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1.
Relationship of fluoride in drinking water with blood pressure and essential hypertension prevalence: a systematic review and meta-analysis.
Davoudi, M, Barjasteh-Askari, F, Sarmadi, M, Ghorbani, M, Yaseri, M, Bazrafshan, E, Mahvi, AH, Moohebati, M
International archives of occupational and environmental health. 2021;(6):1137-1146
Abstract
BACKGROUND AND OBJECTIVE Previous studies showed controversial results of the relationship between fluoride exposure through drinking water and elevated blood pressure. We conducted a systematic review and meta-analysis to assess the direct relationship of drinking water fluoride exposure with blood pressure and essential hypertension prevalence in general populations. METHODS We conducted a systematic search in databases including Web of Knowledge, PubMed, Scopus, and Embase by MeSH and non-MeSH terms for relevant studies with any design published until August 2019, with no limitation in time and language. The pooled effect measure was calculated within a 95% confidence interval (CI). RESULTS Our search retrieved 630 journal articles, six of which were eligible for data extraction. The random-effects model found significantly higher systolic blood pressure (mean difference = 6.49 mmHg; 95% CI 3.73-9.25; p value < 0.01) and diastolic blood pressure (mean difference = 4.33 mmHg; 95% CI 1.39-7.26; p value < 0.01) in groups exposed to high-fluoride drinking water than in groups exposed to normal/low-fluoride drinking water. A significant relationship was also found between high-fluoride drinking water and essential hypertension (odds ratio = 2.14; 95% CI 1.02-4.49; p value = 0.045). CONCLUSION The risk of elevated blood pressure increases in the general population of fluoride endemic areas. However, more research is needed to make a firm conclusion about the adverse effects of excess fluoride intake on the cardiovascular system at the individual level.
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2.
Pharmacokinetics of fluoride in human adults: The effect of exercise.
Mahmood, M, Azevedo, LB, Maguire, A, Buzalaf, M, Zohoori, FV
Chemosphere. 2021;:127796
Abstract
The literature is sparse in terms of the effect of exercise on the pharmacokinetics of fluoride (F) in humans. In a 4-treatment repeated measures cross-over study, we investigated F pharmacokinetics following no exercise (control) and three exercise intensity conditions (light, moderate and vigorous) in healthy adults. At a pre-experimental session, 8 participants (18-30y) residing in a non-fluoridated-area, underwent a VO2 max test to guide the three exercise intensities for the experimental sessions. Participants were on a F-free regime one week before and throughout the four experimental weeks. We measured urinary F excretion (UFE), maximum plasma concentration (Cmax), lag time of Cmax (Tmax), and Area Under the Curve (AUC) for plasma F concentration against time, following F ingestion then no, light, moderate and vigorous exercise. Results showed no statistically significant difference in Tmax among all sessions; whereas Cmax for moderate exercise (226.2 ng/ml) was significantly higher than for no (27.0 ng/ml; p < 0.001), light (105.6 ng/ml; p = 0.016) and vigorous (94.2 ng/ml; p = 0.008) exercise. Mean AUC over 0-90 min following F ingestion was also significantly higher in moderate exercise than for no (p < 0.001), light (p = 0.004) and vigorous (p = 0.001) exercise. Mean UFE over 0-14h was 638.8, 718.7, 574.6 and 450.5 μg for no, light, moderate and vigorous exercise, with no statistically significant differences among different sessions. In conclusion, this human experimental study suggests that moderate exercise may increase the fraction of F absorbed systemically which is therefore available to produce a biological effect. Future studies should be conducted with larger samples, different age groups and using different F doses.
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3.
Oral biofilm uptake of mineral ions released from experimental toothpaste containing surface pre-reacted glass-ionomer (S-PRG) filler.
Kato, K, Tamura, K, Shimazaki, Y
Archives of oral biology. 2020;:104777
Abstract
OBJECTIVE To clarify the fluoride/mineral kinetics in an oral biofilm following concurrent application of fluoride and other mineral ions released from experimental toothpaste containing S-PRG filler using depth-specific analysis. STUDY DESIGN Twenty subjects wore in situ plaque-generating devices, comprised of a pair of enamel slabs, and a biofilm was allowed to form. The devices were removed after three days, immersed in the toothpaste filtrate containing Al, B, Sr and F ions for 1 min, and then reinserted at the same location. After 30 min, the devices were removed and samples were obtained by sectioning into outer, middle and inner biofilm layers (300-μm thick). Samples treated with filtrate containing F without S-PRG filler extract served as the control. Fluoride and the three other mineral ions extracted from 4-μm sections were quantified using a fluoride electrode and ICP-AES, respectively. The results were corrected for biomass volume, estimated by the area measurement of stained 2-μm sections. RESULTS The mean uptake ratios (S-PRG/control, ng/mm3) of Al, B, Sr and F were 186.6/53.7, 58.4/25.0, 456.9/125.7 and 43.6/12.0, respectively, in the outer layer, indicating that the mineral ions could easily diffuse into the biofilm. F concentrations in the outer biofilm treated using filtrate with S-PRG filler extract were significantly higher than those in controls, although both biofilms were exposed to filtrates containing the same level of F. CONCLUSIONS The results suggest that toothpaste containing S-PRG filler promotes fluoride retention in oral biofilms via the uptake of other mineral ions.
