Fluoride gel supplemented with sodium hexametaphosphate reduces enamel erosive wear in situ

Abstract

This study evaluated the effect of fluoride gels, supplemented or not with sodium hexametaphosphate (HMP), on enamel erosive wear in situ. Twelve healthy volunteers wore palatal appliances containing four bovine enamel discs. Subjects were randomly allocated into four experimental phases (double-blind, crossover protocol) according to the gels: Placebo (no fluoride or HMP), 1% NaF, 2% NaF, and 1% NaF+9% HMP. Enamel discs were selected after polishing and surface hardness analysis, and treated only once with the respective gels prior to each experimental phase. Erosion (ERO) was performed by extra-oral immersion of the appliance in 0.05M citric acid, pH 3.2 (four times/day, five minutes each, 5 days). Additional abrasion (ERO+ABR) was produced on only two discs by toothbrushing with fluoridated dentifrice after ERO (four times/day, 30s, 5 days). The specimens were submitted to profilometry and hardness analysis. The results were analyzed by two-way ANOVA and the Student-Newman-Keuls test (p<0.05). The 1% NaF+9% HMP gel promoted significantly lower enamel wear for ERO compared to the other groups, being statistically lower than 1% NaF and Placebo for ERO+ABR. Similarly, the lowest values of integrated lesion area were found for 1% NaF+9% HMP and 2% NaF, respectively, for ERO and ERO+ABR. The addition of HMP to the 1% NaF gel promoted greater protective effect against ERO and ERO+ABR compared to the 1% NaF gel, achieving similar protective levels to those seen for the 2% NaF gel. Gel containing 1% NaF+9% HMP showed a high anti-erosive potential, being a safer alternative when compared to a conventional 2% NaF gel.