Vision is the Art of Seeing Things Invisible

124 JOHCD � www.johcd.org � September 2011;5(3)

Vision is the Art of Seeing Things Invisible -

An invitro Comparative EvaluationShipra Jaidka1, Deepti Jawa2, Rishi Jaidka3, I.K. Pandit4, Rani Somani5, Nishad Md6

Contact Author

Dr. Shipra [email protected]

J Oral Health Comm Dent 2011;5(3)124-131

1Associate Prof.Dept. of Pedodontics & Preventive DentistryD J College of Dental Sciences &ResearchNiwari Road, Modinagar, UP, India

2Sr. LecturerDept. of Pedodontics & Preventive DentistryD J College of Dental Sciences &ResearchNiwari road, Modinagar, UP, India

3Sr. LecturerDept. of Community & Preventive DentistryD J College of Dental Sciences &ResearchNiwari road, Modinagar, UP, India

4Principal, Prof. & HeadDept. Of Pedodontics and Preventive Dentistry,D.A.V (C) Dental College and HospitalYamuna Nagar, Haryana, India

5Prof. & HeadDept. of Pedodontics &Preventive DentistryD J College of Dental Sciences &ResearchNiwari Road, ModinagarUttar Pradesh, India

6Prof. & HeadShri Banke Bihari Dental College & Research CenterN.H. 24, Mussori, Ghaziabad, UP, India

ABSTRACT

Background: Restoration failure due to secondary caries is a continuing problem in restorative dentistry.Aims and objective: The present study is undertaken to see whether various fluoridated dentifrices recharge fluoride releasingrestorative materials and, comparatively evaluate their recharging capabilities.Materials and method: Materials used in the study are Fuji II LC, Compomer, Teethmate F1, Alfadent sealant. Dentifrices used areSodiumflouride and Sodiummonoflurophasphate releasing. All restorative materials were mixed according to manufacturer’s instructionand standardized test pellets were made using autoclaved instruments in sterile Teflon moulds. These test pellets were divided invarious groups and brushed with various fluoridated and nonfluoridated dentifrices accordingly . Results were evaluated stasticallyusing ANOVA , t-test and correlation coefficient for which regression lines were drawn. It was concluded that Sodiumfluoridecontaining dentifrices recharged fluoride releasing restorative material more than Sodium monoflurophasphate containing dentifrices

Keywords: Secondary caries, Fluoride release recharging restorative materials, Dentifrices

ORIGINAL ARTICLE

INTRODUCTION

Restoration failure due to secondary

caries is a continuing problem in

restorative dentistry (1). Secondary

or recurrent caries occurs around restorative

materials when the interface of the tooth

and restorative material is compromised

to such a degree that microleakage occurs

(2).

The metabolic byproducts of dental plaque

bacteria including Lactic acid, Acetic acid and

Citric acid penetrate along the tooth-

restoration interface and reduce the pH in

the microenvironment of the tooth

surface, resulting in the demineralization

of the dental hard tissue (3).

Hence, to be cost effective, we must aim to

fill the carious lesions with those restorative

materials that are truly adhesive in nature

to prevent secondary caries. But till date no

material is truly adhesive. Therefore, until

a proven adhesive system is available, there

is an increased interest of knowing the

mechanisms that inhibit such acid

production, increase resistance to

demineralization and / or facilitate

remineralization of tooth at tooth-

Journal of Oral HealthCommunity Dentistry

&

restoration interface, mainly by increasingthe anticariogenecity of the restorativematerial itself (4).

One of the most proven methods is toincorporate fluoride into the structure ofthe restorative material to make it cariespreventive. The ability of fluoride toprevent caries is well established and hasbeen demonstrated through a plethora ofstudies (4). The materials commonly usedas fluoride releasing restorative materialsare silicates, conventional glassionomers(5), resin hybrid glass ionomers(6), fluoride releasing composite resins (7),fluoride releasing pit and fissure sealants(8) etc.

However, according to Eichmiller FC et al

(9) most fluoride containing restorativematerials release fluoride in an initial burstfor few days and then reduce exponentiallyto a much lower steady state level of release.Moreover, caries inhibition andremineralization potential have beenshown in vitro by all of these materials.

