ODONTO Dental Journal. Volume 3. Nomer 1. Juli 2016
FLUORIDE ABSORBED ON EXTRACTED TEETH AFTER IMMERSING IN FLUORIDE !"#$ %&'#()*)#&+)#( ,)-&!-.&'#()/,.$&.$- /,',*$&0,-&1, /)& $+ 2&
Diyah Fatmasari*, Lanny Sunarjo**
ABSTRACT
"3456789:;< !"# $%&# %' ()%$*+# *, -$#.#,/*,0 /%%/" +#123 4%/" '%$ 1"*&+$#, and adult has been acknowledged internationally. There are several types of ()%$*+# 5%+2&*/*#6 #*/"#$ /%-*12&&3 %$ 636/#5*1 7238 9, 9,+%,#6*2 /"# 5%+2&*/*#6 )6#+ /% 2--&3 2$# ()%$*+# /24&#/: ()%1%& 6%&)/*%, 2,+ ()%$*+# 1%,/2*,*,0 /%%/"-26/#8 !"# -)$-%6# %' /"*6 $#6#2$1" *6 /% ;,+ /"# #<#1/*.#,#66 %' ()%$*+#
modalities.
Method: !"# 6/)+3 +#6*0, 726 =)263 #>-#$*5#,/2& 7*/" ?@ #>/$21/#+
/##/" AB$#5%&2$ /##/"C8 !"# /##/" +*.*+#+ *,/% '%)$ 0$%)-6 D 0$%)- 9 6%2E#+
%, /24&#/ ()%$: F$%)- 99 G 6%2E#+ %, ()%1%& 6%&)/*%,: F$%)- 999 6%2E#+ %, ()%$*+# /%%/" -26/# 2,+ 0$%)- 9H 6%2E#+ %, I*&& J AK=)2+#6/L M%,/$%&
solution). Fluoride concentration before and after soaking was determined using Spectrophotometer UV-Vis. Fluoride absorption was determined by the
$#+)1/*%, %' ()%$*+# 1%,1#,/$2/*%, 2'/#$ 6%2E*,08
Result: N#6#2$1" $#6)&/ 6"%7, /"2/ /"# "*0"#6/ ()%$*+# 246%$-/*%, 726 %, 6%2E*,0 *, ()%$*+# /24&#/: '%&&%7#+ 43 6%2E*,0 %, ()%1%& 2,+ /%%/" -26/#
A5#2, ()%$*+# 246%$-/*%, 726 @:OPG @:@Q 2,+ @:@? --5C8 K,%.2 /#6/ 6"%7, 6*0,*;12,1# &#.#& 726 @:@@@8
*8:4=9>?8:< /"#$# 7#$# 2 6*0,*;12,1# %' ()%$*+# 246%$-/*%, %, 6%2E*,0 *, /24&#/ ()%$*+#: ()%1%& 6%&)/*%, 2,+ /%%/"-26/#8 !"# 5#1"2,*65 %' ()%$*+#
$#0*5#,6 6"%7, +*<#$#,/ ()%$*+# 246%$-/*%,8 Keywords:
Fluride apsorbtion, ()%$*+# /24&#/: ()%1%&
2,+ ()%$*+# /%%/" -26/#
INTRODUCTION
M2$*#6 -$#.#,/*' #<%$/ *, +#,/*6/$3 426#+
on etiology concept. Theoritically, caries -$#.#,/*%, 12, 4# 2-&&*#+ 7*/" 5%+*;#+ 4#/7##, interaction etiology factors and improvement strengthen teeth resistance factor1. Fluoride role to reduce caries has been reported since RSO@8 N%&# %' ()%$*+# *, -$#.#,/*,0 12$*#6 4%/"
for children and adult has been ackowledged
*,/#$,2/*%,2&&38 N)00TF),,2 $#-%$/#+ ()%$*+#
726 .#$3 #<#1/*.# /%72$+6 +#,/2& 12$*#68 Fluoride works optimally when low concentration applied and continuosly maintain
*, -&2=)# 2,+ 62&*.2 38 N%&&2 +2, UE6/$2,+ '%),+
/%%/"4$)6"*,0 7*/" ()%$*+# /%%/"-26/# *,1$#26#
62&*.2 ()%$*+# 1%,1#,/$2/*%, R@@ V R@@@ '%&+
for at least 120 minutes. Toothbrushing with ()%$*+# /%%/"-26/# -$%.#, 26 /"# 5%6/ #<#1/*.#
way to prevent caries.
