IADR Abstract Archives
Comparing Hydroxyapatite and Fluoride Toothpaste for Caries Remineralization and Prevention
Objectives: The aim of this randomized, double-blind, crossover, in situ study was to compare the effectiveness of two toothpastes containing hydroxyapatite (HAP) or 500 ppm fluoride (amine fluoride) in promoting remineralization and inhibiting caries development.
Methods: Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, cut from each of 30 teeth used, were exposed to toothpaste containing either 10% HAP (Kinder Karex toothpaste) or 500 ppm F- (AMF) via an intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using transverse microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups.
Results: Pairwise comparison (baseline vs. post-Test) indicated significant (p<0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. Microradiographic images showed lesion surface lamination in lesions exposed to AMF, and a more homogenous lesion remineralization in HAP treated lesions. Using microradiography, no demineralization could be observed in sound enamel blocks exposed to either toothpaste formulations.
Conclusions: Toothpaste containing 10% HAP achieved comparable efficacy with toothpaste containing 500 ppm fluoride in remineralizing initial caries lesions and preventing enamel surface demineralization in primary teeth. Thus in this study the HAP toothpaste is confirmed to be equal to the fluoride toothpaste, and can serve an effective alternative to fluoride toothpaste for children.
Methods: Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, cut from each of 30 teeth used, were exposed to toothpaste containing either 10% HAP (Kinder Karex toothpaste) or 500 ppm F- (AMF) via an intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using transverse microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups.
Results: Pairwise comparison (baseline vs. post-Test) indicated significant (p<0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. Microradiographic images showed lesion surface lamination in lesions exposed to AMF, and a more homogenous lesion remineralization in HAP treated lesions. Using microradiography, no demineralization could be observed in sound enamel blocks exposed to either toothpaste formulations.
Conclusions: Toothpaste containing 10% HAP achieved comparable efficacy with toothpaste containing 500 ppm fluoride in remineralizing initial caries lesions and preventing enamel surface demineralization in primary teeth. Thus in this study the HAP toothpaste is confirmed to be equal to the fluoride toothpaste, and can serve an effective alternative to fluoride toothpaste for children.