Stannous Fluoride Effects on Enamel: A Systematic Review
Abstract
:1. Introduction
1.1. Rationale
- Stannous fluoride (SnF2);
- Sodium fluoride (NaF);
- Sodium monofluorophosphate (Na2PFO3 or SMFP).
1.2. Objectives
- In dental patients, what is the effect of stannous fluoride compositions on oral health compared to other dental healthcare products?
- On enamel and other hard tooth tissue, what is the effect of stannous fluoride composition on their structure compared to other dental healthcare products?
2. Materials and Methods
2.1. Protocol and Registration
2.2. Eligibility Criteria
- Study about stannous fluoride dentifrice/toothpaste/mouth rinse.
- Study of patient side effects of stannous fluoride.
- Study about stannous fluoride chemo-physical interaction.
- Clinical studies on stannous fluoride use and control groups.
- Articles published in the last 10 years.
- Studies involving subjects with other specific diseases, immunological disorders, oncological patients, osteoporosis, and genetic diseases.
- Not enough information regarding the selected topic.
- No access to the title and abstract in English language or letters, commentary, PhD thesis and editorials.
- Not Randomized Controlled Trial (RCT) studies.
2.3. Information Sources
2.4. Search
2.5. Study Selection
2.6. Data Collection Process
2.7. Data Items
2.8. Risk of Bias in Individual Studies
2.9. Summary Measures
- Authors and Year—Authors and year of publication
- Sample size—Information about sample size and sample type
- Groups—Information about number of groups and type of group (each group is separate by “vs.”)
- Time and/or Follow up—Information about timing and follow up of the study
- Main results—Main outcomes and results of the analyzed study
- Statistic results—Statistical results (if performed)
- Main outcome—Classifications of the outcomes obtained by search
- N. of results—Number of obtained results in that outcome set
- Authors and Year—Authors and year of publication
- Sample—Information about sample size and sample type
- Measured at—Obtaining date of the median value
- Mean value—Mean value of groups (SnF2 group first vs. other)
2.10. Risk of Bias Across Studies
2.11. Additional Analyses
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Risk of Bias within Studies
3.4. Results of Individual Studies
3.5. Additional Analysis
3.6. Risk of Bias Across Studies
4. Discussion
4.1. Summary of Evidence
4.1.1. Hard Tissue Effects of Stannous Fluoride Compounds
4.1.2. Biological and Plaque Effects of Stannous Fluoride Compounds
4.1.3. Oral Health Related Quality of Life Effects of Stannous Fluoride Compounds
5. Limitations
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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---|---|---|---|---|---|
West et al. [33] 2019 | 36 | 2 Groups: 0.454% stannous fluoride dentifrice vs. market dentifrice NaF/triclosan (0.24% sodium fluoride and 0.3% triclosan) | 10 days trial | Stannous fluoride dentifrice demonstrated 93.5% less enamel loss than control | p < 0.001 |
Seriwatanachai et al. [34] 2019 | 135 | 3 Groups: Stabilized SnF2 dentifrice vs. SnF2 with zinc lactate dentifrice vs. a fluoride dentifrice | 6 months | Both SnF2 dentifrice showed a statistically significant reduction of gingival inflammation and plaque. With no statistical differences between themselves | p < 0.001 |
Luo et al. [35] 2019 | 150 | 3 Groups: (48) Potassium nitrate vs. (45) stannous fluoride vs. (46) placebo | 30 days | Authors demonstrated how Potassium nitrate toothpaste could reduce sensitivity after an in-office bleaching treatment, with no differences between stannous fluoride and placebo. | p < 0.05 |
Li et al. [36] 2019 | 18 bovine enamel sample | 3 Groups: 0.454% SnF2 and 1% zinc phosphate vs. Crest Pro-Health Whitening Power vs. non-abrasive SnF2 gel | 6 weeks | In this in vitro study SnF2 and 1% zinc paste performed better results than competitor and non-abrasive gel. It showed a better tooth stain reduction with no adverse effect. | p < 0.01 at 3 weeks |
