Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12

Contents lists available at ScienceDirect

Journal of the Mechanical Behavior of

Biomedical Materials
journal homepage: www.elsevier.com/locate/jmbbm

Effects of dentifrices on mechanical resistance of dentin and restorative T

materials after erosion and abrasion
Diego Felipe Mardegan Gonçalvesa, André Luiz Fraga Brisoa, Nubia Inocencya Pavesi Pinib,
Mariana Dias Modaa, Renata Parpinelli de Oliveiraa, Paulo Henrique dos Santosc,
Ticiane Cestari Fagundesa,∗
a
Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba. R. José Bonifácio 1193, CEP, 16015-050, Araçatuba/SP, Brazil
b
Department of Restorative Dentistry and Prosthodontics, Ingá University Center - UNINGÁ, 317 PR Road, Maringá/PR, Brazil
c
Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araçatuba. R. José Bonifácio 1193, CEP, 16015-050,
Araçatuba/SP, Brazil

ARTICLE INFO ABSTRACT

Keywords: The aim of this study was to evaluate the mechanical resistance of dentin and restorative materials submitted to
Abrasion. erosion. composite resin. resin- erosive/abrasive challenges with different dentifrices. The dentin was restored using a resin-modified glass-
modified glass-ionomer ionomer (RMGIC) or a composite resin (RC). One hemiface of the sample was protected, and the other was
subdivided according to the applied dentifrice (n = 10): without fluoride (SF), sodium fluoride (NaF) and
stannous fluoride (SnF). The specimens were submitted to erosive/abrasive cycles, the varnish was removed, and
the Martens hardness (HMV) and elastic modulus (Eit) were evaluated. The data were analyzed by repeated two-
way ANOVA measurements and Tukey tests (alpha = 0.05). When analyzing the HMV on the test side, there was
no influence of the dentifrices in the dentin; however, the orders of NaF < SnF = SF in RC and SnF > NaF =
SF in RMGIC were observed. Comparing the treated surfaces, there were no differences in the dentin, and only
the SF since CR presented an HMV superior to that of RMGIC. Comparing control and test sides, both dentins
obtained a decreased HMV after the erosive/abrasive challenge; for the restorative materials, superior values
were found only for SnF in the RMGIC. The Eit values were influenced more by the dentifrices on the test side for
the dentin adjacent to the RMGIC, with the lowest values shown for the SF, and for both materials, the highest
values were shown for the SnF group. No differences were found when comparing each dentin treated with the
same dentifrice; however, the RMGIC presented a superior Eit than the CR when brushed with both dentifrices
with a fluoride. Comparing the control and test sides, the same results were obtained for the HMV. The denti-
frices showed little influence on the dentin substrate, whereas the dentifrice with SnF enhanced the mechanical
properties of the restorative materials, which was more evident in the RMGIC.

1. Introduction reducing its resistance and making it more susceptible to mechanical

Erosive dental wear is a multifactorial condition that results in
chemical dissolution of mineralized tissues, loss of enamel and dentin
thickness, and structural changes in the remaining tissues (Lussi and
Carvalho, 2014). Dental erosion occurs from acids of extrinsic (ex-
cessive consumption of acidic substances, citrus juices, and soft drinks)
or intrinsic (gastroesophageal disorders) origin (Huysmans et al.,
2011).
In dental enamel, wear occurs from demineralization and pro-
gressive softening caused by acid on the surface of the dental tissue,
stresses, such as attrition or abrasion (West and Joiner, 2014). Dentin is
a tissue that is less mineralized with a higher organic content (type I
collagen and non-collagenous compounds), lower hardness, and elastic
properties than dental enamel (Lussi et al., 2011). In addition, dentin
presents peritubular and intertubular dentins, which after challenge
acids form a disorganized surface layer (Amaechi and Higham, 2005).
The high prevalence of erosive dental wear has resulted in increased
research to improve the treatment and prevention of disease (Lussi and
Carvalho, 2014). Etiologic factors should be removed or controlled to
reduce the effects of acid on the dental tissue (Amaechi and Higham,

∗
Corresponding author. Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Araçatuba. R. José Bonifácio 1193, CEP,
16015-050, Araçatuba-SP, Brazil.
E-mail addresses: ticiane.fagundes@unesp.br, ticiane_f@hotmail.com (T.C. Fagundes).

https://doi.org/10.1016/j.jmbbm.2019.05.006
Received 30 January 2019; Received in revised form 30 April 2019; Accepted 3 May 2019
Available online 04 May 2019
1751-6161/ © 2019 Published by Elsevier Ltd.
D.F.M. Gonçalves, et al. Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12

2005). Some protective therapies using dentifrices, rinsing solutions,

and varnishes have been proposed to increase tissue resistance to acid

Trybol AG, Neuhausen AM Rheinfall,

dissolution (Young et al., 2006; Ganss et al., 2009).

