CA2226448A1 - Composition and method for remineralization of teeth - Google Patents
Composition and method for remineralization of teeth Download PDFInfo
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- CA2226448A1 CA2226448A1 CA002226448A CA2226448A CA2226448A1 CA 2226448 A1 CA2226448 A1 CA 2226448A1 CA 002226448 A CA002226448 A CA 002226448A CA 2226448 A CA2226448 A CA 2226448A CA 2226448 A1 CA2226448 A1 CA 2226448A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61Q—SPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
- A61Q11/00—Preparations for care of the teeth, of the oral cavity or of dentures; Dentifrices, e.g. toothpastes; Mouth rinses
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K8/00—Cosmetics or similar toiletry preparations
- A61K8/18—Cosmetics or similar toiletry preparations characterised by the composition
- A61K8/19—Cosmetics or similar toiletry preparations characterised by the composition containing inorganic ingredients
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K8/00—Cosmetics or similar toiletry preparations
- A61K8/18—Cosmetics or similar toiletry preparations characterised by the composition
- A61K8/19—Cosmetics or similar toiletry preparations characterised by the composition containing inorganic ingredients
- A61K8/20—Halogens; Compounds thereof
- A61K8/21—Fluorides; Derivatives thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K8/00—Cosmetics or similar toiletry preparations
- A61K8/18—Cosmetics or similar toiletry preparations characterised by the composition
- A61K8/19—Cosmetics or similar toiletry preparations characterised by the composition containing inorganic ingredients
- A61K8/24—Phosphorous; Compounds thereof
Abstract
This invention relates to non-aqeuous compositions and method utilizing same which are useful to remineralize subsurface dental enamel. More specifically, this invention relates to stable, single-part compositions containing calcium and phosphate salts which may be in a hydrophilic, non-aqueous vehicle and which when applied to lesions in dental enamel result in remineralization of subsurface dental enamel and/or mineralization of tubules in dentin thereby counteracting caries and/or hypersensitivity.
Description
-It is suggested as.. Composition and Method For Remineralization of Teeth...
BACKGROUND OF THE INYENTION
1. F1eld of the Invent~on Th~s ~nvent~on relates to non-aqueous compos~t~ons and processes ut11~z~ng same wh1ch are useful to rem~neral~ze subsurface dental enamel. More spec~flcally, th1s ~nvent~on relates to stable. s~ngle-part composlt10ns conta1n~ng calc~um and phosphate salts wh~ch may be ln a hydroph~llc, non-aqueous veh1cle and whlch when appl~ed to les~ons 1n dental enamel result ln rem~neral~zat10n of subsurface dental enamel and/or m~nerallzat10n of tubules 1n dent~n thereby counteract~ng car~es and/or hypersenslt~Y~ty.
BACKGROUND OF THE INYENTION
1. F1eld of the Invent~on Th~s ~nvent~on relates to non-aqueous compos~t~ons and processes ut11~z~ng same wh1ch are useful to rem~neral~ze subsurface dental enamel. More spec~flcally, th1s ~nvent~on relates to stable. s~ngle-part composlt10ns conta1n~ng calc~um and phosphate salts wh~ch may be ln a hydroph~llc, non-aqueous veh1cle and whlch when appl~ed to les~ons 1n dental enamel result ln rem~neral~zat10n of subsurface dental enamel and/or m~nerallzat10n of tubules 1n dent~n thereby counteract~ng car~es and/or hypersenslt~Y~ty.
2. The Prtor Art The pr~mary component of the enamel and dentln ~n teeth ls calc1um phosphate ~n the form of calc~um hydroxyapatlte. Thls mater1al ~s W O 97/05854 PCT~US96/12189 hlghly lnsoluble at normal oral pHs. However, carlous leslons form 1n teeth, when they are sub~ected to acids produced from the glycolys1s of sugars by the act10n of varlous oral bac-ter1a. Thls 1s because calc1um phosphate saltsare more soluble 1n ac1dlc medla.
Sallva ls supersaturated wlth respect to calclum and phosphate lons. Sallva therefore helps protect teeth agalnst demlnerallzatlon and can slowly remlnerallze teeth whlch have become demlnerallzed by aclds. It ls well known that the presence of fluorlde lons can enhance the natural remlneral1zat10n process and th1s ls one of the accepted mechanlsms by wh1ch fluorlde toothpastes and rlnses protect agalnst cartes.
The efflcacy of fluor1de conta1n1ng toothpastes and r1nses to rem1neral1ze teeth 1s llm1ted by the modest levels of calc1um and phosphate ln sallva. It ls evldent from the pr10r art that lt ls hlghly deslrable to lncrease the avallable concentratlon of calclum and phosphate lons ln the oral cavlty to speed up the remlnerallzatlon process. However, because of calclum phosphate's low solubllltY at the pH of sallva the addltlon of hlgher levels of d1ssolved calclum and phosphate lons ls not eas11y accompllshed.
Rem1neral1zat10n of dental enamel has been carrled out exper1mentally both ln vlvo and W O 97/05854 PCTtUS96tl2189 ~n v~tro. Some stud~es have concentrated on the 7 rem~neral~z~ng propert~es of sal1va and synthettc solut~ons supersaturated w~th respect of hydroxyapat~te. Sucn stud~es compr~se the sub~ect matter of U.S. Patent Nos. 3,679,360 (Rub1n) and 4,097,935 (Jarcho).
Generally, the supersaturated solut~ons or slurr~es used ~n these patents for rem~neral~zat~on exper~ments have been prepared from a s~ngle form of calc~um phosphate. When a car~ous les~on ~s flooded w~th one of these supersaturated solut~ons, the calc~um and phosphate ~ons ~n the form of prec~p~tated hydroxyapat~te rem~neral~ze the les10n.
However, these solutlons are ~mpract~cal for use for several reasons. F~rst, the amount of calc~um and phosphate ~ons ava~lable for rem~neral~zat~on ~n these supersaturated solut~ons ~s too low. It ~s reported that ~t takes approx~mately 10,000 unlt volumes of the usual supersaturated solut10n to produce one un~t volume of m~neral. Thus, remtneral~zat10n by th~s method requ~res both an excess1ve volume of flu~d and an excess~ve number of appl~cat~ons. The supersaturated solut~ons are ~nherently l~m~ted ~n th~s respect because they cannot ma~nta~n the~r supersaturated state. When the hydroxyapat~te WO 97/05854 PCT~US96/12189 prec~p~tates out to the po~nt where the solut~on ~s no longer supersaturated, new supersaturated solut70n must be ~ntroduced or the remlneral~zat~on process stops.
Another problem w~th s~ngle calc1um phosphate slurr~es ~s that as the hydroxyapat~te prec~p~tates out of solutlon, the pH of the solut~on chsnges. Unless the old solut~on ~s removed from contact w~th the tooth mater~al, the solut~on may become too ac~dic or alkal~ne and damage the dental t1ssue.
U.S. Patent No. 4,080,440 (D~g~ul~o et al) d~scloses a metastable solut10n of calc~um and phosphate ~ons at a low pH (between 2.5 to 4.0) underwh~ch cond~t~ons the solub~l~ty of calc~um phosphate salts ~s h~gh. After penetrat~on of the solut~on ~nto demineral~zed enamel, rem~neral~zat~on results from the prec~p~tat10n of calc1um phosphate salts when the pH r~ses. Fluor~de ~ons can be ~ncluded ln the metastable solut~on. A s~gn~f~cant d~sadvantage of the use of metastable solut~ons ~s that the relat~vely low pH m~ght dem~neral~ze the dental enamel and/or ~n~ure other t~ssue.
U.S. Patent Nos. 4,177,258, 4,183,915 and 4,348,381 (Gaffar et al) prov1de for a remlnerallz~ng solut~on conta~n~ng supersaturated concentrat~ons of calc~um 10ns, phosphate tons and a fluor~de source stab~l~zed -by the presence of an ant~nucleat~ng agent such as d1am~ne tetramethylenephosphon~c ac~d, ethylened~am~ne tetramethylenephosphon~c ac~d and 2-phosphonobutane-tr~carboxyl~c ac~d-1,2,4, or the water-soluble salts thereof. Th~s solut1on ~s preferably ad~usted to the neutral pH range where lt ~s alleged to most effectlvely rem~neral~ze sub-surface les~ons. Even though the ant~nucleat~ng agent would be expected to stab~l~ze the solut~on, equ~llbr~um of the supersaturated concentrat~ons ~s st~ll found d~ff~cult to ma~nta~n and avo~d preclp~tat~on of hydroxyapat~te and changes ~n the pH of the solut1on.
