CoChat
Sign Up
Cited by 35Dental Erosion and TreatmentDental Health and Care UtilizationEndodontics and Root Canal Treatments

Daily Application of a Toothpaste with Biomimetic Hydroxyapatite and Its Subjective Impact on Dentin Hypersensitivity, Tooth Smoothness, Tooth Whitening, Gum Bleeding, and Feeling of Freshness

Open access
Steinert, Sonja, Zwanzig, Kai, Doenges, Helga, Kuchenbecker, Joern, Meyer, Frederic, Enax, Joachim·2020·Biomimetics
DOI 10.3390/biomimetics5020017PMC PMC7345613
Open this paper in CoChat — free accountOpen PDF

Abstract

The aim of this observational study was to analyze the effect of a toothpaste with biomimetic zinc hydroxyapatite (HAP) on subjective parameters after a four-week home use. Patients with subjective dentin hypersensitivity were recruited at three dental practices in Germany and received a questionnaire with visual analogue scales and Likert scales both at baseline and follow-up. The questionnaire was specifically developed for this study and focused on questions about subjective parameters like dentin hypersensitivity, tooth surface texture, tooth color, and freshness after toothbrushing. Patients answered the questionnaire both at baseline and after a four-week home use (follow-up) of the HAP toothpaste. Data of 46 patients were analyzed by paired t-test and non-parametric Wilcoxon signed-rank test, respectively. Subjective parameters on dentin hypersensitivity were reduced after the four-week use of the HAP toothpaste (p < 0.001). Additionally, patients assessed their tooth surface as smoother (p < 0.001), tooth color as whiter (p = 0.003), and reported a stronger feeling of freshness after toothbrushing (p = 0.014) after four-week use of the HAP toothpaste compared to the previously used toothpaste. In conclusion, the tested toothpaste with biomimetic HAP is well-suited for individuals suffering from dentin hypersensitivity, because subjective symptoms on dentin hypersensitivity were reduced. Additionally, patients reported smoother and whiter teeth after using the HAP toothpaste.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3390/biomimetics5020017

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The systematic search for in vivo evidence resulted in six studies ranging in quality from very low to moderate.

    “The results of the systematic search for in vivo evidence resulted in six studies [42,49,50,51,52,53] ranging in quality from very low to moderate (Table 3).”

    From Tooth Whitening with Hydroxyapatite: A Systematic Review (2023) · cites this paper as [51]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 47 · Cited by 35