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4.
Use of Fluoride as a Marker Solute to Quantify the Current Effective Delivered Dose in Continuous Renal Replacement Therapy: An "in vitro" Study.
Villa, G, Bocciero, V, Neri, M, Pomarè Montin, D, Angeli, E, Di Filippo, A, Falsini, S, Adembri, C, De Gaudio, AR, Romagnoli, S
Blood purification. 2020;(6):685-691
Abstract
BACKGROUND The current effective delivered dose is a quality indicator for continuous renal replacement therapy. Its periodic assessment might enable physicians to deliver personalised treatments. Yet, its quantification as by extracorporeal urea clearance (Cl) is cumbersome and thus often neglected in routine practice. The aim of this in vitro study is to demonstrate the non-inferior effectiveness of assessing the current effective delivered dose using a simpler, cheaper and faster approach based on measurement of fluoride rather than urea extracorporeal Cl. METHODS We compared urea and fluoride removal in 3 post-dilution continuous veno-venous haemofiltration (CVVH) and 3 continuous veno-venous haemodialysis (CVVHD) in vitro experimental models. Experiments ran for 180 min, using 3 L of human blood, heparin anticoagulation and a machine dose of 30 mL/kg/h. Urea and fluoride were measured in the inflow, outflow and effluent lines to compare sieving coefficients (SC), saturation coefficients (SA) and transmembrane Cls. RESULTS In CVVH, the median SC values were 1.06 (1.02-1.07) and 1.02 (1.01-1.04) for fluoride and urea, respectively (discrepancy of 4.3%), while transmembrane convective Cls were 31.28 (30.01-31.31) mL/kg/h and 30.30 (29-31.85) mL/kg/h (discrepancy of 3.13%), respectively. In CVVHD, the median SA values were 1.01 (0.96-1.02) and 1 (0.95-1.01) for fluoride and urea, respectively (discrepancy of 1.6%), while transmembrane dialytic Cls were 30.26 (29.52-31.32) mL/kg/h and 31.16 (30-31.75) mL/kg/h (discrepancy of -2.97%), respectively. CONCLUSION Fluoride transmembrane removal was close to that observed with urea, in terms of SC, SA and transmembrane Cl. Fluoride seems as much accurate as urea in assessing the current effective delivered dose during both CVVH and CVVHD and might therefore be adopted for dose measurement. Besides accuracy, fluoride bedside assessment could present many advantages over urea, particularly in terms of availability, costs, time requirement and rapidity of assessment.
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5.
Scenario, perspectives and mechanism of arsenic and fluoride Co-occurrence in the groundwater: A review.
Kumar, M, Goswami, R, Patel, AK, Srivastava, M, Das, N
Chemosphere. 2020;:126126
Abstract
Arsenic (As) and fluoride (F-) are the two most conspicuous contaminants, in terms of distribution and menace, in aquifers around the world. While the majority of studies focus on the individual accounts of their hydro-geochemistry, the current work is an effort to bring together the past and contemporary works on As and F- co-occurrence. Co-occurrence in the context of As and F- is a broad umbrella term and necessarily does not imply a positive correlation between the two contaminants. In arid oxidized aquifers, healthy relationships between As and F- is reported owing desorption based release from the positively charged (hydr)oxides of metals like iron (Fe) under alkaline pH. In many instances, multiple pathways of release led to little or no correlation between the two, yet there were high concentrations of both at the same time. The key influencer of the strength of the co-occurrence is seasonality, environment, and climatic conditions. Besides, the existing primary ion and dissolved organic matter also affect the release and enrichment of As-F- in the aquifer system. Anthropogenic forcing in the form of mining, irrigation return flow, extraction, recharge, and agrochemicals remains the most significant contributing factor in the co-occurrence. The epidemiological indicate that the interface of these two interacting elements concerning public health is considerably complicated and can be affected by some uncertain factors. The existing explanations of interactions between As-F are indecisive, especially their antagonistic interactions that need further investigation. "Multi-contamination perspectives of groundwater" is an essential consideration for the overarching question of freshwater sustainability.
