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20 DENTISTRY SHOW TRENDS Show Tribune United Kingdom Edition | 3/2017 How dental sensitivity can be improved with Biomin F By Moira Crawford, UK Sensitive teeth, causing discomfort and pain, particularly in reaction to hot or cold food and drinks, are a common problem. They are mainly affecting people aged 40-60, though sufferers can be of any age. Also known as dentine sensitivity, the condition is caused when the enamel surface of the tooth is worn A wide variety of specialised toothpastes and products are available over the counter or on prescription for the treatment of dentine sensitivity, but a new solu- tion has been found to the prob- lem: a bioactive glass which acts with the saliva in the mouth to remineralize tooth enamel, oc- and his team at the Dental Insti- tute, Queen Mary University, Lon- don, and contains a bioactive glass which delivers a combination of calcium, phosphorate and fl uoride ions as it dissolves. This combina- tion promotes effective remineral- ization of tooth enamel through the production of fl uorapatite, for example, BioMin F dissolves more rapidly to restore the equi- librium and prevent deminerali- zation. Tubule occlusion clinical adviser Visitors of the Dentistry Show will fi nd more information about Biomin F at the Trycare booth (E40). There, Dr David Gillam, to BioMin and Senior Lecturer at QMUL will be also giving two short presentations on Dentine Hypersensitivity Management at 9:30 and 11:00 on Friday, 12 May. He will also hold a longer lecture in the Perio Lounge at 13:30 that day. Importantly for the treatment of sensitivity, the glass needs to than other toothpastes tested (Fig. 3). 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Fig. 2: Scanning electron micrograph images showing tubule occlusion before and after brushing and before and after acid challenge. (cid:18)(cid:381)(cid:373)(cid:393)(cid:258)(cid:396)(cid:349)(cid:400)(cid:381)(cid:374)(cid:3)(cid:381)(cid:296)(cid:3)(cid:17)(cid:349)(cid:381)(cid:68)(cid:349)(cid:374)(cid:3)(cid:38)(cid:3)(cid:258)(cid:374)(cid:282)(cid:3)(cid:17)(cid:349)(cid:381)(cid:68)(cid:349)(cid:374)(cid:3)(cid:18)(cid:3) (cid:449)(cid:349)(cid:410)(cid:346)(cid:3)(cid:62)(cid:286)(cid:258)(cid:282)(cid:349)(cid:374)(cid:336)(cid:3)(cid:17)(cid:396)(cid:258)(cid:374)(cid:282)(cid:400) 120 n o i t c u d e R w o F d u F % l l i 100 80 60 40 20 0 Bio M in F Bio M in F A cid Bio M in C Bio M in C A cid S e n s o d y n e R e p air a n d Prote ct C olg ate Pro R elief Fig. 3: Percentage fl uid fl ow reduction compared with other toothpastes. cluding the dentinal tubules and effectively preventing sensitivity. the fl uoride analogue of natural tooth mineral. Unlike conven- tional toothpastes which contain soluble fl uoride, the fl uoride com- ponent of BioMin F is incorpo- rated within the structure of the glass and so is delivered gradually over up to 12 hours as the glass dis- solves. As well its fl uoride component, BioMin F contains a higher phos- phate content than the previous generation of bioactive glasses, such as NovaMin, which form hydroxyapatite material in the mouth. The increased phosphate content of BioMin F aids both the effectiveness and the speed of remineralization, and as the cal- cium, phosphate and fl uoride ions are released, these work in concert with the saliva in the mouth to re- store equilibrium following acid attack, and form fl uorapatite ma- terial, which is more stable and re- sistant to acid than hydroxyapa- tite. dissolve right on the tooth sur- face, so BioMin F contains a poly- mer which bonds it to the calcium in the tooth enamel, holding it in place for several hours while the calcium, phosphate and fl uoride ions are released. The size of the glass particles is extremely small compared with those of NovaMin, enabling them to enter the den- tinal tubules (1–5 microns across) and work to occlude them and prevent fl uid fl owing through them. Fluorapatite forms preferen- tially on the apatite rich walls of the peritubular dentine within the tubules (Fig. 1) gradually fi lling and occluding them, an effect still visi- ble after acid challenge (Fig. 2). Pro- fessor Hill and his research team believe that fl uorapatite crystals probably favour growing on the existing apatite rich surfaces within the dentinal tubules, which have a higher mineral content than elsewhere. away or damaged, exposing the dentine layer below. The dentine contains microscopic tubules, and hot or cold fl uids trigger fl ow through the tubules, stimulating the exposed nerve endings in the pulp chamber, causing sensitivity. Sensitivity is most common at the margin where the tooth meets the gums, gum recession exposes the tubules, or it can be due to erosion where the enamel, which is very thin in this area, has been dissolved away by acid attack. How BioMin F works BioMin F is one of a new gener- ation of bioactive glasses, which were initially introduced for bone grafting. These new glasses, in- corporating other components within their structure, are now fi nding uses in the dental arena. BioMin F toothpaste has been de- veloped by Professor Robert Hill Tests using an NMR spectrom- eter have demonstrated that the fl uoride in BioMin F is converted to fl uorapatite in around six hours in buffer, but as quickly as within 45 minutes in artifi cial saliva, and the remineralization process con- tinues for around 12 hours, with residual activity to 24 hours. At a lower pH, following consumption of an acidic drink, for up As the fl uorapatite occludes the dentinal tubules, it reduces the fl ow of fl uid through them, known as hydraulic conductance, the cause of sensitivity. Owing to the increased stability and resistance of fl uorapatite, the tubules remain occluded more completely, and the hydraulic conductance shows a greater percentage reduction and faster remineralization rates Importantly, patients appear to like it. A BioMin user survey in the UK, looking at patients who suffered from sensitivity, found that around 65 % of them found their sensitivity had improved or even resolved, and almost half said it was more effective than other toothpastes, while just under 40 % found it roughly similar in effect. Overall 95 % reported BioMin to be good or excellent, liking the texture, fl a- vour, sense of cleanliness and level of foaming. sensitivity though, Crucially, rigorous testing in the state of the art labo- ratories at Queen Mary has shown that delivering this precise combi- nation of calcium, phosphate and fl uoride ions in the slow release format provided as the glass dis- solves, forms an apatite material in the mouth which is not only quick to start occluding the den- tinal tubules effectively, but con- tinues to work over several hours and is stable and resistant to acid attack. Great news for sensitivity sufferers. Moira Crawford is a former dental editor and freelance health writer.

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