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Status report: effect of acidulated phosphate fluoride on porcelain and composite restorations
J'A N Q A ___________ ASSOCIATION
REPORTS
Status report: effect of acidulated phosphate fluoride on porcelain and composite restorations Council on Dental Materials, Instruments, and Equipment Council on Dental Therapeutics
opical applications of acidulated phosphate fluoride (APF) prepa rations reduce the incidence of c a rie s .1 T h ese p re p a ra tio n s c o n ta in hydrogen and fluoride ions that react with glass components in restorative materials. It is well known that hydrofluoric acid etches glass. Repeated exposures of porce lain or com posite restorations to APF preparations can result in material loss, surface roughening, and corresponding changes in esthetic appearance. Dental porcelains th at were subjected to p ro longed immersions or repeated applica tions of APF preparations in in vitro studies2"12 showed increases in surface roughness using photography, optical and scanning electron microscopy, and surface profile analysis. Decreases in sur face reflectance were reported for labora tory processed porcelain11 and porcelain denture teeth.7 APF preparations have been reported to react in vitro with the glass or quartz filler particles in compos ite resins13-16 and sealants,17 resulting in weight loss, increased surface roughness, and decreased surface reflectance. T h e effect of APF p rep aratio n s on porcelain or composite restorations is not noticeable after one clinical application. However, the cumulative effect of several applications during a certain period might compromise the esthetic appearance of restorations. It is, therefore, prudent to
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avoid placing APF preparations on sur faces of porcelain or composite restora tions. T he use of a protective layer, such as varnish, may diminish the extent of this effect. The effectiveness of varnish as a protective layer, however, is unknown and may be limited by the durability of the protective layer in contact with the APF preparation as well as the possibility of holes in the protective layer. Nonacidic fluoride preparations that are effective in reducing caries incidence are available.1,18 T heir use m ight be con sidered for patients with extensive porce lain or composite restorations who require fluoride treatment. ---------------------------------- J'A N D A ---------------------------------T his report was approved by the councils in June 1987. Address requests for reprints to the councils. 1. Council on Dental Therapeutics. Accepted den tal therapeutics, ed 40. Chicago, American Dental Association, 1984. 2. G au, D.J., and Krause, E.A. Etching effect of topical fluorides on dental porcelains: a preliminary study. J Can Dent Assoc 39:410-415, 1973. 3. Schlissel, E.R.; Melnick, D.R.; and Ripa, L.W. In vitro effect of topical fluorides on porcelain sur faces. J Dent Res 59 (Special Issue A):495, abstract no. 910, 1980. 4. T hom pson, V.P.; Binkley, T.K.; and Quesenberry, B. T opical fluoride etching of glazed porcelain. J Dent Res 59 (Special Issue):496, abstract no. 916, 1980. 5. Lacy, A.; Copps, D.; and Curtis, T . Effects of topical fluorides on six low-fusing dental porcelains.
J Dent Res 61 (Special Issue):245, abstract no. 602,1982. 6. Copps, D.P., and others. Effects of topical fluo rides on five low-fusing dental porcelains. J Prosthet Dent 52(3):340-343, 1984. 7. Rawson, R.D., and others. SEM and reflectometric evaluation of the effects of fluoride on porcelain. Dent Hyg 58(10):442-445, 1984. 8. Jones, D.A. Effects of topical fluoride prepara tions on glazed porcelain surfaces. J Prosthet Dent 53(4):483-484, 1985. 9. W underlich, R.C., and Yaman, P. T he in vitro effect of topical fluorides on dental porcelain. J Dent Res 64 (Special Issue):296, abstract no. 1093, 1985. 10. W underlich, R.C., and Yaman, P. T he in vitro effect of topical fluorides on dental porcelain. J Prosthet Dent 55(3):385-388, 1986. 11. Gonzales, E., and others. Decrease in reflectance of porcelains treated with APF gels. J Dent Res 65 (Special Issue): 194, abstract no. 221, 1986. 12. Sposetd, V.J.; Shen, C.; and Levin, A.C. The effect of topical fluoride application on porcelain res torations. J Prosthet Dent 55(6):677-682, 1986. 13. Yaffe, A., and Zalkind, M. T h e effect of topical application of fluoride on composite resin restora tions. J Prosthet Dent 45(l):59-62, 1981. 14. Kula, K.; Nelson, S.; and Thom pson, V. In vitro effect of APF gels on three composite resins. J Dent Res 61 (Special Issue):302, abstract no. 1111, 1982. 15. Kula, K.; Nelson, S.; and Thom pson, V. In vitro effect of APF gel on three composite resins. J Dent Res 62(7):846-849, 1983. 16. Kula, K., and others. In vitro effect of acidu lated phosphate fluoride gel on the surface of com posites w ith different filler particles. J Prosthet Dent 56(2): 161-169, 1986. 17. Kula, K.; Thom pson, V.; and Nelson, S. Effect of 1.23% APF gel on sealant materials in vitro. J Dent Res (Special Issue):268, abstract no. 892, 1983. 18. C ouncil on D ental T herapeutics. Accepted therapeutic products. JADA 113(6):1018-1023, 1986.