U.S. Patent Nos. 4,083,955 (Grabenstetter et al) and 4,397,837 (Raaf et al) prov~de a process for rem~nerallz~ng dem~neral~zed enamel by the consecut~e treatment of tooth surfaces w~th separate solut~ons conta~n~ng calc~um ~ons and phosphate lons. In th~s process fluor1de ~ons may be present ~n the phosphate solut~ons. It ls ~mmater~al wh1ch ~on~c solut10n ls used to treat the teeth f~rst. By sequent~ally apply~ng calcium and phosphate lons to the tooth surface h~gh concentrat~ons of the ~ons are able to penetrate ~nto les~ons ~n solut~on form, where they prec~p~tate as a calc~um phosphate salt when ~ons from the second treatment solut~on d~ffuse ~n. Wh~le apparently successful thls method lnvolves the ~nconven~ence of a plural~ty of sequentlal appl~cat~ons wh~ch can also be found to be t~me consum~ng.
Thus, the problem wtth known rem~nerallzat~on composltlons and techntques ~s that there ~s not a one-part, stable rem~neral~z~ng compos~tlon that may be su~tably prepared as a mouthwash or r~nse and can be ~ncorporated lnto other dent~fr~ce composit~ons such as a toothpaste or gel, troche, chew~ng gum, lozenge and the l~ke.
There ~s a need for a method of reminerallz~ng dental enamel wh~ch employes a stable, s~ngle-part rem~nerallz1ng compos{t~on and does not requ1re excess~ve amounts of solutlon and ~nord~nately long or frequent exposure t1mes.
It ~s the ob~ect of the present lnvent~on to prov~de a s~ngle-part stable compos~t~on and process for the rem~neral~zat~on and the prevent~on of demlneral~zat~on of human teeth, wh~ch process and composlt~on are capable of effect~vely ~ncorporat~ng calc~um ~ons, phosphate ~ons and fluorlde ~ons into the dental enamel, the compos~t~on also be~ng eas~ly usable by the consumer and not d~ffer~ng s7gn~f~cantty, ~n flavor and appearance, from customary dental cosmet1cs.
SUMMARY OF THE INVENTION
In accordance w~th the present ~ tnvent~on the problems of rem~neral~zatton, w~thout dem~neraltzat~on are solYed by apply~ng to the teeth a stable, s~ngle-part compos~t~on wh~ch conta~ns rem1neral~zat~on components wh~ch do not react w~th one another unt~l ~ntroduced ~nto the oral cav~ty. The compos~t~on conta~ns at least one water-soluble calc~um compound and at least one water-soluble ~norgan~c phosphate compound and, opt~onally, at least one water-soluble fluor~ne compound. In th~s way the ~ons whlch effect rem~neral~zat~on can be absorbed by the dental enamel and the~r subsequent react10n causes reharden~ng of dem~nerallzed areas ~n the dental enamel.
It has been found that effect~ve rem~neral1z~ng treatments can be prepared by prov~d~ng non-aqueous solut~ons or preparat~ons of soluble salts conta~n~ng h~gh concentrat~ons of calc~um, phosphate and, ~f des~red, fluor~de ~ons and apply~ng them to teeth at moderate pHs.
However, the calc~um ~ons must be prevented from react~ng w~th the phosphate ~ons or fluor~de Z5 ~ons untll ~mmed~ately before use.
In one embod~ment of the ~nvent~on, a non-aqueous toothpaste or gel ~s prov~ded = =
compr1s~ng at least one water-soluble calc1um salt, at least one water-soluble phosphate salt, ~f des1red at least one water-soluble fluorlde compound y1eldlng fluor~de ~ons, and a hydroph11~c, non-aqueous veh1cle whlch ~s water soluble and where~n, when the compos~t~on ~s contacted w~th water, the result1ng solutton has a pH of between about 4.5 and 10Ø
The stable, s~ngle-part system, 1n the form of toothpastes, gels, profess1Onal gels, 1.e., those wh~ch are appl~ed profess1Ona11y or are obta1ned by a prescr~ptlon, mouthwashes or r~nses. troches, chew~ng gums, lozenges, and the l~ke contaln from about 0.05X to about 15X
water-soluble calc~um salt, from about 0.05X to 15X water-soluble phosphate salt, 7f des1red from about O.Ol~ to 5.0X fluor~de releaslng agent, and su1table pH ad~ust1ng compounds, l.e., ac~ds or bases, such that the pH 1s between about 4.5 and 10.0, and preferrably between about 5.0 and 7Ø Compos~t1Ons may be appl1ed d1rectly to the teeth and solub111zed w~th sal1va or are m1xed w1th water, solub111zed and 1mmed1ately appl1ed to the teeth be1ng treated. It has been found that such comblnat1Ons produce rap~d rem1neral1zat1On of les1Ons and are much more effect~ve than convent1Onal fluor~de conta~n~ng toothpastes 1n rem~neral1zlng teeth.
W O 97/05854 PCT~US96/12189 The stable, s~ngle-part system may also be ~n the form of a dry-m~x concentrated product wh~ch may be d~luted w~th water to prepare a mouthwash or otherw~se treated or m~xed to make other products. The dry-m~x product may be ~n the form of a powder, granular mater~al, flake, tablet or the l~ke. Th~s embod~ment conta~ns from about l.OS to 80.0X of the calc~um salt and the phosphate salt. Other ad~uvants may, of course, be ~ncluded.
The compos~t~ons of the ~nvent~on g~ve substant~ally lmproved rem1neral~zat~on and preventton of dem~neral~zat~on of human teeth as compared wlth pr~or art compos~t~ons.
The d~sadvantages of the pr~or art methods are overcome by the present ~nvent~on wh~ch effects subsurface rem~neral~zat~on rather than surface remlneral~zat~on. S~nce dental car~es beg~ns as a subsurface dem~nerallzat10n of the dental enamel, subsurface rem~neral~zat~on arrests and repa~rs the car~ous les~on before any permanent structural damage to the tooth occurs. The present ~nvent~on does not requ1re preparat~on of the enamel surface, capp~ng of the tooth, or removal of decay products. Further, the present ~nvent~on may be conven~ently pract~ced by the publ~c w~thout substant~ally chang~ng the~r dental care habits.
DESCRIPTION OF THE INVENTION
The present ~nvent~on l~es ~n the d~scovery that dental enamel may be remtneral~zed by the appl~cat~on of certa~n soluble salts y~eld~ng ~ons whlch w111 react to form a des1rable rem~neral~z~ng precip~tate. The crux of the ~nvent~on cons~sts of the use of a stable, one-part system ~n the form of paste, gel, granules, powder, f lakes, non-aqueous solutlon, etc, conta~n~ng water-soluble salts whlch are placed ~n contact wtth the tooth surface. Sal1va ~n the mouth causes d~ssolut~on of the soluble salts allow~ng the selected cat~ons and an~ons to d~ffuse through the tooth lS surface to the dem~neral~zed subsurface w~th the cat~ons and an~ons form~ng a prec~p1tate wh~ch ~s bound to the tooth structure. As a result, the tooth's subsurface ~s rem~neral~zed when an effecttve amount of the rem~neral~zat~on system 1s ut~l~zed.
As d~scussed above, the compos~t~ons of the ~nventlon are preferably non-aqueous. By ~non-aqueous~ ~s meant that the compos~ttons do not ~nclude water In such an amount that ~t w~ll adversely affect the stab~l~ty requ1red by the rem~neral~zation compos~t~on of the ~nvent~on, WO 97/05854 PCT~US96/12189 l.e., the components of the composltlons of the lnventlon do not contaln slgn~flcant quantlt~es - of free water. However, they may contaln salts wlth water of hydrat~on. Preferably, the composltlons of the lnventlon lnclude elther no water or only traces of water.
By "effectlve amount of remlnerallzlng system or agent" ls meant an amount when used ln accordance w~th thls lnventlon will brlng about the remlnerallz~ng of teeth havlng car10us leslons, or the mlneral~zlng of normal teeth to prevent carles from form1ng and to ~nhlb~t hypersens1tlvity by utlllzlng a toothpaste, gel, or mouthwash havlng the varlous components ln the amounts set forth below.
