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Vaccinium macrocarpon (cranberry) is a fruit that has an inhibitory effect on matrix metalloproteinases (MMPs) present in dentin and saliva. The inhibition of MMPs has been shown to prevent dentin erosion. The aim of this study was to analyze the effect of cranberry juice on the reduction of dentin erosion in vitro. Specimens of bovine dentin (4×4×2 mm) were randomized and divided into 4 groups (n = 17/group): distilled water (C-control, pH 7.2); green tea extract solution containing 400 µm epigallo-catechin-gallate (EGCg, positive control, pH 4.5); 10% cranberry extract (CrE, pH 3.9), and cranberry juice (CrJ, Cranberry JuxxTM, pH 2.8). Specimens were submitted to erosive pH cycles for 5 days. Each day, four demineralizations were carried out with 0.1% citric acid (90 s). After the acid challenges, specimens were rinsed and kept in treatment solutions for 1 min; afterwards, they were rinsed and stored in artificial saliva for 1 h at 37°C (or overnight at the end of each day). After the experimental period of 5 days, dentin loss was evaluated by contact profilometry. Data were analyzed by ANOVA and Tukey's test (p < 0.05). Dentin loss (µm ± SD) was significantly lower for all treatments (EGCg = 9.93 ± 2.90; CrE = 12.10 ± 5.44; CrJ = 11.04 ± 5.70) compared to control (21.23 ± 11.96), but it did not significantly differ from each other. These results indicate that the commercial cranberry juice, despite its low pH, is able to reduce dentin erosion, which might be due to the ability of cranberry components to inhibit MMPs.

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Abstract Vaccinium macrocarpon (cranberry) is a fruit that has an inhibitory effect on matrix metalloproteinases (MMPs) present in dentin and saliva. The inhibition of MMPs has been shown to prevent dentin erosion. The aim of this study was to analyze the effect of cranberry juice on the reduction of dentin erosion in vitro. Specimens of bovine dentin (4×4×2 mm) were randomized and divided into 4 groups (n = 17/group): distilled water (C-control, pH 7.2); green tea extract solution containing 400 µm epigallo-catechin-gallate (EGCg, positive control, pH 4.5); 10% cranberry extract (CrE, pH 3.9), and cranberry juice (CrJ, Cranberry JuxxTM, pH 2.8). Specimens were submitted to erosive pH cycles for 5 days. Each day, four demineralizations were carried out with 0.1% citric acid (90 s). After the acid challenges, specimens were rinsed and kept in treatment solutions for 1 min; afterwards, they were rinsed and stored in artificial saliva for 1 h at 37°C (or overnight at the end of each day). After the experimental period of 5 days, dentin loss was evaluated by contact profilometry. Data were analyzed by ANOVA and Tukey's test (p < 0.05). Dentin loss (µm ± SD) was significantly lower for all treatments (EGCg = 9.93 ± 2.90; CrE = 12.10 ± 5.44; CrJ = 11.04 ± 5.70) compared to control (21.23 ± 11.96), but it did not significantly differ from each other. These results indicate that the commercial cranberry juice, despite its low pH, is able to reduce dentin erosion, which might be due to the ability of cranberry components to inhibit MMPs.

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OBJECTIVES: Evaluate the effect of dentifrices or gels containing MMP inhibitors on dentine loss in situ. MATERIALS AND METHODS: Acrylic palatal appliances containing bovine dentine blocks were divided into two rows, corresponding to the groups erosion (ERO) and erosion associated with abrasion (ERO+ABR). For ERO, the appliances were immersed in a cola drink for 5 min, 4 times/day, while for ERO+ABR, the blocks were brushed for 15 sec with a dentifrice slurry after the second and third erosive challenges. Ten volunteers took part in study 1 (S1), where the dentifrices evaluated contained 1100 ppm fluoride as NaF, 0.61% green tea extract, or 0.012% chlorhexidine digluconate. Thirteen volunteers participated in study 2 (S2), in which the treatment was performed only once (1 min) with gels containing 400 µM EGCG (EGCG400), 0.012% chlorhexidine, 1 mM FeSO4, 1.23% F (NaF), placebo, or received no treatment. Dentine loss was analyzed by profilometry (µm). RESULTS: Regarding S1, ERO+ABR induced significantly higher dentine loss compared with ERO and all dentifrices tested led to significantly lower dentine loss when compared with placebo. For S2, regardless of the conditions or times of evaluation, gels containing EGCG, CHX, or FeSO4 led to significantly less wear compared with the other groups. CONCLUSION: Both dentifrices and gels containing MMP inhibitors significantly reduced dentine loss. CLINICAL RELEVANCE: Dentifrices and gels containing MMP inhibitors are able to increase the protection against dentine wear, although gels have a better effect when compared with fluoride gel, lasting up to 10 days after a single application.