Research works printed but not linked: 46

  1. [1]Loveren C.V. Toothpastes Karger Basel, Switzerland 2013 Volume 23 10.1159/isbn.978-3-318-02207-0 · DOI
  2. [2]Fejerskov O. Nyvad B. Kidd E. Dental Caries: The Disease and Its Clinical Management Wiley Hoboken, NJ, USA 2015
  3. [3]Enax J. Epple M. Die Charakterisierung von Putzkörpern in Zahnpasten Dtsch. Zahnärztl. Z. 2018 73 100 108 10.3238/DZZ.2018.5054 · DOI
  4. [4]Epple M. Enax J. Moderne Zahnpflege aus chemischer Sicht Chem. Unserer Zeit 2018 52 218 228 10.1002/ciuz.201800796 · DOI
  5. [5]Meyer F. Enax J. Hydroxyapatite in Oral Biofilm Management Eur. J. Dent. 2019 13 287 290 10.1055/s-0039-1695657 31574542 PMC6777166 · DOI
  6. [6]Marsh P.D. Head D.A. Devine D.A. Ecological approaches to oral biofilms: Control without killing Caries. Res. 2015 49 46 54 10.1159/000377732 25871418 · DOI
  7. [7]Enax J. Fabritius H.-O. Fabritius-Vilpoux K. Amaechi B.T. Meyer F. Modes of action and clinical efficacy of particulate hydroxyapatite in preventive oral health care—State of the art Open Dent. J. 2019 13 274 287 10.2174/1874210601913010274 · DOI
  8. [8]Hannig M. Hannig C. Nanomaterials in preventive dentistry Nat. Nanotechnol. 2010 5 565 569 10.1038/nnano.2010.83 20581832 · DOI
  9. [9]Fabritius-Vilpoux K. Enax J. Herbig M. Raabe D. Fabritius H.-O. Quantitative affinity parameters of synthetic hydroxyapatite and enamel surfaces in vitro Bioinspir. Biomim. Nan. 2019 8 141 153 10.1680/jbibn.18.00035 · DOI · Paper page
  10. [10]Meyer F. Amaechi B.T. Fabritius H.-O. Enax J. Overview of calcium phosphates used in biomimetic oral care Open Dent. J. 2018 12 406 423 10.2174/1874210601812010406 29988215 PMC5997847 · DOI
  11. [11]Enax J. Epple M. Synthetic hydroxyapatite as a biomimetic oral care agent Oral Health Prev. Dent. 2018 16 7 19 29335686
  12. [12]Hüttemann R.W. Dönges H. Untersuchungen zur Therapie überempfindlicher Zahnhälse mit Hydroxylapatit Dtsch. Zahnärztl. Z. 1987 42 486 488 3503747
  13. [13]Kani K. Kani M. Isozaki A. Shintani H. Ohashi T. Tokumoto T. Effect of apatite-containing dentifrices on dental caries in school children J. Dent. Health 1989 19 104 109 10.5834/jdh.39.104 · DOI
  14. [14]Lelli M. Marchetti M. Foltran I. Roveri N. Putignano A. Procaccini M. Orsini G. Mangani F. Remineralization and repair of enamel surface by biomimetic Zn-carbonate hydroxyapatite containing toothpaste: A comparative in vivo study Front. Physiol. 2014 5 333 10.3389/fphys.2014.00333 25249980 PMC4155874 · DOI
  15. [15]Hu M.L. Zheng G. Zhang Y.D. Yan X. Li X.C. Lin H. Effect of desensitizing toothpastes on dentine hypersensitivity: A systematic review and meta-analysis J. Dent. 2018 75 12 21 10.1016/j.jdent.2018.05.012 29787782 · DOI
  16. [16]Orsini G. Procaccini M. Manzoli L. Sparabombe S. Tiriduzzi P. Bambini F. Putignano A. A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifrices J. Periodontol. 2013 84 65 73 10.1902/jop.2013.120697 23489232 · DOI
  17. [17]Orsini G. Procaccini M. Manzoli L. Giuliodori F. Lorenzini A. Putignano A. A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice J. Clin. Periodontol. 2010 37 510 517 10.1111/j.1600-051X.2010.01558.x 20507374 · DOI
  18. [18]Schlagenhauf U. Kunzelmann K.-H. Hannig C. May T.W. Hösl H. Gratza M. Viergutz G. Nazet M. Schamberger S. Proff P. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: A randomized, controlled 6-month trial J. Invest. Clin. Dent. 2019 10 e12399 10.1111/jicd.12399 PMC6590169 30701704 · DOI