Ionta et al. [37] 2019 | 256 bovine enamel sample | 4 Groups: calcium silicate, sodium phosphate, and 1450 ppm sodium monofluorophosphate vs. dentifrice with 3500 ppm stannous chloride, 700 ppm amine fluoride, and 700 ppm sodium fluoride vs. conventional dentifrice, with 1450 ppm sodium monofluorophosphate vs. control (deionized water) | 20 days | The group 1 promoted less enamel loss than water (group 4) but it did not differ from group 2 or 3. But group 1 dentifrice promoted a higher wear after erosion than other groups. | p < 0.05 |
Hu et al. [38] 2019 | 100 | 2 Groups: SnF2 dentifrice vs. fluoride dentifrice | 6 months | Both groups had a significant reduction in gingival inflammation and a plaque control improvement. SnF2 dentifrice showed a reduction of all indexed compared to control dentifrice | p < 0.001 |
Haraszthy et al. [39] 2019 | 129 | 2 Groups: Stannous fluoride toothpaste vs. sodium monofluorophosphate toothpaste | 8 weeks | Stannous fluoride group showed a greater reduction of bacteria. From 14% at time zero to 27% at 4 weeks, and 41% at 8-week time. | p < 0.05 |
Hagenfield et al. [40] 2019 | 41 | 2 Groups: anti-adhesive zinc-substituted carbonated hydroxyapatite (HA) vs. with antimicrobial and anti-adhesive amine fluoride/stannous fluoride (AmF/SnF2) | 12 weeks | There were no differences between groups in microbiome changes. | p > 0.05 |
Creeth et al. [41] 2019 | 656 | 2 Groups: (329) experimental anhydrous 0.454% SnF2/polyphosphate toothpaste vs. (327) toothpaste containing 0.76% sodium monofluorophosphate | 3 days | Experimental toothpaste reduced dentine hypersensitivity (DH) after 3 days treatment better than test group. | p < 0.0001 |
Zero et al. [42] 2018 | 168 | 4 Groups: sodium fluoride (NaF)/Carb/silica, NaF/silica, NaF + monofluorophosphate (MFP)/chalk vs. NaF/Carb/silica, NaF + MFP/dical, amine fluoride (AmF)/silica vs. NaF/Carb/silica, NaF + stannous fluoride (SnF2)/silica/hexametaphosphate (HMP) vs. Placebo (0 ppm F) and/or dose-response controls (675 ppm F as NaF [675F-NaF]) ±Carb | 14 days | All 1400–1450 ppm F dentifrices except NaF + SnF2/silica/HMP provided significantly greater lesion remineralization than Placebo. Carb addition did not alter fluoride efficacy. | p < 0.0001 |
West et al. [43] 2018 | 21 samples | 3 Groups: toothpaste containing 0.454% stannous fluoride vs. Control fluoride toothpaste containing 0.76% sodium monofluorophosphate vs. mineral water | 10 days | After 4 days of treatment the degree of tubule occlusion increased in the dentine samples in the groups 1 and 2 than in water. | p < 0.01 |
Frese et al. [44] 2018 | 54 | 2 Groups: special stannous fluoride-containing [(AmF)/NaF/SnCl ] mouth rinse (500 ppm F−, 800 ppm Sn2+), 1 × 30 s and a special toothpaste containing NaF/Sn2+ and the biopolymer chitosan (elmex EROSIONSSCHUTZ, CPGABA GmbH, Hamburg, Germany) vs. fluoridated toothpaste (1500 ppm) | 4 years | Two groups showed similar caries prevalence. There was a decrease of caries superficialis and media. | \ |
West et al. [45] 2017 | 33 human enamel sample | 2 Groups: 0.454% SnF2/0.077% NaF vs. 0.32% NaF/0.3% triclosan. | 15 days | SnF2 group provided a reduction of enamel loss at day 10 and again at day 15. | p < 0.0001 |
West et al. [46] 2017 | 33 | 2 Groups: SnF2 + 0.77% sodium fluoride (NaF) vs. sodium monofluorophosphate/arginine dentifrice | 10 day | Group 1 provided better enamel protection against erosive acid challenge than group 2 | p < 0.0001 |
Marchetti et al. [47] 2017 | 20 | 3 Groups: Alcohol free essential oil mouthwash vs. Amine fluoride/stannous fluoride with zinc lactate mouthwash vs. chlorhexidine (CHX) mouthwash | 3 days | Group 1 showed better results on plaque regrowth compared to alcohol-free essential oil mouthwash. But there was a less impact if compared to CHX. | p < 0.001 |
