Original Article

Effect of Sucrosomial® Iron and Iron Drop Diluted with Natural Fruit Juice on Microhardness of Primary Enamel

Abstract

Objectives: Considering the high prevalence of consumption of iron drops, and the resultant reduction in microhardness of primary enamel, this in vitro study aimed to assess the effects of Sucrosomial® iron and iron drop diluted with natural fruit juice on microhardness of primary enamel. 

Materials and Methods: This in vitro, experimental study evaluated 45 extracted sound primary anterior teeth, that were randomly assigned to three groups (n=15) of Sideral, Irofant, and Irofant + natural apple juice. The titratable acidity and pH of solutions were measured. After measuring the baseline microhardness by a Vickers hardness tester, the teeth in the three groups were exposed to the respective iron drop solutions at 37°C for 5 minutes. They were then rinsed with distilled water, and their secondary microhardness was measured. Data were analyzed using the dependent Student t-test, ANOVA, and ANCOVA (alpha=0.05).

Results: Irofant had the lowest pH and the highest titratable acidity among the tested solutions. A reduction in enamel microhardness occurred in all groups after exposure to iron drops (P=0.0001). The reduction in microhardness was significantly greater in Irofant group compared with Irofant + natural apple juice (P=0.0001). Also, the reduction in microhardness was significantly greater in Irofant + natural apple juice compared with Sideral iron drop group (P=0.0001).

Conclusion: Sideral iron drop with Sucrosomial iron has minimal adverse effect on microhardness of primary enamel. Also, dilution of iron drops with natural apple juice can be suggested as an effective strategy to decrease their adverse effects on microhardness of primary enamel.

