Effectiveness of different coated materials on root caries prevention under simulated tooth brushing: an in vitro study

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Dollaporn Thakolwiboon
Anisha Komolsingsakul
Ratchapin Laovanitch Srisatjaluk
Nisarat Ruangsawasdi
Pong Pongprueksa
Pisol Senawongse


Objective: Sealing tooth root surfaces with coating material is expected to represent an effective approach to preventing root caries. The aim of this study is to investigate the effect of tooth brushing on the efficacy of different coating materials in root caries prevention.
Materials and Methods: The experiment was conducted on root dentin specimens under simultaneous demineralization conditions. Fifty specimens were used in this study. The specimens were divided into 5 groups: Group 1 (control group), no treatment; Groups 2-3, Clinpro White Varnishapplication with or without brushing; and Groups 4-5, PRG Coat Barrierapplication with or without brushing. A multispecies biofilm model was formed on specimens that were exposed to 1% sucrose for 10 days. Then, the % cell viability, bacterial density, % surface microhardness loss, and lesion depth were assessed using a confocal laser scanning microscope, microcomputed tomography, and Knoop microhardness tester, respectively.
Results: The Kolmogorov–Smirnov test revealed a normal distribution of all data. Differences within and between mean values for groups were statistically analyzed using one-way ANOVA and Dunnett’s T3 post hoc test, respectively. No significant differences in bacterial density and biofilm thickness were found among the groups. A difference in the %surface microhardness loss was noted in the control group with relatively higher %cell viability compared with the other groups. The deepest carious lesion was found in the control group. The shallowest carious lesion was found in the PRG Coat Barrier-coated dentin-without brushing group. Brushing only increases the lesion depth on Clinpro White Varnish-coated dentin.
Conclusions: Applying either Clinpro White Varnish or PRG Coat Barrierhas the benefits of reducing the depth of root caries and increasing the hardness of demineralized root dentin. Brushing reduces the efficacy of Clinpro White Varnish.


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Thakolwiboon D, Komolsingsakul A, Srisatjaluk RL, Ruangsawasdi N, Pongprueksa P, Senawongse P. Effectiveness of different coated materials on root caries prevention under simulated tooth brushing: an in vitro study. M Dent J [Internet]. 2023 Apr. 28 [cited 2023 Dec. 6];43(1):21-36. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/262120
Original articles


Hayes M, Burke F, Allen PF. Incidence, prevalence and global distribution of root caries. Monogr Oral Sci. 2017;26:1-8. doi: 10.1159/000479301.

Damé-Teixeira N, Parolo CCF, Maltz M. Specificities of caries on root surface. Monogr Oral Sci. 2017;26:15-25. doi: 10.1159/000479303.

Zambon JJ, Kasprzak SA. The microbiology and histopathology of human root caries. Am J Dent. 1995 Dec;8(6):323-328. PMID: 8695011.

Burgess JO, Gallo JR. Treating root-surface caries. Dent Clin North Am. 2002 Apr;46(2):385-404, vii-viii. doi: 10.1016/s0011-8532(01)00003-9.

Steele JG, Sheiham A, Marcenes W, Fay N, Walls AW. Clinical and behavioural risk indicators for root caries in older people. Gerodontology. 2001 Dec;18(2):95-101. doi: 10.1111/j.1741-2358.2001.00095.x.

Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, et al. Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: a report from the American Dental Association. J Am Dent Assoc. 2018 Oct;149(10):837-849.e19. doi: 10.1016/j.adaj.2018.07.002.

Buzalaf MAR, Pessan JP, Honório HM, Ten Cate JM. Mechanisms of action of fluoride for caries control. Monogr Oral Sci. 2011;22:97-114. doi: 10.1159/000325151.

Bonetti D, Clarkson JE. Fluoride varnish for caries prevention: efficacy and implementation. Caries Res. 2016;50 Suppl(1):45-49. doi: 10.1159/000444268.

Zhang J, Sardana D, Li KY, Leung KCM, Lo ECM. Topical Fluoride to Prevent Root Caries: Systematic Review with Network Meta-analysis. J Dent Res. 2020 May;99(5):506-513. doi: 10.1177/0022034520906384.

Yamamoto S, Sayed M, Takahashi M, Matin K, Hiraishi N, Nikaido T, et al. Effects of a surface prereacted glass-ionomer filler coating material on biofilm formation and inhibition of dentin demineralization. Clin Oral Investig. 2021 Feb;25(2):683-690. doi: 10.1007/s00784-020-03577-x.

Ma S, Imazato S, Chen JH, Mayanagi G, Takahashi N, Ishimoto T, et al. Effects of a coating resin containing S-PRG filler to prevent demineralization of root surfaces. Dent Mater J. 2012;31(6):909-915. doi: 10.4012/dmj.2012-061.

Gando I, Ariyoshi M, Ikeda M, Sadr A, Nikaido T, Tagami J. Resistance of dentin coating materials against abrasion by toothbrush. Dent Mater J. 2013;32(1):68-74. doi: 10.4012/dmj.2012-186.

