Previous studies has shown that hydroxyapatite (HAP) in oral care formulations could serve as a favorable fluoride alternative for caries management. The present study compared the efficacy of different hydroxyapatite-containing toothpastes in remineralizing early caries lesions. Early enamel caries lesion were produced on one hundred and sixty bovine enamel blocks by 3-day demineralization using a multispies microbial caries model. Following this, the 160 lesion-bearing blockswere randomly assigned to eight treatment groups (20/group): Crest cavity protection (1100 ppm fluoride), ClinPro 5000 (5000 ppm fluoride), Fygg (20 % nanoXIM), Boka (nanoXIM; concentration not disclosed), Dr. Jen (10 % nanoHAP), Risewell Regular (10 % microHAP), Risewell PRO (5 % nanoXIM + microHAP), and Just-Ingredients Powder (15 % microHAP). The blocks were subjected to remineralization by daily pH-cycling consisting of a 2-minute acidic challenge, three 2-minute toothpaste treatments, and then storage in artificial saliva for the rest of the time for 14 days. Surface microhardness (SMH) of each lesion was measured before and after remineralization. Data was analyzed statistically (α = 0.05) by paired t-test (intragroup comparisons) and ANOVA/Tukey tests (intergroup comparison). Every product achieved significant (p < .001) increase in SMH (remineralization). Tukey multiple comparison test indicated that Fygg (39.81 ± 24.07; 95 %CI 26.99-52.64) had a statistically significantly higher percentage remineralization than Boka (19.5 ± 10.56; 95 %CI 14.25-24.75, p < .01), Dr. Jen (21.68 ± 6.72; 95 %CI 18.45-24.92, p < .05), and Risewell Regular (21.80 ± 7.88; 95 %CI 18.11-25.49, p < .05), but did not differ significantly from the other products. There were no significant differences in the percentage remineralization among the rest of the toothpastes. Within the limits of this in vitro study, there are differences in the ability of HAP toothpastes to enhance remineralization of early enamel caries lesions. It demonstrated that combining nanoXIM and nanoHAP in a toothpaste significantly enhanced the effectiveness of HAP to remineralize early caries lesion.

Purpose: This study investigated the influence of nanohydroxyapatite-containing (nanoHAP) lozenge on plaque pH following sucrose intake. Patients and Methods: Sixteen adult subjects were enrolled in this double-blind crossover study composed of four interventions: (1) 10% w/v sucrose solution, (2) 10% w/v sorbitol solution, (3) nanoHAP lozenge, and (4) 10% w/v sucrose solution challenge followed by nanoHAP lozenge. Following the determination of each subject’s resting plaque pH, the pH was measured at different time intervals from 3 to 30 minutes from the start of intervention, with 7 days interval between the applications of different interventions. The data were analyzed using the analysis of variance and Tukey’s test (α < 0.05). Results: While sorbitol produces no change in plaque pH, nanoHAP-lozenge increased the plaque pH from a baseline of 7.0 ± 0.3 (mean ± sd) to 7.8 ± 0.2 (mean ± sd) within 30 minutes. Sucrose lowered the plaque pH from a baseline of 7.0 ± 0.4 (mean ± sd) to the lowest minimum of 5.1 ± 0.1 (mean ± sd) at the 7^th minute, rising above the critical pH of enamel dissolution (5.5) at 12^th minute and the baseline pH in more than 30 minutes. With lozenge intervention following sucrose challenge, plaque pH rose to 5.5 in 8 min, and to the baseline pH in 24 min. The cH area (Hydrogen ion concentration area) produced by sucrose (1.82 sq. units) was significantly (p < 0.05) greater than that produced when sucrose was challenged with lozenge (0.48 sq. units). Conclusion: Nanohydroxyapatite-containing lozenge increased plaque pH, reduced plaque pH drop in the presence of sucrose, and facilitated the rapid recovery of plaque pH after sucrose intake.

