Effect of Calcium and Phosphate Containing Fluoride Rinse on Re/Demineralization

Fluoride (F) has been shown to enhance remineralization and reduce demineralization.  These effects may be enhanced by the addition of calcium and phosphate, the mineral components of teeth. OBJECTIVE: Determine the clinical efficacy of a calcium and phosphate containing F rinse using an in situ re/deminerization caries model (Zero, Adv Dent Res 9:214-230, 1995). METHODS:  An intraoral appliance holding two bovine enamel blocks was employed; one partially demineralized block (remineralization model) and one sound block (demineralization model). Changes in the mineral content of the enamel blocks were assessed using surface microhardness (SMH). The test subjects (N=15) wore the appliance and rinsed (15mL) for 90sec twice a day for a 2-week test periods. 5 test treatments were studied: 0ppm , 85ppm, 225ppm F rinses, ACT Dental Rinse (225ppm F, Johnson & Johnson), and ACP-F test rinse (18mM Ca, 10mM P, 85ppm F, mixed immediately before treatment). All subjects completed all treatments using a cross-over design. The precipitate from the ACP rinse was determined by x-ray powder diffraction and Infrared spectroscopy. RESULTS: The supersaturated ACP-F solution precipitated an amorphous calcium-phosphate-fluoride within 90s of mixing. The Table shows the mean(SD) % SMH changes after treatment. In the remineralization model, the % SMH recovery with ACP-F rinse treatment was similar to that of the 225ppm F rinse, and provided a statistically significant 29% and 53% advantage as compared to that of 85ppm F and ACT rinses respectively. There were no statistically significant differences in the demineralization model between these 4 F treatments.

Model	0ppm F	85ppm F	225ppm F	ACT	ACP + F
Remin.	13.9(9.5)	52.3(27.1)	64.9(22.5)	44.0(28.9)	67.5(22.3)
Demin.	-18.1(17.6)	-11(17.0)	-7.8(6.2)	-10.4(5.2)	-9.9(12.6)

CONCLUSION: The ACP-F rinse enhanced the remineralization by deposition of amorphous calcium phosphate and fluoride. Support: EDC, ADAF, NIST, and SKB.