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Fluoride varnishes containing calcium glycerophosphate: fluoride uptake and the effect on in vitro enamel erosion

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Calcium glycerophosphate (CaGP) was added to fluoride varnishes to analyze their preventive effect on initial enamel erosion and fluoride uptake: potassium hydroxide (KOH)-soluble and KOH-insoluble fluoride bound to enamel.

Materials and methods

This study was carried out in two parts. Part 1: 108 enamel samples were randomly distributed into six varnish groups: base varnish (no active ingredients); Duraphat® (2.26 %NaF); Duofluorid® (5.63 %NaF/CaF2); experimental varnish 1 (1 %CaGP/5.63 %NaF/CaF2); experimental varnish 2 (5 %CaGP/5.63 %NaF/CaF2); and no varnish. Cyclic demineralization (90 s; citric acid, pH = 3.6) and remineralization (4 h) was made once a day, for 3 days. Change in surface microhardness (SMH) was measured. Part 2: 60 enamel samples were cut in half and received no varnish (control) or a layer of varnish: Duraphat®, Duofluorid®, experimental varnishes 1 and 2. Then, KOH-soluble and KOH-insoluble fluoride were analyzed using an electrode.


After cyclic demineralization, SMH decreased in all samples, but Duraphat® caused less hardness loss. No difference was observed between varnishes containing CaGP and the other varnishes. Similar amounts of KOH-soluble and insoluble fluoride was found in experimental varnish 1 and Duofluorid®, while lower values were found for experimental varnish 2 and Duraphat®.


The addition of CaGP to fluoride varnishes did not increase fluoride bound to enamel and did not enhance their protection against initial enamel erosion.

Clinical relevance

We observe that the fluoride varnishes containing CaGP do not promote greater amounts of fluoride bound to enamel and that fluoride bound to enamel may not be closely related to erosion prevention.

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The authors are very grateful for Barbara Beyeler’s persistence and determined efforts during the laboratory procedures. We thank Dr. S. Hayoz and Prof. J. Hüsler, Institute of Mathematical Statistics and Actuarial Science, University of Bern, for performing the statistical analyses. We greatly appreciate the valuable comments from the participants of the Post-Graduation in Pediatric Dentistry (FOUSP). Finally, we thank FGM, Brazil, for their support in manufacturing the varnishes and the financial support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, www.cnpq.br; grant number 201901/2009-9).

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Thiago S. Carvalho.

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Carvalho, T.S., Bönecker, M., Altenburger, M.J. et al. Fluoride varnishes containing calcium glycerophosphate: fluoride uptake and the effect on in vitro enamel erosion. Clin Oral Invest 19, 1429–1436 (2015). https://doi.org/10.1007/s00784-014-1363-6

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  • Topical fluorides
  • Calcium glycerophosphate
  • Enamel
  • Dental erosion
  • Fluoride varnish
  • Tooth demineralization