Objective: This study evaluated the efficacy of a novel interproximal fluoride delivery device, Cav-Aid^®, in remineralizing initial proximal caries, comparing it with conventional fluoride treatments. Methods: Initial caries lesions were produced on bovine enamel blocks by subjecting the blocks to a 3-day demineralization process by plaque growth in a mixed-species microbial caries model. After demineralization, the baseline surface microhardness (SMHb) was measured. The blocks were embedded into cavities prepared on the proximal surfaces of extracted human teeth to simulate natural interproximal contacts. The teeth were randomly assigned to six treatment groups (20/group): artificial saliva (AS), Cav-Aid^® only (CA), Cav-Aid^®/fluoride toothpaste (CA+F), fluoride varnish applied via flossing (FV-Floss), fluoride varnish applied via painting on the interdental cleavage (FV-Paint), and daily fluoride mouthrinse (F-Mouthrinse). The samples then underwent a 14-day pH cycling protocol to simulate remineralization conditions. The post-treatment SMH (SMHr) was measured. Statistical analysis comprised paired t-tests and ANOVA/Tukey’s post hoc comparisons (p < 0.05). Results: All fluoride-treated groups exhibited significant increases in SMHr compared with SMHb (p < 0.001). CA+F group showed the highest percentage remineralization (27.39%), followed by CA (22.16%), then the FV and mouthrinse groups (9.25–11.80%). The AS group exhibited the lowest remineralization (4.89%). CA+F demonstrated significantly greater remineralization than FV or mouthrinse (p < 0.05). However, there was no significant difference between CA alone and CA+F. Also, there was no significant difference between CA alone and FV-Floss or FV-Paint (p > 0.05). Conclusions: Within the limit of the present study, the Cav-Aid^® targeted fluoride delivery system demonstrated greater efficacy than FV alone in interproximal remineralization. Dual-modality fluoride treatments (CA+F) provided the greatest remineralization benefits, highlighting the importance of sustained fluoride exposure.

Background/Objectives: Dentifrice tablets are a new over-the-counter dentifrice form that are gaining global interest. The aim of this microbial study was to investigate the effectiveness of a dentifrice tablet (DT) containing nanohydroxyapatite (nHAP) to prevent tooth demineralization. Methods: 120 bovine tooth blocks were randomly assigned to four treatment groups (30/group): Nanohydroxyapatite DT (5% nHAP), placebo DT (Placebo), NaF toothpaste (1100 ppm Fluoride) and no-treatment (Control). Blocks were subjected to 7-day demineralization by plaque growth in a mixed-organism Microbial Caries Model. Toothpaste was made into slurry (1 toothpaste:3 water), while DT was thoroughly crushed and homogenized with water (1 tablet:3 water) to slurry. Both slurries were applied twice daily for 2 min on each occasion. Demineralization was assessed using Surface Microhardness (SMH) testing before and after plaque exposure. Change (ΔSMH) and percentage change (%∆SMH) in SMH (percentage demineralization [%Dem]), and % demineralization inhibition (%Dem-Inhibition) in each group were calculated. Intra-group (SMH) comparison (paired t-test) and intergroup (%∆SMH) comparison (ANOVA/Tukey’s test) were conducted (α = 0.05). Results: The paired t-test indicated a significant difference (p < 0.001) between pre-treatment and post-treatment SMH in all groups. The intergroup comparison based on their %Dem using ANOVA/Tukey’s test showed that Control (29.93 ± 5.58) had significantly (p < 0.05) higher %Dem than Placebo (22.81 ± 7.47, p < 0.05), nHAP (13.93 ± 11.31, p < 0.001) and Fluoride (14.44 ± 10.65, p < 0.001). The Placebo had significantly (p < 0.01) higher %Dem than nHAP and Fluoride. No significant difference between nHAP and Fluoride. Intergroup comparison based on their %Dem-Inhibition (calculated relative to the control) using ANOVA/Tukey’s test, nHAP (51.74 ± 40.05, p < 0.01) and Fluoride (50.56 ± 37.21, p < 0.05) had significantly higher %Dem-Inhibition than Placebo tablet (21.86 ± 5.55). No significant difference in %Dem-Inhibition between nHAP and Fluoride. Conclusions: The present study demonstrated that dentifrice tablets containing 5% nanohydroxyapatite are as effective as NaF toothpastes containing 1100 ppm fluoride in preventing tooth demineralization.

