Download PDF
CC BY-NC-ND 4.0 · Eur J Dent 2020; 14(02): 206-211
DOI: 10.1055/s-0040-1708456
Original Article

In Vivo Effects of a Hydroxyapatite-Based Oral Care Gel on the Calcium and Phosphorus Levels of Dental Plaque

Henny Sudradjat
1   Department for Dentistry, Health Care Center, Braunschweig, Germany
,
Frederic Meyer
2   Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
,
Kateryna Loza
3   Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Essen, Germany
,
Matthias Epple
3   Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Essen, Germany
,
Joachim Enax
2   Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
› Author Affiliations Funding The study was funded by Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany.
› Further Information
   Permissions and Reprints

Abstract

Objectives Particulate hydroxyapatite (HAP; Ca5(PO4)3(OH)) is a biomimetic oral care ingredient. One mode of action in caries-susceptible individuals may be the adhesion/incorporation of HAP into dental plaque. Therefore, the aim of this in vivo study was to analyze the 3-day effects of a newly developed hydroxyapatite-based oral care gel on the calcium and phosphorus levels within the dental plaque of children.

Materials and Methods This study was conducted in Kebon Padangan at Bali in Indonesia. Thirty-four children (mean age, 8.9 years; mean DMF-T [decayed, missing, and filled teeth; permanent teeth], 0.6; mean dmft-t [primary teeth] 4.5) were included in the study. The gel was applied thrice for 3 days by an experienced dentist. Dental plaque was collected at baseline and after the study. Levels of calcium and phosphorus of plaque samples were analyzed by energy-dispersive X-ray spectroscopy.

Statistical Analysis Medians for both calcium and phosphorus levels were calculated (baseline and 3-day application of HAP-gel).

Results The calcium level increased after 3 days of application of the HAP-gel from 0.25 wt% (median) to 0.40 wt% (median), while the phosphorus level increased from 1.17 wt% (median) to 1.41 wt% (median). However, variations in both calcium and phosphorus levels measured in the pooled dental plaque samples were high.

Conclusion Within the limitations of the study, the 3-day application of the oral HAP-gel in children increased the median of both calcium and phosphorus levels in plaque. Consequently, a positive influence on the remineralization/demineralization process is very likely.

Keywords

caries - energy-dispersive X-ray spectroscopy - hydroxyapatite - oral care - dental plaque - calcium and phosphorus levels