Tian HY, Yu P, Yuan CY, Zhang W, Qiu YX, Li DH, et al. Durability of protective effect of resin-based coating material on root surface. Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Oct 18;48(5):889-893. PMID: 27752176.

Wiegand A, Schneider S, Sener B, Roos M, Attin T. Stability against brushing abrasion and the erosion-protective effect of different fluoride compounds. Caries Res. 2014;48(2):154-162. doi: 10.1159/000353143.

Rirattanapong P, Vongsavan K, Suratit R, Tanaiutchawoot N, Charoenchokdilok V, Jeansuwannagorn S, et al. Effect of various forms of calcium in dental products on human enamel microhardness in vitro. Southeast Asian J Trop Med Public Health. 2012 Jul;43(4):1053-1058. PMID: 23077830.

Göstemeyer G, Woike H, Paris S, Schwendicke F, Schlafer S. Root caries preventive effect of varnishes containing fluoride or fluoride + chlorhexidine/cetylpyridinium chloride in vitro. Microorganisms. 2021 Apr; 9(4):737. doi: 10.3390/microorganisms9040737.

Komalsingsakul A, Srisatjaluk RL, Senawongse P. Effect of brushing on surface roughness, fluoride release, and biofilm formation with different tooth-colored materials. J Dent Sci. 2022 Jan;17(1):389-398. doi: 10.1016/j.jds.2021.08.013.

Hamba H, Nikaido T, Inoue G, Sadr A, Tagami J. Effects of CPP-ACP with sodium fluoride on inhibition of bovine enamel demineralization: a quantitative assessment using micro-computed tomography. J Dent. 2011 Jun;39(6):405-413. doi: 10.1016/j.jdent.2011.03.005.

Amaechi BT, Tenuta LMA, Ricomini Filho AP, Cury JA. Protocols to study dental caries in vitro: microbial caries models. Methods Mol Biol. 2019;1922:357-368. doi: 10.1007/978-1-4939-9012-2_32.

Pitchika V, Kokel CJ, Andreeva J, Crispin A, Hickel R, Kühnisch J, et al. Effectiveness of a new fluoride varnish for caries prevention in pre-school children. J Clin Pediatr Dent. 2013;38(1):7-12. doi: 10.17796/jcpd.38.1.8189243pt1m6t716.

Poza-Pascual A, Serna-Muñoz C, Pérez-Silva A, Martínez-Beneyto Y, Cabello I, Ortiz-Ruiz AJ. Effects of fluoride and calcium phosphate-based varnishes in children at high risk of tooth decay: a randomized clinical trial. Int J Environ Res Public Health. 2021 Sep;18(19), 10049. doi: 10.3390/ijerph181910049.

Razmakhnina EM, Kiseleva EA. Rationale for caries prevention in young adults based on caries resistance rates. Stomatologiia (Mosk). 2018;97(2):34-36. doi: 10.17116/stomat201897234-36.

Marinho VC, Higgins JP, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2002;(3):CD002279. doi: 10.1002/14651858.CD002279. Update in: Cochrane Database Syst Rev. 2013;7:CD002279. PMID: 12137653.

Seppä L. Fluoride varnishes in caries prevention. Med Princ Pract. 2004;13(6):307-11. doi: 10.1159/000080466.

Fujimoto Y, Iwasa M, Murayama R, Miyazaki M, Nagafuji A, Nakatsuka T. Detection of ions released from S-PRG fillers and their modulation effect. Dent Mater J. 2010 Aug; 29: 392-397. doi: 10.4012/dmj.2010-015.

Kawasaki K, Kambara M. Effects of ion-releasing tooth- coating material on demineralization of bovine tooth enamel. Int J Dent. 2014; 2014: 463149. doi: 10.1155/2014/463149.

Shiiya T, Mukai Y, Tomiyama K, Teranaka T. Anti- demineralization effect of a novel fluoride-releasing varnish on dentin. Am J Dent. 2012 Dec; 25(6): 347-350. PMID: 23409625.

Shiiya T, Kataoka A, Tomiyama K, Fujino F, Mukai Y. Anti-demineralization characteristics of surface pre-reacted glass-ionomer (S-PRG) filler-containing varnishes. Dent Mater J. 2021 Mar;40(2):416-421. doi: 10.4012/dmj.2019-396.

Mohd Said SN, Ekambaram M, Yiu CK. Effect of different fluoride varnishes on remineralization of artificial enamel carious lesions. Int J Paediatr Dent. 2017 May;27(3):163-173. doi: 10.1111/ipd.12243.

Silverstone LM. Remineralization of human enamel in vitro. Proc R Soc Med. 1972 Oct;65(10):906-908. PMID: 5085103.

Kaga N, Nagano-Takebe F, Nezu T, Matsuura T, Endo K, Kaga M. Protective effects of GIC and S-PRG filler restoratives on demineralization of bovine enamel in lactic acid solution. materials. 2020 May; 13(9):2140. doi: 10.3390/ma13092140.