Geidel et al. [48] 2017 | 76 | 3 Groups: Herbal toothpaste vs. triclosan/copolymer toothpaste vs. amine/stannous fluoride toothpaste | 24 weeks | Approximal plaque index (API) and Oral hygiene index (OHI) changed in all groups with a significantly lower API e OHI in group 1. Sulcus bleeding index (SBI) was improved in all groups after 12 weeks. Bleeding on Probing (BoP) was unchanged. | p = 0.001 |
Lorenz et al. [49] 2015 | 28 | 5 Groups: amine fluoride/stannous fluoride (AmF/SnF2), 250 ppm F−; low concentration of film-forming agents; low concentration of humectants vs. amine fluoride/stannous fluoride, 250 ppm F−; low concentration of film-forming agents, high concentration of humectants vs. amine fluoride/stannous fluoride, 250 ppm F−; high concentration of film-forming agents; high concentration of humectants vs. Phenolic/essential oil mouth rinse vs. Volvic Still Water, Danone Waters | 10 days | All mouth rinses led to tooth and tongue staining, statistically significant differences existed between groups 1, 3, 4 and 5 on tooth staining | \ |
Hove et al. [50] 2014 | 64 human teeth sample | 4 Groups: Fluoride-free toothpaste vs. toothpaste 0.4% SnF2 vs. toothpaste 0.454% SnF2 vs. fluoride free toothpaste and a 0.4% SnF2 solution (1000 ppm F) | 9 days | The SnF2 groups showed significantly lower enamel wear than the group 1 | p < 0.05 |
Bellamy et al. [51] 2014 | 12 | 3 Groups: sodium fluoride dentifrice vs. Stannous fluoride dentifrice vs. water | 15 days | Enamel loss was significantly lower for treatment in group 2 versus 1 or 3 | p < 0.005 |
Bellamy et al. [52] 2014 | 27 | 2 Groups: SnF2/sodium fluoride (NaF) dentifrice vs. anticavity dentifrice | 17 days | Group 1 showed better results on 17 days usage period, it demonstrated a statistically significant a lower mean plaque area at each timepoint. | p < 0.0001 |
Stenhagen et al. [53] 2013 | 16 molars sample | 4 Groups: NaF vs. SnF2 vs. TiF4 vs. control | 9 days | The mean surface loss in the NaF, SnF2 and TiF4 groups was significantly lower than in the control group | p < 0.05 |
Jentsch et al. [54] 2013 | 24 | 3 Groups: Essential oil mouth rinse vs. amine/stannous fluoride mouth rinse vs. chlorhexidine digluconate 0.12% mouth rinse | 96h | The counts of cocci and bacilli and plaque thickness are statistically different only in chlorhexidine digluconate 0.12% group, with positive results | p ≤ 0.05 |
West et al. [55] 2012 | 20 | 4 Groups: AmF/SnF2 mouthrinse 250 ppm, F— 430 ppm Sn vs. AmF/SnF2—mouthrinse 250 ppm, F—430 ppm Sn vs. essential oil vs. water | 4 days | Rinse 2 produced less stain than rinse 1, but the difference was not significant. Rinse 2 produced significantly more stain than rinse 3 and 4. For tongue staining, rinse 2 produced significantly more staining than 4 but not 1 or 3. | p < 0.05 |
Fine et al. [56] 2012 | 35 | 3 Groups: Sodium fluoride/triclosan/copolymer dentifrice vs. Stannous fluoride/sodium hexametaphosphate/zinc lactate dentifrice (SnF2/SHMP) vs. sodium fluoride dentifrice | 13 days | Group 1 demonstrated significant reduction on plaque compared to other groups. | p < 0.01 |
Huysmans et al. [57] 2011 | 20 enamel samples | 3 Groups: SnF2 toothpaste (1050 ppm fluoride from stan- nous fluoride and 350 ppm from amine fluoride) vs. SnF2 toothpaste (containing 1100 ppm fluoride from stannous fluoride and 350 ppm from sodium fluoride) vs. sodium fluoride toothpaste | 5 days | SnF2 toothpastes significantly reduced erosive wear. | p < 0.05 |
Wigger-Alberti et al. [58] 2010 | 174 | 4 Groups: Amine fluoride/stannous fluoride 0.2% zinc lactate mouthrinse + malodour counteractives vs. 0.05% CHX, 0.05% cetylpyridinium chloride, 0.14% zinc lactate mouthrinse vs. (0.12% CHX mouthrinse vs. tap water. | 21 days | Group 1 showed efficacy to teeth discoloration, a significant reduction of organoleptxic ratings and volatile sulfur compounds was achieved after single application and after days 7 and 21. | p < 0.001 |