Colgate-Palmolive, São Bernardo do

Conventional formulations with sodium fluoride in their composi-

GC Corporation, Tókio, Japan.

tion form precipitates on the organic layer of demineralized dentin;
however, this layer is unstable and does not provide protection after
new challenges (Huysmans et al., 2014). In this context, dentifrices

P&G, Cincinnati, USA.

St. Paul, MN, USA.
with stannous ions associated with fluoride have presented a better

Campo, SP, Brazil.

anti-erosion effect (Young et al., 2006; Hooper et al., 2007; Faller et al.,

Manufacturer
2011). The deposition of stannous ions in the eroded tissue form a

3M ESPE
protective barrier that remains in position for up to 4 h, preventing

Swiss.
contact with the acids. Furthermore, such composition can reduce the
susceptibility of dental tissues to mineral loss by 80% (Hooper et al.,
2007).

Phosphate, Sodium Lauryl Sulfate, Sodium Lauryl Sulfate, Carrageenan, Sodium Saccharin, Xanthan Gum, Blue 1
Water, Sorbitol, Hydrated Silica, Glycerin, Steareth-20, Titanium Dioxide (Cl 77891), Aroma, Sodium Phosphate,

Glycerin, Hydrated Silica, Sodium Hexametaphosphate, Propylene Glycol, PEG 6, Water, Zinc Lactate, Trisodium
In this context, abrasive components are added to the dentifrices to

Water, Triclosan, Sorbitol, Silica, Sodium Lauryl Sulfate, PMV/ MA Copolymer, Sodium Hydroxide, Saccharin
improve their cleaning and polishing potential, and the concentration is

Powder: fluor-amino-silicate glass. Liquid: aqueous solution of polycarboxylic acid, TEGDMA and HEMA
varied according to the therapeutic purpose. These values have been set

Carrageenan, Sodium Chloride, Citric Acid, Sodium Benzoate, Potassium Thiocyanate, Glucose Oxidase,
Bis-GMA, UDMA, Bis-EMA, TEGDMA, PEGDMA, Zirconia and agglomerates of silica, camphorquinone
by the American Dental Association (ADA) according to the relative
dentin abrasivity (RDA) or relative enamel abrasivity (REA). In erosive
dental wear, there is no consensus regarding the influence of the
abrasiveness of the dentifrices in terms of a protective effect on the
erosion/abrasion (Hughes et al., 2008; Aykut-Yetkiner et al., 2014).
After a loss of tissue thickness in the cervical region, composite
resins and glass ionomer cement should be used to replace the lost
tissue and prevent the occurrence of larger lesions (Colon and Lussi,
2014). It has been observed that composite resin shows less loss of
surface material after an erosive challenge, and RMGIC demonstrates a
reduced acid degradation and protected dental surfaces adjacent to the
erosion (Alghilan et al., 2015). However, few studies have evaluated
the effect of different dentifrices in the prevention of the erosion/
abrasion of composite resin and glass ionomer cement restorations,
mainly analyzing superficial mechanical properties, such as Martens
hardness and modulus of elasticity, since the majority of studies have
evaluated the profilometry (Ganss et al., 2011; Schlueter et al., 2011;

Stannous fluoride (1100 ppm F as SnF2)

Alghilan et al., 2015).
Amyloglucosidase, Lactoperoxidase .
Sodium Fluoride (1450 ppm as NaF)

Therefore, the objective of the present study was to investigate the

protective capacity of dentifrices on the mechanical resistance of dentin
and restorative materials after erosion and abrasion. Three null hy-
Sodium, Titanium Dioxide

potheses were proposed: (1) there is no difference among the dentifrices

applied for dentin and restorative materials after erosion and abrasion
cycles, (2) there are no differences among the analyzed surfaces when a
Composition

single type of dentifrice is evaluated after the erosion and abrasion

cycles, and (3) there is no difference between both sides (control and
test) for the dentin and restorative materials.

