Impact of Milk on Erosion/Abrasion of Enamel and Dentin - an in Situ Study

Study Overview
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Brief Summary
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This in situ study aims to investigate the protective potential of milk and fluoridated milk on erosive wear of enamel the protective potential of milk and fluoridated milk on erosive wear of dentin to compare to protective potential of milk and fluoridated milk with products containing casein phosphopeptide-amorphous calcium phosphate to compare the protective potential of milk and fluoridated milk with a fluoridated toothpaste or stannous-chloride containing fluoride solution (SnCl2/AmF/NaF)

Detailed Description
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Dental erosion is defined as the pathogenic, chronic, chemical removal of dental hard tissues due to the frequent contact to extrinsic or intrinsic acids. The dissolution process is determined by the pH, the chelating properties, mineral content and kind of acid, but in the same time modified by various biological (e.g. saliva, pellicle) and behavioural factors. The anticariogenic properties of milk are widely investigated, but information of the effects of milk or milk components on the development of erosion are limited. It is suggested that the demineralisation process is reduced by the presence of calcium and phosphate, but also that casein proteins affect the demineralisation by adsorbing to the hydroxyapatite surface and inhibiting its dissolution. Initial studies suggest that milk is able to increase rehardening of acid-softened enamel, but information about the effects of milk on dentin erosion are not available yet. Particularly, the effect of fluoridated milk on dental erosion was not investigated yet. In contrast, recent studies analysed the effects of products containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on erosion, as it is suggested that CPP-ACP promotes a supersaturated state and increased remineralisation of demineralised dental hard tissue. However, in situ studies on the effect of CPP-ACP on erosion are limited to one study, which compared microhardness of enamel after treatment with CPP-ACP and CPP-ACP and 900 ppm fluoride, but failed to use appropriate controls in form of other products containing calcium and phosphate or fluoride. In summary, the effects of milk, in particular fluoridated milk, and products containing milk proteins, such as casein phosphopeptide-amorphous calcium phosphate, on erosive wear were not analysed in an in-situ-model so far.

Official Title
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Impact of Milk and Casein Phosphopeptide-amorphous Calcium Phosphate on Erosion/Abrasion of Enamel and Dentin - an in Situ Study

Conditions
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Erosion Protection

Intervention / Treatment
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* Other: Toothpaste
* Dietary Supplement: Milk
* Dietary Supplement: Fluoridated Milk
* Drug: Tooth Mousse
* Drug: MI Paste Plus
* Drug: Elmex Erosion Protection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: healthy volunteers Exclusion Criteria: non-treated caries lesions orthodontic treatment which does not allow to wear an intraoral device hyposalivation allergy against milk or milk proteins

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Fluoride-free toothpaste<br> | |
| Active Comparator: Fluoride toothpaste<br> | Other: Toothpaste<br> <br> |
| Active Comparator: Milk<br> | Dietary Supplement: Milk<br> <br> |
| Active Comparator: Fluoridated milk<br> | Dietary Supplement: Fluoridated Milk<br> <br> |
| Active Comparator: CPP-ACP<br> | Drug: Tooth Mousse<br> <br> |
| Active Comparator: Fluoridated CPP-ACP<br> | Drug: MI Paste Plus<br> <br> |
| Active Comparator: Fluoride mouthrinse<br> | Drug: Elmex Erosion Protection<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Substance loss (profilometry) | Each intervention will be tested for 5 days in situ. Then, enamel or dentin loss, respectively, will be determined by profilometry | after each study phase (5 days) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dental erosion, enamel, dentin