As this fluoride from the restorativematerial is leached continuously, there is a

JOHCD � www.johcd.org � September 2011;5(3) 125

danger of emptying the fluoride resourcesafter some period of time. If, on the otherhand, these fluoride releasing restorativematerials are capable of binding fluoridefrom outside resources and releasing itagain, this would ensure a permanentanticariogenic effect. Thus to ensure apermanent anticariogenic effect, a dynamicsituation of fluoride release and uptake isdesirable.

A number of studies have suggested thatthere is such an ability of these materials toserve as rechargeable reservoirs, deliveringa low level of fluoride to the oral cavity forlonger period of time after the ion sourcehas been removed (10-13).

Various studies conducted recently suggestthat these fluoride releasing restorativematerials can be recharged with fluoride byprofessional application of topical fluorideslike APF gel (14), NaF gel (15) or by dailyuse of fluoridated mouth rinses (16) orfluoridated dentifrices (11).

It has been observed that professionalapplication of topical fluoride increasesfluoride dissemination in the restorativematerials immediately, but it gets depletedwithin 48 hours (12) and it requires patient

compliance also. Hence recharging withprofessional application of topical fluorideis not of much use.

On the other hand, daily tooth brushingwith fluoridated dentifrice may replenishmaterial surface fluoride level at eachbrushing interval and thus, a reservoir offluoride could be created for constant releaseand a certain reduction in caries is evidenttill the time the restoration is maintainedin the oral cavity.

0The present study is undertaken to seewhether various fluoridated dentifricesrecharge fluoride releasing restorativematerials and, comparatively evaluate theirrecharging capabilities.

METHODOLOGY

The restorative materials viz. Fuji II LC, F-2000, Teethmate F-1 and Alphadent(Figure 1) were mixed according tomanufacturer’s instructions and 48specimens (12 of each material) were madeusing autoclaved instruments in sterileTeflon moulds [4 mm (diameter) x 3mm(ht.)], supported by a glass slide in amounting jig. A glass slide was placed onthe top of the Teflon mould in slot in thejig followed by the tightening of the screwembedded in the vertical arm of the jig to

apply gentle and uniform pressure on theupper slide to extrude the excess material.The specimens were cured using a visiblelight cure device (Figure 1).

After the materials were set the pellets wereremoved from the Teflon moulds andplaced in separate autoclaved plastic vialscontaining 10ml deionized water andstored at room temperature (Figure 2). 12pellets of each material (Fuji II LC, F-2000,Teethmate F-1, and Alphadent) wereprepared to make total 48 experimentalsamples. These samples were divided intofour groups:� Group I - 12 Samples of Fuji II LC� Group II - 12 Samples of F-2000� Group III - 12 Samples of Teethmate

F-1� Group IV - 12 Samples of Alphadent

Each group was further divided into 4experimental subgroups with three pelletsin each subgroup (Table 1)

Each sample of subgroup IA was pickedup by a sterile tweezer, brushed for twominutes with pea sized amount ofsodium fluoride containing Pepsodent 2-in-1 toothpaste and then rinsed with 5mlof deionized water and placed again in thesame plastic vial containing 10ml deionizedwater.

Likewise samples of group IB, IC werebrushed with Colgate Herbal containingsodium monofluorophosphate and nonfluoridated, Close-Up respectively. Samplesof ID which were not brushed with anypaste were kept as control (Figure 3).

Fluoride ions leached out in the storagemedia (deionized water) containing

Figure 1: Equipments and Materials used in the study

Table 1: Division of samples

Subgroups (Dentifrices)

Name of Material Group Pepsodent Colgate Close-Up Control2-in-1 Herbal

Fuji II LC I IA IB IC ID

F-2000 II IIA IIB IIC IID

Teethmate F-1 III IIIA IIIB IIIC IIID

Alphadent IV IVA IVB IVC IVDFigure 2: Preparation of samples

VISION IS THE ART OF SEEING THINGS INVISIBLE -AN INVITRO COMPARATIVE EVALUATION


restorative material pellets, were estimatedafter 24 hours (T1), 7th day (T7), 14th day(T14), 21st day (T21), and 28th day (T28)using a standard ion selective electrodemethod with the help ofspectrophotometer (Hach / AU/4000) inparts per million unit (ppm) (Figure 4).After every estimation the pellets were thenreplaced in the vial, containing fresh 10mlof deionized water.

However, the brushing with specificdentifrices was continued twice daily asdescribed above.

Statistics

The data was statistically analyzed usinganalysis of variance (ANOVA) test and ‘t’test. The relation between different groupswas obtained by correlation coefficient forwhich regression lines were drawn.

