Toothpaste containing TiF4 and chitosan against erosive tooth wear in situ.

Objective This study compared the protective effect of an experimental TiF4/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) TiF4 (1400 ppm F−) plus Chitosan, 2) Elmex®, Erosion Protection (1400 ppm F−, Chitosan), and 3) Placebo (negative control). Tooth wear was measured using contact profilometry (μm) 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). TiF4/Chitosan [erosion 2.98±1.12 μm vs. erosion and abrasion 3.12±1.33 μm] and Elmex® toothpastes [erosion 2.35±0.93 μm vs. erosion and abrasion 2.98±1.0 μm] minimized the impact of brushing compared to placebo on enamel [erosion 4.62 ± 1.48 μm vs. erosion and abrasion 5.15 ± 1.50 μm]. Conclusions TiF4 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.