The present disclosure relates to a formulation for use in oral teeth, and more particularly relates to a formulation for propylaxising and treating dentin-associated diseases or symptoms.
Dentin, which is also known as “dentine,” is a tissue constituting the tooth matrix, and located between dental enamel and dental pulp. Dentin is composed of 70% of inorganic substance, 20% of organic substance and 10% of water. The hardness of dentin is lower than that of dental enamel, but higher than that of cementum. Dentinal tubules throughout the dentin are arranged radially from the surface of the dental pulp towards the dental enamel. The dentinal tubules are wider at the ends near the dental pulp. The closer toward the surface the dentinal tubules with branches therebetween are, the narrower they are.
Common dentin-associated diseases or symptoms, which cause pain, include dental caries, tooth wearing, enamel loss and dentin hypersensitivity etc.
Dentin hypersensitivity is sometimes referred to as “tooth hypersensitivity” and “hypersensitive dentine.” Currently, various types of products or methods for relieving dentin hypersensitivity have been developed. However, up to now, none of the products or methods can provide a rapid and long-term relieving effect.
Generally, the clinical methods for treating dentin hypersensitivity can fall into the following two categories: (1) chemical desensitizing method; and (2) physical desensitizing method.
As to the chemical desensitizing methods, corticosteroids were used in the early years to suppress inflammation. However, such methods are ineffective. Further, protein precipitation, which is also categorized as a chemical desensitizing method, utilizes a chemical agent to coagulate and denature the proteins in the dentinal tubule. For example, a formulation containing silver nitrate, phenol, formaldehyde or strontium chloride is used to denature collagen, and then forms precipitates which block the openings of the dentinal tubules. However, such formulation stimulates dental pulp and gingival, and the relapse rate is extremely high. Further, silver nitrate dyes teeth black permanently.
Moreover, chemical desensitizing methods also include a treating method for paralyzing pulp nerves. For example, some commercially available desensitizing toothpastes use potassium nitrate to suppress the excitation of pulp nerves. However, the clinical cases have shown that the pain on a patient cannot be relieved until the desensitizing toothpaste is persistently used for two weeks, and the therapeutic effect can last for only several months. That is to say, the methods for paralyzing pulp nerves cannot provide rapid and long-term therapeutic effects. Also, the long-term use of potassium nitrate leads to disorders associated with the paralysis of pulp nerves.
On the other hand, as to the physical desensitizing methods, for example, a sealant for dentinal tubules is used to directly seal the openings of dentinal tubules. The sealant includes, for example, resins, glass ionomer cements or the like. For example, Jensen et al. (“A comparative study of two clinical techniques for treatment of root surface hypersensitivity,” Gen. Dent. 35:128-132) proposed a method for directly sealing the openings of dentinal tubules using a resin-type dentin bonding agent. Although this method can immediately relieve the pain caused by dentin hypersensitivity, it cannot provide a long-term therapeutic effect. More specifically, the clinical cases have shown that, after a 6-months treatment, the resin-type bonding agent detaches significantly from the surfaces of teeth. As to the glass ionomer cements, Low et al. (“The treatment of hypersensitive cervical abrasion cavities using ASAP cement,” J. Oral Rehabil. 8(1):81-9) used glass ionomer cements to treat dentin hypersensitivity in 1981. Although glass ionomer cements can provide therapeutic effects, this type of material will be removed by constantly brushing the tooth. Further, Hansen et al. (“Dentin hypersensitivity treated with a fluoride-containing varnish or a light-curd glass ionomer liner,” Scand. J. Dent. Res. 100(6):305-9) used resin-enhanced glass ionomer cements to treat dentin hypersensitivity, but still no long-term therapeutic effects were achieved.
Recently, formation of precipitates on enamel has been reported that can recover teeth enamel. Nevertheless, the precipitates can only be formed on the surface of teeth, and thus are easily detached from the tooth surface.
Accordingly, it is an urgent and important issue to provide a rapid and efficient effect to relieve dentin-associated symptoms and diseases.