Concentrat~ons of the soluble salt are from about O.OS to 15X or the l~mlt of solubll~ty of the salt. Excess salt can be present, ~f deslred. Concentratlons from about zo O.lOX to lOX are preferred. The concentrat~ons of the soluble salts contaln~ng the des~red an~ons are essentlally the same as those for the water-soluble salts contaln~ng the deslred cat~ons.
Although many prec~p~tates are w~thln the broad scope of thls lnventlon, by depos~tlng a preclpltate less soluble than the orlglnal enamel, the remlnerallzed subsurface can be made WO 97/05854 PCT~US96/12189 to be more res~stant to dem~neral~zat~on than was the orlg~nal enamel. When a fluor~de salt ls ut~l~zed which y~elds fluor~de tons, the remlnerallzed enamel ~s even more reslstant to dem1neral~zat~on than was the or1glnal enamel.
The concentratlon of salt contalnlng fluor~de lon ln the solutlon may be from about O.OlX to 5.0X, but from about 0.02~ to 2.0~ ls preferred.
~n order to effect rem1nerallzat~on of the dental enamel. an effectlve amount of the deslred cat~ons and a lons must be employed 1n the oral cav1ty. ~he amount of solutlon ln the mouth must conta1n at least 100 ppm of des~red catlons and 100 ppm of des~red anlons and preferably conta~ns more than 1,000 ppm of deslred catlons and 1,000 ppm of deslred anlons.
It ls preferred to prov~de a level of fluor~de lons between about 20 ppm to 5,000 ppm ln the oral cavlty from the dent~fr~ce or profess~onally appl~ed or prescr~bed gel.
Wh~le the length of t~me of contact between the dlssolved salts and the tooth's surface ~s not cr~t~cal, lt ~s necessary for the length of t~me to be great enough to allow dlffuslon of the ~ons through the tooth's surface to the demlneral~zed subsurface. It ls submltted that at least ten seconds ls requlred for th~s d~ffus~on and preferably ~t should be W 097/05854 PCT~US96/12189 greater than th~rty seconds and even longer ~f poss~ble.
After d~ssolv1ng ~n the sal~va the solut~on should have a pH of from about 4.5 to 10.0 and preferably between about 5.0 and 7.0 before and after the prec~p~tatlon react~on, and be otherw~se compat~ble ~n the oral env~ronment.
~h~le some prec~p~tatlon may occur upon solub~l~zat~on or upon appl~cat~on to the teeth, not all of the ~ons should comb~ne prematurely ~n the solut~on to form a prec~p~tate, but must be able to d~ffuse through the surface of the tooth to a dem~neraltzed subsurface area and be able to form an ~nsoluble salt wlth the~r respect~ve counter~ons.
The compos~t~ons ut~l~zed and the ~nsoluble prec~p~tates must have acceptable levels of tox~c~ty t~.e., the part~cular ~ons, ~n the amounts used 1n the rem1neral~zat~on process, must be non-tox~c).
In a preferred embod1ment of the present ~nvent~on, the stable, one-part, non-aqueous rem~neral~z~ng compos~tton conta1ns about 0.05X to 15X, preferably about O.lOX to lOX of a water-soluble calc~um salt y~eld1ng calc~um ~ons, from about O.OSX to 15X, preferably about O.lOX to lO~, of a water-soluble phosphate salt y~eld~ng phosphate lons and from a~out O.OlX to 5.0X, preferably from about 0.02~ to 2.0X, of a soluble fluorlde - salt yield1ng fluor1de ~ons ~n a hyroph~l~c, non-aqueous veh1c1e wh1ch ~s water-soluble. The pH of the compos1t~on ~n the oral caY1ty ~s between about 4.5 and 10.0, preferably between about 5.0 and 7Ø
The result~ng preclp~tate ~s a calc1um phosphate or hydroxyapat~te, the natural const~tuent of tooth enamel, with ~ncorporated fluor~de lons. Not only does thls process result 1n rem1neral1zed enamel, but the rem1neralized enamel may be more res~stant to subsequent dem~neral1zat~on than was the or~g~nal enamel.
As the calclum compound ~t ~s, ~n pr~nc~ple, poss1ble to employ, 1n the preparat~ons of the 1nYent~on, all water-soluble tox~colog~cally harmless calc~um compounds. A
compound ~s cons~dered to be water-soluble when at least 0.25 gram thereof d1ssolYes 1n 100 ml of H20 at 20~ C.
Su~table water-soluble calclum compounds are, for example, calc~um chlorlde, calc~um brom1de, calc~um n~trate, calc~um acetate, calc~um gluconate, calc1um benzoate, calc~um glycerophosphate, calc~um formate, calcium fumarate, calc1um lactate, calclum butyrate and calc~um ~sobutyrate, calc1um malate, calclum maleate, calc1um prop10nate, - calc1um valerate or m1xtures of water-soluble calc1um compounds. Calctum n1trate 1s preferred.
In the compos1t10ns of the ~nvent10n for the remtneral1zat10n of human dental enamel, at least about 100 ppm of calc1um 10ns should be present; the upper l~m~t 1s about 35,000 ppm of calc1um 10ns.
Su1table water-soluble 1norgan1c phosphates with1n the scope of the present 1nvent10n are, for example, alkall salts and ammon1um salts of orthophosphorlc ac1d, such as potass1um, sod1um or ammonlum orthophosphate, monopotass1um phosphate, d1potass1um phosphate, tr1potass1um phosphate, monosod1um phosphate, d1sod1um phosphate and tr~sod1um phosphate. The concentrat10n of the phosphate 10ns 1s preferably about 100 ppm to 40,000 ppm;
solub111ty 1n water 1s def1ned as ~n the case of the calc~um compounds.
If deslred, water-soluble salts y1eld1ng both calc~um and phosphate 10ns, such as monobas1c-calc~um orthophosphate, may be employed. The compos~t10ns of the 1nvent10n for the rem1neral1zat10n or preYent1on of dem1neral1zat10n of human teeth preferably also conta1n water-soluble fluor~de compounds, the car1es-prophylact~c act1v1ty of wh1ch has for a long t1me been cons~dered to be establ1shed.
Su~table fluor~de compounds are the alkall fluor~des such as sod~um. potass~um, llth~um or ammon~um fluorlde. t~n fluor1de, ~nd~um fluor~de, z~rcon~um fluor~de, copper fluorlde, n~ckel fluor~de, pallad~um fluor~de, fluoroz1rconates such as sodlum, potass~um or ammonlum fluoroz~rconate or t~n fluoroz~rconate, fluoros~l~cates, fluoroborates, fluorostann~tes.
Organ~c fluor1des, such as the known amine fluor~des are also su~table for use ~n the compositlons of the ~nvent~on.
Water-soluble alkal~ metal monofluor-ophosphates such as sod~um monofluorophosphate, l~th~um monofluorophosphate and potasslum monofluorophosphate. preferably, sod~um monofluorophosphate may be employed. In add~t~on other water-soluble monofluorophosphate salts may be employed ~nclud~ng ammon~um monofluoro-phosphate alum~num monofluorophosphate, and the l~ke.
Su1table hydrophll~c, non-aqueous veh~cles for use ~n the present ~nvent~on include polyalkylene glycols, the humectant polyols such as glycerine, propylene glycol, d~propylene glycol and hexylene glycol.
Glycer~n, propylene glycol and polyethylene glycol are preferred. As used here~n, ~propylene glycol~ lncludes l,2-propylene glycol and 1,3-propylene glycol.
WO 97/05854 PCT~US96/12189 For a mouthwash ethyl alcohol could also be used as a veh~cle. Such a product would be added to water 1mmedlately before be~ng used.
Non-lontc surfactants could be used as the hydrophlllc, non-aqueous vehlcle ln the toothpaste or gel compos~tlon of the lnventlon 1nclude materlals such as polyoxyethylene sorbltan fatty acld esters. Polyoxyethylene fatty acld esters are also su1table for use as the vehlcle ln the composlt~ons of the lnventlon. Another sultable class of non-~onlc surfactants for use ~n the vehlcle ln the present lnventlon are polyoxyethyne fatty ethers.
The hydrophll~c, non-aqueous, water-soluble vehlcles preferably provlde a vlscoslty for the composttlon sultable for lts use as a toothpaste or gel, e.g., between about 50,000 cps. to 600,000 cps. If the selected veh~cle does not ltself provlde the deslred vlscoslty, vlscoslty modlflers, and/or other veh~cle agents can be lncluded to provlde such deslred vlscos~ty. The use of hlgher molecular welght polyethylene glycol such as Carbowax 8000 ls one preferred means of ~ncreaslng the vlscoslty of a non-aqueous system.
