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A computer simulation of the reactions between hydroxyapatite and fluoride in aqueous acidic solutions.

A precipitation reaction between hydroxyapatite (HAp) and fluoride solution was analyzed by computer simulation. The system comprised excess HAp and 0.05-0.2 M acetic buffer solutions containing 0.5-2.0 mM potassium fluoride. The amounts of HAp dissolved and calcium salts precipitated and activities of all the species present in the solution were calculated during the process. In the systems, calcium fluoride was initially precipitated when applying the fluoride solution to HAp, followed by precipitation of fluorapatite (FAp) and re-dissolution of the previously precipitated calcium fluoride at a critical pH at which the ion activity product exceeded the solubility product of FAp. The critical pH was increased with pH of the buffer, whereas it was scarcely affected by fluoride ion concentration, and it was necessary to introduce phosphate ions in advance into the buffer for predominant precipitation of FAp in this system.

Algorithms↗

Tooth wear prevention: a quantitative and qualitative in vitro study.

BACKGROUND: Management of tooth wear from grinding presents a significant clinical challenge. Acrylic nightguards are often used to protect the teeth, but many patients still grind with these appliances. This study aimed to test the effectiveness of three lubricants in reducing enamel wear by using an electro-mechanical machine under controlled conditions, with a view to undertaking a subsequent longitudinal clinical study. METHODS: Sectioned tooth specimens were worn against each other under different loads and with the addition of three different lubricants: calcium fluoride (CaF) powder, olive-oil, and a combination of calcium fluoride with olive-oil in the form of a slurry. Wear rates of enamel only were quantified by weighing the specimens, and resin replicas of the worn tooth surfaces were made for examination under a scanning electron microscope. RESULTS: All three lubricants reduced the amount of enamel wear significantly compared with wearing specimens without adding lubricants. Wear rate was influenced by the type of lubricant and the load applied. Wear rates were significantly less for olive-oil and the olive-oil/CaF slurry compared with CaF alone. The microwear detail differed between the three lubricants. CONCLUSIONS: This study has shown that enamel wear can be reduced using dry or wet lubricants between opposing teeth that are worn under controlled conditions. Further research is required to clarify their possible clinical applications.

Analysis of Variance↗

The effect of fluoride and calcium on spinal bone mineral content: a controlled, prospective (3 years) study.

Daily treatment with 30 mg of sodium fluoride (NaF) and 1 g of calcium over a 3-year period increased the bone mineral content (BMC) in the spines of women (n = 25) with osteoporosis. Determination of the BMC was followed with dual photon absorptiometry (137Cs-241Am) in the third lumbar vertebra. No increase in BMC was found with only 10 mg sodium fluoride in combination with calcium (n = 25), with calcium alone (n = 25), or with placebo (n = 25). No serious side effects were registered. There was, however, minor gastrointestinal distress in one-fifth of the patients taking 30 mg NaF daily.

Aged↗

Orthodontic appliances and enamel demineralization. Part 2. Prevention and treatment of lesions.

Clinical experiments were performed to investigate the effect of fluoride on carious lesion development and on lesions established during fixed orthodontic therapy. All presently available fluoride agents are developed from the concept of fluoridating the enamel in the form of fluorhydroxyapatite. Recent research has indicated, however, that calcium fluoride formation may be a major aspect of the mechanism of the cariostatic effect of topical fluoride. Therefore a fluoride solution with very low pH (1.9) that induced large amounts of calcium fluoride also was tested on lesion development underneath orthodontic bands. Daily fluoride mouth rinsing with a 0.2% solution sodium fluoride (NaF) retarded lesion development significantly, whereas the fluoride solution with low pH inhibited lesion formation completely. Fluoride applied as a mouth rinse to plaque-covered lesions underneath orthodontic bands retarded lesion progression. The remineralizing capacity of saliva was found to be rapid in the absence of any fluoride. Although white spot lesions may remineralize and even disappear, most of the emphasis should be directed against prevention of carious lesion development during treatment with fixed orthodontic appliances.

Adolescent↗

Saturation of human saliva with respect to calcium salts.

It may be assumed that free ionic concentrations of calcium and phosphate in resting saliva tend to equilibrate with those in plaque fluid, and that salivary data can therefore be used to illustrate chemical conditions in both saliva and plaque. In the present study, salivary data collected from the literature or obtained in our laboratory were used to calculate degrees of super- and undersaturation with respect to apatites, brushite, beta-tricalcium phosphate, octacalcium phosphate, calcium carbonate and calcium fluoride in the pH range from 3 to 9. Concentrations of calcium, phosphate, fluoride, carbonate, and background ion strength of resting parotid saliva, resting submandibular saliva, and resting and stimulated whole saliva were entered into a computer program, and curves illustrating saturation in the pH range 3-9 constructed. It was found that oral fluids are supersaturated with respect to apatites above pH 5.3 and with respect to octacalcium phosphate and beta-tricalcium phosphate above pH 6. Parotid saliva was undersaturated with respect to brushite whilst submandibular saliva was supersaturated with respect to that salt in the pH range 6-8. Stimulated whole saliva with 25 mmol/l carbonate became supersaturated with respect to calcium carbonate only above pH 7.3, which may explain the absence of this salt in the human oral cavity. To maintain the saturation of oral fluids with respect to calcium fluoride, i.e. to ensure its survival in the mouth required 6 ppm fluoride in the aqueous phase. Therefore, this salt, the outcome of topical fluoride therapy, will inevitably dissolve in the oral fluids.