Suwelo4 6/2/#+ 7"#, ()%$*+# *, 72/#$
supply lower than 0.3 ppm, it is suggested /% )6# ()%$*+# /%-*12&&3 %$ 636/#5*18 W&)%$*+#
concentration in Goverment Water Supply (PDAM) is lower than 0.3 ppm, therefore ()%$*+# /24&#/ '%$ 1"*&+$#, *6 ,##+#+8 X),2$Y%17 reported most Semarang dentists (61,7%) 20$## '%$ ()%$*+# -$#61$*-/*%, '%$ 1"*&+$#,8 Central Java Health of Department has 2--&*#+ ()%$*+# /24&#/ 26 5%)/" $*,6# '%$
school children. Fluoride applied topically 6)1" 26 ()%$*+# /%%/"-26/#G ()%1%& 6%&)/*%, 2,+ ()%$*+# 5%)/"$*,6# 2$# 5%$# %-/*52& /"2, ()%$*+# 2--&*#+ 636/#5*15,6.
!"#$%!&'()$*$+!,-.!&/0#'11'2!-'3'(1'2!"'3$+$()
@87A>B8:;A:>?<&C3DE3>37?;?F3GH6E3?=I48E
Fluoride usage in appropriate dosage can minimize side absorption obtained on the use
%' ()%$*+# /%%/"-26/#: ()%$*+# /24&#/6 2,+
2--&*12/*%, %' ()%$*+# 6%&)/*%, /% /"# /##/"8 Yamazaki, et al.7 stated there is a relationship 4#/7##, /"# 2.2*&24*&*/3 %' ()%$*+# *, /"#
-$#-2$2/*%, 2,+ #<#1/*.#,#66 %' ()%$*+# *, preventing tooth demineralization.
U<%$/6 /% +#/#$5*,# ()%$*+# 2.2*&24*&*/3 *, ()%$*+# /24&#/ +*66%&.#+: ()%$*+# /%%/"-26/#
2,+ )6# ()%12& 6%&)/*%, *6 #66#,/*2& /% 2.%*+
#>1#66*.# ()%$*+# *,/2E# %$ .*1# .#$62 *, %$+#$
/% %4/2*, %-/*52& ()%$*+# /"#$2-#)/*1 +%6#
(0.07 ppm or 0.7 mg per day) to prevent caries.
RESEARCH METHOD
N#6#2$1" +#6*0, 726 =)263 #>-#$*5#,/2&
with extracted teeth as samples. Healthy and free caries extracted premolar permanent teeth which has been extracted for 1-2 months 20% 726 )6#+8 X25- 7#$# E#-/ *, 2=)2+#6/
before has been manipulated. Fluoride tablets )6#+ *6 H*,2()%$ 7*/" 2 +%6# %' R 50: W&)%1%&
*6 ()%$*+# 6%&)/*%, 7*/" "*0" 1%,1#,/$2/*%,8 !"#
1%,/#,/ %' ()%1%& *6 X%+*)5 W&)%$*+# AZ2WC 2/
a concentration of 24 mg in 1 kg NaF solution, ()%$*+# /%%/"-26/# 726 ()%$*+# -26/# 7*/"
2 652&& +%6# %' ()%$*+# R 50 *, R E0: I*&& J (distilled water) is a sterile solution was used as control group.