2. Materials and methods

RMGIC
Code

NaF

SnF
CR

SF

2.1. Study design

Stannous Fluoride Toothpaste
Resin-modified glass-ionomer

Sodium Fluoride Toothpaste

A total of 120 dentin bovine blocks; two restorative materials,

Fluoride-free Toothpaste

namely, a composite resin (CR) and resin-modified glass ionomer ce-

ment (RMGIC); three dentifrices, namely, without a fluoride group with
Composite Resin

low abrasivity (SF), sodium fluoride with medium abrasivity (NaF), and
stannous fluoride with high abrasivity (SnF); and control and test sides
were employed in this in vitro study. Erosive/abrasive cycles were ap-
cement
Type

plied. The Martens hardness (HMV) and elastic modulus (Eit) were used
to evaluate the mechanical properties of dentin and the restorative
material surfaces. The materials used are described in Table 1.
Colgate Total 12 (RDA-70/80)
Materials used in this study.

Curaprox Enzycal Zero (RDA-

Crest Pro-Health (RDA-155)

Filtek Z350 XT (color A2B)

2.2. Specimen preparation

Fuji II LC (color A3)

Bovine teeth were obtained and stored in a 0.1% thymol solution for
30 days (#00453–2017 ethical protocol). Dentin blocks (4 × 4 mm2)
were obtained from the cervical dentin using diamond discs (Isomet
Material

30)
Table 1

1000, Buehler, Illinois, USA). The samples were polished with sand-
paper (#600, #1200, #2000) under constant irrigation. The specimens

8
D.F.M. Gonçalves, et al.
were then polished using a felt disc and 1-μm diamond paste (Arotec,
Cotia, SP, Brazil). These procedures allowed dentin blocks with a
thickness of 1 mm to be obtained, which were controlled using a digital
caliper. The specimens were then exposed to Knoop microhardness
(Shimadzu Corporation, Kyoto, Japan) with a static load 50 g for 15 s
until standardization (Souza et al., 2015).
Two specimens were embedded in acrylic resin using a metal matrix
with a 1-mm distance. Wear was carried out between the blocks using a
diamond tip (#1090, KG Sorensen, Barueri, SP, Brazil) coupled in a
high-rotation, simulating cavity walls adhered to the restorative ma-
terials. Thirty samples were restored using CR and photocured for 20 s
(Kavo, Joinville, SC, Brazil). Thirty other samples were restored using
RMGIC, photocured for 40 s, protected with petroleum jelly, and kept
under humid conditions at 37 °C for 7 days. After storage, the samples
were polished as previously described for excess removal. A hemiface of
each specimen was protected using an acid-resistant varnish (Colorama,
São Paulo, SP, Brazil) to create the control and test sides.
2.3. Erosion/abrasion cycling
The specimens of each type of material tested were divided into
three groups according to the dentifrices (n = 10): SF, NaF, and SnF.
The sample size was determined from a previous pilot study using the
minimum difference between the means and the mean of the standard
deviations, with a test power of at least 80% and a significance level of
5%. During the experiment period, specimens were subjected to a 5-day
erosive/abrasive cycling regimen. Erosive cycles were performed four
times daily, and abrasive challenges were applied after the first and last
cycles.
The samples were eroded by immersion in 250 ml of citric acid
(pH = 3.2) for 2 min under an orbital shaking table (Tecnal TE – 420,
Piracicaba, SP, Brazil) (Cruz et al., 2015). The dentifrices were diluted
in distilled water (1:3), and 2 ml of this solution was pipetted on the
samples after the first and last cycles. The abrasive challenge was ap-
plied with an electric brush (Oral-B Plak Control Ultra; Braun, Frank-
furt, Germany) with a weight of 200 g for 15 s, and immersed in the
slurry for 2 min (Pini et al., 2016). After the daily challenges, the
samples were stored in artificial saliva at 37 °C for 1 h until the next
cycle (Pini et al., 2016). At the end of experiment period, the acid-
resistant layer was removed and the samples were stored under 100%
humidity until analysis.
2.4. Surface analyses
The response variables (HMV and Eit) were measured using a dy-
namic ultra microhardness tester (DUH-211S; Shimadzu, Kyoto, Japan)
under a load of 50 mN for 5 s (Mahoney et al., 2003). Three indenta-
tions were applied using a Vickers indenter in each region of the
9
Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12
Fig. 1. Experimental design. (a) The specimens obtained
(4 × 4 mm2) were submitted to initial microhardness
analyses for selection (b). Both specimens were included
in an acrylic base with a 1-mm distance between them
(c). A cavity was prepared on the walls of the specimens,
with a total distance of 2 mm between them (d). The re-
storation was applied, (e) the restorations were polished
(f) and the hemiface of each specimen/restoration set was
covered with an acid-resistant varnish (g). The samples
were submitted to erosive/abrasive challenges (h).
Finally, the acid-resistant varnish was removed (i) and
the samples were subjected to the Martens hardness and
modulus of elasticity (j).
adhesive interface: dentin underlying the restorative materials, RMGIC,
and CR on the control and test sides (Guedes et al., 2016). A flowchart
of the study is shown in Fig. 1.
2.5. Statistical analyses
Data were analyzed for normality using a Shapiro-Wilk test.
Repeated two-way ANOVA measurements and a Tukey's post-test were
used. The level of significance was 5%. The data were analyzed using
SigmaPlot 12.0 software (Systat Software, San Jose, CA, USA).
3. Results
The HMV analyses (Table 2) showed differences only for dentin
adjacent to the RMGIC on the control side (p < 0.05); however, there
were no differences between the dentifrices applied to the adjacent
dentin to the restorative materials on the test side. Lower values for the
NaF as compared to the SF and SnF were found in the CR (p < 0.05);
however, the SnF showed higher values than the NaF and SF
(p < 0.05). Comparing the treated surfaces, there were no differences
between the dentins (p > 0.05), and only SF CR presented a superior
HMV than the RMGIC (p < 0.05). The HMV of the dentin on both the
control and test sides decreased after the challenge; for the restorative
materials, superior values were found only for the SnF in the RMGIC
(p < 0.05).
Regarding the Eit data (Table 3), a statistical difference was de-
monstrated only for DRMGIC in the NaF group for the control side
(p > 0.05). On the test side, the Eit values were influenced by denti-
frices in the dentin adjacent to the RMGIC, with the lowest values
shown for SF (p < 0.05). The SnF group presented the highest values
for both materials (p < 0.05). No differences were found when com-
paring the dentin treated with the same dentifrice; however, the RMGIC
presented a superior Eit than the CR when brushed with both denti-
frices with fluoride (p < 0.05). Comparing the control and test sides,
the same results as those obtained for HMV were found.
4. Discussion
HMV analyses were conducted to measure the mechanical proper-
ties and the simultaneous plastic and elastic deformations of the dentin
and restorative materials through indentations applied under low loads
(Schlueter et al., 2011; Alghilan et al., 2015; Suzuki et al., 2015). These
analyses allow an evaluation of not only the mechanical behavior of
dentin and the restorative materials, but also the changes in resistance
values of different areas, in other words, if one “reference area” remains
unchanged. In the present study, the sound untreated dentin or re-
storative material served as the “intra-specimen” reference area used to
analyze the change in resistance of the treated areas after erosion/
D.F.M. Gonçalves, et al. Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12