RESULTS AND OBSERVATIONS

The mean fluoride ion concentration valuesof various materials when brushed withdifferent dentifrices at various time intervalsare displayed in Table 2. It was observedthat mean leached out fluoride ionconcentration from the glass ionomercement sample, when brushed withsodium fluoride containing dentifrice was6.35 + .269 ppm. While the leached outfluoride ion concentration was 4.52 + .115ppm for glass ionomer cement samplesbrushed with sodium monofluoro-phosphate dentifrice and 3.53 + .1193 ppmfor those samples which were brushedwith non fluoride containing dentifrice NewClose-Up. The mean fluoride ionconcentration for the samples not brushedwith any dentifrice was 3.0 + .0500 ppm. Itclearly indicates that sodiumfluoride

containing dentifrice is recharging Fujji IIlight cure GIC more than sodiummonofluorophosphate.The same trend isbeing followed by other fluoride releasingrestorative materials used in the study.

The mean leached out fluoride ionconcentration from the F-2000 sample was3.2 + .132 ppm, when brushed withsodium fluoride containing Pepsodent 2-in-1 dentifrice. While the leached out fluorideion concentration for F-2000 sampleswhen brushed with sodiummonofluorophosphate dentifrice was 2.52+ .225 ppm and for those samples whichwere brushed with non fluoride containingdentifrice New Close-Up was 1.24 + .102ppm. The mean fluoride ion concentrationfor the samples not brushed with anydentifrice was 1.04 + .0500 ppm. It was seenthat mean fluoride ion concentration of thespecimen brushed with non fluoridateddentifrice is slightly more than specimensnot brushed at all. This could be attributedto the fact that brushing abrades thesuperficial matrix of restorative material andthus releasing more fluoride ion.

Figure 3: Division of samples

Pep

sode

nt

Col

gate

Clo

se-U

p

Con

trol

Pep

sode

nt

Col

gate

Clo

se-U

p

Con

trol

Pep

sode

nt

Col

gate

Clo

se-U

p

Con

trol

Pep

sode

nt

Col

gate

Clo

se-U

p

Con

trol

Figure 4: Spectrophotometer



The mean leached out fluoride ionconcentration from the Teethmate F-1,when brushed with sodium fluoridecontaining Pepsodent 2-in-1 dentifrice was1.16 + .070 ppm. While the leached outfluoride ion concentration was 0.84 + .110ppm for Teethmate F-1 sampleswhen brushed with sodiummonofluorophosphate dentifrice and 0.55+ .1200 ppm for those samples which werebrushed with non fluoride containingdentifrice New Close-Up. The meanfluoride ion concentration for the samplesnot brushed with any dentifrice was .42 +.071 ppm.

All restorative materials used in the studyshowed a Fluoride ion concentrationdecreased for all the samples from T1 toT28 irrespective of the dentifrice used.

Moreover, there is significant difference inrecharging of fluoride ion concentration (‘p’> .001) of all fluoride releasing materialswhen brushed with sodium fluoridecontaining dentifrice as compared towhen brushed with sodiummonofluorophosphate containing dentifrice. There is no significant difference(‘p’>.05) in fluoride ion concentrationrelease of all material when not brushed

with any dentifrice or brushed with a nonfluoridated dentifrice (Figure 5).

Regression line was represented by y = a +

bx. In which ‘b’ represented the rate at whichthe mean concentration of fluoridechanged (increased / decreased) with time.‘x’ represented the days (time factor) and‘y’ represented the fluoride ionconcentration (in ppm). The ‘b’ value wasnegative for all restorative materials usedwhich supports the observationmentioned above concerning the timebound decrease in fluoride ionconcentration of all fluoride releasingrestorative materials when either brushedwith fluoride containing / non fluoridecontaining dentifrice or when not brushedat all (Table 3, Figure 6, Figure 7, Figure 8).Table 4 shows analysis of variance fordifferent restorative materials testing fortheir fluoride release and recharging capacity,when brushed with different dentifricesafter 24 hours, 7 days, 14 days, 21 days and28 days. ‘p’ value was found to be <.01 forall the intergroup and intragroupcomparisons indicating a highly significantdifference.

