Tooth Erosion
Conditions
Brief summary
The purpose of this study is to investigate the ability of an experimental dentifrice containing 1150 parts per million (ppm) fluoride to remineralize acid-softened dental enamel and help prevent further demineralization compared to a 0 ppm fluoride placebo dentifrice and a marketed, fluoride-containing dentifrice (Reference Dentifrice).
Detailed description
This will be a randomized, controlled, single center, single-blind, 3 period, 3 treatment, cross-over, in situ design study. Previously demineralized bovine enamel specimens will be placed intra orally using a palatal appliance and the remineralizing performance of the experimental, reference and placebo dentifrices will be evaluated at 4 and 12 hours post toothbrushing, based on surface micro hardness measurements of the bovine enamel specimens. At each treatment visit, once the palatal the appliance is fitted in the mouth, a five minute equilibration period will ensue following which each participant will brush their teeth with their assigned product. Participants will remove the appliance for 30 minutes at 4 and 8.5 hours post brushing and will remove and store the appliance 13 hours post brushing (12 hours intraoral exposure). Sufficient participants will be screened to randomize approximately 33 participants to study treatment to ensure approximately 30 participants complete the study.
Interventions
Dentifrice containing 1150 ppm fluoride and 5% KNO3.
DRUGPlacebo Control Dentifrice
Dentifrice containing 0 ppm fluoride and 5% KNO3.
Dentifrice containing 1100 ppm fluoride as SnF2.
Sponsors
HALEON
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Participant provision of a signed and dated informed consent document indicating that the participant has been informed of all pertinent aspects of the study before any assessment is performed. * Participant is of either sex and any gender who, at the time of screening, is between the ages of 18-65 years, inclusive. * Participant is willing and able to comply with scheduled visits, and other study procedures and restrictions. * Participant is in good general and mental health with, in the opinion of the investigator or medically qualified designee, no clinically significant or relevant abnormalities in medical history or upon oral examination, or condition, that would impact the participant's safety, wellbeing or the outcome of the study, if they were to participate in the study, or affect the individual's ability to understand and follow study procedures and requirements. * Participant with generally good oral health that fulfil all of the following: 1. Having an unstimulated salivary flow rate of at least 0.2 milliliter per minute (mL/minute) and a stimulated salivary flow rate of at least 0.8 mL/minute. 2. Having a maxillary dental arch suitable for the retention of the palatal appliance. 3. Having no lesions of the oral cavity that could interfere with the study evaluations.
Exclusion criteria
* Participant who is an employee of the investigational site, either directly involved in the conduct of the study or a member of their immediate family; or an employee of the investigational site otherwise supervised by the investigator; or, a Haleon employee directly involved in the conduct of the study or a member of their immediate family (employees of the study site and associated academic institutes who are not directly involved in the conduct of the study are eligible to be considered as participants.) * Participant who has participated in other studies (including non-medicinal studies) involving investigational product(s) within 30 days prior to study entry and/or during study participation. * Participant with, in the opinion of the investigator or medically qualified designee, an acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator or medically qualified designee, would make the participant inappropriate for entry into this study. * Participant who is pregnant (self-reported) or intending to become pregnant over the duration of the study or who is breastfeeding. * Participant with known or suspected intolerance or hypersensitivity to the study materials (or closely related compounds) or any of their stated ingredients. * A participant who, in the opinion of the investigator or medically qualified designee, can't comply with study requirements or who should not participate in the study for other reasons. * Participant unwilling or unable to comply with the Lifestyle Considerations described in this protocol. * Participant taking medication that may interfere significantly with the saliva flow in the judgment of the investigator. Should new medications that may interfere with the saliva flow be added, a second salivary flow test will be performed. * Participant with any condition that would impact on their safety or wellbeing or affect their ability to understand and follow study procedures and requirements. * Participant with any sign of grossly carious lesions (active), moderate or severe periodontal conditions, or severe tooth wear. Participant presenting at screening with minor caries may continue in the study if their carious lesions are repaired prior to the first treatment visit of the study. * Participant who wears an oral piercing or oral appliance or orthodontia (besides participants wearing permanent lower retainers, which are eligible). * Participant who has previously been enrolled in this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adjusted Mean Percent Surface Microhardness Recovery (%SMHR) at 4 Hours (Test Dentifrice Versus (vs.) Placebo Control Dentifrice) | At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using surface microhardness (SMH) technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (micrometre \[μm\]) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 hours in situ remineralization. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adjusted Mean %SMHR at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using surface SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 hours in situ remineralization. |
