The role of fluoride and casein phosphopeptide/amorphous calcium phosphate in the prevention of erosive/abrasive wear in an in vitro model using hydrochloric acid.

OBJECTIVE To investigate the effect of various fluoride compounds and casein phosphopeptide/amorphous calcium phosphate (CPP-ACP) on the reduction of erosive/abrasive tooth wear. METHODS Forty enamel samples were prepared from bovine lower incisors, stratified and allocated to 4 groups (1-4). Samples in group 1 remained untreated and served as negative controls. The test samples were treated for 2 min/day as follows: group 2 amine/sodium fluoride gel (pH 4.8; 12,500 ppm), group 3 sodium fluoride gel (pH 7.1; 12,500 ppm) and group 4 CPP-ACP-containing mousse. De- and remineralization cycling was performed for 20 days with 6 erosive attacks for 20 s with HCl (pH 3.0) per day. Samples were stored in artificial saliva between cycles and overnight. Toothbrushing (15 s; 60 strokes/min; load 2.5 N) with a toothpaste slurry was performed each day before the first and 1 h after the last erosive exposure. Tooth wear was measured by comparing baseline surface profiles with the corresponding posttreatment profiles. RESULTS Tooth wear was significantly reduced in groups 2 and 3 compared with group 1, while the enamel loss of group 4 was not significantly lower compared to the negative control group 1. Between the fluoride groups 2 and 3, no significant difference in tooth wear was recorded. CONCLUSION Erosive/abrasive tooth wear under the conditions used could be reduced significantly by the daily application of fluoride gels, irrespective of the fluoride compound, while the application of CPP-ACP-containing mousse was less effective.