Relative cariostatic effects of KOH-soluble and KOH-insoluble fluoride in situ

The relative cariostatic effects of fluoride as fluorapatite, CaF2, loosely-bound fluoride, or KOH-soluble fluoride are debated. The present study was carried out to investigate this further in an intra-oral caries model. Pairs of premolars extracted for orthodontic reasons were used. Enamel from one tooth of each pair was used as control (untreated). Two slabs were cut from the enamel of the other contralateral premolar. These slabs were treated with 2% NaF for 24 h. One slab was then treated with 1 mol/L KOH twice for 24 h for removal of all loosely-bound fluoride. The slabs treated with 2% NaF and then with 1 mol/L KOH would contain the KOH-insoluble fluoride. Those treated with only 2% NaF would, in addition, contain KOH-soluble fluoride. Each slab, control, KOH-insoluble F, and KOH-soluble and insoluble F was mounted on different upper removable appliances. The slabs were covered with orthodontic banding material, thus allowing space for plaque accumulation. Five individuals wore the appliance in three separate four-week periods. The slabs were analyzed by quantitative microradiography. The average mineral loss (delta Z) was 1680 +/- 1000 vol% x microns in the control teeth, 620 +/- 76 vol% x microns in the KOH-soluble and -insoluble F teeth, and 2167 +/- 1278 vol% x microns in the KOH-insoluble F teeth. The average lesion depths were 90 +/- 41 microns in the control teeth, 35.3 +/- 5.5 microns in the KOH-soluble F teeth, and 88 +/- 35 microns in the KOH-insoluble F teeth. It was concluded that only KOH-soluble fluoride reduced mineral loss and lesion depths significantly, compared with the untreated teeth.