Other sultable thlckenlng agents are water-soluble salts of cellulose ethers, such as W 097/05854 PCTAUS96/121~9 sod~um carboxymethyl cellulose, hydroxy methyl cellulose, hydroxypropyl cellulose, and hydroxyethyl cellulose. Hatural gums such as gum karaya, gum arab1c, carrageenan and gum tragacanth, can also be used. Colloldal magnes~um alum~num sll~cate, s~l~ca aerogels, sil~ca xerogels, fumed s~l~ca, or other f~nely divlded s~l~ca can be used as part of the th~cken1ng agent for further ~mproved texture.
Typlcally, hydroph~l~c, non-aqueous, water-soluble veh~cles employed ~n the toothpaste or gel compos~t~ons of the Invent~on are present ~n an amount of from about 20X to 80S. Preferably, the veh~cles are present ~n an amount of from about 30X to 70S. The amount of hydroph~l~c, non-aqueous, water-soluble veh~cle employed 1n l~quld format~ons, e.g., mouthwashes, r~nses, sprays, and the l~ke is from about 50S to 95X.
In add~t10n to the rem~neral~z~ng ~ngred~ents of the ~nvent~on, su1table non-aqueous toothpastes and gels can be made by employing ~n the toothpaste or gel, from about 0.5X to 50~, preferably from about 5X to 40%, of an abras~ve, from about O.ZX to 5S of a suds~ng agent, from about O.IX to 5X of a b~nd1ng agent, and the balance, hydroph~l1c, non-aqueous veh1cle and m~nors, such as flavor, sweetner, color~ng, etc.
The pH of a of the toothpaste or gel conta~n~ng the active cat10n~c ~ngred~ents must have a pH of from about 4.5 to about 10.0 and, preferably, between about 5.0 and 7.0 when d~ssolved ~n sal~va.
Su~table abrastves ~nclude s~l~ca xerogels. Other convent~onal toothpaste abras~ves can be used ~n the compos~t~ons of th~s ~nventlon, and ~nclude beta-phase calc~um pyrophosphate, d~calc~um phosphate d~hydrate, anhydrous calcium phosphate, calc~um carbonate, z~ron~um s~l~cate, and thermosett1ng polymer1zed res~ns. S~l~ca aerogels and the ~nsoluble metaphosphates such as ~nsoluble sod~um metaphosphate can be used. M~xtures of abras~ves can be also be used. S~l~ca xerogel abras~ves are preferred.
Su~table sudslng agents are those wh~ch are reasonably stable and form suds throughout the per~od of appl~cat~on.
Preferably, non-soap an~on~c or non~on~c organ~c synthet~c detergents are employed. Examples of such agents are water-soluble salts of alkyl sulfate hav~ng from 10 to 18 carbon atoms ~n the alkyl rad~cal, such as sod~um lauryl sulfate, water-soluble salts of sulfonated monoglycer~des of fatty ac~ds hav~ng from 10 to 18 carbon atoms, such as sod~um monoglycer~de sulfonate, -WO 97/05854 PCT~US96/12189 -salts of Clo-C1g fatty acld am1des of taur1ne, such as sod1um N-methyl taurate, salts of Clo-Clg fatty ac~d esters of 1seth10n1c ac1d, and substant1ally saturated al1phat1c acyl am1des of saturated monoam1nocarboxyllc ac1ds hav1ng 2 to 6 carbon atoms, and tn whlch the acyl rad~cal conta1ns 12 to 16 carbon atoms, such as sod1um-N-lauryl sarcos1de. Mlxtures of two or more suds1ng agents can be used.
Toothpaste or gel compos1t10ns may also conta1n flaYorlng agents such as o11 of w1ntergreen, o11 of pepperment, o11 of spearm1nt, o11 of sassafras, and o11 of clove.
Toothpaste or gel compos1t10ns may also contaln sweeten1ng agents such as sacchar1n, dextrose, levulose, sod1um cyclamate. and aspartame M~xtures of sugar ~th a sweetner, e.g., sucralose, are contemplated.
It 1s, of course, also poss1ble to manufacture the dent1fr1ce compos~t10n 1n the form of a transparent or translucent gel. Th1s 1s accompl1shed by matchlng the refract~Ye 1ndex of the veh~cle w1th the abras1Yes or 1norgan1c th1ckeners, ~f used.
The non-aqueous rem~neral~z~ng systems here1n can also be prov~ded ~n the form of a mouthwash or s1m11ar product e.g., a mouthr~nse product. The mouthwash can be made 1n accordance WO 97/05854 PCT~US96/12189 w~th the follow1ng. Mouthwashes generally compr1se an alcohol, e.g., ethyl alcohol and flavor~ng mater~als. The alcohol prov~des an ant~bacter~al effect, solub~l~zes the flavor~ng mater~als and prov~des a pleasant mouth feel~ng.
Alcohol-free mouthwashes are now, however, ga~n1ng ~n popularlty.
An alcohol-free mouthwash would best be provlded ln the form of a dry powder or tablets wh1ch are added to water ~mmedlately before use. Such a product would conta1n 10 to g5~ rem1neral1ztng salts and the balance would be flavors, sweeteners, and opt~onally ant1bacter1al, efferves~ng agents etc.
Examples of sultable flavor~ng agents 1nclude hel10tropyl nltr~le, w1ntergreen o11 (methyl sal~cylate), oll of pepperm~nt, o11 of ass~a, o~l of an1se, o~l of c~nnamon, and m1xtures thereof. Su~table sweetenlng agents 1nclude sacchar~n, glycer~ne, sorb~tol, levulose, and 6-(tr~bluoromethyl)-tryptophane and aspartyl phenylalan~ne methyl ester.
It has been found that w1th the non-aqueous systems used 1n the present 1nvent~on some react~on between the calc~um and phosphate 10ns may, ~n fact, take place and cause some format~on of ~nsoluble calc~um phosphate, etc. dur~ng storage. The present W 097/OS8~4 PCTAUS96/12189 1nvent10n opt10nally overcomes th~s problem by 1ncludlng su~table stab~l~zers wh~ch prevent react~on of the calc~um ~ons wtth the phosphate 10ns and also w~th the fluor~de ~ons ~f they are present.
Any orally acceptable mater~al that stab~l1zes one or more of the calc~um, phosphate and/or fluor~de salts dur~ng storage of the non-aqueous compos1t1on ~n a closed conta~ner can be ewployed 1n the present compos1t~on.
Examples of su1table stab11~z~ng agents ~nclude desslcat1ng agents, coat~ng or encapsulating mater1als and m~xtures of such stab~l1z~ng agents.
Examples of su~table dess~catlng agents 1nclude magnes1um sulfate, sod1um sulfate, calc~um sulfate, calc~um chlor1de and collo~dal s111ca, e.g., collo1dal s~l1ca part~cles s~ntered together 1n chalnl1ke format10ns hav~ng surface areas of from about 50 to about 400 square meters per gram such as mater1als sold under the trademark Cab-0-S11 by Cabot Corp. It ~s bel~eved that such mater~als act 1n stab~l1z1ng the composlt1ons of the 1nvent~on by, for examp1e, absorb1ng any exlst1ng water e1ther present 1n or contacted w~th the compos~t~on so as to prevent react10n of the calc1um, phosphate and/or fluorlde salts.
-The stab~l~z~ng mater1al ~s 1ncluded ~n the compos~t~on of the ~nvent1On ~n an amount effect~ve so as to tnh~b~t react~on between the - calc1um, phosphate and/or fluor~de salts 1n the compos~t1On dur~ng storage ~n a closed conta~ner, but so as to allow release of suff~c~ent calc~um phosphate and/or fluor~de ~ons when the compos~tion ~s contacted w~th sal1va, e.g., dur~ng brush~ng of teeth.
Typ~cally, the stab~l~z~ng mater~al ~s ~ncluded ~n the compos~t~ons of the present ~nvent~on ~n an amount of up to about 7.5X, preferably from about O.lX to 5.0X.