W&)%$*+# 2.2*&24*&/3 *6 ()%$*+# 1%,1#,/$2/*%, on extracted teeth in ppm (part per million) and measured with Spektrofotometer UV Visual.
N#6#2$1" 6/#-6 7#$#D
1. Twenty premolar teeth were prepared 2. The sample teeth were divided into 4
groups ( each groups was 5 teeth )
3. Made solution for soaking teeth (inserted into the glass tube Conical )
[ F$%)- 9D P 5& I*&& J -&)6 R 50 H*,2()%$
which has been crushed ( pulverized )
[ F$%)- 99D P 5& I*&& J 2++#+ O +$%-6 %' ()%1%& 6%&)/*%,
[ F$%)- 999D P 5& I*&& J -&)6 R 50 /%%/"-26/#
[ F$%)- 9HD P 5& 6%&)/*%, %' I*&& J
4. Each group put on the Vortex 6%&)/*%, '%$ .%$/*;12/*%, /% 52E# */
homogeneousFluoride concentration measurements using a spectrophotometer A \ ]S] 55 C: /"# $#6)&/6 7#$# $#1%$+#+
*, /"# /24&# 26 /"# 1%,1#,/$2/*%, %' ()%$*+#
before immersion
[ F$%)- 9D U>/$21/#+ /##/" *55#$6#+ *, 2 6%&)/*%, %' ()%$*+# /24&#/6
[ F$%)- 99D U>/$21/#+ /##/" *55#$6#+ *, ()%1%& 6%&)/*%,
[ F$%)- 999D U>/$21/#+ /##/" *55#$6#+ *, 2 ()%$*+# /%%/"-26/# 6%&)/*%,
[ F$%)- 9HD U>/$21/#+ /##/" *55#$6#+ *, 2 solution of Mill Q
5. K&& 0$%)- *55#$6#+ *, '%)$ +*<#$#,/ 0$%)- solution then centrifuged for 5 minutes at 1,500 rpm
6. Fluoride concentration measured using a
^H 6-#1/$%-"%/%5#/#$ 7*/" \ H*6)2& ]S]
mm , the results recorded in the table as /"# ()%$*+# 1%,1#,/$2/*%, 2'/#$ *55#$6*%, 7. Fluoride concentration absorbed to
extracted teeth was assumed as a result
%' /"# 1%,1#,/$2/*%, %' ()%$*+# 4#'%$#
*55#$6*%, 5*,)6 ()%$*+# 1%,1#,/$2/*%, after immersion
Paired t test was used to determine the
#<#1/ %' *55#$6*%, *, /"# 0$%)- A-$# 2,+
-%6/ /$#2/5#,/C %, /"# 246%$-/*%, %' ()%$*+#8 KZ_HK /#6/ 726 )6#+ /% +#/#$5*,# +*<#$#,1#6
%' ()%$*+# 2.2*&24*&*/3 *, ? A'%)$C #>-#$*5#,/2&
and control groups. Post hoc tests need to be +%,# /% ;,+ /"# "*0"#6/ ()%$*+# &#.#&6 '$%5 2&&
groups.
