Compare wondeful fluoride to embrace by pulpdent

Conclusion

Fluoride-based treatments contributed to partial remineralization of tooth hard tissues. Fluoride varnish showed a tendency toward greater fluoride incorporation, particularly in enamel; however, statistically significant superiority over other treatment approaches was not demonstrated. These findings support the role of fluoride in remineralization while highlighting the need for further clinically relevant studies.

Elemental changes in tooth hard tissues during demineralization and fluoride-induced remineralization: an SEM-EDX study. Copyright © 2026 Nino, Marina, Labanca and Dea. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

1. Background

Fluoride is the agent par excellence in preventing and detaining cavities [6]. Fluoride varnishes were developed to prolong the contact time between fluoride and tooth enamel [7]. Systematic reviews, meta-analyses and clinical guidelines worldwide recommend fluoride varnishes as caries inhibitors and repairers of initial caries lesions in temporary and permanent teeth [8,9,10]. As remineralization may be hampered by the limited bioavailability of calcium and phosphate, new products have been developed to ensure their constant supply [11]. Two of the most used products are amorphous calcium phosphate stabilized with casein phosphopeptide (CPP-ACP) and tricalcium phosphate modified by fumaric acid (fTCP) [12,13].

Effects of Fluoride and Calcium Phosphate-Based Varnishes in Children at High Risk of Tooth Decay: A Randomized Clinical Trial. © 2021 by the authors. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

1. Introduction

Although essential, fluoride alone is not sufficient for the prevention of demineralization and possible redeposition of minerals into hydroxyapatite crystals. The presence of bioavailable calcium and phosphate in the plaque fluid is also necessary for maintaining the structural integrity of hydroxyapatite crystals. While normal saliva does not usually contain an optimal level of fluoride, it has been shown that saliva is supersaturated with respect to calcium and phosphate [13]. Several proteins including statherins are responsible for stabilizing calcium and phosphate in saliva and preventing their spontaneous precipitation [14]. However, with the aim of increasing the amount of calcium and phosphate in saliva and desiring to improve the demineralization prevention efficacy and possible remineralization of the lesion, fluoride varnishes with added calcium and phosphate compositions have been introduced recently. These include fluoride varnishes with added amorphous calcium phosphate (Enamel Pro® Varnish), tri-calcium phosphate (Clinpro White varnish™), casein phosphopeptide stabilized amorphous calcium phosphate (MI Varnish™ with RECALDENT™), and Xylitol coated calcium and phosphate (Embrace Varnish). Considering the recent development of these formulations for sodium fluoride varnishes, the effect of the addition of calcium and phosphate in amplifying or debilitating the action of fluoride remains unclear. Therefore the aim of this study was to investigate the efficacy of various fluoride varnishes in the protection of the structural and nanomechanical properties of dental enamel and to examine the effect of added calcium and phosphate on the performance of different fluoride varnishes in vitro.

Efficacy of Fluoride Varnishes with Added Calcium Phosphate in the Protection of the Structural and Mechanical Properties of Enamel. Copyright © 2017 Mahdi Shahmoradi et al. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).