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OBJECTIVES: The aim of this study was to evaluate the effect of Cranberry and Grape seed-enriched extract gels in inhibiting wear and degradation of demineralized organic matrix (DOM). DESIGN: 225 dentin specimens obtained from bovine incisors were randomly allocated into 5 groups (n=45): 10% Grape seed extract gel (GSE), 10% Cranberry extract gel (CE), 0.012% Chlorhexidine gel (CX), 1.23% NaF gel (F), and no active compound gel (P, placebo). Before the treatments, samples were demineralized by immersion in 0.87M citric acid, pH 2.3 (36h). Then, the studied gels were applied once over dentin for 1min. Next, the samples were immersed in artificial saliva containing collagenase obtained from Clostridium histolyticum for 5days. The response variable for dentin wear was depth of dentin loss measured by profilometry and for collagen degradation was hydroxyproline determination. Data were analyzed by ANOVA followed by Tukey's test and Pearson Correlation Test (p<0.05). RESULTS: Grape seed extract significantly reduced dentin wear compared to the other groups (p<0.05). Cranberry extract and Chlorhexidine did not differ statistically and were able to reduce wear when compared to NaF and placebo treatments. The hydroxyproline analysis showed that there was no significant difference among groups for all treatments (p<0.05). Correlation analysis showed a significant correlation between the amount of degraded DOM evaluated by profilometry and the determination of hydroxyproline. CONCLUSION: Cranberry extract was able to reduce the dentin wear and collagen degradation, likely due to the proanthocyanidin content and its action. Therefore, Cranberry could be suggested as an interesting natural-based agent to prevent dentin erosion.

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UNLABELLED: The use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro. MATERIAL AND METHODS: Five groups each containing 12 specimens of human root dentine were prepared. The specimens were subjected to 1 min erosion by immersion in a cola drink, 4 times a day, for 5 d. Each day, after the first and last erosive challenges, the specimens were brushed for 15 s with a slurry of dentifrice and water (1:3) containing placebo, 1,100 ppm fluoride, 0.61% green tea extract, 0.12% chlorhexidine or 0.004% chlorhexidine (commercial toothpaste). Between the acid challenges, the specimens were stored in artificial saliva with remineralizing potential until the next treatment. Dentine loss was determined using profilometry. Data were analyzed using one-way ANOVA after log transform (p<0.05). RESULTS: The mean wear values (µm) were as follows: placebo 1.83±0.53; 0.61% green tea extract 1.00±0.21; fluoride 1.27±0.43; 0.12% chlorhexidine 1.19±0.30; and 0.004% chlorhexidine 1.22±0.46. There was a significant difference in wear between placebo and all the treatment toothpastes, which did not differ from each other. CONCLUSION: The results suggest that toothpastes containing MMP inhibitors are as effective as those based on NaF in preventing dentine erosion and abrasion.

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ABSTRACT The use of gels and mouthrinses with MMP inhibitors (chlorhexidine, and green tea extract) was shown to prevent erosive wear. The aim of this study was to analyze the protective effect of toothpastes containing MMP inhibitors on dentine loss induced by erosion in vitro. Material and Methods Five groups each containing 12 specimens of human root dentine were prepared. The specimens were subjected to 1 min erosion by immersion in a cola drink, 4 times a day, for 5 d. Each day, after the first and last erosive challenges, the specimens were brushed for 15 s with a slurry of dentifrice and water (1:3) containing placebo, 1,100 ppm fluoride, 0.61% green tea extract, 0.12% chlorhexidine or 0.004% chlorhexidine (commercial toothpaste). Between the acid challenges, the specimens were stored in artificial saliva with remineralizing potential until the next treatment. Dentine loss was determined using profilometry. Data were analyzed using one-way ANOVA after log transform (p<0.05). Results The mean wear values (μm) were as follows: placebo 1.83±0.53; 0.61% green tea extract 1.00±0.21; fluoride 1.27±0.43; 0.12% chlorhexidine 1.19±0.30; and 0.004% chlorhexidine 1.22±0.46. There was a significant difference in wear between placebo and all the treatment toothpastes, which did not differ from each other. Conclusion The results suggest that toothpastes containing MMP inhibitors are as effective as those based on NaF in preventing dentine erosion and abrasion.