RESULT
ODONTO Dental Journal. Volume 3. Nomer 1. Juli 2016
1. Fluoride concentration after immersing in /24&#/ ()%$*+# 6%&)/*%,
!24&# R 6"%7, 2 +#1$#26# %' ()%$*+#
1%,1#,/$2/*%, 2'/#$ *55#$6*,0 *, ()%$*+# /24&#/
6%&)/*%,8 9/ 726 266)5#+ /"2/ ()%$*+# 246%$4#+
in extracted teeth. Paired t test was 0,000 2,+ 1%,1&)+#+ /"2/ /"#$# 726 2 6*0,*;12,1#
+*<#$#,1#6 %, ()%$*+# 1%,1#,/$2/*%, 2'/#$
*55#$6*,0 *, ()%$*+# /24&#/ 6%&)/*%,8
2. Fluoride concentration after immersing on ()%1%& 6%&)/*%,
!24&# P 6"%7, 2 ()%$*+# +#1$#26# 4#'%$#
2,+ 2'/#$ *55#$6*,0 *, ()%1%& 6%&)/*%,8 9/ 726 -$%.#, /"#$# 726 ()%$*+# 246%$4#+ *,/% /"#
extracted teeth. Paired t test was 0,001 and /"#$#'%$# */ 726 1%,1&)+#+ 2, *,()#,1# %' ()%1%& *55#$6*%, *, ()%$*+# 1%,1#,/$2/*%,
!24#& R8 W&)%$*+# 1%,1#,/$2/*%, 246%$4#+ *, 2 /24&#/ ()%$*+# 6%&)/*%,
!24#& P8 W&)%$*+# 1%,1#,/$2/*%, 246%$4#+ *, ()%1%& 6%&)/*%,
!24#& O8 W&)%$*+# 1%,1#,/$2/*%, 246%$4#+ *, ()%$*+# /%%/"-26/# 6%&)/*%,
!24&# ?8 I#2, ()%$*+# 1%,1#,/$2/*%, 246%$4#+ 2'/#$ *55#$6*,0 *, ()%$*+# /24&#/G ()%1%& 2,+ ()%$*+#
toothpaste solution
absorbed.
3. Fluoride concentration after immersing on ()%$*+# /%%/"-26/# 6%&)/*%,
9/ 726 6"%7, 2 +#1$#26# %' ()%$*+#
concentration before and after teeth immersing
*, ()%$*+# /%%/"-26/# 6%&)/*%,8 9/ 726 -$%.#, ()%$*+# 246%$-/*%, *,/% /"# /##/"8 B2*$#+ / /#6/
'%),+ 6*0,*;12,13 &#.#& @:OP]8 !"#$# 726 ,%
*,()#,1#6 %' ()%$*+# /%%/"-26/# *55#$6*%, %, 246%$4#+ ()%$*+# 1%,1#,/$2/*%,8
4. Fluoride absorption after immersing in ()%$*+# /24&#/G ()%1%& 2,+ ()%$*+# /%%/"-26/#
solution
From table 4 we can see that immersing in ()%$*+# /24&#/ 6%&)/*%, $#6)&/#+ "*0"#6/ ()%$*+#
246%$-/*%,: '%&&%7#+ 43 *55#$6*,0 *, ()%1%&
6%&)/*%, 2,+ ()$*+# /%%/"-26/#8 K,%.2 /#6/
$#6)&/#+ 6*0,*;12,13 &#.#& 726 @8@@@: /"#$#
726 2 +*<#$#,1#6 *,()#,1# %, *55#$6*%, 7*/" /"$## 0$%)- %' /$#2/5#,/ /%72$+ ()%$*+#
absorbtion.
DISCUSSION
!"# )6# %' 636/#5*1 ()%$*+# /"$%)0"
+$*,E*,0 72/#$ 2,+ ()%$*+# /24&#/6 "26 4##, started about 25 years ago. Mechanism 21/*%, %' /"*6 636/#5*1 #<#1/ *6 /% 6/$#,0/"#, /"# /%%/" -$*%$ /% /%%/" #$)-/*%,8 K6 2, #<#1/
of this mechanism tooth become resistant to caries attack during tooth eruption. Fluoride is absorbed by email apatite and reduced solubility of apatite which increases endurance email to demineralization. However this systemic mechanism can generate negative
#<#1/6 7"*1" 726 /"# *,1*+#,1# %' ()%$%6*6:
/"#$#'%$# 2,%/"#$ 5#1"2,*65 %' ()%$*+#
delivery is needed to be developed 8.