1. Miller JL. Iron deficiency anemia: A common and curable disease. Cold Spring Harb Perspect Med. 2013 Mar;3(7):1–13.
2. Lozoff B, Beard J, Connor J, Barbara F, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006 May;64(5 Pt 2):S34–91.
3. Tabari M, Alaghemand H, Rabiee M, Khefri S, Seyyed Ahadi M, Nikpour M-R. The effect of silicone oil and nano-hydroxyapatite/chitosan powder on microhardness and surface structure of primary teeth enamel after iron drop consumption. J Dent Sch. 2013 Jun;31(3):138–47.
4. Mehran M, Mohammadi Bassir M, Jafari S. Effect of two kinds of iron drops on the discoloration, atomic absorption and structural changes of primary teeth enamel. J Dent Med. 2008 Nov;21(4):290–9.
5. Christofides A, Asante KP, Schauer C, Sharieff W, Owusu-Agyei S, Zlotkin S. Multi-micronutrient Sprinkles including a low dose of iron provided as microencapsulated ferrous fumarate improves haematologic indices in anaemic children: a randomized clinical trial. Matern Child Nutr. 2006 Aug;2(3):169–80.
6. Nunn J, Ng S, Sharkey I, Coulthard M. The dental implications of chronic use of acidic medicines in medically compromised children. Pharm World Sci. 2001 Jul;23:118–9.
7. Hotz C, Gibson RS. Complementary feeding practices and dietary intakes from complementary foods amongst weanlings in rural Malawi. Eur J Clin Nutr. 2001 May;55(10):841–9.
8. Sideral Iron Drop [Internet]. Available at: https://juniapharma.it/en/products/sideral-gocce/
9. Irofant Iron Drop [Internet]. Available at: https://kharazmipharm.com/products/irofant/?lang=en
10. Pasdar N, Alaghehmand H, Mottaghi F, Tavassoli M. Experimental study of iron and multivitamin drops on enamel microhardness of primary tooth. J Int Soc Prev Community Dent. 2015 Dec;5(6):518–24.
11. Eskandarian T, Motamedifar M, Hekmatfar S, Tamaddon AM. Comparison of the effect of three types of iron drops on surface roughness of deciduous teeth in a simulated cariogenic environment. J Dent Sch. 2013 Mar;31(1):15–22.
12. Hekmatfar S, Piraneh H, Jafari K. Evaluation of the relationship between pH and titrable acidity of five different of iron supplements with the absorption of iron ions in the anterior primary teeth (an in vitro study). Dent Res J (Isfahan). 2018 Feb;15(5):367–71.
13. Shabzendehdar M, Makarem A, Orafai H, Khashayarmanesh Z, Ebrahimzadeh S. Comparsion of primary enamel discoloration caused by the use of three different iron drops (An in vitro study). J Mashhad Dent Sch. 2006 Aug;30(Issue 3,4):247–54.
14. Rathi N, Baid R, Baliga S, Thosar N. Comparative evaluation of nano-hydroxyapatite preparation and calcium sucrose phosphate on microhardness of deciduous teeth after iron drop exposure - An in-vitro study. J Clin Exp Dent. 2017 Feb;9(4):e579–83.
15. Maguire A, Baqir W, Nunn JH. Are sugars-free medicines more erosive than sugars-containing medicines? An in vitro study of paediatric medicines with prolonged oral clearance used regularly and long-term by children. Int J Paediatr Dent. 2007 Jun;17(4):231–8.
16. Sales-Peres SHC, Pessan JP, Buzalaf MAR. Effect of an iron mouthrinse on enamel and dentine erosion subjected or not to abrasion: An in situ/ex vivo study. Arch Oral Biol. 2007 Feb;52(2):128–32.
17. Cavalcanti AL, De Sousa RIM, Clementino MA, Vieira FF, Cavalcanti CL, Xavier AFC. In vitro analysis of the cariogenic and erosive potential of paediatric antitussive liquid oral medications. Tanzan J Health Res. 2012 Apr;14(2):139–45.
18. Wang YL, Chang CC, Chi CW, Chang HH, Chiang YC, Chuang YC, et al. Erosive potential of soft drinks on human enamel: An invitro study. J Formos Med Assoc. 2014 Jun;113(11):850–6.
19. Xavier AFC, Moura EFF, Azevedo WF, Vieira FF, Abreu MHNG, Cavalcanti AL. Erosive and cariogenicity potential of pediatric drugs: study of physicochemical parameters. BMC Oral Health. 2013 Jan;13(1):71.
20. Bueno MG, Marsicano JA, Sales-Peres SHC. Preventive effect of iron gel with or without fluoride on bovine enamel erosion in vitro. Aust Dent J. 2010 Aug;55(2):177–80.
21. Buzalaf MAR, de Moraes Italiani F, Kato MT, Martinhon CCR, Magalhães AC. Effect of iron on inhibition of acid demineralisation of bovine dental enamel in vitro. Arch Oral Biol. 2006 Apr;51(10):844–8.
22. Alves KMRP, Franco KS, Sassaki KT, Buzalaf MAR, Delbem ACB. Effect of iron on enamel demineralization and remineralization in vitro. Arch Oral Biol. 2011 Apr;56(11):1192–8.
23. Eshghi A, Kowsari-Isfahan R, Rezaiefar M, Razavi M, Zeighami S. Effect of iron containing supplements on rats’ dental caries progression. J Dent (Tehran). 2012 Mar;9(1):14–9.
24. Pecharki GD, Cury JA, Paes Leme AF, Tabchoury CPM, Del Bel Cury AA, Rosalen PL, et al. Effect of sucrose containing iron (II) on dental biofilm and enamel demineralization in situ. Caries Res. 2005 Apr;39(2):123–9.
25. Gómez-Ramírez S, Brilli E, Tarantino G, Muñoz M. Sucrosomial® iron: A new generation iron for improving oral supplementation. Pharmaceuticals. 2018 Oct;11(4):1–23.
26. Ballot D, Baynes RD, Bothwell TH, Gillooly M, Macfarlane J, Macphail AP, et al. The effects of fruit juices and fruits on the absorption of iron from a rice meal. Br J Nutr. 1987 Mar;57(3):331–43.
27. Mehta LK, Hegde A, Thomas A, Virdi MS. Acidogenic potential of packaged fruit juices and its effect on plaque and salivary pH. Int J Clin Pediatr Dent. 2019 Aug;12(4):312–7.
IssueVol 19 (Continuously Published Article-Based) QRcode
SectionOriginal Article
Keywords
Hardness; Dental Enamel; Tooth Deciduous; Sucrosomial Iron

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sahebnazar N, Tavassoli-Hojjati S, Aghaei S. Effect of Sucrosomial® Iron and Iron Drop Diluted with Natural Fruit Juice on Microhardness of Primary Enamel. Front Dent. 2022;19.