In an embodlment of th~s ~nvent~on there ls prov1ded a stable slngle-part non-aqueous dent~fr~ce product for rem~neral~z~ng dental enamel compr~s~ng~
from about O.OSX to 15.0X, preferably about O.lOX to IO.OX, water-soluble calc~um salt; (~) from about 0.05X to 15.0X, preferably about O.IOX to IO.OX water-soluble phosphate salt, opt~onally together w~th from about O.OlX to lO.OX and preferably from about 0.02X to S.OX
water-soluble fluor1de salt, (~) from about 0 to 7.5X of an orally acceptable dess~cat~ng agent; and (~v~ wherein when the salts are contacted w~th water or sal~va the pH ~s between about 4.5 and 10.0 and preferably between about 5.0 and 7Ø
W O 97/05854 PCTrUS96/12189 Another method for ~nh~b~tlng premature react~on of the calc~um, phosphate and/or fluorlde salts ~n the dentifrlce composltions of the present lnvent~on ~s to provlde a coatlng on or encapsulatlon thereof, e.g., wlth an oleophll~c or, preferably, a polymer~c mater~al, whlch prevents reactlon between the act~ve mater~als. The presence of the coatlng on the varlous salts ~n the compos~t~ons of the present ~nventlon preYents react~ons of the act~ve mater~al by other substances, for example, by traces of water ~n or absorbed ~nto the system. Preferably, the coat~ng ~s an ed~ble coat~ng. Su~table encapsulat~ng or coat~ng mater1als ~nclude oleoph~l~c and other mater~als such as conventlonal edlble gums, polymers whlch exhlb~t proportlon rang1ng from hydroph~l~c to hydrophob~c (water-lnsoluble). reslns, waxes and mlneral o~ls. The coatlng ls preferably r1nsable from the mouth.
In accordance wlth the ~nvent~on a polymer employed for coat1ng the water-soluble calc~um and/or phosphate salt part~cles and the l~ke of the ~nvent~on ls selected from hydrophlllc organ1c polymers and hydrophoblc (water-~nsoluble) organlc polymers and m~xtures thereof.
-A hydroph~l~c polymer employed for coat~ng the rem1neral~z~ng salt part~cles ls selected from water-soluble and water-d~spers1ble oraan~c polymers. A m~xture of polymers can be employed, and a content of between about 5.0X to 95.0~ of a water-~nsoluble polymer, based on the coat~ng we~ght, can be ~ncluded w~th a hydroph~l~c polymer.
The term "hydroph~l~c" as employed here~n refers to an organlc polymer wh~ch has a water-solub~l~ty of at least about one gram per 100 grams of water at 25~C. The term nhydrophob~c~ or ~water-~nsoluble" as employed here~n refers to an organ~c polymer wh~ch has a IS water solub~l~ty of less than about one gram per 100 grams of water at 25~C.
Su~table hydroph~l~c polymers for coattng rem~neral~z~ng salt partlcles ~nclude gum arab~c, gum karaya, gum tragacanth, guar gum, locust bean gum, xanthan gum, carrageenan, alg~nate salt, case~n, dextran, pect~n, agar, sorb~tol, 2-hydroxyethyl starch, 2-am~noethyl starch, maltodextr~n, amylodextrtn, 2-hydroxyethyl cellulose, methyl cellulose, carboxymethyl cellulose salt, cellulose sulfate salt, polyv~nylpyrrol~done, polyethylene glycol, polypropylene glycol, polyethylene ox~de, polyv~nyl alcohol/acetate, and the l~ke.
-WO 97/05854 PCT~US96/12189 Polyv1nyl acetate ~s tllustrat1ve of a water-1nsoluble polymer whlch can be 1ncluded as ~ an add1ttonal coattng component to moderate the hydrophtl1ctty of a hydroph111c polymer coat~ng.
Su1table water-tnsoluble polymers, alone or 1n combtnatton wlth one or more other components, for coattng rem~neraltzlng salt part1cles 1nclude polyvtnyl acetate, polyacrylamtde, polyv1nyl chlortde, polystyrene, polyethylene, polyurethane, and the 11ke.
The appl1catlon of the polymer coat1ng to the blend of calc1um, phosphate, and other salt part1cles of the tnvent10n process ts accompl1shed by convent10nal means such as pan coat1ng, flutd1zed coat1ng, centr1fugtl flutdtzed coat1ng, and the l~ke. The coat~ng polymer usually ts dtssolYed 1n a suttable solvent such as water, methanol, ethanol, acetone, tetrahydrofuran, ethyl acetate, dtmethylformam1de, and the 11ke, as appropr1ate for a selected polymer spectes. A coattng polymer also can be appl1ed 1n the form of an emulsion or suspenslon. After the coatlng med~um ts appl1ed to the part~cles, the solvent med~um ts removed by evaporatton, thereby formtng a conttnuous f~lm coat~ng whlch encapsulates the dtscrete crystall1te parttcles.
The coat~ng th~ckness on the surface of the salt typ1cally w111 Yary 1n the range between about 0.1-20 m1crons. The coat1ng can cons1st of a s1ngle layer or mult1ple layers.
- The polymerlc coat1ng can const1tute between about 5.0X to 50.0X of the total dry we19ht of the coated part1cles.
For purposes of release of the core matr1x rem~nerallz1ng calc1um phosphate and, 1f des1red, fluor1de salts 1n the encapsulated part1cles when 1ntroduced 1nto the aqueous env1ronment, a surface coat1ng of water-1nsoluble polymer of the oral cav1ty may have a content between about 5.0X to 30.0X
we19ht percent of a part1culate water-extractable organ1c or 1norgan1c f111er, such as sod1um monosacchar1de or d1saccharlde, sorb1tol powder, mann1tol, and the 11ke.
The rate of release of rem1neral1z1ng salt core matr1x content of the encapsulated part1cles under aqueous cond~t1Ons can be controlled by the quant1ty and type of polymer coat1ng on the part1cle surface.
Low molecular we19ht hydroph111c polymers w111 release the part1cle core matr1x content at a relatlvely fast rate 1n the presence of mo1sture. H19h molecular we1ght polymers wh1ch are less hydroph111c w111 release at a relat1vely slow rate. Add~t~onal rate -contro1 ~s obta1ned by employ~ng m~xtures of polymer components of var~ed hydroph~l~clty.
Polyethylene glyco1 (M.~. of 4000) or polyv1nyl alcohol will release the part1cle core matr1x content at a relat~vely fast rate.
Polyethylene ox~de (M.W. of 4,000,000) or part1ally hydrolyzed polyv~nyl acetate wlll release at a relat1Yely slow rate.
Polyv~nylpyrrol~done wlll release the part~cle core matr1x content at an 1mmed1ate rate, when the encapsulated part~cles lncorporated 1nto a dent1fr1ce, e.g., toothpaste or gel, are appl~ed to the teeth.
A present ~nvent10n encapsulated rem~nerallzlng salt part~cle compos1t~on exh~b1ts a un1que comb~nat10n of propert1es because of the novel phys~cal form of the free-flow~ng, but substant~ally ~nert, polymer-coated partlcles when ut111zed as an ~ngred~ent 1n a dent1fr1ce.
Examples of su~table oleoph11~c coat1ngs or enscapsulat1ng mater1als ~nclude paraffln, m~neral o~l, edlble olls such as peanut o11, coconut o~l. palm o11, or safflower oll, oleoph~llc organ1c esters such as ~sopropyl slloxane myr1state or ~sopropyl palm1tate, ed~ble polys~loxanes, and the 11ke.
EncapsulAt~ng salts w1th a m1xture of par~ff~n and waxes ~s also su1table.
W O 97/05854 PCT~US96/12189 -8y employ1ng m~neral o11 as an oleoph~l~c coat~ng mater~al for the calc~um, phosphate and/or fluor~de salts ~n the compos~t~ons of the ~nventton, one other S advantageous character~st~c ~s prov~ded.
Spec~f~cally, oral bacter~a known to be adversely affected by oleoph~l~c mater~als.
Thus, the m~neral o~l used ~n the compos1t~ons of the ~nventton will help ~n remov~ng undes~red bacter1a dur~ng the course of treatment.
The coat~ng should be of a th1ckness and compos~tion so that ~t elther readlly d~ssolves, d~sperses or emuls~f~es ~n water, e.g., ~n the mouth dur~ng brush~ng, or d1s~ntegrates durtng such act~on to release the act~ve mater~als, ~.e., one or more salts.
~ f the oleoph~l~c materlal used for the coat~ng 1s water ~nsoluble, such as mlneral o~l, the coat~ng phase can be pre-emuls~f~ed w~th a non-ionic, non-aqueous surfactant such as a hydroph~l~c ethoxylated sorbltan monooleate, e.g., the mater~al sold under the trademark Tween. In th~s manner, when the compos~t~on ls placed ~n water. the m~neral o~l or other oleph~llc coat~ng on the part~cles ~s emuls~f~ed more read~ly than without the emuls~f~cat~on agent be1ng present. Other s~m~lar surfactants can be employed such as sod~um lauryl sulfate and other non-~on~c surfactants.
