Remineralization with calcium phosphate products Flashcards
What are the four sources of ions in products for remineralisation?
Crystalline, Glasses, Unstabilized, Stabilized
What are some examples of glass-source ions in calcium phosphate product systems?
Brand names?
Calcium phosphosilicate glasses
ie. Novamin, Biomin
What are some examples of crystalline-source ions in calcium phosphate product systems?
Tricalcium phosphate
Hydroxyapatite
What are some examples of Unstabilized-source ions in calcium phosphate product systems?
Amorphous calcium phosphate
What are some examples of Stabilized-source ions in calcium phosphate product systems?
what’s the brand name of the most common one?
Statherin stabilized ACP
Casein phosphopeptide stabilized ACP
Recaldent
Rank from smallest ksp to largest ksp
HA, FA, CA, TCP, DCPD, OCP
FA, HA, CA, OCP, TCP, DCPD
how does Nano mHAP work?
cons?
nano sized HA crystals that provide Ca2+ and PO43- ; and fills in pits/fissures in enamel surface by being filler
Cons: Abrasive, low F- availablity
What is Remin pro and how does it work?
A paste containing HA, F- and Xylitol
HA fills enamel lesions and tiny irregulairities
fluoride strengthens teeth
Xylitol is cariostatic
What’s the conclusion with crystalline, HA or nano HA toothpastes?
low amount of clinical studies and high bias risk make it not as efficaciious
How do you functionalize TCP?
What is the purpose behind adding functionalised tricalcium phosphate to tootpaste?
Use sodium lauryl sulphate (SLS) or fumaric acid to coat TCP molecules
Prevent TCP from reacting with F- in tooth paste
Purpose is to allow saliva to defunctionalize SLS/Fumaric acid and releases both F- and TCP into teeth
If you had white spot lesions, would you prefer using 0.21% of NaF creme containing TCP twice daily or a single application of 5% NaF cream containing CPP-ACP?
Single application of CPP-ACP because it doesn’t matter in effectiveness
Sensodyne contains the active ingredient from Novamin, a company it acquired for millions of dollars.
What is this active ingredient and how do it work in remineralization and reducing sensitivity?
Sodium calcium phosphosilicate glass
Glass dissolves intra-orally and releases silicates that bind dentine
silicates act as nucleation sites for heterogenous calcium phosphate crystal growth
Calcium and phosphates increases DS and promotes remin
Silicates that cause nucleation in dentine help produce a new layer of HA on exposed dentine surfaces
What type of product is biomin?
Calcium fluorophosphosilicate
Why were ACP products discontinued in the market?
Unstable and often reacted in the tube leading to unusable product
Also, mineralization often occured on the surface of enamel rather than subsurface
What are the 6 general problems to look out for wrt calcium phosphate products
Localisation/Substantivity
Stability
Abrasivity
Compatibility with F-
Amount of active ingredient
Release of ions
What types of images are these?
Which is the most effective in remineralization? How can you tell?
Microradiograph
Toothmousse plus, most white means least radiolucency
Hwy is microradiography a preferred choice to quantify remineralization compated to microhardness?
Microhardness cannot visualize subsurface remineralization
What is curodont?
How does it facilitate remineralization?
What are the limitations?
self-assembling pepetide 11-4
peptide = <50AA
CA-P precipitation template theory: act as a template inside teeth to help facilitate crystal deposition
Limited in microradiographic evidence to quantify mineral density
In vitro studies use Ca and Po4, this product requires ions which saliva may not have enough of
What are the considerations when assessing evidence of enamel remineralisation?
BSB PIE
What are the pros and cons of using peptides for remin?
Can provide:
Template for nucleation
Direct crystal growth
Stabilize ions and facilitate superaturation/growth
However can also
clog interrod spaces and limit deep ionic diffusion
Bind HA crystals and inhibit remin/demin (damaged HA crystal needed for remin)
