Effects of TiF₄, AmF, and Fluor Protector^® on Enamel Erosion in vitro

Objectives: This study aimed at comparing the effect of titanium tetrafluoride (TiF₄), amine fluoride (AmF) and Fluor Protector^® (FP) in the prevention of dental erosion. Methods: Erosion was modelled using bovine enamel submitted to alternate cycles of acid attacks in citric acid and remineralisation in artificial saliva. The samples were polished and allocated to one of 6 groups which were pre-treated as follows: TiF₄ gel 1 %; TiF₄ gel 4 %; AmF fluid 1%; AmF gel 0.25% (1% NaF); FP; control (no pre-treatment). Calcium loss was quantified by atomic absorption spectroscopy (AAS) and erosion depths were estimated. Two samples of each experimental group were analysed by white light confocal microscopy (CM).Results: The cumulative calcium loss (in mM) after 72 min was: TiF4 gel 1 % 0.60 ± 0.13; TiF4 gel 4 % 0.56 ± 0.15; AmF fluid 1% 0.57 ± 0.14; AmF gel 0.25% 0.62 ± 0.10; FP 0.21 ± 0.19; control 0.65 ± 0.11. Multiple comparisons using both the Bonferroni procedure and the Dunnett test yielded a statistical significant difference (p £ 0.000) merely for the group pre-treated with FP. Repeated measures analysis of variance revealed a significant interaction between the experimental groups and the erosion cycles. A trend analysis on the erosion cycles (etching time) showed that the interaction was particularly significant for the first (p £ 0.001) and last (p £ 0.002) cycles. The erosion depths obtained by CM were considerably higher than those obtained with AAS. Conclusion: Within the limitations of an in vitro study it may be concluded that topical application of FP has a protective effect in the prevention of dental erosion. The differences found between the results obtained with AAS and CM suggest the need of further research focusing on the development of techniques best suited for the quantification of dental erosion.