Fluorides and hydroxyapatite in treatment of changes in hard tissue of teeth

Karijes je najčešće zdravstveno stanje koje pogađa ljude diljem svijeta, a ujedno i četvrta najskuplja bolest za liječenje koju je moguće prevenirati. Fluoridi su se pokazali učinkovitim sredstvom u prevenciji karijesa sve od otkrića njihova preventivnog djelovanja 1942. godine pa do danas. Fluoridi se mogu primijeniti sistemski ili topikalno. Sistemska primjena uključuje konzumaciju fluoridirane vode, soli ili mlijeka, te unos tableta fluora. Topikalna fluoridacija podrazumijeva upotrebu zubnih pasti i vodica za ispiranje usta, namijenjenih individulanoj primjeni, te otopina, gelova, lakova i pjena, namijenjenih profesionalnoj primjeni. Uz velik izbor i dostupnost različitih metoda fluoridacije javlja se problem prevelikog dnevnog unosa fluora. Dentalna fluoroza jest neželjeni učinak fluorida na mineralizaciju cakline zuba. Njezin nastanak nije razjašnjen, no čini se kako, uz povišen unos fluora, na njezin razvoj utječe genski čimbenik. Hidroksiapatit je biokompatibilni preparat koji ima vrlo veliku moć remineralizacije. Kristali nanohidroksiapatita koji veličinom i oblikom nalikuju prirodnim caklinskim kristalima, sposobni su se uklopiti u područja demineralizirane cakline, oponašajući ritom ustroj prirodnih caklinskih kristala. S obzirom na njihovu biokompatibilnost, primjena zubnih pasti s nanohidroksiapatitom kod djece ne povećava rizik od nastanka dentalne fluoroze. Osim preventivnog antikarijesnog, primijećeno je i profilaktičko djelovanje nanohidroksiapatita na stvaranje dentalnog biofilma, te učinkovitost u terapiji dentinske preosjetljivosti. In vitro studije ukazuju na antierozivno djelovanje hidroksiapatita.Tooth decay is the most common health condition among people in the entire world. At the same time, it is the fourth most expensive condition to cure out of those that are possible to be prevented. Fluorides have proved to be an efficient measure against tooth decay since the discovery of their preventive effect in 1942, up until today. Fluorides can be applied systematically or topically. Systematic fluoride application includes consuming fluorided water, salt or milk and taking flouride supplements. Topical fluoride application presupposes using toothpaste and mouthwash, intended for individual use, as well as solutions, gels, polishing products and dental foams intended for professional use. Due to the wide range of choices and availability of different fluoridation methods, a problem of overdosing a daily amount of fluoride now appears. Dental fluorosis is an undesirable effect of fluorides on mineralization of tooth enamel. Its casuse is still not explained, although it seems that genetic preconditions, along with a high consumption of fluoride, are affecting its appearance. Hydroxyapatite is a biocompatible product that has a great remineralisation effect. The crystals of nano-hydroxyapatite, which resemble the natural enamel crystals due to their size and form, are able to fit into the area of demineralised enamel, acting as the natural enamel crystals. Due to their biocompatibility, children using toothpaste with nano-hydroxyapatite have lower chances of dental fluorosis occuring. Besides preventing tooth decay, a prophylactic effect of nano-hydroxyapatite on creating dental plaque has been noted, as well as its efficiency in the dentin hypersensitivity treatment. In vitro studies show anti-erosive effect of hydroxyapatite