The non fluoride releasing pit and fissuresealant Alphadent neither have any potentialfor fluoride release nor did it show anyrecharging and subsequent release offluoride ion when brushed with fluoridated

Table 2. Mean fluoride ion concentration at various time intervals of all fluoride releasing restorative materials.

T 1 (Day 1) T7 (Day 7) T 14 (Day 14) T 21 (Day 21) T 28 (Day 28)

M SD SE M SD SE M SD SE M SD SE M SD SE

IA 6.35 .2695 .1556 5.02 .1818 .1049 3.99 .0556 .0321 2.02 .0529 .0305 1.62 .0315 .0202

IB 4.52 .1115 .0643 3.99 .0814 .0470 2.03 .0611 .0352 1.21 .0300 .0173 0.92 .0200 .0115

IC 3.53 .1193 .0688 3.22 .0450 .0260 1.06 .0404 .0233 0.64 .0300 .0173 0.54 .0264 .0152

ID 3.0 .0500 .0288 2.98 .0737 .0425 0.90 .0251 .0145 0.57 .0360 .0208 0.48 .0351 .0202

IIA 3.2 .1323 .0763 3.01 .04000 .0230 2.78 .0360 .0208 1.72 .0300 .0173 1.31 .0404 .0233

IIB 2.52 .2255 .1302 2.15 .0568 .0328 1.93 .0200 .0115 1.03 .0400 .0230 0.87 .0351 .0202

IIC 1.24 .1026 .0592 1.17 .0624 .0360 0.78 .0416 .0240 0.27 .0351 .0202 0.22 .0251 .0145

IID 1.04 .0556 .0321 1.02 .0680 .0393 0.61 .0458 .0264 0.21 .0251 .0145 0.15 .0251 .0145

IIIA 1.16 .0702 .0405 1.07 .0611 .0352 0.93 .0208 .0120 0.87 .0493 .0284 0.85 .0351 .0202

IIIB 0.84 .1100 .0635 0.81 .0208 .0120 0.76 .0404 .0233 0.72 .0450 .0260 0.57 .0351 .0202

IIIC 0.55 .1200 .0692 0.51 .1054 .0608 .29 .0737 .0425 0.27 .0200 .0115 0.17 .0152 .0088

IIID .42 .0709 .0409 .39 .0602 .0348 0.21 .0100 .0577 0.20 .0458 .0264 0.13 .0251 .0145

Table 3 Correlation between time and mean fluoride ion concentrationand regression line equation for all fluoride releasing restorative materials

FUJII II LC Correlation Coefficient’r’ valueRegression LineY = a + bx

Pepsodent 2-in-1 (IA) -0.985 Y = 6.39 + (- 0.18) xColgate Herbal (IB) - 0.965 Y = 4.61 + (- 0.15) xNew Close-Up (IC) - 0.928 Y = 3.58 + (- 0.12) xControl (ID) - 0.913 Y = 3.14 + (- 0.11) x

COMPOMER F-2000Pepsodent 2-in-1 (IIA) -0.962 Y = 3.46 + (- 0.07) xColgate Herbal (IIB) - 0.961 Y = 2.78 + (- 0.07) xNew Close-Up (IIC) - 0.968 Y = 1.35 + (- 0.04) xControl (IID) - 0.966 Y = 1.15 + (- 0.04) x

TEETHMATE F-1Pepsodent 2-in-1 (IIIA) -0.963 Y = 1.14 + (- 0.01) xColgate Herbal (IIIB) - 0.948 Y = 0.87 + (- 0.009) xNew Close-Up (IIIC) - 0.979 Y = 0.59+ (- 0.15) xControl (IIID) - 0.943 Y = 0.26 + (- 0.004) x



dentifrices thus proving that experimentwas done under standard conditions andwas giving true results.

DISCUSSION

Dental caries – the decay of tooth, has beenone of the commonest occurrencesaffecting the human population, and hascrippled our oral health for generations. Itimpairs the quality of life for many peoplecausing pain, discomfort and loss offunction. In addition, it places a heavyfinancial burden on patients. Scientificresearch, technologic advances and a betterunderstanding of the disease process havecontributed to dentistry’s emergence froma purely repairable art towards a preventiveoriented science. Fluorides play a key rolein the prevention of caries. As cariespreventive properties of fluorides becamemore widely demonstrated, it becameapparent that fluoride not only preventsdental caries pre-eruptively by systemicincorporation into developing enamel, butalso post eruptively by topical action (17).The options available for topical applicationof fluoride are either professional or athome. Professional application of topicalfluorides though effective in cariesprevention, relies largely on patient’scompliance. Amongst the homeapplication of topical fluorides, the mostconvenient is fluoridated dentifrices.

