Kurzfassung

Effects of Innovative Dentifrice Treatments on Hypersensitivity Related to Surface Chemistries

Project Neptune is directed toward development of stannous fluoride dentifrice providing multibenefit protection against caries, sensitivity, gingivitis, tartar, plaque and tooth susceptibility to dietary erosive wear. The technology approach is to maximize bioavailable stannous fluoride. The sensitivity benefits of bioavailable stannous fluoride are important to consumers. Tooth (dentin or dentinal)...Effects of Innovative Dentifrice Treatments on Hypersensitivity Related to Surface Chemistries

Project Neptune is directed toward development of stannous fluoride dentifrice providing multibenefit protection against caries, sensitivity, gingivitis, tartar, plaque and tooth susceptibility to dietary erosive wear. The technology approach is to maximize bioavailable stannous fluoride. The sensitivity benefits of bioavailable stannous fluoride are important to consumers. Tooth (dentin or dentinal) sensitivity is a common condition.' Epidemiological studies suggest that the percentage of the population which experiences sensitive teeth ranges somewhere between 8 - 30 % and the peak incidence has been reported to occur in 20 - 40 year olds." Dentin sensitivity is characterized by patient experience of tooth pain (described as short, sharp, aching) arising from environmental stimuli including thermal, tactile or osmotic changes on the tooth surface Although tooth (dentinal) sensitivity can develop as a result of numerous intraoral conditions including chipped or cracked teeth, dental caries, marginal leakage of restorations, cracked cusps, or palatallgingival grooves, the majority of patients who report tooth sensitivity present without structural damage to the tooth. Instead, these patients typically show signs of exposed root dentin as their most likely source of the condition. Dentin hypersensitivity is unique in that it affects populations at 'both ends' of the hygiene spectrum. Patients with poor oral hygiene may develop exposed dentin due to attachment loss of the gingiva associated with periodontal disease. Patients with enthusiastic hygiene may also develop exposed dentin due to brushing-induced gingival recession. While 'garden variety' hypersensitivity is not necessarily harmful to the patient, the pain associated with the condition can be debilitating and the condition may have broader consequences, affecting nutrition and oral hygiene measures.

Regardless of the source of the exposed root, the mechanism of dentinal sensitivity is believed to follow the so-called Bränströmm hydrodynamic model, which is supported by considerable empirical and fundamental evidence. In this model, the exposed root surfaces may contain Open (exposedldisclosed) dentinal tubuli. These exposed channels provide a conduit for fluid movement in the dentin associated with pressure gradients induced on the tooth surface. Common environmental stimuli which may act to produce these gradients include abrupt temperature changes (hot or cold foods), tactile activity (rubbing on the dentin surface) or high osmotic pressures (foodslfluids with high salt or Sugar content). The fluid movement serves as a
stimulant that excites nerve terminals at the inner ends of the dentinal tubules or in the outer layers of the pulp.
In this manner, external stimuli produce hypersensitivity sensory response.

With improved understanding of the cause and aetiology of dentinal hypersensitivity, various technological approaches have been developed toward providing amelioration of symptoms, including strategieslingredients applied in conventional oral products (toothpastes and mouthrinses). One important class of ingredients with proven efficacy toward controlling tooth hypersensitivity are those targeted at sealing dentinal surface tubuli. Successful physical blockage of tubuli and excellent clinical responses have been associated with dentist applied dental restoratives and dental sealants. With respect to 'at-home' treatments, incorporation of tubule-blocking ingredients in toothpastes has also had a measure of success, with clinical efficacy reported for various formulations, including those containing stannous fluoride, strontium chloride salts and a variety of oxalate preparations.

Stannous fluoride formulations are attractive options for hypersensitivity control, with combined anticaries and antimicrobial benefits also reported for this fluoride source when applied in highly bioavailable formulations. Recently, stannous fluoride formulations have been developed containing highly bioavailable stannous fluoride in combination with sodium hexametaphosphate (HMP). HMP is a condensed polyphosphate molecule in the class of ingredients known as 'calcium phosphate surface active builders' whose inclusion in dentifrices has been shown to provide efficacy in the safe removal of dental stains and prevention of stain and calculus build up between dental prophylaxes. Research has established clinical efficacy for SnF2/HMP formulations in the prevention of caries, calculus, gingivitis and plaque formation.

The purpose of these studies will be to examine a combination 'multi-benefit' stannous fluoride -hexametaphosphate dentifrice with elevated stannous fluoride for effects on root dentin smear layers in vitro, including the protection of root surfaces against dietary acid demineralization and smear layer solubilisation, as a means to assess the potential of this technology for relief of dentinal hypersensitivity. The effects of this novel combination dentifrice will be compared with marketed control dentifrices, including standard NaF dentifrice

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