| Adjusted Mean %SMHR at 12 Hours | At 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 12 hours in situ remineralization. |
| Adjusted Mean %RER at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice). |
| Adjusted Mean %RER at 12 Hours | At 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice). |
| Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | EFU is a measure of how much fluoride has been incorporated into the enamel during the process of remineralization. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and chemically analyzed to measure the amount of fluoride incorporated into the enamel by the dentifrice treatment. |
| Adjusted Mean Percent Relative Erosion Resistance (%RER) at 4 Hours (Test Dentifrice vs. Placebo Control Dentifrice) | At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice). |
| Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatment in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization. |
| Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | %RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice). |
| Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | EFU is a measure of how much fluoride has been incorporated into the enamel during the process of remineralization. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and chemically analyzed to measure the amount of fluoride incorporated into the enamel by the dentifrice treatment. |
| Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | ARR was used to measure the resistance of the remineralized enamel to further acid softening. SMH technique was used to calculate ARR. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to yield ARR. The ARR was derived as 1 - \[(E2-R)/(E1-B)\] where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization. |
| Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between) | ARR was used to measure the resistance of the remineralized enamel to further acid softening. SMH technique was used to calculate ARR. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate ARR. The ARR was derived as 1 - \[(E2-R)/(E1-B)\] where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization. |
Countries
United States
Participant flow
Recruitment details
This study was conducted at a single center in the United States.
Pre-assignment details
A total of 34 participants were screened of which 33 participants were randomized as per crossover design to receive either one of the 6 treatment sequences: Sequence ABC, Sequence ACB, Sequence BAC, Sequence BCA, Sequence CAB, Sequence CBA where Treatment A=Test Dentifrice, Treatment B=Placebo Control Dentifrice, Treatment C=Reference Dentifrice. All 33 randomized participants completed the study.
Participants by arm
| Arm | Count |
|---|---|
| Overall Study Participants Participants brushed the buccal surfaces of their natural teeth using 1.5+/-0.1 g of the Test Dentifrice (Treatment A) containing 1150 ppm fluoride and 5% KNO3, Placebo Control Dentifrice (Treatment B) containing 0 ppm fluoride and 5% KNO3, Reference Dentifrice (Treatment C) containing 1100 ppm fluoride as SnF2 on Day 1 of Treatment Period 1, 2 or 3 as per randomization schedule. Participants used the assigned dentifrice under supervision of the study staff while the intraoral appliance was in place and brushed the buccal surfaces of their natural teeth for 25 timed seconds and then swished the resulting dentifrice slurry around the mouth, without further brushing, for a timed period of 95 seconds. | 33 |
| Total | 33 |
Baseline characteristics
| Characteristic | Overall Study Participants |
|---|---|
| Age, Continuous | 50.7 years STANDARD_DEVIATION 10.5 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 27 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race/Ethnicity, Customized Asian | 4 Participants |
| Race/Ethnicity, Customized Black or African American | 9 Participants |
| Race/Ethnicity, Customized White | 20 Participants |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 8 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 33 | 0 / 33 | 0 / 33 |
| other Total, other adverse events | 4 / 33 | 1 / 33 | 5 / 33 |
| serious Total, serious adverse events | 0 / 33 | 0 / 33 | 0 / 33 |
Outcome results
Primary
Adjusted Mean Percent Surface Microhardness Recovery (%SMHR) at 4 Hours (Test Dentifrice Versus (vs.) Placebo Control Dentifrice)
%SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using surface microhardness (SMH) technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (micrometre \[μm\]) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 hours in situ remineralization.