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OBJECTIVE: The aim of this study was to evaluate the effect of the addition of metallic ions to carbonated drinks on their erosive potential. MATERIAL AND METHODS: Powdered enamel was added to carbonated beverages (Coca-ColaTM or Sprite ZeroTM and shaken for 30 s. The samples were then immediately centrifuged and the supernatant removed. This procedure was repeated 5 times with the beverages containing Cu2+, Mg2+, Mn2+ or Zn2+ (1.25-60 mmol/L). For Coca-ColaTM, the concentration of each ion that exhibited the highest protection was also evaluated in combination with Fe2+. The phosphate or calcium released were analyzed spectrophotometrically. Data were analyzed using ANOVA and Tukey's test (p<0.05). RESULTS: For Coca-ColaTM, the best protective effect was observed for Zn2+ alone (10 mmol/L) or in combination (1 mmol/L) with other ions (12% and 27%, respectively, when compared with the control). Regarding Sprite ZeroTM, the best protective effect was observed for Cu2+ at 15 and 30 mmol/L, which decreased the dissolution by 22-23%. Zn2+ at 2.5 mmol/L also reduced the dissolution of powdered enamel by 8%. CONCLUSIONS: The results suggest that the combination of metallic ions can be an alternative to reduce the erosive potential of Coca-ColaTM. Regarding Sprite ZeroTM, the addition of Cu2+ seems to be the best alternative.

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OBJECTIVE: The aim of this study was to evaluate the effect of the addition of metallic ions to carbonated drinks on their erosive potential. MATERIAL AND METHODS: Powdered enamel was added to carbonated beverages (Coca-ColaTM or Sprite ZeroTM and shaken for 30 s. The samples were then immediately centrifuged and the supernatant removed. This procedure was repeated 5 times with the beverages containing Cu2+, Mg2+, Mn2+ or Zn2+ (1.25-60 mmol/L). For Coca-ColaTM, the concentration of each ion that exhibited the highest protection was also evaluated in combination with Fe2+. The phosphate or calcium released were analyzed spectrophotometrically. Data were analyzed using ANOVA and Tukey's test (p<0.05). RESULTS: For Coca-ColaTM, the best protective effect was observed for Zn2+ alone (10 mmol/L) or in combination (1 mmol/L) with other ions (12% and 27%, respectively, when compared with the control). Regarding Sprite ZeroTM, the best protective effect was observed for Cu2+ at 15 and 30 mmol/L, which decreased the dissolution by 22-23%. Zn2+ at 2.5 mmol/L also reduced the dissolution of powdered enamel by 8%. CONCLUSIONS: The results suggest that the combination of metallic ions can be an alternative to reduce the erosive potential of Coca-ColaTM. Regarding Sprite ZeroTM, the addition of Cu2+ seems to be the best alternative. .

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UNLABELLED: Dental erosion is a multifactorial condition. The consideration of chemical, biological and behavioral factors is fundamental for its prevention and therapy. Among the biological factors, saliva is one of the most important parameters in the protection against erosive wear. OBJECTIVE: This review discusses the role of salivary factors on the development of dental erosion. MATERIAL AND METHODS: A search was undertaken on MeDLINe website for papers from 1969 to 2010. The keywords used in the research were "saliva", "acquired pellicle", "salivary flow", "salivary buffering capacity" and "dental erosion". Inclusion of studies, data extraction and quality assessment were undertaken independently and in duplicate by two members of the review team. Disagreements were solved by discussion and consensus or by a third party. RESULTS: Several characteristics and properties of saliva play an important role in dental erosion. Salivary clearance gradually eliminates the acids through swallowing and saliva presents buffering capacity causing neutralization and buffering of dietary acids. Salivary flow allows dilution of the acids. In addition, saliva is supersaturated with respect to tooth mineral, providing calcium, phosphate and fluoride necessary for remineralization after an erosive challenge. Furthermore, many proteins present in saliva and acquired pellicle play an important role in dental erosion. CONCLUSIONS: Saliva is the most important biological factor affecting the progression of dental erosion. Knowledge of its components and properties involved in this protective role can drive the development of preventive measures targeting to enhance its known beneficial effects.

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OBJECTIVE: This in vitro study evaluated the effect of calcium glycerophosphate (CaGP) supplemented to soft drinks on bovine enamel erosion. MATERIAL AND METHODS: Four pH-cycles were performed, alternating demineralization by the beverage and remineralization in artificial saliva. RESULTS: Mean wear (± SD, µm) was 7.91 ± 1.13, 7.39 ± 1.01, 7.50 ± 0.91 and 5.21 ± 1.08 for Coca-Cola® without CaGP or containing CaGP at 0.1, 1.0 or 2.0 mM, respectively, while no wear was detected for CaGP at 5.0 and 10.0 mM. Corresponding figures for Sprite Zero® without CaGP or containing CaGP at 0.1, 1.0, 2.0, 5.0 or 10.0 mM were 8.04 ± 1.30, 7.84 ± 0.71, 7.47 ± 0.80, 4.96 ± 0.81, 3.99 ± 0.10 and 1.87 ± 0.12, respectively. CONCLUSION: Supplementation of both beverages with CaGP seems to be an alternative to reduce their erosive potential.

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