Author | Random Sequence Generation (Selection Bias) | Allocation Concealment (Selection Bias) | Blinding of Participants and Personnel (Performance Bias) | Blinding of Outcome Assessment (Detection Bias) | Incomplete Outcome Data (Attrition Bias) | Selective Reporting (Reporting Bias) |
---|---|---|---|---|---|---|
West et al. [33] 2019 | + | + | + | + | + | + |
Seriwatanachai et al. [34] 2019 | + | + | + | + | + | + |
Luo et al. [35] 2019 | + | + | - | - | + | + |
Li et al. [36] 2019 | + | + | + | + | + | + |
Ionta et al. [37] 2019 | + | - | + | - | + | + |
Hu et al. [38] 2019 | + | + | + | - | + | + |
Haraszthy et al. [39] 2019 | + | + | - | - | + | + |
Hagenfield et al. [40] 2019 | + | + | + | + | + | + |
Creeth et al. [41] 2019 | - | - | + | + | + | + |
Zero et al. [42] 2018 | + | + | - | - | + | + |
West et al. [43] 2018 | + | + | + | - | + | + |
Frese et al. [44] 2018 | + | + | - | - | + | + |
West et al. [45] 2017 | + | + | + | + | + | + |
West et al. [46] 2017 | + | + | + | + | + | + |
Marchetti et al. [47] 2017 | + | - | + | + | + | + |
Geidel et al. [48] 2017 | - | + | - | - | + | + |
Lorenz et al. [49] 2015 | + | - | + | - | + | + |
Hove et al. [50] 2014 | - | - | - | - | + | + |
Bellamy et al. [51] 2014 | + | - | - | - | + | + |
Bellamy et al. [52] 2014 | + | - | + | + | + | + |
Stenhagen et al. [53] 2013 | - | - | - | - | + | + |
Jentsch et al. [54] 2013 | - | - | - | - | + | + |
West et al. [55] 2012 | + | - | + | - | + | + |
Fine et al. [56] 2012 | + | + | + | + | + | + |
Huysmans et al. [57] 2011 | + | + | - | - | - | + |
Wigger-Alberti et al. [58] 2010 | + | - | + | + | + | + |
Main Outcome | No. of Results |
---|---|
Enamel loss reduction [17,21,29,30,33,34,36,40] | 9 |
Bacteria and others microorganisms reduction [23,24,31,32,35,37,39] | 7 |
tooth stain reduction [20,38,49] | 4 |
Gingival inflammation reduction [18,22,32] | 2 |
Dentinal hypersensitivity reduction [19,25] | 2 |
Carious lesion remineralization [26,28] | 2 |
Dentin tubule occlusion [27] | 1 |
organoleptic ratings and volatile sulfur compounds [41] | 1 |
Author and Year | Sample | Measured at | Mean Value |
---|---|---|---|
West et al. 2019 [33] | 36 Intraoral appliances with human enamel sample | Day 10 | 0.097 µm vs. 1.495 µm |
Ionta et al. 2019 [37] | 256 Bovine enamel blocks | Day 5 | 4.8 ± 2.5 µm vs. 4.8 ± 1.4 µm |
West et al. 2017 [43] | 33 Intraoral appliances with human enamel sample | Day 15 | 1.60 µm vs. 5.03 µm |
West et al. 2017 [44] | 33 Human enamel specimens | Day 15 | 5.75 µm vs. 23.75 µm |
Hove et al. 2014 [50] | 16 Intraoral appliances with human molar | Day 9 | 14.5 ± 9.3 µm and 33.3 ± 7.4 µm and 0.4 ± 1.3 µm vs. 29.2 ± 10.5 µm |
Bellamy et al. 2014 [51] | 12 intraoral appliances with human enamel sample | Day 15 | 2.03 µm vs. 15.53 µm |
Stenhagen et al. 2013 [53] | 16 intraoral appliances with molar sample | Day 9 | 1.8 ± 1.9 µm vs. 26.3 ± 4.7 µm vs. 3.1 ± 4.8 |
Huysmans et al. 2011 [57] | 20 intraoral appliances with human enamel sample | Day 5 | data not clear or incomplete |
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Fiorillo, L.; Cervino, G.; Herford, A.S.; Laino, L.; Cicciù, M. Stannous Fluoride Effects on Enamel: A Systematic Review. Biomimetics 2020, 5, 41. https://doi.org/10.3390/biomimetics5030041
Fiorillo L, Cervino G, Herford AS, Laino L, Cicciù M. Stannous Fluoride Effects on Enamel: A Systematic Review. Biomimetics. 2020; 5(3):41. https://doi.org/10.3390/biomimetics5030041
Chicago/Turabian StyleFiorillo, Luca, Gabriele Cervino, Alan Scott Herford, Luigi Laino, and Marco Cicciù. 2020. "Stannous Fluoride Effects on Enamel: A Systematic Review" Biomimetics 5, no. 3: 41. https://doi.org/10.3390/biomimetics5030041