Citation Information :
Uthman US. Impact of Fluoride Varnishes on Enamel Surface Microhardness of Primary Teeth: An In Vitro Study. World J Dent 2022; 13 (5):469-472.
Aim: Aim of the current research was performed to assess the outcome of three fluoride varnishes on enamel surface microhardness (SMH) of primary teeth.
Materials and methods: A total of 60 primary teeth indicated for extraction were utilized in this research. The specimens were cleaned employing pumice slurry. The specimens were subjected to storage in distilled water having 0.2% thymol for prevention of bacterial growth through the period of the research. A 2 mm by 2 mm window was made on the enamel of the buccal surface, followed by embedding in acrylic with enamel surface exposed. The specimens were then randomly allocated to one of the three investigational groups as follows: group 1- Bifluorid 10® varnish, group 2- Clinpro white varnish, group 3- Fluorprotector varnish. The specimens underwent a pH cycle to replicate laboratory conditions similar to the mouth. And every cycle lasted for 24 hours. The SMH of enamel was gauged prior to treatment at baseline and following pH cycles employing the Vickers microhardness tester.
Results: Bifluorid 10® group exhibited a mean SMH of 328.32 ± 0.11, 332.14 ± 0.08 by the Clinpro white, and 331.13 ± 0.06 by the Fluorprotector group at baseline, and there were no significant dissimilarities amid the various varnish groups. Clinpro white exhibited the lowest SMH at 284.02 ± 0.17 in pursuit by Fluorprotector varnish at 268.58 ± 0.10 as well as Bifluorid 10® varnish at 229.86 ± 0.21. There were statistically significant dissimilarities amid the various varnish groups with p < 0.001.
Conclusion: The current research, amid its limitations, arrived at a conclusion that various fluoride-containing varnishes had a positive influence on preventing demineralization of primary teeth. However, Clinpro white varnish delineated maximum efficacy in enhancing the resistance of deciduous enamel to acid attacks vs Fluorprotector as well as the Bifluorid 10 fluoride varnish group.
Clinical significance: Cycles of demineralization and remineralization occurring in an alternative manner on the surface of enamel lead to dental caries. Varnishes containing fluoride exhibit a dental caries preventive action on the dentition by exerting remineralizing effects. As a result, the enamel becomes unyielding to disintegration by acids. Fluoride varnish is a noninterventional, anticariogenic substance that can be used to manage early childhood caries (ECC).
Ismail AI, Tellez M, Pitts NB, et al. Caries management pathways preserve dental tissues and promote oral health. Community Dent Oral Epidemiol 2013;41(1):e12–40. DOI: 10.1111/cdoe.12024
Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phosphopeptide on enamel lesions: An in vitro comparative evaluation. J Conserv Dent 2010;13(1):42–46. DOI: 10.4103/0972-0707.62634
McDonagh MS, Whiting PF, Wilson PM, et al. Systematic review of water fluoridation. BMJ 2000;321(7265):855–859. DOI: 10.1136/bmj.321.7265.855
Subramaniam P, Telegeti S. Effect of different concentrations of fluoride varnish on enamel surface microhardness: An in vitro randomized controlled study. J Indian Assoc Public Health Dent 2016;14(3):344–347. DOI: 10.4103/2319-5932.187172
Cochrane NJ, Cai F, Huq NL, et al. New approaches to enhanced remineralization of tooth enamel. J Dent Res 2010;89(11):1187–1197.
Haghgou HR, Haghgoo R, Asdollah FM. Comparison of the microhardness of primary and permanent teeth after immersion in two types of carbonated beverages. J Int Soc Prev Community Dent 2016;6(4):344–348. DOI: 10.4103/2231-0762.186803
Magalhães AC, Comar LP, Rios D, et al. Effect of a 4 % titanium tetrafluoride (TiF4) varnish on demineralisation and remineralisation of bovine enamel in vitro. J Dent 2008;36(2):158–162.
Alamoudi SA, Pani SC, AlOmari M. The effect of the addition of tricalcium phosphate to 5% sodium fluoride varnishes on the microhardness of enamel of primary teeth. Int J Dent 2013;2013:486358. DOI: 10.1155/2013/486358
Gatti A, Camargo LB, Imparato JCP, et al. Combination effect of fluoride dentifrices and varnish on deciduous enamel demineralization. Braz Oral Res 2011;25(5):433–438. DOI: 10.1590/s1806-83242011000500010
Medeiros IC, Brasil VL, Carlo HL, et al. In vitro effect of calcium nanophosphate and high–concentrated fluoride agents on enamel erosion: an AFM study. Int J Paediatr Dent 2014;24(3):168–174. DOI: 10.1111/ipd.12046
Rosin–Grget K, Lincir I. Current concept on the anticaries fluoride mechanism of the action. Coll Antropol 2001;25(2):703–712. https://pubmed.ncbi.nlm.nih.gov/11811302/
Itthagarun A, King NM, Yuen-Man C. The effect of nano-hydroxyapatite toothpaste on artificial enamel carious lesion progression: an in-vitro pH-cycling study. Hong Kong Dent J 2010;7:61–66. https://www.academia.edu/48538251/The_effect_of_nano_hydroxyapatite_toothpaste_on_artificial_enamel_carious_lesion_progression_an_in_vitro_pH_cycling_study
Erdem PA, Sepet E, Kulekci G, et al. Effects of two fluoride varnishes and one fluoride/chlorhexidine varnish on Streptococcus mutans and Streptococcus sobrinus biofilm formation in vitro.Int J Med Sci 2012;9(2):129–36. DOI: 10.7150/ijms.3637
de Bruyn H, Buskes JA, Jongebloed W, et al. Fluoride uptake and inhibition of intra-oral demineralization, following the application of varnishes with different concentrations of fluoride. J Biol Buccale 1988;16(2):81–87. https://pubmed.ncbi.nlm. nih.gov/3170531/
Delbem ACB, Bergamaschi M, Sassaki KT, et al. Effect of fluoridated varnish and silver diamine fluoride solution on enamel demineralization: pH-cycling study. J Appl Oral Sci 2006;14(2):88–92. DOI: 10.1590/s1678-77572006000200005
Karlinsey RL, Mackey AC, Walker TJ, et al. In vitro remineralization of human and bovine white-spot enamel lesions by NaF dentifrices: a pilot study. J Dent Oral Hyg 2011;3(2):22–29. https://pubmed.ncbi.nlm.nih.gov/3170531/
Doddamani GM, KL GB. Effect of Fluoridated Varnishes on surface micro-hardness of Enamel. Int J Oral Health Med Res 2017;4(2):1–3. https://pubmed.ncbi.nlm.nih.gov/3170531/