In view of the foregoing, the present disclosure provides a non-aqueous formulation for oral teeth, comprising a source of a metal ion and a source of a phosphate ion. The metal ion is chosen from alkaline earth metals, Zn, Zr or any combination thereof, and a molar ratio of the metal ion to the phosphate ion in the formulation is between about 0.01 and about 1.0. The source of the phosphate ion of the non-aqueous formulation is a kind of soluble phosphates. As applying the formulation for oral teeth of the present disclosure to teeth with dentin-associated symptoms or diseases, the formulation of the present disclosure can rapidly and efficiently treat dentin-associated symptoms or diseases within hours, preferably minutes, by forming precipitates in the dentinal tubules, without the need to use any particulate carrier preformed with the source of metal ions for carrying the metal ions. In addition, the depths of the precipitates in the dentinal tubules are deep enough for the sealing effect of dentinal tubules to be maintained for a long period of time. The aforementioned precipitates are formed by the metal ion and the phosphate ion.
The present disclosure further provides a method for preventing or treating a dentin-associated symptom or disease, comprising administering the aforesaid non-aqueous formulation for oral teeth to the oral cavity of a subject.
In one embodiment, the dentine tubule-associated syndrome is dentin hypersensitivity, crack tooth syndrome, enamel loss, dentin loss or postoperative hypersensitivity. In another embodiment, the dentin-associated disease is dental caries, root caries, tooth fracture, root fracture, cervical abrasion, tooth wearing, root perforation, radicular cyst, apicitis, pulpitis, periapical periodontitis, pulp necrosis or dentin-associated pulp disease.
The present disclosure further provides a method for dental therapy, comprising: providing the aforesaid non-aqueous formulation; and administering the non-aqueous formulation to the oral cavity of a subject by smearing, pasting, attaching or brushing.
The present disclosure can be more fully understood by reading the following detailed description of the embodiments, with reference made to the accompanying drawings, wherein:
The following specific examples are used to exemplify the present disclosure. A person of ordinary skills in the art can conceive the other advantages of the present disclosure, based on the disclosure of the specification of the present disclosure. The present disclosure can also be implemented or applied as described in different specific examples. It is possible to modify and/or alter the above examples for carrying out this disclosure without contravening its spirit and scope, for different aspects and applications.
In order to solve the issues in prior art, the inventors accomplished a non-aqueous formulation for oral teeth after performing a variety of experiments. The formulation comprises a source of a metal ion and a source of a phosphate ion, wherein the metal ion is chosen from alkaline earth metals, Zn, Zr or any combination thereof, and a molar ratio of a metal ion to a phosphate ion in the formulation is between about 0.01 and about 1.0, and wherein the metal ion and the phosphate ion form a precipitate in dentinal tubules of the teeth.
In an embodiment of the formulation for oral teeth, a molar ratio of the metal ion to the phosphate ion in the formulation has a lower limit chosen from 0.01, 0.05, 0.1, 0.15, 0.2, 0.25, 0.3, 0.35, 0.4, 0.45 and 0.5 and an upper limit chosen from 1, 0.9, 0.8, 0.7 and 0.6. In an embodiment of the formulation for oral teeth, a molar ratio of the metal ion to the phosphate ion in the formulation is between about 0.1 to about 1. In an embodiment, the molar ratio of the metal ion to the phosphate ion in the formulation is between about 0.2 to about 1. In an embodiment, the molar ratio of the metal ion to the phosphate ion in the formulation is between about 0.2 to about 0.6.
In an embodiment of the formulation for oral teeth, the formulation is used in combination with water or saliva to form a mixture having a pH value between about 2.0 and about 6. In an embodiment, the pH of the mixture has a lower limit chosen from 2.0, 2.5, 3, 3.5 and 4 and an upper limit chosen from 6, 5.5 and 5. In an embodiment, the pH value of the mixture is between about 2.0 and about 5.5. In an embodiment, the pH value of the mixture is between about 2.0 and about 5.0. In an embodiment, the pH value of the mixture is between about 2.0 and about 4.0. In an embodiment, the pH value of the mixture is between about 3.0 and about 4.0. In an embodiment, the pH value of the mixture is between about 4.0 and about 6.0.