Table 2
Mean and standard deviation of HMV (GPa) according to each dentifrice, substrate and restorative material.
Dentifrice Control

DCR DRMGIC CR RMGIC

SF 1.57 ± 0.05 Aa 1.28 ± 0.02 Cb 1.69 ± 0.05 Aa 1.47 ± 0.11 Aa

NaF 1.66 ± 0.07 Aa 1.68 ± 0.14 Aa 1.49 ± 0.06 Aa 1.59 ± 0.16 Aa
SnF 1.58 ± 0.04 Aa 1.48 ± 0.07 Ba 1.79 ± 0.04 Aa 1.78 ± 0.05 Aa

Dentifrice Test
DCR DRMGIC CR RMGIC

SF 0.55 ± 0.02 Aa* 0.58 ± 0.01 Aa* 1.84 ± 0.05 Aa 1.42 ± 0.06 Bb
NaF 0.53 ± 0.02 Aa* 0.74 ± 0.04 Aa* 1.59 ± 0.14 Ba 1.64 ± 0.10 Ba
SnF 0.49 ± 0.04 Aa* 0.62 ± 0.03 Aa* 1.98 ± 0.04 Aa 2.22 ± 0.07 Aa*

SF (Without Fluoride)/ NaF (Sodium Fluoride)/ SnF (Stannous Fluoride)/ DCR (Dentin adjacent Composite Resin)/ DRMGIC (Dentin adjacent Resin-Modified Glass-
Ionomer).
Upper case letters compare toothpastes. Lowercase letters compare surfaces alone between dentin and restorative materials. * Compare differences between control
side and test.

