A comparative in vitro study investigating the occlusion and mineralization properties of commercial toothpastes in a four-day dentin disc model.

OBJECTIVE: The objective of this study was to evaluate the relative level of dentin tubule occlusion and dentin mineralization conferred by a 5% w/w calcium sodium phosphosilicate (45S5)/1450 ppm fluoride toothpaste in comparison to a range of commercial toothpastes reported to occlude dentin tubules.

METHODS: Two separate experiments were employed to (i) determine the level of dentin tubule occlusion, and (ii) explore the change in dentin mineralization conferred by a number of marketed toothpastes and controls, following twice-daily brushing in a longitudinal, acid challenge-based, dentin disc model. In Study I, 192 bovine dentin discs, polished and etched in citric acid to provide a smooth dentin surface with patent tubules, were divided into eight treatment groups and subjected to brushing with one of seven test toothpastes or deionized water over four days. Prior to and between treatments, the dentin samples were stored in saliva. The test products were fluoridated toothpastes containing: calcium sodium phosphosilicate (45S5); strontium acetate; arginine/calcium carbonate; amine fluoride; calcium sulphate/diphosphate; stannous fluoride; casein stabilized amorphous calcium phosphate toothpaste; and a non-occluding negative control, deionized water. At the end of each treatment day (1 though 4), one group of samples was removed for scanning electron microscopy (SEM) analysis and graded on a categorical visual scale to assess the level of dentin tubule occlusion. A subset of samples from Study I was also cross-sectioned and examined using SEM. For the exploratory mineralization study (Study II), 120 dentin specimens were prepared as previously described and divided into four treatment groups consisting of A, C, F, and a tooth sealant varnish (I), and subjected to the treatment regimen described in Study I. The dentin samples were assessed for changes in surface microhardness using an indenter fitted with a Knoop probe and the level of dentin occlusion.

RESULTS: In Study I, the 5% w/w calcium sodium phosphosilicate/1450 ppm fluoride-containing toothpaste (A), the stannous fluoride-containing toothpaste (F), and the strontium acetate-containing toothpaste (B) delivered the highest level of occlusion following four days of twice-daily brushing and a twice-daily acid challenge on days 3 and 4. Surface analysis of a subset of Study I samples, following four days of treatment, indicated that the 5% w/w calcium sodium phosphosilicate/1450 ppm fluoride-containing toothpaste formed a distinct layer at the surface of dentin. For Study II, surface microhardness analysis revealed that the 5% w/w calcium sodium phosphosilicate/1450 ppm fluoride-containing toothpaste (A) delivered significantly more surface hardening then the control or competitor toothpastes on days 2 and 4.

CONCLUSION: Desensitizing toothpastes reported to operate by an occlusion mechanism have been observed to confer varying degrees of dentin tubule occlusion and dentin mineralization over four days in an acid challenge-based in vitro model. A 5% w/w calcium sodium phosphosilicate/1450 ppm fluoride-containing toothpaste was observed to impart a significant level of dentin tubule occlusion and surface hardening, and form durable occlusive deposits following four days of twice-daily brushing in vitro.