CA 02226448 l998-0l-07 WO 97/05854 PCT~US96J12189 In an embod~ment of th~s ~nvent~on there ~s prov~ded a stable s~ngle-part non-aqueous dent~fr~ce product for rem1neral~zlng dental enamel compr~s1ng~
from about 0.05X to 15.0X, preferablY about O.lOX to lO.OX, water-soluble calc1um salt; (~) from about 0.05X to 15.0X, preferablY about O.lOX to lO.OX water-soluble phosphate salt, opt~onally together w~th from about O.OlX to lO.OZ and preferably from about 0.02X to 5.0X
water-solub1e fluor~de salt. (~) where~n there ~s an encapsulat~ng coat1ng on at least one of the water-soluble salts that e1ther read~ly d~ssolves, d~sposes or emuls~f~es ~n water, e.g., sal~va, and ~v) wherein when the salts are contacted w1th water and/or sal~va the pH ~s between about 4.5 and 10.0 and preferably between about 5.0 and 7Ø
In another embod~ment of th~s ~nvent~on there ~s prov~ded a stable, s~ngle-part non-aqueous product for rem~neral~zatlon wh1ch can be reconst~tuted lnto a mouthwash by add~t1On of water or tnto other products from the concentrate-l~ke product.
Accord~ngly the product compr1ses from about l.OX to 80.0X of a calclum salt, from about 1.0X
to 80.0X of a phosphate salt, from about O.lX to 20.0X of a stab~l~zer compr~s~ng a mater1al WO 97/058~4 PCT/US96/12189 selected from at least one member of the group cons~st~ng of a desslcat1ng agent and a coat1ng of at least one of the water-soluble salts that e~ther read~ly d~ssolves, d~sperses or emuls~f~es ~n water, from about O.QlX to 20.0X
of a flavor, from about O.OlX to 30.X of a sweetener, from 0 to about lO.OX of a fluor~de salt, from 0 to about 5.0X of a surfactant and where~n when the concentrate ~s m~xed w~th water the pH of the result~ng m~xture is between about 4.5 and 10Ø
In st~ll another embodlment of th~s ~nvent~on there ~s prov~ded a stable s~ngle-part non-aqueous product for remlneral~z1ng dental enamel comprls~ng: (~) from about 0.05X to 15.0X, preferably about O.lOX to lOX, water-soluble calc~um salt; (~) from about 0.05X to 15.0X, preferably about O.lOX to lOX
water-soluble phosphate salt, opt~onally together w~th from about O.OlX to 10.0X and preferably from about 0.02X to 5.0X fluor1de releas~ng agent, (~i~) from about 0 to 7.5X of an orally acceptable dess~cat~ng agent;
(~v) a hydroph~l1c, non-aqueous veh~cle wh~ch ~s water-soluble; and (v) where~n when the salts are contacted w~th water or sal~va the pH ~s between about 4.5 and lO.0 and preferably between about 5.0 and 7Ø
W097t0~854 PCTAUS96/12189 A plural1ty of packag1ng methods may be employed 1n order to conta~n or store the components and prov1de effect1ve d1spenslng thereof into the oral cav~ty.
Thus, the components of a toothpaste, gel, cream, or the 11ke, may be s1multaneously d1spensed from separate collaps1ble tubes preferably made of plast1c, a plastlc and metal lam1nate, etc.
The tubes of the above embod~ments are usually f111ed from the bottom and are subsequently sealed together by conventlonal techn~ques.
Another alternat1ve packag1ng arrangement compr1ses of a pressur1zed conta1ner wh1ch 1s prov1ded w1th a compartment and a spout. The 1nternal pressure of the compartment 1s ma~nta1ned by a pressur1zed gas, l.e., n1trogen, at the bottom of the compartment.
Operat~on of a mechanlcal actuator actuates a valve wh1ch releases the contents of the compartment through the spout caus1ng d1scharge of the paste or gel components onto a brush.
The mouthwash or r~nse and sim11ar Z5 11qu1d embod~ments are ma~nta~ned 1n a manner s1m11ar to the pastes or gels 1n that dur~ng storage, each of the components are stab11~zed w1th regards to one another to prevent premature -react~on. Upon d1spensing, the components m~x and react ~n the oral cav~ty to effect rem~neral~zat~on of dental enamel. The llqu~d - components can therefore be stored ln the compartment of a d~spenser. The d~spenser usually 1ncludes a closure system compr~s~ng for example, an tncl~ned crown port~on, a pour~ng spout extend~ng upwardly from an upper surface of the crown port~on and a cover for securement to the crown port~on. The cover ~s provided w~th closure means, for example, depend~ng plugs, to close the closure. The pour~ng spout ~s preferably prov1ded w~th a vent open~ng ~n add~t~on to a product or~f~ce ~n the spouts.
Transparent contalners have proven to be the most satisfactory. Transparency a~ds a person's ab11~ty to accurately and controllably d~spense relat~vely exact volumes from a d~spenser.
Transparent walled conta~ners also serve as a wlndow funct~on for gaug1ng the amounts of l~qu~d rema~n~ng ~n the d~spenser. The walls of the conta~ners can be scr~bed or otherw~se cal~brated to ass~st ~n d1spens~ng the correct rem~nerallzlng amount of product.
~h~le appl~cants do not w~sh the scope of the present ~nvent~on to be l~m~ted by theory, ~t ~s bel~eved that the calc~um, phosphate, and fluor~de ~ons d~ffuse through the W097/05854 PCT~US96/12189 tooth surface to the dem~neral~zed subsurface and preclp~tate ~n the dem~neral~zed subsurface where they rem~neral~ze the tooth structure.
Th1s ~s surpr~slng because suff~c1ent calc~um, phosphate, and fluoride ~ons rema~n soluble for a per~od of t~me sufftc~ent to permtt the~r d~ffuslon ~nto the dem~neral~zed subsurface of the dental enamel. Th~s ~s accompl~shed by allow~ng the product to m~x w~th sal~va when applled to the teeth or by comb~n~ng the part~cular ~ons just pr~or to the~r appl~cat~on to the teeth in a solut10n hav~ng a pH of about 4.5 to 10 and preferably from about 5.0 to 7 at wh~ch pH enough of the calc~um, phosphate, and fluor~de ~ons rema~n soluble for the per~od of t~me requ~red to rem~neral~ze the les~ons of the dental enamel. As here~nbefore descr~bed, salts y~eld~ng the calclum lons, phosphate ~ons, and ~f des1red, fluor~de ~ons are stored ~n a hydroph~l~c, non-aqueous veh~cle andJor are stab~l~zed against react~on to avo~d the premature prec~p~tat~on of calc~um phosphate.
Chemtcally equ~valent concentrat~ons are not necessary as long as the molar rat~o of calc~um and phosphate ~ons ~n the mixture is from about 0.01 to U? to 100 to 1. It ~s preferred that the rat~o ~s from about 0.2 to 1 up to 5 to 1, and ~t ~s most preferred that the W 097/05854 PCTrUS96/12189 rat~o ts between about 1 to 1 and 1.~67 to 1; the rat~o of calc1um to phosphate ~n ~nsoluble calc~um phosphate salts.
W~th regard to the length of t~me of exposure to the teeth of the solut~ons applled to, or formed ~n, the oral cavtty ~t ~s neces5ary that the per~od of t~me be great enough to allow d1ffus~on of the ~ons lnto the dem~neral~zed subsurface. At least about ten seconds are requtred for th~s d~ffus10n. The paste, gel, or aqueous solut10n ~s preferably appl~ed to the teeth for from about 10 seconds to about S mlnutes. The pH of the solut~on rema~ns relat~vely constant after ~ts ~ntroduct~on ~nto the oral cav~ty. Calc~um phosphate may prec~p~tate at th~s pH, but most surpr1s~ngly wh~le some of the prec~pttat~on may occur ~mmed~ately and some small amount even before appllcat~on to the teeth, suff~c~ent calclum, phosphate and fluor~de ~ons rema~n ~n solut~on to d~ffuse ~nto the teeth and rem~neral~ze the dem~neral~zed dental enamel. It ~s bel1eved that the ab~l~ty of the solut~ons to provlde ~ons for remlneral~zat~on ~s greatest upon the~r f~rst ~ntroduct~on 1nto the oral cav~ty, thereafter decreas~ng.