abrasion cycling. Therefore, sound untreated dentin and restorative
materials needed to be protected during the erosion/abrasion cycling.
Care was taken to apply and remove the “protective” nail varnish.
The first null hypothesis was partly rejected because there was an
influence of the dentifrices in dentin adjacent to the RMGIC and re-
storative materials. For dentin, the effect of the dentifrice with fluoride
was more evident when the dentin adjacent to the RMGIC was brushed
with NaF. This effect was observed in the same manner for the HMV of
the control side. The protective effect of sodium fluoride on dental
erosion is related to the formation of a physical barrier with minerals
similar to CaF2, which can be dissolved through an acidic challenge
before the underlying tissue is affected (Ganss et al., 2001; Diamanti
et al., 2016). In this study, the superiority of the NaF group on the
dentin adjacent to the RMGIC may have occurred owing to a confine-
ment of F ions in the monomeric matrix of the ionomeric material, al-
lowing an effect on the surface mechanical properties. Furthermore, the
RMGIC is able to recharge using F ions that bind poorly in the matrix
and release slowly, as well as protect the adjacent dental structure
submitted to erosive challenges (Freedman and Diefenderfer, 2003;
Mousavinasab and Meyers, 2009; Selimović-Dragaš et al., 2013;
Alghilan et al., 2015). The NaF contains approximately 10%–20%
abrasive silica particles (medium abrasivity), which may reduce the loss
of the substrate and increase the mechanical properties, presenting
superior results when compared to the SnF (high abrasivity) (Ganss
et al., 2017). However, dentifrice formulations with polyvalent fluoride
sources, such as a stannous association, have been shown to be pro-
mising for a dental erosion (Lussi and Carvalho, 2015). Dentin
demineralization and remineralization around the restorations depend
on the restorative material used, and this effect was not observed on the
substrate adjacent to the CR (Zan et al., 2018). Furthermore, a residual
effect from the presence of fluoride may occur in the dentin-adjacent
RMGIC on the control side because the analyses were conducted after
the challenge cycles. It is thought that the acid penetrated the dentinal
tubules and acted at a distance, changing the hardness on the control
side because the HMV was evaluated relatively close to the border re-
gion of the control and test sides. For the other conditions evaluated, no
differences were shown between the dentifrices in the dentin substrates,
corroborating with a previous study (Schlueter et al., 2007) that also
did not find an anti-erosive action for NaF with the formulations ma-
nipulated in the laboratory under pH conditions similar to those of the
present study (Huysmans et al., 2014). Moreover, the dentin on the test
side may have been similar in all groups owing to its loss on the surface
after an erosive/abrasive challenge (Ganss et al., 2011; Schlueter et al.,
2011; Alghilan et al., 2015).
Regarding the restorative materials, the SnF group in contact with
the restorative materials presented the highest mechanical properties,
being more evident its effect on the RMGIC. It is assumed that stannous
created a protective film on the restorative materials, as demonstrated
in the dental substrates (Hooper et al., 2010). In addition, another study
observed that enamel specimens brushed with the dentifrices con-
taining stannous/amine fluorides revealed significant mineral gains and
lesion depth reductions in pre-demineralized enamel (Kielbassa et al.,
2009). It has been speculated that negative zeta-potential abrasive silica
particles have bound to the positive stannous and formed a precipitate

Table 3
Mean and standard deviation of Eit (GPa) according to each dentifrice, substrate and restorative material.
Dentifrice Control

DCR DRMGIC CR RMGIC

SF 30.03 ± 1.57 Aa 24.78 ± 2.84 Ba 27.16 ± 2.45 Aa 27.75 ± 2.36 Aa

NaF 31.80 ± 1.29 Aa 32.31 ± 2.15 Aa 25.31 ± 1.17 Aa 32.79 ± 1.38 Aa
SnF 31.32 ± 1.33 Aa 28.10 ± 2.79 ABa 28.45 ± 1.80 Aa 34.41 ± 0.78 Aa

Dentifrice Test
DCR DRMGIC CR RMGIC

SF 15.52 ± 0.72 Aa* 15.72 ± 0.52 Ba* 28.44 ± 0.92 ABa 25.36 ± 1.85 Ca
NaF 15.42 ± 0.54 Aa* 20.50 ± 1.81 Aa* 23.22 ± 0.97 Bb 34.56 ± 2.03 Ba
SnF 15.03 ± 0.80 Aa* 17.44 ± 0.79 ABa* 30.45 ± 0.46 Ab 44.79 ± 0.95 Aa*

SF (Without Fluoride)/ NaF (Sodium Fluoride)/ SnF (Stannous Fluoride)/ DCR (Dentin adjacent Composite Resin)/ DRMGIC (Dentin adjacent Resin-Modified Glass-
Ionomer).
Upper case letters compare toothpastes. Lowercase letters compare surfaces alone between dentin and restorative materials. * Compare differences between control
side and test.

