2) Whitening toothpaste (Colgate Luminous White, Colgate-Palmolive); and Group 3) Whitening toothpaste with fast action (Close up White Now, Unilever). The bristles of toothbrushes used by the participants were analyzed by SEM (Field Emission Gun Microscope XL30, Philips) in two regions of the brush: peripheral and central. The periods of action analysis of whitening toothpaste were 7, 30 and 90 days. The measured values (before and after the testing periods) were statistically analyzed (3-way ANOVA, repeated measures, Tukey, p <0.05) and the results showed no significant color change of the substrates analyzed independently of the type toothpaste used, but the time of use of a dentifrice over the composites was significant for the color change. There was no surface roughness change enamel independently of the toothpaste used. The surface roughness change of composites is dependent on material, but the time of brushing with these toothpaste does not interfere in this property. The longer the time of brushing, the greater the degradation in the tips of the bristles of the toothbrush independently of the toothpaste used and the region to which it belongs. It is conclude that the color change and surface roughness of the composites is material-dependent and time-dependent to color change and to degradation of the brush bristles.

<p>Aim: To determine whether there was any significant difference in the antimicrobial activity of 4 herbal toothpastes against cultures of 3 primary plaque colonizers (Streptococcus mutans, Streptococcus sanguinis and a non-specific &alpha / -heamolytic streptococcus).</p>