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Fluoride Uptake, Retention, and Remineralization Efficacy of a Highly Concentrated Fluoride Solution on Enamel Lesions in situ

¹ Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, IN, USA;
² Department of Operative Dentistry and Periodontology, University of Freiburg, Germany;
³ Department of Operative Dentistry and Periodontology, University of Göttingen, Germany; and
⁴ Institute for Medical Biometry, University of Freiburg, Germany;

*corresponding author, present address, Georg-August-Universität Göttingen, Zentrum Zahn-, Mund- und Kieferheilkunde, Abteilung für Zahnerhaltung, Präventive Zahnheilkunde und Parodontologie, Robert-Koch-Str. 40, 37075 Göttingen, Germany, buchalla{at}med.uni-goettingen.de

Repeated topical application of concentrated fluorides is known to reduce caries. Little is known about fluoride retention and remineralization in incipient caries lesions following a single application. We investigated fluoride and the remineralization kinetics of a single application of elmex^® fluid (GABA International AG, Münchenstein, Switzerland; 10,000 ppm F) in initial enamel lesions. In this double-blind, placebo-controlled, randomized, crossover in situ study that conformed to good clinical practice, volunteers received intra-oral removable appliances carrying demineralized enamel samples after application of elmex fluid or placebo. After 5 min, 1, 2, 3, and 4 weeks in situ, KOH-soluble fluoride (KOHF), structurally bound fluoride (SBF), mineral gain, and lesion depth reduction were measured. Elmex fluid promoted higher KOHF and SBF at all times, decreased KOHF with time, increased SBF up to 3 weeks, and registered a higher mineral gain than placebo. Volunteers with higher stimulated salivary flow rates had lower fluoride uptake, but higher mineral gain. In conclusion, a single application of highly concentrated fluoride solution increases remineralization.

KEY WORDS: fluoride • carious enamel • remineralization • clinical study • salivary flow rate

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