Pellicle Modification with Casein and Mucin Does Not Affect Surface Loss from Erosion and Abrasion

A combination of the proteins casein and mucin is known to modify the salivary pellicle and improve its protection of the underlying enamel from erosion. It is so far not known if this protection is confined solely to erosion, or if it also extends to abrasion, and this in vitro study aimed at investigating this question.

A total of 72 human enamel specimens were prepared and randomly assigned to four groups: pellicle (P), casein/mucin (CM), pellicle + casein/mucin (PCM), and control (Ctrl). Each specimen underwent five cycles, each cycle consisting of a pellicle/treatment part, an erosion part (3 min in 1% citric acid, pH 3.6, 25°C, 70 rpm), and an abrasion part (50 toothbrush strokes within 25 s in toothpaste slurry with a 200-g load). The pellicle/treatment part consisted of 2 h of incubation in whole human saliva for group P, 2 h of incubation (25°C, 70 rpm) in a protein mixture of 1% casein and 0.27% mucin for group CM, and 2 h of incubation in saliva followed by 2 h of incubation in the protein mixture for group PCM. The fourth group (Ctrl) served as the control and was kept in a humid chamber without saliva or protein treatment. The enamel surfaces were scanned with an optical profilometer initially and after the final cycle, and surface loss was analyzed. Furthermore, the surface microhardness (SMH) was measured initially, after each pellicle/treatment part and each erosion cycle, and after the final abrasion cycle. The results were analyzed with Kruskal-Wallis and Wilcoxon tests with Bonferroni corrections.

The different treatments did not show differences in surface loss and therefore did not protect enamel from surface loss by abrasion. Nonetheless, we observed differences in the SMH values, namely the Ctrl group being significantly softer than the experimental groups.

The observed differences in SMH suggest that a different abrasion protocol could lead to differences in surface loss, and further investigation of whether and under which conditions pellicle modification leads to increased resistance to abrasion remains worthwhile.