In an embodiment of the formulation for oral teeth, the metal ion may be selected from the group consisting of magnesium ion, calcium ion, strontium ion and barium ion.
In an embodiment of the formulation for oral teeth, the source of the metal ion may be selected from the group consisting of carbonates, acetates, lactates, citrates, chlorides, oxides, nitrates and hydroxides.
In an embodiment of the formulation for oral teeth, the formulation of the present disclosure is preferably non-aqueous. As used herein, the term “non-aqueous” means that the formulation does not include water in such an amount that will prematurely trigger the reaction of the component(s) in the formulation, and/or reduce the stability of the formulation. In an embodiment, the formulation of the present disclosure includes either no water or only traces of water from, for example, salts with water of hydration. In another embodiment, the individual components of the non-aqueous formulation may contain limited amounts of water as long as the overall formulation remains substantially free of water. Thus, in certain embodiments, no water is added to the formulation prior to use.
In an embodiment of the formulation for oral teeth, the source of the phosphate ion may be at least one selected from the group consisting of disodium hydrogen phosphate, dipotassium hydrogen phosphate, lithium dihydrogen phosphate, sodium dihydrogen phosphate, potassium dihydrogen phosphate, trisodium phosphate, tripotassium phosphate, ammonium phosphate, and a phosphate-containing drug.
In an embodiment of the formulation for oral teeth, the phosphate-containing drug may be selected from the group consisting of tetracycline phosphate complex, oleadomycin phosphate, codeine phosphate, estramustine phosphate, primaquine phosphate, dimemorfan phosphate, pyrldoxal phosphate, pyridoxal phosphate, piperazine phosphate, clindamycin phosphate, sodium phosphate, dexamethasone sodium phosphate, oseltamivir phosphate, benproperine phosphate, prednisolone sodium phosphate, betamethasone sodium phosphate, chloroquine phosphate, disopyramide phosphate, etoposide phosphate, fludarabine phosphate, histamine phosphate, hydrocortisone sodium phosphate, sodium biphosphate, ruxolitinib phosphate, sitagliptin phosphate, anileridine phosphate, sonidegib phosphate, oritavancin diphosphate, tedizolid phosphate, antazoline phosphate, estramustine phosphate, codeine phosphate, toceranib phosphate and chromic phosphate P32.
In an embodiment of the formulation for oral teeth, the formulation further comprises an additive, wherein the additive may be a thickening agent, an adhesive, an excipient, a stabilizer, an emulsifier, a humectant, or a combination thereof.
In an embodiment of the formulation for oral teeth, the thickening agent may be selected from the group consisting of methyl cellulose, hydroxyethyl cellulose, carbomer, titanium dioxide, zinc phosphate, zinc oxide, silicon dioxide, silicoaluminate, aluminum oxide and calcium phosphate.
In an embodiment of the formulation for oral teeth, the adhesive may be selected from the group consisting of acacia, alginate, alginic acid, candelilla wax, carnuba wax, corn, starch, copolyvidone, ethyl cellulose, gelatin, glyceryl behenate, hydroxyl propyl cellulose, hydroxyl propyl methyl cellulose, hypromellose, lactose hydrous, lactose anhydrous, lactose monohydrate, lactose spray dried, methyl cellulose, povidone, polyvinylpyrrolidone, polyethylene oxide, potato starch, starch pregelatinized, starch, sodium starch and sodium carboxy methyl cellulose.
In an embodiment of the formulation for oral teeth, the excipient may be pectin, eudragit or a combination thereof.
In an embodiment of the formulation for oral teeth, the formulation may be in the form of a powder, a paste, a flake, a gel, a soft gel, a gum, a semi-solid, a slurry, a patch, an emulsion, a glue, a buccal tablet, a pill, a film, a cream, an aerosol, or an orabase.