Time frame: At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population included all participants who were randomized.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean Percent Surface Microhardness Recovery (%SMHR) at 4 Hours (Test Dentifrice Versus (vs.) Placebo Control Dentifrice) | 32.20 percent SMHR | Standard Error 2.021 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Percent Surface Microhardness Recovery (%SMHR) at 4 Hours (Test Dentifrice Versus (vs.) Placebo Control Dentifrice) | 23.85 percent SMHR | Standard Error 2.021 |
p-value: 0.001295% CI: [3.42, 13.28]Mixed Models Analysis
Secondary
Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours
ARR was used to measure the resistance of the remineralized enamel to further acid softening. SMH technique was used to calculate ARR. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate ARR. The ARR was derived as 1 - \[(E2-R)/(E1-B)\] where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization.
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 0.562 ratio | Standard Error 0.0214 |
| Test Dentifrice (Treatment A) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 0.604 ratio | Standard Error 0.02 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 0.580 ratio | Standard Error 0.0214 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 0.635 ratio | Standard Error 0.02 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 0.273 ratio | Standard Error 0.0214 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Acid Resistance Ratio (ARR) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 0.394 ratio | Standard Error 0.02 |
Secondary
Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice)
ARR was used to measure the resistance of the remineralized enamel to further acid softening. SMH technique was used to calculate ARR. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to yield ARR. The ARR was derived as 1 - \[(E2-R)/(E1-B)\] where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization.
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 0.580 ratio | Standard Error 0.0214 |
| Test Dentifrice (Treatment A) | Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 0.635 ratio | Standard Error 0.02 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 0.273 ratio | Standard Error 0.0214 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean ARR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 0.394 ratio | Standard Error 0.02 |
Comparison: At 4 hours of intra-oral exposurep-value: <0.000195% CI: [0.252, 0.362]Mixed Models Analysis
Comparison: At 12 hours of intra-oral exposurep-value: <0.000195% CI: [0.19, 0.293]Mixed Models Analysis
Secondary
Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice)
EFU is a measure of how much fluoride has been incorporated into the enamel during the process of remineralization. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and chemically analyzed to measure the amount of fluoride incorporated into the enamel by the dentifrice treatment.
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (GEOMETRIC_LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 3.81 microgram fluoride per square centimeter |
| Test Dentifrice (Treatment A) | Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 3.89 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 2.20 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean EFU at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 2.45 microgram fluoride per square centimeter |
Comparison: At 4 hours of intra-oral exposurep-value: <0.000195% CI: [1.53, 1.97]Mixed Models Analysis
Comparison: At 12 hours of intra-oral exposurep-value: <0.000195% CI: [1.42, 1.78]Mixed Models Analysis
Secondary
Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours
EFU is a measure of how much fluoride has been incorporated into the enamel during the process of remineralization. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and chemically analyzed to measure the amount of fluoride incorporated into the enamel by the dentifrice treatment.
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (GEOMETRIC_LEAST_SQUARES_MEAN) |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 4.80 microgram fluoride per square centimeter |
| Test Dentifrice (Treatment A) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 4.80 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 3.81 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 3.89 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 4 hours of intra-oral exposure | 2.20 microgram fluoride per square centimeter |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Enamel Fluoride Uptake (EFU) at 4 and 12 Hours | At 12 hours of intra-oral exposure | 2.45 microgram fluoride per square centimeter |
Secondary
Adjusted Mean Percent Relative Erosion Resistance (%RER) at 4 Hours (Test Dentifrice vs. Placebo Control Dentifrice)
%RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice).
Time frame: At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean Percent Relative Erosion Resistance (%RER) at 4 Hours (Test Dentifrice vs. Placebo Control Dentifrice) | -11.56 percent RER | Standard Error 3.024 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean Percent Relative Erosion Resistance (%RER) at 4 Hours (Test Dentifrice vs. Placebo Control Dentifrice) | -48.89 percent RER | Standard Error 3.024 |
p-value: <0.000195% CI: [30.9, 43.76]Mixed Models Analysis
Secondary
Adjusted Mean %RER at 12 Hours
%RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice).
Time frame: At 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %RER at 12 Hours | -0.28 percent RER | Standard Error 2.76 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %RER at 12 Hours | 0.19 percent RER | Standard Error 2.759 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %RER at 12 Hours | -26.98 percent RER | Standard Error 2.76 |
Secondary
Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice)
%RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice).