10
D.F.M. Gonçalves, et al.
on the surface (Ganss et al., 2017). The action of the SnF on the RMGIC
owing to the ionic interactions between the phosphate (sodium hex-
ametaphosphate) groups present in the dentifrice and the unreacted
calcium inside the RMGIC may have created an anti-erosive effect, as
occurs with calcium in the dental enamel (Hooper et al., 2007). Ac-
cording to our results, it is more advantageous to use a low-abrasive
dentifrice without fluoride or a high-abrasive dentifrice with an anti-
erosive effect because a conventional dentifrice (NaF) with medium
abrasiveness showed lower hardness than other dentifrices in the
composite resin. Evaluating the effect of a preventive mouthwash or gel
on composite resin materials, the authors found that a gel with 0.4%
stannous fluoride did not decrease the surface hardness, whereas a
mouthwash with Na fluoride affected this mechanical property in the
composite resin (Al-Samadani, 2016).
When evaluating the surfaces analyzed under the same type of
dentifrice, differences were found between the surfaces, countering the
second hypothesis. For the HMV on the test side, these differences were
observed only for the restorative materials, because for SF, superior
values were found for the CR. The difference between the responses of
the restorative materials may have occurred owing to the heterogeneity
between the materials (Sidhu and Nicholson, 2016; Tsujimoto et al.,
2018). The highest values for the HMV in CR brushed with SF may be
related to the higher hardness of CR when compared to RMGIC (Kaur
et al., 2015). It has been speculated that the action of a dentifrice with
low abrasiveness and the absence of fluoride has a minor influence on
the surface hardness of the restorative materials, maintaining such su-
periority. In this context, only Eit demonstrated superiority for RMGIC
when compared to CR brushed with fluoride dentifrices. The high va-
lues for RMGIC may be explained from the release of fluoride from the
ionomeric material, and may have increased in association with the
presence of fluoride and other active components presented in the NaF
and SnF dentifrices (Zan et al., 2018).
The third null hypothesis was rejected because the erosive/abrasive
challenges reduced the mechanical properties of the dentin, as pre-
viously reported (Lussi et al., 2011). Citric acid is considered a calcium
chelator and promotes demineralization on the dentin substrate (Reis
et al., 2008; Pancote et al., 2014). A study evaluating an erosive model
using citric acid at different concentrations concluded that 1% was
satisfactory to demonstrate the erosive effects when associated with an
abrasion, corroborating the results of the present study (Schlueter et al.,
2016). Regarding the restorative materials with statistical differences,
increased values were found.
One limitation of this in vitro study is that it is impossible to measure
the exact RDA values of the analyzed dentifrices, such as other authors
have evaluated, using manipulated dentifrices (Ganss et al., 2017).
Moreover, in situ and in vivo studies should be conducted to analyze the
action of dentifrices with anti-erosion effects in an oral environment.
5. Conclusion
The different dentifrices evaluated showed a low influence on the
dentin substrate, although a dentifrice with stannous fluoride increased
the mechanical properties of the ionomeric material after an erosive/
abrasive challenge.
Declarations of interest
None.
Acknowledgments
This study was financially supported by the FAPESP—São Paulo
Research Foundation (2017/11742-9).
11
Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12
References
Alghilan, M.A., Cook, N.B., Platt, J.A., Eckert, G.J., Hara, A.T., 2015. Susceptibility of
restorations and adjacent enamel/dentine to erosion under different salivary flow
conditions. J. Dent. 43, 1476–1482. https://doi.org/10.1016/j.jdent.2015.10.007.
Al-Samadani, K.H., 2016. Surface hardness of dental composite resin restorations in re-