According to another aspect of the present disclosure, the present disclosure further provides a method for preventing or treating a dentin-associated symptom or disease, comprising the step of administering the aforesaid non-aqueous formulation of the present disclosure to the oral cavity of a subject. More specifically, the dentin-associated symptoms which can be prevented or treated by the method of the present disclosure are not limited, and may include dentin hypersensitivity, crack tooth syndrome, enamel loss, dentin loss, and postoperative hypersensitivity. Enamel loss or dentin loss is generally caused by corrosion, abrasion, wearing or cracking to the teeth. Postoperative hypersensitivity generally occurs after dental operations such as teeth bleaching, prosthodontic and restoration.
Further, the diseases which can be prevented or treated by the method of the present disclosure are not limited, and preferably include dental caries, root caries, tooth fracture, root fracture, cervical abrasion, tooth wearing, root perforation, radicular cyst, apicitis, pulpitis, periapical periodontitis, pulp necrosis, and dentin-associated pulp disease.
According to another aspect of the present disclosure, the present disclosure provides a method for dental therapy, comprising the steps of: providing the aforesaid non-aqueous formulation; and administering the non-aqueous formulation to the oral cavity of a subject by smearing, pasting, attaching or brushing.
KH2PO4 and K2HPO4 were ground and mixed well with SiO2 as a thickening agent, and then CaCl2 powder was added thereto and mixed well to form a solid material. The solid material was then mixed with water to obtain Samples 1-6. The amounts of SiO2, KH2PO4, K2HPO4 and CaCl2 powder in Samples 1-6, as well as the molar ratios of calcium ion to phosphate ion (Ca/P) and the pH value of Samples 1-6 were shown in the following Table 1.
Preparation of the formulations having molar ratio of calcium ion to phosphate ion of 0.2 or 0.6 with different pH values was the same as that described in Example 1. The amounts of SiO2, KH2PO4, K2HPO4 and CaCl2 powder in Samples 7-9, as well as the molar ratio of calcium ion to phosphate ion and the pH value of Samples 7-9 were shown in the following Table 2.
In addition to calcium ion, the other ions of alkaline earth metals such as Mg and Sr would create precipitation with phosphate ion. Further, in dentistry, Zn and Zr are commonly used and have low toxicity for human, and they could also create precipitation with phosphate ion. Thus, the inventors additionally used the magnesium ion, strontium ion, zinc ion and zirconium ion to accomplish the present disclosure.
Preparation of the formulations having magnesium ion, strontium ion, zinc ion or zirconium ion was the same as that described in Example 1. The amounts of SiO2, KH2PO4, K2HPO4 and MgCl2 powder, SrCl2 powder, ZnSO4.7H2O powder or ZrOCL2 powder in Samples 10-13, as well as the molar ratio of metal ion to phosphate ion (i.e., Mg/P, Sr/P, Zn/P or Zr/P) and the pH values of Samples 10-13 were shown in the following Table 3.
Preparation of the formulations respectively having different kinds of thickening agents was the same as that described in Example 1. The amounts of KH2PO4, K2HPO4, CaCl2 powder and the thickening agent (zinc phosphate, methyl cellulose, carbomer, titanium dioxide or calcium phosphate) in Samples 14-18, as well as the molar ratio of calcium ion to phosphate ion and the pH value of Samples 14-18 were shown in the following Table 4.
Preparation of the formulation in a form of orabase was similar to that described in Example 1 except that the solid material containing CaCl2 and KH2PO4 was mixed with water and then incorporated into to Carboxe orabase, so as to obtain Sample 19. Carboxe orabase is a hydrophobic substance and contains Carbenoxolone. If the orabase is applied to oral cavity and mixed with saliva, it will become thick and release hydrophilic substances therein, thereby treating mouth wounds.
The amounts of CaCl2 and KH2PO4 powder and Carboxe orabase in Sample 19, as well as the molar ratio of calcium ion to phosphate ion and the pH value of Sample 19 were shown in the following Table 5.
Twenty premolars and molars, provided with complete crowns having no caries and no fillers, just removed from a human were collected.
An ultrasonic dental scaler (Sonicflex 2000, Kayo Co Biberbach, Germany) was used to remove dental calculus and periodontal tissues from the premolars and molars. Then, the premolars and molars were stocked in 4° C. distilled water, so as to maintain the freshness of the dentin.