~ lth a toothpaste, gel, and the l~ke, m~x~ng ~s achleved on the surface to the teeth W 097/05854 PCTAUS96/lZ189 whtle brush1ng and w1th a l~quid non-aqueous mouthwash upon ~ntroduct~on 1nto the oral cav~ty. The essence of the present ~nvent~on 11es with the stable, s1ngle part product; ~n the m1xing of the product components 1n the mouth; and the qu1ck and t~mely appl~cat10n of the result1ng aqueous solut10n wh1ch w111 prec1p1tate calc1um phosphate, calctum fluor~de, and calc1um fluoro-apatlte ~n the subsurface enamel of the teeth. Before such preclpltat10n occurs, the m1xture comprls1ng the aqueous solut10n must qu1ckly be appl~ed to the teeth.
Surpr1slngly, the solut~on can have a pH of about 4.5 to 10, but preferably about 5.0 to 7 to ach1eve th1s result. At a pH below about 3, dem1neral1zatton occurs rap~dly. A pH below 2.5 ls generally undeslrable from a safety standpo1nt.
The pH of the solut~ons of the present lnvent10n may be adjusted to the pH des1red by methods well known 1n the art. The pH may be controlled by the add1t10n of any ac1d whlch 1s safe for use 1n the oral cav~ty and wh1ch y1elds the des1red pH at the amount employed. Examples of suitable ac~ds are acet1c ac1d, phosphor~c ac1d, hydrochlor1c ac1d, c1tr1c ac1d and maltc ac1d; by the add1t10n of a base, for example.
sod~um hydrox~de; or buffered, for example with WO 97/05854 PCT~US96/12189 sod~um c~trate benzoate, carbonate, or b1carbonate, d~sodlum hydrogen phosphate, sod~um d~hydrogen phosphate, etc. Preferably the rem~neral~z~ng salts employed can be selected to obta~n the des~red pH. Usually a comblnat~on of monobas~c, d~bas~c and/or tr~bas~c alkal~ metal phosphate salt ~s selected to provide the target pH.
The follow~ng Examples ~llustrate the ~nvent~on: In the Examples and elsewhere here~n parts and percent are by welght unless otherw~se stated.
In th1s example a non-aqueous product for testlng was prepared and m1xed with water ~ust prev10us to testlng. The testlng procedure was as follows:
Artlf1clal les~ons, about 50 u deep, were formed ln one surface of bovine enamel chlps us1ng a demineral1zlng Carbopol gel, wh1ch was used to treat the speclmens for 72 hours. The surface hardness of the surface to be treated was then measured.
The reglmen cycle cons1sted of a 30 m1nute dem1neral1zatlon ln a standard demlneral1zlng solut10n followed by a 5 minute treatment of the test products d11uted 1 part product to two parts human sal1va, followed by a 60 m~nute remlneral1zatlon 1n human sal1va. Overn1ght, wh1ch was every flfth cycle, the speclmens were kept w1th a layer of sallva and stored ~n a cold room. The test ran for three days, from a total of 15 dem1nerallzat10n:treatment:rem~neral1zat10n cycles.
For the treatment cycle, the rem1neraliz1ng test agent of the example was d11uted 1 part product to 2 parts sal1va and mtxed together 1mmed1ately before 1mmers~on of the enamel spec1mens.
The non-aqueous oral remlneral1zlng test agent was prepared as follows:
Calclum n1trate 4 25 Dipotass1um phosphate 8.00 Sodlum fluor1de 0.55 Glycerln 50 Acetlc ac~d To ad~ust pH of A ~ B mlxture of 5.5 ~0 lmmedlately after mlxlng.
The above product was then mlxed w1th 137.45 parts of water to solubll1ze the salts and then was d11uted wlth sal1va as descr1bed above.
WO 97/05854 PCT~US96/12189 (V1ckers Hardness Units) 1200 ppm Fluor~de at ExamPle 1 Crest pH 5.5Placebo 5 cycles17.0 + 1.9 11.8 + 1.4 10 cycles23.6 + 1.413.0 + 3.6 13.7 + 2.3 3.9 + 0.7 15 cycles34.8 + 2.811.2 + 1.7 20 cycl~s48.2 + 2.817.5 + 2.2 (ug/cm3~
1200 ppm Fluor~de at Example 1 Crest PH 5.5Placebo 5 cycles 2433 1879 10 cycles 3523 Z082 2928 244 15 cycles 4431 2196 20 cycles 4749 2964 The results show much greater rem~neral~zat~on, as measured by hardness ~ncrease and fluor~de ~ptake, due to treatment wlth the product of Example 1 than Crest, fluor~de solut1On or placebo.
EXAMPLES 2. 3. 4 and 5 Examples 2-S 111ustrate var~ous embod~ments of rem~neral1z~ng toothpaste formulat~on of the ~nvent~on as follows:
Example Glycer~n 55.560.00 0.00 59.54 Carbowax 400 Q.0038.15 0.00 0.00 Propylene glycol 0.00 0.00 42.80 0.00 S~l~ca abras1ve 15.000.00 0.00 12.00 S~l~ca thlckener 8.00 4.00 4.00 6.00 DCPDH* 0.0040.00 0.00 0.00 Calc~um chlor~de 5.00 0.00 0.00 5.00 Calc~um glycerophosphate0.007.50 3.50 5.00 D~sod~um phosphate3.707.50 6.50 10.00 Sod~um meta-phosphate 0.00 0.00 38.00 0.00 Sod~um lauryl sulfate 1.50 1.70 1.20 1.00 Sod~um fluor~de 0.24 0.00 0.00 0.00 Stannous fluorlde0.00 0.00 1.80 0.00 Sod1um MFP 0.00 0.00 0.00 0. 76 Flavor 0.80 0.90 0.90 0.70 Sacchar~n O.Z00. 20 0.30 0.20 *DCPDH = D~calclum phosphate d~hydrate Example 6 lllustrates an embod~ment of a remlnerallz~ng mouthwash formulat~on and Example 7 ~llustrates a dry-m~x concentrate su~table for d~lution as follows:
Example 6 ExamPle 7 61ycertn QS
Ethanol 5.00 Sod~um MFP 0.20 Calc~um nttrate 7.00 50 Monopotass~um phosphate4.00 41.725 Sod~um fluor~de 0.275 Spray dr~ed flavor1.0 5.0 Aspartame 0. 6 3.0 Example 7 ~s d~luted 59 to 100 9 -~ater before use.
Example 8-11 lllustrate dry-m~x concentrated formulat~ons wh~ch can be d~luted w~th water when they are to be employed.
Example Calc~um lactate pentahydrate 59.7 Calc~um acetate anhydrous 40.0 Calc~um gluconate 65.0 Encapsulated~ calc~um n1trate 97~ 45.4 10 Magnes~um chlor~de 10.0 Monopotass~um phosphate 30.0 Z8.0 21.0 D~potass~um phosphate 8.0 Monosod~um phosphate 12.5 D~sodium phosphate 2.5 7.0 15 Sod~um fluoride 0.3 Stannous fluor~de 2.5 Sod1um MFP 3.6 Flavor 6.0 4.0 5.0 15.0 Sacchar~n 3.0 2.5 8.0 20 Aspartame 20.0 *Cacl~um nitrate encapsulated w~th water soluble ethyl cellulose encapsulent Usage Concentrat~on 1.0 9 0.75 g 1.2 9 0.429 per oz per oz per oz per oz Examples 12-14 each ~llustrate a formulat10n wh~ch can be employed as an efferevercent mouthwash when dllutent w1th water.
Example 5 Calctum acetate anhydrous 30.0 Encapsulated* calc~um n1trate 97X 26.0 36.0 Monopotasstum phosphate 20.0 28.0 30.0 Mal~c acld 16.0 17.0 11.0 Magnes~um chlor~de 5,0 Sodlum bicarbonate lO.0 15.0 10.0 Sod1um fluorlde Z.0 2.0 Flavor 6.0 5.5 4.0 Saccharln 4.5 2.0 Aspartame 20.0 *Calc~um nltrate encapsulated w1th water soluble ethyl cellulose encapsulent Usage Concentrat1On 5.0 9 4.0 9 5.0 9 per oz per oz per oz
Sallva ls supersaturated wlth respect to calclum and phosphate lons. Sallva therefore helps protect teeth agalnst demlnerallzatlon and can slowly remlnerallze teeth whlch have become demlnerallzed by aclds. It ls well known that the presence of fluorlde lons can enhance the natural remlneral1zat10n process and th1s ls one of the accepted mechanlsms by wh1ch fluorlde toothpastes and rlnses protect agalnst cartes.
