Influence of hydroxyapatite nanoparticles on the formation of calcium fluoride surface layer on enamel and dentine in vitro.

Topical application of different fluoride preparations is considered to be the gold standard of oral prophylaxis measures in preventive dentistry. Hydroxyapatite nanoparticles (nano-HAP) as well, have received considerable attention for dental use in the past few decades. The purpose of this in-vitro study was to analyze the interaction between nano-HAP and different fluoride preparations. In order to investigate the possibility to establish, in the presence of nano-HAP, reproducible calcium fluoride surface layers, specimens were visually examined with regard to the surface coverage's structure, morphology, homogeneity and stability. Test series based on enamel and dentine specimens, that were obtained from extracted bovine teeth, were conducted. Thereby, sodium fluoride, olaflur, elmex Fluid (10.000 ppm) and an aqueous nano-HAP solution (5%) served as test products and sterile water as reference. First, single application of nano- HAP and fluoride was tested. After 5 min of incubation in the test solution, the surface coverage was examined by scanning electron microscopy (SEM). Furthermore, samples were determined by energy dispersive X-ray spectroscopy (EDX) to identify the present elements of the surface layer, particularly fluoride. To test the calcium fluoride layer's persistence and stability, samples were exposed to the spray of a dental multifunctional syringe for 20 s using maximum pressure and maximum water supply. In the second application protocol, fluoride and nano-HAP were applied simultaneously and in the third application protocol they were used sequentially. SEM visualisation showed that the simultaneous or sequential addition of nano-HAP led to a distinct change in the surface layer's structure. Agglomerates of various sizes were formed, with obviously different morphology from the calcium fluoride globules, not covering the surface homogeneously and sprayed off with the multifunctional syringe easily. Application of pure fluoride compounds resulted in a more homogeneous calcium fluoride surface layer with higher persistence in comparison to the combination of fluoride and nano-HAP. Interaction between fluoride and nano-HAP clearly could be proved. On enamel as well as dentine surfaces, the combined application of nano-HAP and fluoride has a negative effect on the stability and persistence of the calcium fluoride surface precipitate.