Before applying the formulation, the teeth were taken out of the water, and the enamel at the occlusion site was removed in a horizontal direction using a low speed saw (Isomet low speed saw, Buehler, LTD.), and incised at a distance of 1.5 mm along the direction of the neck to obtain a specimen of dentin. Then, a tapered fissure bur (1961 tapered fissure bur) was used to create a groove on the back of the experimental area of each of the specimens, to guide the direction of future incision of the specimens. Thirty-seven point five percent of phosphoric acid as gel etchant (Kerr Co USA) was used to acid etch the specimens up to 40 seconds. Then, a large amount of distilled water was used to wash the coating layer, and the surfaces of the specimens were blow-dried.
The formulations of Samples 1-6 recited in Example 1, Samples 7-9 recited in Example 2, Samples 10-13 recited in Example 3, Samples 14-18 recited in Example 4 and Sample 19 recited in Example 5 were used to coat the specimens, respectively, by the following approaches.
To examine the sealing effect on dentin of the formulation of Sample 1 recited in Example 1, the formulation was applied on the surfaces of tooth samples, allowing it to react for 10 minutes, 10 minutes with 3 minutes/3 minutes/4 minutes intervals, 30 minutes with 6 times 5 minutes intervals, 0.5 day, 1 day and 2 days.
Then, a field emission scanning electronic microscope (SEM; Field Emission Scanning Electronic Microscope Hitachi S-800, Hitachi Co., Tokyo, Japan) was used to observe the depth of the precipitates in the dentinal tubules in each of the samples.
To examine the sealing effect of the formulations of Samples 1-3 with different molar ratios of calcium ion to phosphate ion and a pH value of 2 recited in Example 1, each of the formulation of Samples 1-3 was applied on the surfaces of tooth samples, allowing it to react for 30 minutes. Then, the depth of the precipitates in the dentinal tubules of each of the specimens was observed by SEM.
To examine the sealing effect of the formulations of Samples 7-9 with molar ratio of calcium ion to phosphate ion of 0.2 and pH values of 3.5, 4 and 5 on dentin, each of the formulation of Samples 7-9 was applied on the surfaces of tooth samples, allowing it to react for 1 hour or 1 day. Then, the depth of the precipitates in the dentinal tubules in each of the specimens was observed by SEM.
To examine the sealing effect of the formulations of Samples 10-13 with a molar ratio of metal ion to phosphate ion (i.e., Mg/P, Sr/P, Zn/P or Zr/P) of 0.2 and a pH value of 2 or 3, each of the formulation of Samples 10-13 was applied on the surfaces of tooth samples, allowing it to react for 1 day. Then, the depth of the precipitates in the dentinal tubules in each of the specimens was observed by SEM.
To examine the sealing effect of the formulations of Samples 14-18 with a molar ratio of calcium ion to phosphate ion of 0.2, a pH value of between 2-3 and an additive (zinc phosphate, methyl cellulose, carbomer, titanium dioxide or calcium phosphate), each of the formulation of Samples 14-18 was applied on the surfaces of tooth samples, allowing it to react for 1 day. Then, the depth of the precipitates in the dentinal tubules in each of the specimens was observed by SEM.
To examine the sealing effect of the formulation of Sample 19 in a form of orabase, the formulation of Sample 19 was applied on the surfaces of tooth samples, allowing it to react for 1 day. Then, the depth of the precipitates in the dentinal tubules in each of the specimens was observed by SEM.
To determine whether the phosphate-containing drug comprised in the formulation of the present disclosure enters into the dentinal tubules, the quantity and the permeability of the phosphate-containing drug released from the formulation of the present disclosure coated on the dentin were evaluated by high-performance liquid chromatography (HPLC) assay. Before HPLC, the formulation comprising the phosphate-containing drug was applied on the surfaces of tooth samples, allowing it to react for 1 day. Then, the substance penetrated through the dentinal tubules was collected to be analyzed. The assays for the formulation of Samples 20 and 21 containing the phosphate-containing drug were respectively performed as follows.