A unique feature of fluoride containingdentifrices, compared to other fluoridecompounds, is that they are generally usedas a part of normal body hygieneprocedures. Surface enamel and plaque aretherefore, exposed to fluoride regularly andmore or less continuously on a daily basis(18).

So in the present study, sodium fluorideand sodium monofluorophosphatecontaining dentifrices were used as they arethe most widely accepted fluoridateddentifrices in use. Fluoride doesn’t eradicatethe dental caries enmass but reduces theincidence and progression of cariouslesion, studies indicate that fluoride reducesup to 40% – 60% of carious lesion (18).Therefore, it was thought to incorporatefluoride into the structure of the restorative

Figure 5: Cumulative Fluoride Release in ppm By Various RestorativeMaterials In The Stipulated Time Period Of 28 Days

Figure 6: Linear regression lines for resin modified GIC (Fuji II IC)

Figure 7: Linear Regression Lines For Compomer (F-2000)



material so that it would be cariespreventive with the introduction offluoride releasing dental materials, anoption for simultaneously restoring theclinically evident caries along with protectionagainst recurrent caries became available.

But these fluoride releasing materialsrelease fluoride in an initial burst and thenreduce exponentially to a much lowersteady state level of release in few days (9).If there was only a one way release offluoride there would be a danger ofemptying the fluoride resources after someperiod of time ?(10).

Several recent reports have assessed theability of fluoridated dentifrices to reducethe acid solubility of tooth material and toremineralize incipient lesions both in vitroand in vivo using a variety of parametersincluding microradiography and polarizedlight microscopy (19).

Figure 8: Linear Regression Lines For Fluoride Releasing Pit And FissureSealant

Table 4: ANOVA TABLE: Comparison between the different dentifrices (A, B, C and D) vs. different restorativematerials (I, II, III)

Group - I T1 (Day 1) T7 (Day 7) T14 (Day 14) T21 (Day 21) T28 (Day 28)

Fuji II LC B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n

g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s g r o u p s

Degree of Freedom 3 8 3 8 3 8 3 8 3 8

Sum of Square 35.665 .204 26..025 .094 9.556 .018 4.698 .011 2.001 .007

Mean Square 11.888 .025 8.675 .011 3.185 .002 1.566 .001 .667 .0008

Significance .000-HS .000-HS .000-HS .000-HS .000-HS .000-HS .000-HS .000-HS .000-HS .000-HS

Group - II T1 (Day 1) T7 (Day 7) T14 (Day 14) T21 (Day 21) T28 (Day 28)

F - 2 0 0 0 B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n



Sum of Square 9.603 .164 8.784 .026 9.379 .011 4.562 .008 2.782 .008

Mean Square 3.201 .020 2.928 .003 3.126 .001 1.521 .001 .927 .001


Group - III T1 (Day 1) T7 (Day 7) T14 (Day 14) T21 (Day 21) T28 (Day 28)

Teethmate F-1 B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n B e t w e e n W i t h i n



Sum of Square 1.369 .072 1.200 .037 .926 .015 .997 .013 1.051 .006

Mean Square .456 .009 .400 .004 .309 .001 .332 .001 .350 .0008




So, if fluoride from dentifrice can beincorporated into tooth material, it can alsoget incorporated into fluoride releasingrestorative materials and recharge theirfluoride ion concentration, as daily toothbrushing with fluoridated dentifrices mayreplenish material surface level at eachbrushing interval. Thus, a reservoir offluoride could be created for constant releaseand a certain reduction in caries could beevident till restoration is maintained in theoral cavity as concluded by Donly Kevin J(1997) (11).

Hence, in the light of above knowledge,the aim of the present study was to seewhether various fluoridated dentifricesrecharge fluoride releasing restorativematerials and to comparatively evaluatetheir recharging capabilities.

Among the fluoride releasing restorativematerials, resin modified glass ionomercement(Fuji II light cure), Compomer (F-2000),Fluoridated pit and fissuresealant(Teethmate F1) was used in thepresent study

A non fluoride releasing pit and fissuresealant was used as a control just to confirmthat experiment was done under standardconditions and was giving true results. Itfurther proved that fluoride ion did notget incorporated in experimental setupfrom sources other than intentional useof fluoridated dentifrices.