Adult↗

Exocytotic enzyme release from rabbit polymorphonuclear leukocytes after treatment with fluoride and calcium.

Treatment of rabbit polymorphonuclear leukocytes (PMNs) with 20 mM sodium fluoride for 10 min, followed by removal of fluoride and addition of Ca2+ results in extensive exocytosis. This is apparent from a strong lysozyme release, together with a slight LDH release. During fluoride-activated Ca2+-dependent exocytosis an increase of indo fluorescence and a strong association of 45Ca with the cells occurs. Different inhibitors inhibit both 45Ca association and lysozyme release. Pretreatment of PMNs with pertussis toxin, or the presence of AI3+ in the medium has little effect on fluoride-activated Ca2+-dependent exocytosis. During pretreatment with fluoride, the ATP level strongly decreases. Exocytosis nevertheless occurs upon addition of Ca2+, indicating that a normal ATP level is not required for exocytosis. The glycogen content of the cell strongly decreases during exposure to Ca2+ after pretreatment with fluoride, but not during pretreatment with fluoride. Breakdown of glycogen and accumulation of 3-phosphoglycerate suggest that glycolysis is blocked at the enolase step, but proceeds as far as that step.

Adenosine Triphosphate↗

Effect of soluble calcium on fluoride uptake by enamel from sodium monofluorophosphate.

The fluoride uptake by sound, acid-etched and artificial white spot lesions treated with sodium monofluorophosphate in dentifrice slurries, abrasive slurries, or calcium chloride solutions was determined. Fluoride uptake by sound enamel decreased in the presence of soluble calcium; however, uptake by etched and white spot enamel was greatly enhanced. The optimum Ca:MFP molar ratio was 0.5. Because fluorine-containing dentifrices probably inhibit dental caries by interaction with white spots or at the initial stage of acid-attack, the soluble calcium contained in saliva or a dentifrice might enhance the anti-caries effect of monofluorophosphate.

Animals↗

[Multidisciplinary study of the prolonged treatment of involution osteoporosis using sodium fluoride with calcium, phosphate and vitamin D].

A multidisciplinary study on the prolonged treatment of involution osteoporosis with fluoride was performed on a homogeneous population of 31 women aged 51 to 75 years (mean 64 years). The selection criteria were the following: significant backache, vertebral compression fractures on X-rays, bone biopsy evidence of osteoporosis, and absence of other risk factors after a complete workup. The patients were treated for a period of 3 to 6 years (mean 4 years) with daily doses of 30 mg (10 mg 3 times) fluorides ion associated during the last 3 years with 500 mg calcium twice daily, 750 mg phosphate and 1000 units vitamin D daily. The study demonstrated a favourable effect of the treatment on the backache and that it was well tolerated in the majority of cases, the side effects being intermittent osteo-articular pains of the lower extremities due to the fluoride in 9 patients, and gastric intolerance to the phosphate in 7. X-ray follow-up showed slowing of the vertebral compressions after the first year of treatment, but no effect on fractures of the extremities. There was no evidence of alterations in parameters of mineral and bone metabolism, and in endocrine, hepatic, renal or hematological assays. Histomorphometric and biophysical examination of biopsies indicated that, although there was no significant increase in the quantity of mineralized bone under the treatment, there was a very significant improvement in the crystallinity of the mineral substance, thus enhancing the quality of the bone tissue and its resistance to pressure. This study is the first in which a catamnesis of the patients was undertaken, 28 of them having received a clinical and radiological examination 2 years after the end of therapy: a favourable evolution was observed in most of the cases, both in those patients treated for a period of 3 years and in those whose treatment had lasted for a longer period.

Aged↗

Effect of artificial saliva and calcium on fluoride output of controlled-release devices.

The purpose of this in vitro study was to assess the effect of graded concentrations of calcium in artificial saliva on the output of fluoride from HEMA/MMA controlled-release devices. After the initial release rates were determined in deionized water, the devices were assigned to five groups. The devices of one group remained in deionized water throughout the 19-day study while those of the other groups were placed in artificial saliva containing 0, 4.5, 8.0, or 12.0 mg% calcium on days 4-13. Ten devices of each group were placed in deionized water again on days 14-17 and then in 0.1 mol/l HCl on days 18-19. The five devices of each group that were not placed in deoinized water on day 14 were inspected for surface crystals and then placed in 1 mol/l KOH for 2 days. The fluoride release rates in artificial saliva were reduced by 71-90% and in proportion to the calcium concentration. The release rates in deionized water (days 14-17) approached the baseline values; they exceeded baseline rates by 13-49% while in HCl. The fluoride release rates did not differ among the groups while in KOH, but calcium output was directly related to the calcium concentration of the artificial saliva. The results indicate that fluoride release from HEMA/MMA devices is markedly reduced in artificial saliva and that the reduction is proportional to the concentration of calcium.

Calcium↗