  19. [19]Amaechi B.T. AbdulAzees P.A. Alshareif D.O. Shehata M.A. Lima P.P.d.C.S. Abdollahi A. Kalkhorani P.S. Evans V. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children BDJ Open 2019 5 18 10.1038/s41405-019-0026-8 31839988 PMC6901576 · DOI
  20. [20]Najibfard K. Ramalingam K. Chedjieu I. Amaechi B.T. Remineralization of early caries by a nano-hydroxyapatite dentifrice J. Clin. Dent. 2011 22 139 143 22403978
  21. [21]Hagenfeld D. Prior K. Harks I. Jockel-Schneider Y. May T.W. Harmsen D. Schlagenhauf U. Ehmke B. No differences in microbiome changes between anti-adhesive and antibacterial ingredients in toothpastes during periodontal therapy J. Periodont. Res. 2019 54 435 443 10.1111/jre.12645 30851050 PMC6767489 · DOI
  22. [22]Harks I. Jockel-Schneider Y. Schlagenhauf U. May T.W. Gravemeier M. Prior K. Petersilka G. Ehmke B. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A randomized trial PLoS ONE 2016 11 e0160142 10.1371/journal.pone.0160142 27467683 PMC4965058 · DOI
  23. [24]Epple M. Review of potential health risks associated with nanoscopic calcium phosphate Acta Biomater. 2018 77 1 14 10.1016/j.actbio.2018.07.036 30031162 · DOI
  24. [25]Cieplik F. Rupp C.M. Hirsch S. Muehler D. Enax J. Meyer F. Hiller K.-A. Buchalla W. Ca2+ release and buffering effects of synthetic hydroxyapatite following bacterial acid challenge BMC Oral Health 2020 20 85 10.1186/s12903-020-01080-z 32199447 PMC7085149 · DOI
  25. [26]Sudradjat H. Meyer F. Loza K. Epple M. Enax J. In vivo effects of a hydroxyapatite-based oral care gel on the calcium and phosphorus levels of dental plaque Eur. J. Dent. 2020 in press PMC7274817 32283562
  26. [27]Peetsch A. Epple M. Characterization of the solid components of three desensitizing toothpastes and a mouth wash Materialwiss. Werkstofftech. 2011 42 131 135 10.1002/mawe.201100744 · DOI
  27. [28]Irwin C.R. McCusker P. Prevalence of dentine hypersensitivity in a general dental population J. Ir. Dent. Assoc. 1997 43 7 9 9584750
  28. [29]Vano M. Derchi G. Barone A. Pinna R. Usai P. Covani U. Reducing dentine hypersensitivity with nano-hydroxyapatite toothpaste: A double-blind randomized controlled trial Clin. Oral Investig. 2018 22 313 320 10.1007/s00784-017-2113-3 28361171 · DOI
  29. [30]Vano M. Derch G. Barone A. Covani U. Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: A double-blind randomized controlled trial Quintessence Int. 2014 45 703 711 25019114
  30. [31]Gillam D.G. Dentine Hypersensitivity: Advances in Diagnosis, Management, and Treatment Springer Cham, Switzerland 2015
  31. [32]Hiller K.-A. Buchalla W. Grillmeier I. Neubauer C. Schmalz G. In vitro effects of hydroxyapatite containing toothpastes on dentin permeability after multiple applications and ageing Sci. Rep. 2018 8 4888 10.1038/s41598-018-22764-1 29559639 PMC5861090 · DOI
  32. [33]Amaechi B.T. Mathews S.M. Ramalingam K. Mensinkai P.K. Evaluation of nanohydroxyapatite-containing toothpaste for occluding dentin tubules Am. J. Dent. 2015 28 33 39 25864240
  33. [34]Lenzi T.L. Guglielmi C.d.A. Arana-Chavez V.E. Raggio D.P. Tubule density and diameter in coronal dentin from primary and permanent human teeth Microsc. Microanal. 2013 19 1445 1449 10.1017/S1431927613012725 23947480 · DOI
  34. [35]Hannig C. Hannig M. The oral cavity—A key system to understand substratum-dependent bioadhesion on solid surfaces in man Clin. Oral Invest. 2009 13 123 139 10.1007/s00784-008-0243-3 19137331 · DOI