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | -13.78 percent RER | Standard Error 3.022 |
| Test Dentifrice (Treatment A) | Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 0.19 percent RER | Standard Error 2.759 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | -48.89 percent RER | Standard Error 3.024 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %RER at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | -26.98 percent RER | Standard Error 2.76 |
Comparison: At 4 hours of intra-oral exposurep-value: <0.000195% CI: [28.69, 41.54]Mixed Models Analysis
Comparison: At 12 hours of intra-oral exposurep-value: <0.000195% CI: [21.14, 33.21]Mixed Models Analysis
Secondary
Adjusted Mean %RER at 4 Hours (Test Dentifrice vs. Reference Dentifrice)
%RER was used to measure the ability of the dentifrice to protect enamel from further acid-induced demineralization by both acid protection and remineralization. SMH technique was used to calculate %RER. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and further treated with acid ex situ followed by additional SMH evaluations to calculate %RER. The %RER was derived as \[(E1-E2)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), E2 = indentation length (μm) after second erosive challenge (with a commercially available grapefruit juice).
Time frame: At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %RER at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | -11.56 percent RER | Standard Error 3.024 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %RER at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | -13.78 percent RER | Standard Error 3.022 |
p-value: 0.49395% CI: [-4.21, 8.64]Mixed Models Analysis
Secondary
Adjusted Mean %SMHR at 12 Hours
%SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 12 hours in situ remineralization.
Time frame: At 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %SMHR at 12 Hours | 39.32 percent SMHR | Standard Error 1.826 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %SMHR at 12 Hours | 36.66 percent SMHR | Standard Error 1.824 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %SMHR at 12 Hours | 33.66 percent SMHR | Standard Error 1.826 |
Secondary
Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice)
%SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatment in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 and 12 hours in situ remineralization.
Time frame: At 4 and 12 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 28.25 percent SMHR | Standard Error 2.019 |
| Test Dentifrice (Treatment A) | Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 36.66 percent SMHR | Standard Error 1.824 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 4 hours of intra-oral exposure | 23.85 percent SMHR | Standard Error 2.021 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %SMHR at 4 and 12 Hours (Reference Dentifrice vs Placebo Control Dentifrice) | At 12 hours of intra-oral exposure | 33.66 percent SMHR | Standard Error 1.826 |
Comparison: At 4 hours of intra-oral exposurep-value: 0.078995% CI: [-0.52, 9.32]Mixed Models Analysis
Comparison: At 12 hours of intra-oral exposurep-value: 0.217895% CI: [-1.82, 7.81]Mixed Models Analysis
Secondary
Adjusted Mean %SMHR at 4 Hours (Test Dentifrice vs. Reference Dentifrice)
%SMHR was used to measure the ability of the dentifrice to remineralize enamel. Previously demineralized, sterilized bovine enamel specimens were placed intra orally using a palatal appliance. The enamel specimens were exposed to the dentifrice treatments in the mouth during the treatment application and allowed to remineralize intra orally under the action of the participant's saliva. The specimens were then removed from the palatal appliance and the extent of remineralization was evaluated using surface SMH technique to yield the %SMHR. The enamel specimens were evaluated both prior to and after intra-oral exposure and indentation lengths were measured. The %SMHR was derived as \[(E1-R)/(E1-B)\] \* 100 where: B = indentation length (μm) of sound enamel at baseline, E1 = indentation length (μm) after first erosive challenge (with a commercially available grapefruit juice), R = indentation length (μm) after 4 hours in situ remineralization.
Time frame: At 4 hours of intra-oral exposure following treatment on Day 1 of each treatment period (each treatment period was of 2 days with 3 days washout in between)
Population: ITT population.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Test Dentifrice (Treatment A) | Adjusted Mean %SMHR at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | 32.20 percent SMHR | Standard Error 2.021 |
| Placebo Control Dentifrice (Treatment B) | Adjusted Mean %SMHR at 4 Hours (Test Dentifrice vs. Reference Dentifrice) | 28.25 percent SMHR | Standard Error 2.019 |
p-value: 0.113895% CI: [-0.97, 8.87]Mixed Models Analysis