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6.
Zinc-Calcium-Fluoride Bioglass-Based Innovative Multifunctional Dental Adhesive with Thick Adhesive Resin Film Thickness.
Yao, C, Ahmed, MH, Li, X, Nedeljkovic, I, Vandooren, J, Mercelis, B, Zhang, F, Van Landuyt, KL, Huang, C, Van Meerbeek, B
ACS applied materials & interfaces. 2020;(27):30120-30135
Abstract
Apart from producing high bond strength to tooth enamel and dentin, a dental adhesive with biotherapeutic potential is clinically desirable, aiming to further improve tooth restoration longevity. In this laboratory study, an experimental two-step universal adhesive, referred to as Exp_2UA, applicable in both the etch-and-rinse (E&R) and self-etch (SE) modes and combining a primer, containing 10-methacryloyloxydecyldihydrogen phosphate as a functional monomer with chemical binding potential to hydroxyapatite, with a bioglass-containing hydrophobic adhesive resin, was multifactorially investigated. In addition to primary property assessment, including measurement of bond strength, water sorption, solubility, and polymerization efficiency, the resultant adhesive-dentin interface was characterized by transmission electron microscopy (TEM), the filler composition was analyzed by energy-dispersive X-ray spectroscopy, and the bioactive potential of the adhesive was estimated by measuring the long-term ion release and assessing its antienzymatic and antibacterial potential. Four representative commercial adhesives were used as reference/controls. Application in both the E&R and SE modes resulted in a durable bonding performance to dentin, as evidenced by favorable 1 year aged bond strength data and a tight interfacial ultrastructure that, as examined by TEM, remained ultramorphologically unaltered upon 1 year of water storage aging. TEM revealed a 20 μm thick hydrophobic adhesive layer with a homogeneous bioglass filler distribution. Adequate polymerization conversion resulted in extremely low water sorption and solubility. In situ zymography revealed reduced endogenous proteolytic activity, while Streptococcus mutans biofilm formation was inhibited. In conclusion, the three-/two-step E&R/SE Exp_2UA combines the high bonding potential and bond degradation resistance with long-term ion release, rendering the adhesive antienzymatic and antibacterial potential.
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7.
A randomised oral fluoride retention study comparing intra-oral kinetics of fluoride-containing dentifrices before and after dietary acid exposure.
Burnett, G, Nehme, M, Parkinson, C, Karwal, R, Badrock, T, Thomas, GV, Hall, P
Archives of oral biology. 2020;:104891
Abstract
OBJECTIVE This exploratory, randomised, single-blind, crossover, study evaluated fluoride and calcium ion concentrations and pH following use of one of two 1450 ppm fluoride (NaF), 5% w/w KNO3 dentifrices: (1) test dentifrice (with cocamidopropyl betaine) with an orange juice (OJ) rinse; (2) test dentifrice with a deionized (DI) water rinse or (3) comparator dentifrice (with sodium lauryl sulphate and tetrasodium pyrophosphate) with an OJ rinse. DESIGN Eighteen participants used their assigned dentifrice, rinsed with DI water, then expectorate was collected. Sixty min post-brushing, participants rinsed with OJ or DI water then expectorate was collected. Saliva samples were collected pre-brushing and at 1, 5, 10, 15, 30 and 60 min post-brushing and following the 60 min OJ/DI water rinse. The pH of samples was taken. RESULTS Significant differences (p < 0.05) were found in salivary fluoride ion concentrations between test and comparator dentifrices at 30 and 60 min and following the 60 min OJ rinse, favouring the former. Significant differences were also found between test and comparator dentifrices for salivary calcium ion concentration at 1, 5 and 10 min (p < 0.0001), favouring the former, and between test or comparator + OJ rinse and test + water rinse (p < 0.005), favouring the latter. No pH differences were shown prior to OJ/water rinse. Products were generally well-tolerated. CONCLUSIONS Results confirmed that acid-labile fluoride is released from the oral cavity following a dietary acid challenge and showed that formulation excipients may impact on retention of such.
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8.
Influence of Hydroxyapatite Coating for the Prevention of Bone Mineral Density Loss and Bone Metabolism after Total Hip Arthroplasty: Assessment Using 18F-Fluoride Positron Emission Tomography and Dual-Energy X-Ray Absorptiometry by Randomized Controlled Trial.
