Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro.

Objectives: Analyse the effect of varnishes containing xylitol alone or combined with fluoride on the remineralization of artificial enamel caries lesions in vitro. Methods: Bovine enamel specimens were randomly allocated to 7 groups (n = 15/group). Artificial caries lesions were produced by immersion in 30 mL of lactic acid buffer containing 3 mM CaCl2·2H2O, 3 mM KH2PO4, 6 µM tetraetil metil diphosphanate (pH 5.0) for 6 days. The enamel blocks were treated with the following varnishes: 10% xylitol; 20% xylitol; 10% xylitol plus F (5% NaF); 20% xylitol plus F (5% NaF); Duofluorid™ (6% NaF, 2.71% F + 6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6 h. The blocks were subjected to pH-cycles (demineralization--2 h/remineralization--22 h during 8 days) and enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analysed by ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p < 0.05). Results: Enamel surface remineralization was significantly increased by Duraphat™, 10% xylitol plus F and 20% xylitol plus F formulations, while significant subsurface mineral remineralization could be seen only for enamel treated with Duraphat™, Duofluorid™ and 20% xylitol formulations. Conclusions: 20% xylitol varnishes seem to be promising alternatives to increase remineralization of artificial caries lesions. Clinical significance: effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in vitro, which should be confirmed by in situ and clinical studies. [ABSTRACT FROM AUTHOR]