sponse to preventive agents. J. Contemp. Dent. Pract. 17, 978–984.
Amaechi, B., Higham, S., 2005. Dental erosion: possible approaches to prevention and
control. J. Dent. 33, 243–252. https://doi.org/10.1016/j.jdent.2004.10.014.
Aykut-Yetkiner, A., Attin, T., Wiegand, A., 2014. Prevention of dentine erosion by
brushing with anti-erosive toothpastes. J. Dent. 42, 856–861. https://doi.org/10.
1016/j.jdent.2014.03.011.
Colon, P., Lussi, A., 2014. Minimal intervention dentistry: part 5. Ultra-conservative
approach to the treatment of erosive and abrasive lesions. Br. Dent. J. 216, 463–468.
https://doi.org/10.1038/sj.bdj.2014.328.
Cruz, N.V., Pessan, J.P., Manarelli, M.M., Souza, M.D., Delbem, A.C., 2015. In vitro effect
of low-fluoride toothpastes containing sodium trimetaphosphate on enamel erosion.
Arch. Oral Biol. 60, 1231–1236. https://doi.org/10.1016/j.archoralbio.2015.05.010.
Diamanti, I., Koletsi-Kounari, H., Mamai-Homata, E., 2016. Effect of toothpastes con-
taining different NaF concentrations or a SnF2/NaF combination on root dentine
erosive lesions in vitro. J. Clin. Exp. Dent. 8, 577–583. https://doi.org/10.4317/jced.
53047.
Faller, R.V., Eversole, S.L., Tzeghai, G.F., 2011. Enamel protection: a comparison of
marketed dentifrice performance against dental erosion. Am. J. Dent. 24, 205–210.
Freedman, R., Diefenderfer, K.E., 2003. Effects of daily fluoride exposures on fluoride
release by glass ionomer based restoratives. Operat. Dent. 28, 178–185.
Ganss, C., Klimek, J., Schäffer, U., Spall, T., 2001. Effectiveness of two fluoridation
measures on erosion progression in human enamel and dentine in vitro. Caries Res.
35, 325–330. https://doi.org/10.1159/000047470.
Ganss, C., Lussi, A., Grunau, O., Klimek, J., Schlueter, N., 2011. Conventional and anti-
erosion fluoride toothpastes: effect on enamel erosion and erosion-abrasion. Caries
Res. 45, 581–589. https://doi.org/10.1159/000334318.
Ganss, C., Möllers, M., Schlueter, N., 2017. Do Abrasives play a role in toothpaste efficacy
against erosion/abrasion? Caries Res. 51, 52–57. https://doi.org/10.1159/
000452867.
Guedes, A.P., Moda, M.D., Suzuki, T.Y., Godas, A.G., Sundfeld, R.H., Briso, A.L., Santos,
P.H., 2016. Effect of fluoride-releasing adhesive systems on the mechanical properties
of eroded dentin. Braz. Dent. J. 27, 153–159. https://doi.org/10.1590/0103-
644020160635.
Hooper, S.M., Newcombe, R.G., Faller, R., Eversole, S., Addy, M., West, N.X., 2007. The
protective effects of toothpaste against erosion by orange juice: studies in situ and in
vitro. J. Dent. 35, 476–481. https://doi.org/10.1016/j.jdent.2007.01.003.
Hughes, N., Mason, S., Creeth, J., Hara, A.T., Parmar, M., González-Cabezas, C., 2008.
The effect of anti-sensitivity dentifrices on brushing abrasion of eroded dentin in vitro.
J. Clin. Dent. 19, 143–146.
Huysmans, M.C., Chew, H.P., Ellwood, R.P., 2011. Clinical studies of dental erosion and
erosive wear. Caries Res. 45, 60–68. https://doi.org/10.1159/000325947.
Huysmans, M.C., Young, A., Ganss, C., 2014. The role of fluoride in erosion therapy.
Monogr. Oral Sci. 25, 230–243. https://doi.org/10.1159/000360555.
Kaur, S., Makkar, S., Kumar, R., Pasricha, S., Gupta, P., 2015. Comparative evaluation of
surface properties of enamel and different esthetic restorative materials under erosive
and abrasive challenges: an in vitro study. Indian J. Dent. 6, 172–180. https://doi.
org/10.4103/0975-962X.165047.
Kielbassa, A.M., Tschoppe, P., Hellwig, E., Wrbas, K.T., 2009. Effects of regular and
whitening dentifrices on remineralization of bovine enamel in vitro. Quintessence
Int. 40, 103–112.
Lussi, A., Carvalho, T.S., 2014. Erosive tooth wear: a multifactorial condition of growing
concern and increasing knowledge. Monogr. Oral Sci. 25, 1–15. https://doi.org/10.
1159/000360380.
Lussi, A., Carvalho, T.S., 2015. The future of fluorides and other protective agents in
erosion prevention. Caries Res. 49, 18–29. https://doi.org/10.1159/000380886.
Lussi, A., Schlueter, N., Rakhmatullina, E., Ganss, C., 2011. Dental erosion – an overview
