Mechanism of Action of Fluoride in Dental Caries Pedo
Mechanism of Action of Fluoride in Dental Caries Pedo
Mechanism of Action of Fluoride in Dental Caries Pedo
dental caries.
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Mechanism of action of systemic
fluoride
Improved crystallinity:- Fluoride increases the
crystal size and less produces, less strain in crystal
lattice. This takes place through conversion of
amorphous calcium phosphate into crystalline
hydroxy phosphate.
Void theory :- void in the crystals decreases the
stability and increases chemical reactivity. If fluoride
fills these void in the hydroxy apetite crystals it will
attain stable from with formation of more and
stronger hydrogen bonds. Greater stability will leads
to lower solubility and hence greater resistance to
dissolution in acids.
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The acid solubility : The simplest explanation
for the decreased solubility of fluoridated
enamel is that fluorapatite (with a solubility
product constant of 10-60 ) is less soluble than
hydroxyapatite (whose solubility product is
constant between 10-55 and 10-60 ) 46 However,
the amount of fluoride in surface enamel from
the teeth of persons living in a fluoridated
area is only 500 to 2000 ppm F-. This is but a
fraction of the theoretie amount of fluoride in
fluorapatite (38000 ppm F in enamel).
Obviously little of the enamel is composed of
fluorapatite.
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The fluorapatie is more insoluble than
hydroxyapatite but the actual difference
in the amounts dissolving is usually so
small that it is not likely to be a factor in
cariostasis.
Affects morphology:-
Shallow fissures (more in mandible)
More obtuse inter cuspal angles
Mesio – distal dimension – 2 %
decreased.
Reduced buccal convexity
Reduced uptake of matrix protein by
Ameloblast
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Such a material is termed amphoteric. Acidic
protein groups may be bound at calcium sites
on the crystal surface whereas basic protein
side groups will be bound at phosphate sites on
the crystal. Fluoride is a most efficient inhibitor
of binding of acidic proteins to hydroxyapatite.
This inhibition is attributed to a competition for
positive calcium sites on the crystal surface.
Whether a concentration of 1 ppm will have an
appreciable effect in this regard is doubtful, but
the higher concentrations found in topical
applications may well have.
The high concentration of topical fluorides may
also affect the wettability of the enamel
surface.
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Thus higher concentrations of fluoride
may be effective in desorbing protein by
a competitive inhibition for calcium sites
and may also affect the wettability of
dental enamel. A lowered free surface
energy or less wettable surface would
imply a cleaner surface with less plaque
adherence.
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Growth of Crystals:
Carbonate
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1. Affects morphology:-
Shallow fissures (more in mandible)
More obtuse inter cuspal angles
Mesio – distal dimension – 2 % decreased.
Reduced buccal convexity
Reduced uptake of matrix protein by
Ameloblast
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2. Growth of Crystals:
Carbonate
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Post eruptive incorporation – fluoride
continuous to enter the enamel surface,
causing crystal to change from
predominatly carbonated apatite and
hydroxy apatite to flour apatite (FAP)
and flour hydroxy apatite (FHAP)
crystals. These fluoride rich crystals are
less acid soluble then the original
enamel apatite.
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Remenerilization of Acid Dissolved enamel
Minerals of tooth enamel are continuously in
exchange with the minerals of saliva and thus
the balance is maintained. This Equilibrium can
get disturbed with the organic acid produced by
the metabolism of fermentable carbohydrates by
the microorganism. This leads to drop in PH. of
the plaque on the enamel surface and in the sub
surface. Minerals, particularly calcium and
phosphate leave the dissolved enamel in their
ionic form an entrace the plaque fluid. This
process is called deminerilization this get
reverrse with the factor like fluoride and is terms
reminerilization.
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3. Enzyme Inhibition:-
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Phosphatase liberated from dental plaque,
desquamated epithelial cells or bacteria
precipitate calcium phosphate by hydrolyzing
organic phosphate in saliva thus increasing
the concentration of free phosphate ions.
Esterase may initiate calcification by
hydrolyzing fatty esters into free fatty acids.
Fatty acids forms soaps with calcium and
magnesium that latter converted in to the less
ca.p salts .
Seeding agent induce small foci of
calcification that enlarge and coalesce to form
calcified mass.
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