This study investigated the efficacy of Isomalt-containing toothpaste in preventing development of dental caries. Methods: Human dental enamel slabs were allocated to six groups (30/group) at random: De-ionized distilled water (DDW), and toothpaste containing 10% Isomalt, 1100 ppm fluoride, 0.05% cetylpyridinium chloride [CPC] (ICT); 10% Isomalt, 1100 ppm fluoride (IT); 10% Isomalt, 1100 ppm fluoride, 1.5% Sodium lauryl sulfate [SLS] (IST); 1100 ppm fluoride only (FT); 1100 ppm fluoride with SLS (FST). The enamel slabs were exposed to caries development via plaque growth in a Microbial Caries Model for 7 days. Toothpastes were applied as slurries (one toothpaste–three DDW) for 2 min twice daily. Demineralization was measured as the change in surface microhardness (ΔSMH) and amount of mineral lost (∆Z), and these metrics were assessed using Transverse Microradiography. Intra-group (SMH) and intergroup (%∆SMH and ∆Z) comparisons were paired t-test and Tukey’s test (α = 0.05), respectively. Results: With SMH, demineralization was found to be significant (p < 0.001) in all groups compared to sound enamel baseline, except ICT group. With %ΔSMH, all other groups had significantly (p < 0.001) less demineralization compared to DDW. Significantly (p < 0.001) greater demineralization was observed in IT, FT and FST compared to ICT, and no significant difference was observed between IST and ICT or FT. With ∆Z, relative to the DDW group, the inhibition of demineralization was significant (p < 0.0001) in all groups at varying percentages. Conclusions: Toothpaste containing 10% Isomalt, 1100 ppm fluoride, and 0.05% CPC demonstrated greater efficacy in inhibiting caries development amid dental plaque compared to toothpaste containing only 1100 ppm fluoride.

Objectives: The effectiveness of an Isomalt-containing mouthrinse to prevent caries development was investigated. Methods: Human enamel blocks were randomly assigned to five groups (n = 30/group): De-ionized distilled water (DDW), and mouthrinse containing either (IFC) 1% Isomalt, 225 ppm fluoride, and 0.05% cetylpyridinium chloride (CPC), (IF) 1% Isomalt and 225ppm fluoride, (FC) 225 ppm fluoride and 0.05% CPC or (F) 225 ppm fluoride. During 7-day demineralization in a Microbial Caries Model, mouthrinses were applied once daily for 1 min. Demineralization was assessed using Surface Microhardness testing for percentage change in SMH (%ΔSMH) and Transverse Microradiography for mineral loss (ΔZ). Data analysis (α = 0.05) used paired t-test (Intra-group comparison using SMH) and ANOVA/Tukey’s for inter-group comparisons (%ΔSMH and ΔZ). Results: With SMH, relative to sound enamel baseline, demineralization was significant (P < 0.001) in all groups, except in IFC. Intergroup comparison with %ΔSMH showed significantly (p < 0.001) greater demineralization in DDW compared to other groups, and in IF, FC, and F compared to IFC (P < 0.001). With ΔZ, relative to DDW, all groups significantly (p < 0.0001) inhibited demineralization at varying percentages. Conclusions: Mouthrinse containing Isomalt, fluoride, and CPC inhibited demineralization amidst cariogenic biofilm; thus, highlighting its potential as a more effective caries control tool than mouthrinse with only fluoride.