`26/ ;,+*,06 +#5%,6/$2/#+ ()%$*+#
/%-*12&&3 #<#1/6 A2--&*#+ +*$#1/&3 L 1%,/21/
with the tooth) was the most appropriate method9,10,11. Mechanism action of topical ()%$*+# *6 43 #,"2,1*,0 $#5*,#$2&*a2/*%, and inhibiting demineralization, increasing ()%$*+# 1%,1#,/$2/*%, *, 62&*.2 2,+ -&2=)#
*, 1%,6#=)#,1# *,"*4*/ 21*+ -$%+)1/*%, 43 bacteria, can also reduce email solubility12. W&)%$*+# *, %$2& ()*+6 12, 2&6% 6#$.# /% *,1$#26#
2,/*T12$*#6 #<#1/ 43 *,1$#26*,0 -$#1*-*/2/*%, %' Fluoroapatite.
!%-*12& ()%$*+# 5%+2&*/*#6 4#6/ 2--&*#+
*, &%7 +%6#6 2,+ '$#=)#,13 %' 2+5*,*6/$2/*%, 1%,/*,)%)6&38 9/ 726 '%),+ /"2/ ()%$*+# 7*&&
have a major role in low doses in the process of demineralization and remineralization of +#,/2& "2$+ /*66)# 7"*&# ()%$*+# *, "*0" +%6#6 would likely weaken email crystallization and increase the production of acid by bacteria13.
Most studies have been conducted to -$%.# #<#1/ %' ()%$*+# #*/"#$ -$# %$ -%6/T
#$)-/*%, #<#1/ *6 &2$0#&3 +%,# *, .*.%: 4#12)6#
5#26)$#5#,/ %' ()%$*+# 1%,1#,/$2/*%, *, 62&*.2 2,+ +#,/2& -&2=)# 12, 4# 6##, +*$#1/&3
*, %$2& 12.*/38 N#1#,/ 6/)+3 726 1%,+)1/#+ *, vitro, so the ideal situation in the oral cavity can not be achieved. The results showed the
"*0"#6/ 246%$4#+ ()%$*+# *6 2'/#$ *55#$6*%, %' ()%$*+# /24&#/6 A.*,2()%$ R 50C 2,+ /"# &%7#6/
*6 /"# )6# %' ()%$*+# /%%/"-26/#8
This study used method of measuring ()%$*+# 1%,1#,/$2/*%, /"$%)0" 5#+*)5 of immersion therefore produces high 1%,1#,/$2/*%, %' ()%$*+# /24&#/6 *, 6%&)/*%, (1 mg NaF). When dissolution in the Mill Q 6%&)/*%,: ()%$*+# 1%,1#,/$2/*%, *, /"# 6%&)/*%, 4#1%5#6 "*0"8 b"*&# %, ()%1%& 6%&)/*%,:
although NaF concentration high enough but by the time the dissolution with a solution I*&&J /2E#, %,&3 O +$%-6 /"#$#'%$# ()%$*+#
1%,1#,/$2/*%, *6 &%78 9, *55#$6*%, 7*/" ()%$*+#
toothpaste although lower doses are mixed in 6%&)/*%, I*&&J 4)/ ()%$*+# 1%,1#,/$2/*%,6 7#$#
ODONTO Dental Journal. Volume 3. Nomer 1. Juli 2016
+#/#1/#+ 4#'%$# 2,+ 2'/#$ *55#$6*%, =)*/# "*0"8
!"*6 523 4# +)# 2/ /"# /*5# %' '%$/*;12/*%,:
()%$*+# 1%,1#,/$2/*%, *, /%%/"-26/# *,/% 2
"%5%0#,#%)6 6%&)/*%,: 12)6*,0 I*&& J ()%$*+#
detected high enough.