All the materials were evaluated for theirrecharging capabilities with fluoride ions,within 24 hours of their setting and thenafter 7 days, 14 days, 21 days and 28 days.Pellets of each material were kept in differentvials to avoid any physical and chemicalcontamination of the restorative material.For the whole experimental period, thestorage media used was deionized water asit is devoid of any ions, doesn’t react withthe ions of restorative materials. Reportsfrom the studies of Robertella Francis(1999) (20) suggested that, there are certainvariations seen in natural saliva and technicaldifficulties associated with the use ofartificial saliva so deionized water was usedin this study to ensure that fluoride release

would be unaffected by these variables.Teflon moulds were used in the presentstudy to prepare the experimental pelletsas they can be autoclaved and do not reactwith any material

In the present study, the fluoride ionmeasurement was done by standard ionselective method as this is the standardmethod for the examination of the waterand waste water as accepted by AmericanPublic Health Association, American WaterWorks Association and WaterEnvironment Federation (21). Theinstrument used was spectrophotometer(HACH/DR/4000U) which is a highlysensitive fluoride ion digital analyzer. Itmeasures the fluoride ion with the help ofinfrared rays and appropriate sensors, andis not as technique sensitive as fluoride ionelectrode used in other studies

All the findings clearly show that therecharging of fluoride ion was greatest whenbrushed with sodiumfluoride containingdentifrice Pepsodent 2-in-1 followed bysodium monofluorophosphate containingdentifrice Colgate Herbal.

These findings are favoured by theindependent studies done regarding thedeposition of fluoride in incipient cariouslesions which suggested that a greateramount of fluoride deposition wasobtained with sodium fluoride dentifricesthan with sodium monofluorophosphatedentifrices (19-22)

As Sodium fluoride is an odourless, whitesolid powder. It is highly soluble in waterto the extent of one gram in 25ml. Whilesodium monofluorophosphate is a stablewhite powder. Dilute solutions are verystable as the fluoride of this compound isbound covalently with phosphate, andthus, caries inhibiting action of sodiummonofluorophosphate is linked to itsslow hydrolysis, whereby smallconcentrations of fluoride are released.

PO3F¯ + H

2O H

2PO

4 + F¯

The potential caries preventive effect of therelease – adsorption-release of fluoridefound in dental materials should be

investigated extensively beforesubstantiating the results obtained fromthis study.

CONCLUSION

� All restorative materials used in thestudy showed a fluoride rechargingcapability when brushed withfluoridated dentifrices.

� Sodium fluoride containing dentifricerecharged fluoride releasing restorativematerials more than sodiummonoflurophosphate containingdentifrice.

� All materials exhibited a large initialrelease followed by a gradual decreasein fluoride ion concentration inspite ofbeing brushed with fluoride containingdentifrices regularly.

� Initial fluoride release was found to bemaximum and then decreased whichcould not be restored to the initial leveleven after brushing with fluoridateddentifrices regularly.

� Resin modified glass ionomer cementreleased maximum cumulative fluoridecompared to other restorative materialstested over 28 day period.

� Fluoride releasing pit and fissure sealantTeethmate F-1 released least cumulativefluoride in comparison to otherrestorative material tested over 28 dayperiod.

� Thus, the cumulative fluoride releasefrom the restorative materials could besummarized as Fuji II LC > F-2000 >Teethmate F-1

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4. Council on Dental Materials, Instruments,and Equipment. Restorative Materialscontaining fluoride. J Am Dent Assoc1988;116:762-63.



5. Retient DH, Bradley EL, Denton JC,Switzer P. Enamel and cementum fluorideuptake from a glass ionomer cement.Caries Res 1984;18:250-57.

6. Kreulen CM, DeSoet JJ, Weerheijm KL. Invivo cariostatic effect of resin modifiedglass ionomer cement and amalgam ondentin. Caries Res 1997; 31:384-89.

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8. Shinji H, Vohimura N, Ishida M, MotokawaW, Miyazak K, Garcia GF. Enamel fluorideuptake from a fluoride releasing sealant.Am J Dent 1998;11:58-60.

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10. Forsten L. Resin modified glass ionomercements : fluoride release and uptake.Acta Odontol Scand 1995;53:222-25.

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Vision is the Art of Seeing Things Invisible