Toothpaste containing TiF(4) and chitosan against erosive tooth wear in situ.

OBJECTIVE: This study compared the protective effect of an experimental TiF(4)/Chitosan toothpaste with a commercial toothpaste on the prevention of erosive tooth wear (ETW) in situ. METHODS: Fifteen subjects took part in this crossover and double-blind study, in which they wore a palatal appliance containing 4 bovine enamel and 4 dentin in 3 phases (5 days each). Half of the samples were subjected to erosive challenges (90 s in 0.1 % citric acid, pH 2.5, 4 times/day), and the other half to erosive plus abrasive challenges (15 s plus 45 s of contact, 2 times/day). The phases corresponded to the application of the different toothpastes: 1) TiF(4) (1400 ppm F(-)) plus Chitosan, 2) Elmex(R), Erosion Protection (1400 ppm F(-), Chitosan), and 3) Placebo (negative control). Tooth wear was measured using contact profilometry (mum) and submitted to two-way RM ANOVA/Tukey test (p < 0.05). RESULTS: No significant differences were detected between the experimental and commercial toothpastes, regardless of the challenge on both tissues. Both significantly reduce ETW compared to negative control (p < 0.0006). Tooth wear was increased by brushing only on eroded enamel (p < 0.01), but not on dentin (p = 0.6085). TiF(4)/Chitosan [erosion 2.98 +/- 1.12 mum vs. erosion and abrasion 3.12 +/- 1.33 mum] and Elmex(R) toothpastes [erosion 2.35 +/- 0.93 mum vs. erosion and abrasion 2.98 +/- 1.0 mum] minimized the impact of brushing compared to placebo on enamel [erosion 4.62 +/- 1.48 mum vs. erosion and abrasion 5.15 +/- 1.50 mum]. CONCLUSIONS: TiF(4) plus chitosan toothpastes showed to be effective in minimizing the ETW as the commercial toothpaste is in situ. CLINICAL RELEVANCE: The experimental toothpaste has similar effect against ETW compared to the commercial toothpaste. Considering the increased ETW prevalence worldwide, this result supports clinical trials and a possible application of this experimental anti-erosive toothpaste in the future.