  35. [36]Kensche A. Holder C. Basche S. Tahan N. Hannig C. Hannig M. Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ Arch. Oral Biol. 2017 80 18 26 10.1016/j.archoralbio.2017.03.013 28364672 · DOI
  36. [38]Hannig C. Basche S. Burghardt T. Al-Ahmad A. Hannig M. Influence of a mouthwash containing hydroxyapatite microclusters on bacterial adherence in situ Clin. Oral Investig. 2013 17 805 814 10.1007/s00784-012-0781-6 22782257 · DOI
  37. [39]Roveri N. Battistella E. Bianchi C.L. Foltran I. Foresti E. Iafisco M. Lelli M. Naldoni A. Palazzo B. Rimondini L. Surface enamel remineralization: Biomimetic apatite nanocrystals and fluoride ions different effects J. Nanomater. 2009 10.1155/2009/746383 · DOI
  38. [40]Tschoppe P. Zandim D.L. Martus P. Kielbassa A.M. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes J. Dent. 2011 39 430 437 10.1016/j.jdent.2011.03.008 21504777 · DOI
  39. [41]Yamagishi K. Onuma K. Suzuki T. Okada F. Tagami J. Otsuki M. Senawangse P. Materials chemistry: A synthetic enamel for rapid tooth repair Nature 2005 433 819 10.1038/433819a 15729330 · DOI
  40. [42]Huang S. Gao S. Cheng L. Yu H. Remineralization potential of nano-hydroxyapatite on initial enamel lesions: An in vitro study Caries Res. 2011 45 460 468 10.1159/000331207 21894006 · DOI
  41. [44]Bommer C. Flessa H.-P. Xu X. Kunzelmann K.-H. Hydroxyapatite and self-assembling peptide matrix for non-oxidizing tooth whitening J. Clin. Dent. 2018 29 57 63 30211992
  42. [45]Jin J. Xu X. Lai G. Kunzelmann K.H. Efficacy of tooth whitening with different calcium phosphate-based formulations Eur. J. Oral Sci. 2013 121 382 388 10.1111/eos.12063 23841792 · DOI
  43. [46]Dabanoglu A. Wood C. Garcia-Godoy F. Kunzelmann K.H. Whitening effect and morphological evaluation of hydroxyapatite materials Am. J. Dent. 2009 22 23 29 19281109
  44. [47]Loveren C.V. Schmidlin P.R. Martens L.C. Amaechi B.T. Dentin hypersensitivity management Clin. Dent. Rev. 2018 2 6 10.1007/s41894-017-0019-8 · DOI
  45. [48]Frese C. Wohlrab T. Sheng L. Kieser M. Krisam J. Wolff D. Clinical effect of stannous fluoride and amine fluoride containing oral hygiene products: A 4-year randomized controlled pilot study Sci. Rep. 2019 9 7681 10.1038/s41598-019-44164-9 31118458 PMC6531450 · DOI
  46. [49]Ellingsen J.E. Eriksen H.M. Rolla G. Extrinsic dental stain caused by stannous fluoride Scand. J. Dent. Res. 1982 90 9 13 10.1111/j.1600-0722.1982.tb01518.x 6952551 · DOI

Authors
Steinert, S., Zwanzig, K., Doenges, H., Kuchenbecker, J., Meyer, F., & Enax, J.
Affiliations
  • Dental practice, Bielefeld 33602, Germany
  • Dental practice, Frankfurt am Main 60594, Germany
  • Zahnklinik Bochum (DE)
  • Dr. August Wolff (Germany) (DE)
Corresponding author
Enax, Joachim
ORCID
Venue
Biomimetics
Publisher
MDPI AG
Published
2020-04-28
Volume
5
Issue
2
Pages
17
ISSN
2313-7673 (ISSN-L)
DOI
10.3390/biomimetics5020017
PMC
PMC7345613
OpenAlex
W3022129017
Cited by
35
References
47
Citations by year
2025: 5 · 2024: 9 · 2023: 7 · 2022: 5 · 2021: 5 · 2020: 4
FWCI
5.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Biomimetics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Dentistry › Orthodontics › Dental Erosion and Treatment
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
Keywords
dentin hypersensitivity, tooth bleaching, gingival bleeding, patient-reported outcomes, toothpaste

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review