Publication History

Article published online:
13 April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Listl S, Galloway J, Mossey PA, Marcenes W. Global economic impact of dental diseases. J Dent Res 2015; 94 (10) 1355-1361
    Google Scholar
  • 2 Fejerskov O, Kidd E. eds, In: Dental Caries: The Disease and Its Clinical Management. Oxford, United Kingdom: Blackwell Munksgaard Ltd; 2009
    Google Scholar
  • 3 Loveren Cv. Toothpastes. Vol. 23. Basel, Switzerland: Karger; 2013
    Google Scholar
  • 4 Deinzer R, Schmidt R, Harnacke D. et al. Finding an upper limit of what might be achievable by patients: oral cleanliness in dental professionals after self-performed manual oral hygiene. Clin Oral Investig 2018; 22 (02) 839-846
    CrossrefPubMedGoogle Scholar
  • 5 Dewhirst FE, Chen T, Izard J. et al. The human oral microbiome. J Bacteriol 2010; 192 (19) 5002-5017
    CrossrefPubMedGoogle Scholar
  • 6 Sztajer H, Szafranski SP, Tomasch J. et al. Cross-feeding and interkingdom communication in dual-species biofilms of Streptococcus mutans and Candida albicans. ISME J 2014; 8 (11) 2256-2271
    CrossrefPubMedGoogle Scholar
  • 7 Teng F, Yang F, Huang S. et al. Prediction of early childhood caries via spatial-temporal variations of oral microbiota. Cell Host Microbe 2015; 18 (03) 296-306
    CrossrefPubMedGoogle Scholar
  • 8 Hurley E, Barrett MPJ, Kinirons M. et al. Comparison of the salivary and dentinal microbiome of children with severe-early childhood caries to the salivary microbiome of caries-free children. BMC Oral Health 2019; 19 (01) 13-13
    CrossrefPubMedGoogle Scholar
  • 9 Worthington HV, MacDonald L, Poklepovic Pericic T. et al. Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal diseases and dental caries. Cochrane Database Syst Rev 2019; 4: CD012018
    PubMedGoogle Scholar
  • 10 Enax J, Epple M. Synthetic hydroxyapatite as a biomimetic oral care agent. Oral Health Prev Dent 2018; 16 (01) 7-19
    PubMedGoogle Scholar
  • 11 Meyer F, Enax J. Hydroxyapatite in oral biofilm management. Eur J Dent 2019; 13 (02) 287-290
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Meyer F, Enax J. Early childhood caries: epidemiology, aetiology, and prevention. Int J Dent 2018; 2018: 1415873
    PubMedGoogle Scholar
  • 13 Epple M. Review of potential health risks associated with nanoscopic calcium phosphate. Acta Biomater 2018; 77: 1-14
    CrossrefPubMedGoogle Scholar
  • 14 Fabritius-Vilpoux K, Enax J, Herbig M, Raabe D, Fabritius H-O. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfacesin vitro . Bioinspir Biomim Nan. 2019; 8: 141-153
    Google Scholar
  • 15 Kensche A, Holder C, Basche S, Tahan N, Hannig C, Hannig M. Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ. Arch Oral Biol 2017; 80: 18-26
    CrossrefPubMedGoogle Scholar
  • 16 Lelli M, Putignano A, Marchetti M. et al. Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: a comparative in vivo study. Front Physiol 2014; 5: 333
    PubMedGoogle Scholar
  • 17 Schlagenhauf U, Kunzelmann KH, Hannig C. et al. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: a randomized, controlled 6-month trial. J Investig Clin Dent 2019; 10 (02) e12399
    CrossrefPubMedGoogle Scholar
  • 18 Hu ML, Zheng G, Zhang YD, Yan X, Li XC, Lin H. Effect of desensitizing toothpastes on dentine hypersensitivity: a systematic review and meta-analysis. J Dent 2018; 75: 12-21
    CrossrefPubMedGoogle Scholar
  • 19 Hagenfeld D, Prior K, Harks I. et al. No differences in microbiome changes between anti-adhesive and antibacterial ingredients in toothpastes during periodontal therapy. J Periodontal Res 2019; 54 (04) 435-443
    CrossrefPubMedGoogle Scholar
  • 20 Enax J, Fabritius H-O, Fabritius-Vilpoux K, Amaechi BT, Meyer F. Modes of action and clinical efficacy of particulate hydroxyapatite in preventive oral health care – state of the art. Open Dent J 2019; 13: 274-287
    CrossrefGoogle Scholar
  • 21 Lussi A, Carvalho TS. The future of fluorides and other protective agents in erosion prevention. Caries Res 2015; 49 (Suppl. 01) 18-29
    PubMedGoogle Scholar
  • 22 Shaw L, Murray JJ, Burchell CK, Best JS. Calcium and phosphorus content of plaque and saliva in relation to dental caries. Caries Res 1983; 17 (06) 543-548
    CrossrefPubMedGoogle Scholar
  • 23 Bayrak S, Okte Z, Fidanci UR. Relationship between caries and dental plaque composition. Am J Dent 2011; 24 (01) 45-48
    PubMedGoogle Scholar
  • 24 Epple M, Enax J. Moderne Zahnpflege aus chemischer Sicht. Chem Unserer Zeit 2018; 52: 218-228
    CrossrefGoogle Scholar
  • 25 Min JH, Kwon HK, Kim BI. The addition of nano-sized hydroxyapatite to a sports drink to inhibit dental erosion: in vitro study using bovine enamel. J Dent 2011; 39 (09) 629-635
    CrossrefPubMedGoogle Scholar
  • 26 Najibfard K, Ramalingam K, Chedjieu I, Amaechi BT. Remineralization of early caries by a nano-hydroxyapatite dentifrice. J Clin Dent 2011; 22 (05) 139-143
    PubMedGoogle Scholar
  • 27 Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 2011; 39 (06) 430-437
    CrossrefPubMedGoogle Scholar
  • 28 Amaechi BT, AbdulAzees PA, Alshareif DO. et al. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open 2019; 5: 18
    CrossrefPubMedGoogle Scholar
  • 29 Scimeca M, Bischetti S, Lamsira HK, Bonfiglio R, Bonanno E. Energy dispersive X-ray (EDX) microanalysis: A powerful tool in biomedical research and diagnosis. Eur J Histochem 2018; 62 (01) 2841
    PubMedGoogle Scholar
  • 30 Kensche A, Pötschke S, Hannig C, Richter G, Hoth-Hannig W, Hannig M. Influence of calcium phosphate and apatite containing products on enamel erosion. ScientificWorldJournal 2016; 2016: 7959273
    PubMedGoogle Scholar
  • 31 Venegas SC, Palacios JM, Apella MC, Morando PJ, Blesa MA. Calcium modulates interactions between bacteria and hydroxyapatite. J Dent Res 2006; 85 (12) 1124-1128
    Google Scholar
  • 32 Hannig C, Basche S, Burghardt T, Al-Ahmad A, Hannig M. Influence of a mouthwash containing hydroxyapatite microclusters on bacterial adherence in situ. Clin Oral Investig 2013; 17 (03) 805-814
    CrossrefPubMedGoogle Scholar
  • 33 Zhang M, He LB, Exterkate RA. et al. Biofilm layers affect the treatment outcomes of NaF and Nano-hydroxyapatite. J Dent Res 2015; 94 (04) 602-607
    Google Scholar
  • 34 Vogel GL, Zhang Z, Carey CM, Ly A, Chow LC, Proskin HM. Composition of plaque and saliva following a sucrose challenge and use of an alpha-tricalcium-phosphate-containing chewing gum. J Dent Res 1998; 77 (03) 518-524
    Google Scholar
  • 35 Nedeljkovic I, De Munck J, Slomka V, Van Meerbeek B, Teughels W, Van Landuyt KL. Lack of buffering by composites promotes shift to more cariogenic bacteria. J Dent Res 2016; 95 (08) 875-881
    Google Scholar
  • 36 Papas A, Russell D, Singh M, Kent R, Triol C, Winston A. Caries clinical trial of a remineralising toothpaste in radiation patients. Gerodontology 2008; 25 (02) 76-88
    CrossrefPubMedGoogle Scholar
  • 37 Hr P, Ra H, Re H, H. S, P. P. Concentration of calcium, phosphate and fluoride ions in microbial plaque and saliva after using CPP-ACP paste in 6-9 year-old children. J Dent Biomater 2016; 3 (02) 214-219
    PubMedGoogle Scholar
  • 38 Meyer F, Amaechi BT, Fabritius HO, Enax J. Overview of calcium phosphates used in biomimetic oral care. Open Dent J 2018; 12: 406-423
    CrossrefPubMedGoogle Scholar