Recent advances in stannous fluoride technology: antibacterial efficacy and mechanism of action towards...

Stannous fluoride (SnF2) is highly susceptible to oxidation and hydrolysis but both anhydrous and aqueous preparations can be well established by proper formulation. When stability in aqueous preparations is achieved by the use of certain strong complexing agents, reduced antibacterial activity is observed which may be attributed to reduced bioavailability of the stannous ion. In contrast, an anhydrous SnF2 preparation maintains stannous ion in a stable but, uncomplexed form. This preparation displays antibacterial activity in saliva and delivers stannous ion which is absorbed onto surfaces making them less susceptible to plaque formation for an extended period of time (hours). When this anhydrous preparation is brushed onto dentine in vitro or in situ, one observes a nearly complete coverage of the dentine surface and occlusion of tubules by a tin-rich surface deposit. This finding indicates that the observed clinical efficacy of this preparation at relieving hypersensitivity is due to occlusion of tubules by a mixture of low solubility complexes of tin. A water-based SnF2 preparation containing strongly complexed stannous ions does not form a surface coating on dentine in vitro suggesting that this preparation may not be optimal for treating hypersensitivity. Overall, the findings indicate that the stannous ions in a SnF2 preparation must be maintained in a stable, bioavailable form for optimal efficacy against plaque and hypersensitivity to be obtained. The results suggest that these properties are provided by stable anhydrous preparations but are difficult to achieve simultaneously in aqueous preparations. When properly formulated, stannous fluoride preparations can provide multiple oral therapeutic benefits.