JADA, Vol. 116, January 1988 ■ 115
REPORTS
Status report: effect of acidulated phosphate fluoride on porcelain and composite restorations Council on Dental Materials, Instruments, and Equipment Council on Dental Therapeutics
opical applications of acidulated phosphate fluoride (APF) prepa rations reduce the incidence of c a rie s .1 T h ese p re p a ra tio n s c o n ta in hydrogen and fluoride ions that react with glass components in restorative materials. It is well known that hydrofluoric acid etches glass. Repeated exposures of porce lain or com posite restorations to APF preparations can result in material loss, surface roughening, and corresponding changes in esthetic appearance. Dental porcelains th at were subjected to p ro longed immersions or repeated applica tions of APF preparations in in vitro studies2"12 showed increases in surface roughness using photography, optical and scanning electron microscopy, and surface profile analysis. Decreases in sur face reflectance were reported for labora tory processed porcelain11 and porcelain denture teeth.7 APF preparations have been reported to react in vitro with the glass or quartz filler particles in compos ite resins13-16 and sealants,17 resulting in weight loss, increased surface roughness, and decreased surface reflectance. T h e effect of APF p rep aratio n s on porcelain or composite restorations is not noticeable after one clinical application. However, the cumulative effect of several applications during a certain period might compromise the esthetic appearance of restorations. It is, therefore, prudent to
T
avoid placing APF preparations on sur faces of porcelain or composite restora tions. T he use of a protective layer, such as varnish, may diminish the extent of this effect. The effectiveness of varnish as a protective layer, however, is unknown and may be limited by the durability of the protective layer in contact with the APF preparation as well as the possibility of holes in the protective layer. Nonacidic fluoride preparations that are effective in reducing caries incidence are available.1,18 T heir use m ight be con sidered for patients with extensive porce lain or composite restorations who require fluoride treatment. ---------------------------------- J'A N D A ---------------------------------T his report was approved by the councils in June 1987. Address requests for reprints to the councils. 1. Council on Dental Therapeutics. Accepted den tal therapeutics, ed 40. Chicago, American Dental Association, 1984. 2. G au, D.J., and Krause, E.A. Etching effect of topical fluorides on dental porcelains: a preliminary study. J Can Dent Assoc 39:410-415, 1973. 3. Schlissel, E.R.; Melnick, D.R.; and Ripa, L.W. In vitro effect of topical fluorides on porcelain sur faces. J Dent Res 59 (Special Issue A):495, abstract no. 910, 1980. 4. T hom pson, V.P.; Binkley, T.K.; and Quesenberry, B. T opical fluoride etching of glazed porcelain. J Dent Res 59 (Special Issue):496, abstract no. 916, 1980. 5. Lacy, A.; Copps, D.; and Curtis, T . Effects of topical fluorides on six low-fusing dental porcelains.
J Dent Res 61 (Special Issue):245, abstract no. 602,1982. 6. Copps, D.P., and others. Effects of topical fluo rides on five low-fusing dental porcelains. J Prosthet Dent 52(3):340-343, 1984. 7. Rawson, R.D., and others. SEM and reflectometric evaluation of the effects of fluoride on porcelain. Dent Hyg 58(10):442-445, 1984. 8. Jones, D.A. Effects of topical fluoride prepara tions on glazed porcelain surfaces. J Prosthet Dent 53(4):483-484, 1985. 9. W underlich, R.C., and Yaman, P. T he in vitro effect of topical fluorides on dental porcelain. J Dent Res 64 (Special Issue):296, abstract no. 1093, 1985. 10. W underlich, R.C., and Yaman, P. T he in vitro effect of topical fluorides on dental porcelain. J Prosthet Dent 55(3):385-388, 1986. 11. Gonzales, E., and others. Decrease in reflectance of porcelains treated with APF gels. J Dent Res 65 (Special Issue): 194, abstract no. 221, 1986. 12. Sposetd, V.J.; Shen, C.; and Levin, A.C. The effect of topical fluoride application on porcelain res torations. J Prosthet Dent 55(6):677-682, 1986. 13. Yaffe, A., and Zalkind, M. T h e effect of topical application of fluoride on composite resin restora tions. J Prosthet Dent 45(l):59-62, 1981. 14. Kula, K.; Nelson, S.; and Thom pson, V. In vitro effect of APF gels on three composite resins. J Dent Res 61 (Special Issue):302, abstract no. 1111, 1982. 15. Kula, K.; Nelson, S.; and Thom pson, V. In vitro effect of APF gel on three composite resins. J Dent Res 62(7):846-849, 1983. 16. Kula, K., and others. In vitro effect of acidu lated phosphate fluoride gel on the surface of com posites w ith different filler particles. J Prosthet Dent 56(2): 161-169, 1986. 17. Kula, K.; Thom pson, V.; and Nelson, S. Effect of 1.23% APF gel on sealant materials in vitro. J Dent Res (Special Issue):268, abstract no. 892, 1983. 18. C ouncil on D ental T herapeutics. Accepted therapeutic products. JADA 113(6):1018-1023, 1986.
JADA, Vol. 116, January 1988 ■ 115