Preparation of Standard 1:
Betamethasone sodium phosphate RS (reference standard) was dissolved in a mixture of methanol and water (3:2), and then diluted to a concentration of about 0.16 mg/ml.
Preparation of Sample 20:
KH2PO4 was ground and mixed well with SiO2 as thickening agent, and then CaCl2 powder and betamethasone sodium phosphate were added thereto and mixed well to form a solid material. The solid material was then mixed with water to obtain Sample 20. The amounts of SiO2, KH2PO4, CaCl2 powder and betamethasone, as well as water in Sample 20 were shown in the following Table 11.
Preparation of Mobile Phase:
A mixture of methanol and 0.07 M anhydrous monobasic potassium phosphate (3:2) was degassed.
High-performance liquid chromatography was performed by separately injecting equal volumes (about 20 μl) of Standard 1 and Sample 20 into a 4.0 mm×30 cm column that contains packing L1, and the flow rate was about 1.5 ml/min. Betamethasone sodium phosphate RS was detected with a 254 nm detector. The content of betamethasone sodium phosphate in Sample 20 was calculated as following formula:
(As/At)×(weight of Standard 1/weight of Sample 20)×(50/100)×(0.7/volume of Sample 20)×F×100
As represents average area of betamethasone sodium phosphate in Standard; At represents area of betamethasone sodium phosphate in Sample, and F represents content of the standards in percentage.
As shown in
Preparation of Sample 21:
KH2PO4 was ground and mixed well with SiO2 as thickening agent, and then CaCl2 powder and clindamycin phosphate were added thereto and mixed well to form a solid material. The solid material was then mixed with water to obtain Sample 21. The amounts of SiO2, KH2PO4, CaCl2 powder and clindamycin phosphate, as well as water were shown in the following Table 12.
Preparation of Buffer Solution:
14 ml of phosphoric acid was added to 4000 mL of HPLC grade water, and then added 10 ml of ammonium hydroxide thereto, and finally adjust with ammonium hydroxide to a pH value of 3.90±0.05.
Preparation of Organic Solution:
Acetonitrile was mixed with methanol in a ratio of 9:1.
Preparation of Diluent:
The buffer solution was mixed with the organic solution in a ratio of 8:2.
Preparation of Solution I:
The buffer solution was mixed with the organic solution in a ratio of 92:8.
Preparation of Solution II:
The buffer solution was mixed with the organic solution in a ratio of 52:48.
Preparation of Mobile Phase:
The solution I was mixed with the solution II in a ratio to prepare the mobile phase.
Preparation of Standard 2:
42.7 mg of USP clindamycin phosphate RS was dissolved in 20 ml of dilute to prepare the Standard 2.
HPLC was performed by separately injecting equal volumes (about 20 μl) of Standard 2 and Sample 21 into a 4.6 mm×25 cm column that contains packing L7, and the flow rate was about 1.2 ml/min Clindamycin phosphate was detected with a 214 nm detector. The quantity, in percentage, of clindamycin in the portion of clindamycin phosphate was calculated as following formula:
(As/At)×(weight of Standard 2/weight of Sample 21)×(100/20)×(50/1)×(50/5)×(0.7/volume of Sample 21)×F
As shown in
In this example, a formulation of Sample 22 containing betamethasone sodium phosphate was provided. Preparation of the formulation of Sample 22 was similar to those described in the above examples. The Ca/P ratio and pH value of the formulation of Sample 22 were 0.25 and 4, respectively. To examine the sealing effect of the formulation containing the phosphate-containing drug, the formulation of Sample 22 was applied on the surfaces of tooth samples, allowing it to react for 1 day. Then, the depth of the precipitates in the dentinal tubules in each of the specimens was observed by SEM.
The disclosure has been described using exemplary preferred embodiments in detail in the above. However, it is to be understood that the scope of the disclosure is not limited to the disclosed embodiments. On the contrary, it is intended to cover various modifications and similar rearrangement. The scope of the claims therefore should be accorded the broadest interpretation so as to encompass all such modifications and similar arrangements.