Vergleich der remineralisierenden Wirkung von Zahnpasten mit unterschiedlichen Fluoridgehalten

Comparison of the remineralising effect of toothpastes with different fluoride contents Objective: In the present in vitro study, the remineralising effect of fluoride-containing toothpastes with different fluoride contents was analysed over a period of 90 days. The aim of the in vitro study was to investigate the remineralising effect of a toothpaste with bioactive glass and a lower fluoride content with commercially available toothpastes on demineralised tooth samples. The aim was to determine an optimal fluoride content in toothpastes that would provide effective caries prophylactic protection. Material and Method: Cleaned extracted teeth were used for the study. The surfaces to be evaluated were polished, and the tooth samples were artificially demineralised, thereby creating an initial lesion. The samples were divided into three different groups (A, B, C) of 15 tooth samples each and assigned to three toothpastes with different fluoride contents: A) BioMin™ F – 530 ppm, B) Duraphat® 5 mg/g toothpaste – 5000 ppm and C) Colgate® Total Original – 1450 ppm. The tooth samples were stored in a remineralisation solution throughout the study and underwent a pH cycling model for 90 days. This involved a two-minute acid attack with lactic acid (pH = 4.6) twice daily, followed by a two-minute simulation of the groups brushing their teeth in their respective toothpaste slurry. Measurements were made by quantitative light-induced fluorescence (QLF) method before and after demineralisation and after 7, 30, 60 and 90 days. The target parameter was the fluorescence loss/fluorescence gain measured on the reference standard QLF. The evaluation of the measuring ranges of the tooth samples referred to the analysis of the fluorescence loss (ΔF in %) and the volume of the lesion (ΔQ in % x px²). Statistics: The analysis was performed with the statistical software programme MedCalc, version 19.3.1. The normal distribution was checked by using Shapiro-Wilk test. The Kruskal-Wallis test was used for the independent data and the Friedman test for the dependent data. The significance tests were carried out with the Dunn and Conover post-hoc analysis. The significance level was set at α = 0.05. Results: The remineralising effect between group A (530 ppm F) and group B (5000 ppm F) showed no significant difference after 90 days. The remineralising effect related to ∆F was significantly lower in group A (530 ppm F) compared to group C (1450 ppm F) after 90 days (∆F: p = 0.019) and related to ∆Q without significant difference. With regard to the remineralising effect, there was no significant difference over time after 90 days between group A (530 ppm F) and group C (1450 ppm F). The remineralising effect showed a significant improvement over time after 90 days within group B (5000 ppm F) (∆F: p = 0.039 – ∆Q: p = 0.005). Discussion and Conclusion: The results lead to the conclusion that improved remineralisation is due to a higher fluoride content of the toothpastes. The toothpaste with 5000 ppm F (Duraphat) was the only one to show a significant improvement in remineralisation after 90 days. Accordingly, it can be said that the toothpaste with the highest fluoride content showed the most effective caries-preventive protection in the period studied. In the group comparisons, the commercial toothpaste with 1450 ppm F (Colgate Total Original) had a significantly higher remineralising effect compared to the toothpaste with 530 ppm F (BioMin F). The results obtained in this in vitro study would now have to be verified by further clinical investigations.