Tezuka, T, Kobayashi, N, Hyonmin, C, Oba, M, Miyamae, Y, Morita, A, Inaba, Y
BioMed research international. 2020;:4154290
Abstract
BACKGROUND Hydroxyapatite- (HA-) coated implants tend to achieve good osteoinductivity and stable clinical results; however, the influence of the coating on the prevention of bone mineral density (BMD) loss around the implant is unclear. The purpose of this randomized controlled trial was to evaluate the effectiveness of HA-coated implants for preventing BMD loss and to determine the status of bone remodeling after total hip arthroplasty (THA), making comparisons with non-HA-coated implants. METHODS A total of 52 patients who underwent primary THA were randomly allocated to HA and non-HA groups. BMD was measured by dual-energy X-ray absorptiometry (DEXA) at 1 week postoperation to form a baseline measurement, and then 24 weeks and 48 weeks after surgery. The relative change in BMD was evaluated for regions of interest (ROIs) based on the Gruen zone classifications. 18F-fluoride positron emission tomography (PET) was performed at 24 weeks postsurgery, and the maximum standardized uptake values (SUVmax) were evaluated in the proximal (HA-coated) and distal (non-HA-coated) areas in both groups. RESULTS There were significant differences in BMD loss in ROIs 3 and 6 (p = 0.03), while no significant difference was observed in ROI 7 at either 24 or 48 weeks postsurgery. There was no significant correlation between PET uptake and BMD (24 or 48 weeks) in either group. CONCLUSION The influence of a HA coating in terms of BMD preservation is limited. No significant correlation was found between BMD and SUVmax measured by PET, either with or without the use of a HA coating.
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9.
Principles of fluoride toxicity and the cellular response: a review.
Johnston, NR, Strobel, SA
Archives of toxicology. 2020;(4):1051-1069
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Abstract
Fluoride is ubiquitously present throughout the world. It is released from minerals, magmatic gas, and industrial processing, and travels in the atmosphere and water. Exposure to low concentrations of fluoride increases overall oral health. Consequently, many countries add fluoride to their public water supply at 0.7-1.5 ppm. Exposure to high concentrations of fluoride, such as in a laboratory setting often exceeding 100 ppm, results in a wide array of toxicity phenotypes. This includes oxidative stress, organelle damage, and apoptosis in single cells, and skeletal and soft tissue damage in multicellular organisms. The mechanism of fluoride toxicity can be broadly attributed to four mechanisms: inhibition of proteins, organelle disruption, altered pH, and electrolyte imbalance. Recently, there has been renewed concern in the public sector as to whether fluoride is safe at the current exposure levels. In this review, we will focus on the impact of fluoride at the chemical, cellular, and multisystem level, as well as how organisms defend against fluoride. We also address public concerns about fluoride toxicity, including whether fluoride has a significant effect on neurodegeneration, diabetes, and the endocrine system.
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10.
Developmental fluoride neurotoxicity: an updated review.
Grandjean, P
Environmental health : a global access science source. 2019;(1):110
Abstract
BACKGROUND After the discovery of fluoride as a caries-preventing agent in the mid-twentieth century, fluoridation of community water has become a widespread intervention, sometimes hailed as a mainstay of modern public health. However, this practice results in elevated fluoride intake and has become controversial for two reasons. First, topical fluoride application in the oral cavity appears to be a more direct and appropriate means of preventing caries. Second, systemic fluoride uptake is suspected of causing adverse effects, in particular neurotoxicity during early development. The latter is supported by experimental neurotoxicity findings and toxicokinetic evidence of fluoride passing into the brain. METHOD An integrated literature review was conducted on fluoride exposure and intellectual disability, with a main focus on studies on children published subsequent to a meta-analysis from 2012. RESULTS Fourteen recent cross-sectional studies from endemic areas with naturally high fluoride concentrations in groundwater supported the previous findings of cognitive deficits in children with elevated fluoride exposures. Three recent prospective studies from Mexico and Canada with individual exposure data showed that early-life exposures were negatively associated with children's performance on cognitive tests. Neurotoxicity appeared to be dose-dependent, and tentative benchmark dose calculations suggest that safe exposures are likely to be below currently accepted or recommended fluoride concentrations in drinking water. CONCLUSION The recent epidemiological results support the notion that elevated fluoride intake during early development can result in IQ deficits that may be considerable. Recognition of neurotoxic risks is necessary when determining the safety of fluoride-contaminated drinking water and fluoride uses for preventive dentistry purposes.