with emphasis on chemical and histopathological aspects. Caries Res. 45, 2–12.
https://doi.org/10.1159/000325915.
Mahoney, E., Beattie, J., Swain, M., Kilpatrick, N., 2003. Preliminary in vitro assessment
of erosive potential using the ultra-micro-indentation system. Caries Res. 37,
218–224. https://doi.org/10.1159/000070448.
Mousavinasab, S.M., Meyers, I., 2009. Fluoride release by glass ionomer cements, com-
pomer and giomer. Dent. Res. J. 6, 75–81.
Pancote, L.P., Manarelli, M.M., Danelon, M., Delbem, A.C., 2014. Effect of fluoride gels
supplemented with sodium trimetaphosphate on enamel erosion and abrasion: in
vitro study. Arch. Oral Biol. 59, 336–340. https://doi.org/10.1016/j.archoralbio.
2013.12.007.
Pini, N.I.P., Lima, D.A., Lovadino, J.R., Ganss, C., Schlueter, N., 2016. In vitro efficacy of
experimental chitosan-containing solutions as anti-erosive agents in enamel. Caries
Res. 50, 337–345. https://doi.org/10.1159/000445758.
Reis, C., De-Deus, G., Leal, F., Azevedo, E., Coutinho-Filho, T., Paciornik, S., 2008. Strong
effect on dentin after the use of high concentrations of citric acid: an assessment with
co-site optical microscopy and ESEM. Dent. Mater. 24, 1608–1615. https://doi.org/
10.1016/j.dental.2008.03.027.
Schlueter, N., Ganss, C., Mueller, U., Klimek, J., 2007. Effect of titanium tetrafluoride and
sodium fluoride on erosion progression in enamel and dentine in vitro. Caries Res. 41,
141–145. https://doi.org/10.1159/000098048.
Schlueter, N., Hara, A., Shellis, R.P., Ganss, C., 2011. Methods for the measurement and
characterization of erosion in enamel and dentine. Caries Res. 45, 13–23. https://doi.
D.F.M. Gonçalves, et al.
org/10.1159/000326819.
Schlueter, N., Lussi, A., Tolle, A., Ganss, C., 2016. Effects of erosion protocol design on
erosion/abrasion study outcome and on active agent (NaF and SnF2). Caries Res. 50,
170–179. https://doi.org/10.1159/000445169.
Selimović-Dragaš, M., Hasić-Branković, L., Korać, F., Đapo, N., Huseinbegović, A.,
Kobašlija, S., Lekić, M., Hatibović-Kofman, Š., 2013. In vitro fluoride release from a
different kind of conventional and resin modified glass-ionomer cements. Bosn. J.
Basic Med. Sci. 13, 197–202. https://doi.org/10.17305/bjbms.2013.2362.
Sidhu, S.K., Nicholson, J.W., 2016. A review of glass-ionomer cements for clinical den-
tistry. J. Funct. Biomater. 7, 6–15. https://doi.org/10.3390/jfb7030016.
Souza, B.M., Comar, L.P., Vertuan, M., Fernandes Neto, C., Buzalaf, M.A., Magalhães,
A.C., 2015. Effect of an experimental paste with hydroxyapatite nanoparticles and
fluoride on dental demineralisation and remineralisation in situ. Caries Res. 49,
499–507. https://doi.org/10.1159/000438466.
Suzuki, T.Y., Gomes-Filho, J.E., Gallego, J., Pavan, S., Dos Santos, P.H., Fraga Briso, A.L.,
2015. Mechanical properties of components of the bonding interface in different
12
Journal of the Mechanical Behavior of Biomedical Materials 97 (2019) 7–12
regions of radicular dentin surfaces. J. Prosthet. Dent 113, 54–61. https://doi.org/10.
1016/j.prosdent.2014.07.009.
Tsujimoto, A., Barkmeier, W.W., Fischer, N.G., Nojiri, K., Nagura, Y., Takamizawa, T.,
Latta, M.A., Miazaki, M., 2018. Wear of resin composites: current insights into un-
derlying mechanisms, evaluation methods and influential factors. Jpn. Dent. Sci. Rev.
54, 76–87. https://doi.org/10.1016/j.jdsr.2017.11.002.
West, N.X., Joiner, A., 2014. Enamel mineral loss. J. Dent. 42, 2–11. https://doi.org/10.
1016/S0300-5712(14)50002-4.
Young, A., Thrane, P.S., Saxegaard, E., Jonski, G., Rölla, G., 2006. Effect of stannous
fluoride toothpaste on erosion-like lesions: an in vivo study. Eur. J. Oral Sci. 114,
180–183. https://doi.org/10.1111/j.1600-0722.2006.00354.x.
Zan, K.W., Nakamura, K., Hamba, H., Sadr, A., Nikaido, T., Tagami, J., 2018. Micro-
computed tomography assessment of root dentin around fluoride-releasing restora-
tions after demineralization/remineralization. Eur. J. Oral Sci. 126, 390–399.
https://doi.org/10.1111/eos.12558.