!"#$# 726 2, *,()#,1# %' /##/" *55#$6*%,
*, +*<#$#,/ 5%+2&*/*#6 %' ()%$*+#8 W&)%$*+#
1%,1#,/$2/*%, *, ()%$*+# /24&#/6 6%2E*,0 4%/"
before and after immersion is high enough, /"#, /"# 246%$4#+ ()%$*+# *6 2&6% =)*/# "*0"8
!"# "*0"#6/ 246%$-/*%, %' ()%$*+# '%),+ *,
*55#$6*%, 7*/" ()%$*+# /24&#/6 A.*,2()%$C8 9, /"# 1&*,*12& 2--&*12/*%,: ()%$*+# /24&#/6 administered systemically, so although high 1%,1#,/$2/*%,6 246%$4#+: 6%5# %' ()%$*+#
concentration absorbed into blood plasma therefore not all be absorbed into teeth 14.
955#$6*%, *, ()%1%& 6%&)/*%, $#6)&/ &%7 ()%$*+# 1%,1#,/$2/*%,6 4%/" 4#'%$# 2,+
2'/#$ *55#$6*%, 4)/ 246%$-/*%, %' ()%$*+#
concentration is higher than immerse with ()%$*+# /%%/"-26/#8 W&)%1%& *6 ()%$*+# *, /"#
'%$5 %' "*0" 1%,1#,/$2/*%, &*=)*+: 7"#, */ 726 1#,/$*')0#+: 6)1" /"*1E ()%$*+# 1%,1#,/$2/*%, will be absorbed into the tooth. Although at the time of measurement (before and after
*55#$6*%,C '%),+ ()%$*+# &%7 1%,1#,/$2/*%, +)# /% '%$/*;12/*%, 6/20# A"%5%0#,#*/3C8
X%2E*,0 *, ()%$*+# /%%/"-26/# 6%&)/*%,
$#6)&/#+ /"# &%7#6/ ()%$*+# 1%,1#,/$2/*%,: /"*6 might be due to the resulting solution between /%%/"-26/# 2,+ I*&& J =)*/# 1$ A+*&)/#C 6% /"2/
7"#, */ 726 1#,/$*')0#+: ()%$*+# 1%,1#,/$2/*%, 246%$4#+ 4#1%5# /"# &%7#6/8 9, 1&*,*12&
2--&*12/*%,6: /"# )6# %' ()%$*+# /%%/"-26/# /%
0*.# #<#1/ ,%/ %,&3 %, /"# /##/" /%-*12&&3: 4)/
2&6% *,1$#26#6 *%,6 ()%$*+# *, 62&*.2: -&2=)#
2,+ -&2=)# 6%&)/*%, 15.
The study results do not conform with the
$#1%55#,+2/*%,6 0*.#, *, /#$56 %' ()%$*+#
use. American Dental Association advocate '%$ /"# )6# %' &%7T+%6# ()%$*+# -$#-2$2/*%,6 7*/" 2 '$#=)#,13 %' /7*1# +2*&3 /%-*12&&3 than high-dose topical and systemic16. This recommendations was given by consideration
%' /"# #<#1/ %' ()%$*+# 246%$4#+ ,%/ E,%7,
"%7 5)1" ()%$*+# 726 246%$4#+8 9,+*.*+)2&
+#52,+6 %' ()%$*+# 2++#+ +#-#,+ %, /"# $*6E
%' 12$*#6 *,+*.*+)2&&38 9/ 2&6% ,##+6 /% 1%,6*+#$
/"# *66)# -$*1# A1%6/ #<#1/*.#,#66C: *,+*.*+)2&&3 comfort, patient acceptance and security, also dentist advices.
CONCLUSION
!"#$# 726 2, *,()#,1# %' *55#$6*,0
#>/$21/#+ /##/" %, +*<#$#,/ ()%$*+# 5%+2&*/*#6 /%72$+ ()%$*+# 24%6#$4#+: /"# 5%6/ #<#1/*.#
726 *55#$6#+ *, ()%$*+# /24&#/8 REFFERENCES
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