Yamamoto S, Sayed M, Takahashi M, Matin K, Hiraishi N, Nikaido T, et al. Effects of a surface prereacted glass-ionomer filler coating material on biofilm formation and inhibition of dentin demineralization. Clin Oral Investig. 2021 Feb;25(2):683-690. doi: 10.1007/s00784-020-03577-x.

Manarelli MM, Delbem AC, Lima TM, Castilho FC, Pessan JP. In vitro remineralizing effect of fluoride varnishes containing sodium trimetaphosphate. Caries Res. 2014;48(4):299-305. doi: 10.1159/000356308.

Godoi FA, Carlos NR, Bridi EC, Amaral F, França FMG, Turssi CP, et al. Remineralizing effect of commercial fluoride varnishes on artificial enamel lesions. Braz Oral Res. 2019 May;33:e044. doi: 10.1590/1807-3107bor-2019.vol33.0044.

Karlinsey RL, Mackey AC, Walker ER, Frederick KE. Surfactant-modified beta-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions. J Mater Sci Mater Med. 2010 Jul;21(7):2009-2020. doi: 10.1007/s10856-010-4064-y.

Balakrishnan A, Jonathan R, Benin P, Kuumar A. Evaluation to determine the caries remineralization potential of three dentifrices: an in vitro study. J Conserv Dent. 2013 Jul;16(4):375-379. doi: 10.4103/0972-0707.114347.

Cochrane NJ, Shen P, Yuan Y, Reynolds EC. Ion release from calcium and fluoride containing dental varnishes. Aust Dent J. 2014 Mar;59(1):100-105. doi: 10.1111/adj.12144.

Schemehorn BR, Wood GD, McHale W, Winston AE. Comparison of fluoride uptake into tooth enamel from two fluoride varnishes containing different calcium phosphate sources. J Clin Dent. 2011;22(2):51-54. PMID: 21702326.

Wasiluk A. Fluoride compounds in dental caries prophylaxis in children and adolescents – review of polish literature. Przegl Epidemiol. 2017;71(4):603-611. PMID: 29417787.

Ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med. 1991;2(3):283-296. doi: 10.1177/10454411910020030101.

Wong L, Sissons C. A comparison of human dental plaque microcosm biofilms grown in an undefined medium and a chemically defined artificial saliva. Arch Oral Biol. 2001;46(6):477-86. doi: 10.1016/s0003-9969(01)00016-4. Erratum in: Arch Oral Biol 2001 Aug;46(8):779. Sissions CH [corrected to Sissons C]. PMID: 11311195.

Vieira A, Ruben JL, Huysmans MC. Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on enamel erosion in vitro. Caries Res. 2005 Sep-Oct;39(5):371-379. doi: 10.1159/000086843.

Kim HN, Kim JB, Jeong SH. Remineralization effects when using different methods to apply fluoride varnish in vitro. J Dent Sci. 2018 Dec;13(4):360-366. doi: 10.1016/j.jds.2018.07.004.

Cai J, Burrow MF, Manton DJ, Hardiman R, Palamara JEA. Remineralising effects of fluoride varnishes containing calcium phosphate on artificial root caries lesions with adjunctive application of proanthocyanidin. Dent Mater. 2021 Jan;37(1):143-157. doi: 10.1016/j.dental.2020.10.021.

Yoneda M, Suzuki N, Hirofuji T. Antibacterial effect of surface pre-reacted glass ionomer filler and eluate —mini review. Pharm Anal Acta. 2015; 6: 349. doi:10.4172/2153-2435.100034.

Uo M, Wada T, Asakura K. Structural analysis of strontium in human teeth treated with surface pre-reacted glass-ionomer filler eluate by using extended X-ray absorption fine structure analysis. Dent Mater J. 2017 Mar; 36(2): 214-221. doi: 10.4012/dmj.2016-266.

Kaga M, Kakuda S, Ida Y, Toshima H, Hashimoto M, Endo K, et al. Inhibition of enamel demineralization by buffering effect of S-PRG filler-containing dental sealant. Eur J Oral Sci. 2014 Feb; 122: 78-83. doi: 10.1111/eos.12107.

Yamamoto S, Sayed M, Takahashi M, Matin K, Hiraishi N, Nikaido T, et al. Effects of a surface prereacted glass–ionomer filler coating material on biofilm formation and inhibition of dentin demineralization. Clin Oral Invest. 2021 Feb; 25(2), 683–690. doi: 10.1007/s00784-020-03577-x.

Hong L, Watkins CA, Ettinger RL, Wefel JS. Effect of topical fluoride and fluoride varnish on in vitro root surface lesions. Am J Dent. 2005 Jun;18(3):182-187. PMID: 16158810.

Kono Y, Tamura M, Cueno ME, Tonogi M, Imai K. S-PRG Filler Eluate Induces Oxidative Stress in Oral Microorganism: Suppression of Growth and Pathogenicity, and Possible Clinical Application. Antibiotics (Basel). 2021 Jul;10(7):816. doi: 10.3390/antibiotics10070816.

Cai J, Palamara J, Manton DJ, Burrow MF. Status and progress of treatment methods for root caries in the last decade: a literature review. Aust Dent J. 2018 Mar;63(1):34-54. doi: 10.1111/adj.12550.