The efflcacy of fluor1de conta1n1ng toothpastes and r1nses to rem1neral1ze teeth 1s llm1ted by the modest levels of calc1um and phosphate ln sallva. It ls evldent from the pr10r art that lt ls hlghly deslrable to lncrease the avallable concentratlon of calclum and phosphate lons ln the oral cavlty to speed up the remlnerallzatlon process. However, because of calclum phosphate's low solubllltY at the pH of sallva the addltlon of hlgher levels of d1ssolved calclum and phosphate lons ls not eas11y accompllshed.
Rem1neral1zat10n of dental enamel has been carrled out exper1mentally both ln vlvo and W O 97/05854 PCTtUS96tl2189 ~n v~tro. Some stud~es have concentrated on the 7 rem~neral~z~ng propert~es of sal1va and synthettc solut~ons supersaturated w~th respect of hydroxyapat~te. Sucn stud~es compr~se the sub~ect matter of U.S. Patent Nos. 3,679,360 (Rub1n) and 4,097,935 (Jarcho).
Generally, the supersaturated solut~ons or slurr~es used ~n these patents for rem~neral~zat~on exper~ments have been prepared from a s~ngle form of calc~um phosphate. When a car~ous les~on ~s flooded w~th one of these supersaturated solut~ons, the calc~um and phosphate ~ons ~n the form of prec~p~tated hydroxyapat~te rem~neral~ze the les10n.
However, these solutlons are ~mpract~cal for use for several reasons. F~rst, the amount of calc~um and phosphate ~ons ava~lable for rem~neral~zat~on ~n these supersaturated solut~ons ~s too low. It ~s reported that ~t takes approx~mately 10,000 unlt volumes of the usual supersaturated solut10n to produce one un~t volume of m~neral. Thus, remtneral~zat10n by th~s method requ~res both an excess1ve volume of flu~d and an excess~ve number of appl~cat~ons. The supersaturated solut~ons are ~nherently l~m~ted ~n th~s respect because they cannot ma~nta~n the~r supersaturated state. When the hydroxyapat~te WO 97/05854 PCT~US96/12189 prec~p~tates out to the po~nt where the solut~on ~s no longer supersaturated, new supersaturated solut70n must be ~ntroduced or the remlneral~zat~on process stops.
Another problem w~th s~ngle calc1um phosphate slurr~es ~s that as the hydroxyapat~te prec~p~tates out of solutlon, the pH of the solut~on chsnges. Unless the old solut~on ~s removed from contact w~th the tooth mater~al, the solut~on may become too ac~dic or alkal~ne and damage the dental t1ssue.
U.S. Patent No. 4,080,440 (D~g~ul~o et al) d~scloses a metastable solut10n of calc~um and phosphate ~ons at a low pH (between 2.5 to 4.0) underwh~ch cond~t~ons the solub~l~ty of calc~um phosphate salts ~s h~gh. After penetrat~on of the solut~on ~nto demineral~zed enamel, rem~neral~zat~on results from the prec~p~tat10n of calc1um phosphate salts when the pH r~ses. Fluor~de ~ons can be ~ncluded ln the metastable solut~on. A s~gn~f~cant d~sadvantage of the use of metastable solut~ons ~s that the relat~vely low pH m~ght dem~neral~ze the dental enamel and/or ~n~ure other t~ssue.
U.S. Patent Nos. 4,177,258, 4,183,915 and 4,348,381 (Gaffar et al) prov1de for a remlnerallz~ng solut~on conta~n~ng supersaturated concentrat~ons of calc~um 10ns, phosphate tons and a fluor~de source stab~l~zed -by the presence of an ant~nucleat~ng agent such as d1am~ne tetramethylenephosphon~c ac~d, ethylened~am~ne tetramethylenephosphon~c ac~d and 2-phosphonobutane-tr~carboxyl~c ac~d-1,2,4, or the water-soluble salts thereof. Th~s solut1on ~s preferably ad~usted to the neutral pH range where lt ~s alleged to most effectlvely rem~neral~ze sub-surface les~ons. Even though the ant~nucleat~ng agent would be expected to stab~l~ze the solut~on, equ~llbr~um of the supersaturated concentrat~ons ~s st~ll found d~ff~cult to ma~nta~n and avo~d preclp~tat~on of hydroxyapat~te and changes ~n the pH of the solut1on.
U.S. Patent Nos. 4,083,955 (Grabenstetter et al) and 4,397,837 (Raaf et al) prov~de a process for rem~nerallz~ng dem~neral~zed enamel by the consecut~e treatment of tooth surfaces w~th separate solut~ons conta~n~ng calc~um ~ons and phosphate lons. In th~s process fluor1de ~ons may be present ~n the phosphate solut~ons. It ls ~mmater~al wh1ch ~on~c solut10n ls used to treat the teeth f~rst. By sequent~ally apply~ng calcium and phosphate lons to the tooth surface h~gh concentrat~ons of the ~ons are able to penetrate ~nto les~ons ~n solut~on form, where they prec~p~tate as a calc~um phosphate salt when ~ons from the second treatment solut~on d~ffuse ~n. Wh~le apparently successful thls method lnvolves the ~nconven~ence of a plural~ty of sequentlal appl~cat~ons wh~ch can also be found to be t~me consum~ng.
Thus, the problem wtth known rem~nerallzat~on composltlons and techntques ~s that there ~s not a one-part, stable rem~neral~z~ng compos~tlon that may be su~tably prepared as a mouthwash or r~nse and can be ~ncorporated lnto other dent~fr~ce composit~ons such as a toothpaste or gel, troche, chew~ng gum, lozenge and the l~ke.
There ~s a need for a method of reminerallz~ng dental enamel wh~ch employes a stable, s~ngle-part rem~nerallz1ng compos{t~on and does not requ1re excess~ve amounts of solutlon and ~nord~nately long or frequent exposure t1mes.
It ~s the ob~ect of the present lnvent~on to prov~de a s~ngle-part stable compos~t~on and process for the rem~neral~zat~on and the prevent~on of demlneral~zat~on of human teeth, wh~ch process and composlt~on are capable of effect~vely ~ncorporat~ng calc~um ~ons, phosphate ~ons and fluorlde ~ons into the dental enamel, the compos~t~on also be~ng eas~ly usable by the consumer and not d~ffer~ng s7gn~f~cantty, ~n flavor and appearance, from customary dental cosmet1cs.
SUMMARY OF THE INVENTION
In accordance w~th the present ~ tnvent~on the problems of rem~neral~zatton, w~thout dem~neraltzat~on are solYed by apply~ng to the teeth a stable, s~ngle-part compos~t~on wh~ch conta~ns rem1neral~zat~on components wh~ch do not react w~th one another unt~l ~ntroduced ~nto the oral cav~ty. The compos~t~on conta~ns at least one water-soluble calc~um compound and at least one water-soluble ~norgan~c phosphate compound and, opt~onally, at least one water-soluble fluor~ne compound. In th~s way the ~ons whlch effect rem~neral~zat~on can be absorbed by the dental enamel and the~r subsequent react10n causes reharden~ng of dem~nerallzed areas ~n the dental enamel.
It has been found that effect~ve rem~neral1z~ng treatments can be prepared by prov~d~ng non-aqueous solut~ons or preparat~ons of soluble salts conta~n~ng h~gh concentrat~ons of calc~um, phosphate and, ~f des~red, fluor~de ~ons and apply~ng them to teeth at moderate pHs.
However, the calc~um ~ons must be prevented from react~ng w~th the phosphate ~ons or fluor~de Z5 ~ons untll ~mmed~ately before use.
In one embod~ment of the ~nvent~on, a non-aqueous toothpaste or gel ~s prov~ded = =
compr1s~ng at least one water-soluble calc1um salt, at least one water-soluble phosphate salt, ~f des1red at least one water-soluble fluorlde compound y1eldlng fluor~de ~ons, and a hydroph11~c, non-aqueous veh1cle whlch ~s water soluble and where~n, when the compos~t~on ~s contacted w~th water, the result1ng solutton has a pH of between about 4.5 and 10Ø
The stable, s~ngle-part system, 1n the form of toothpastes, gels, profess1Onal gels, 1.e., those wh~ch are appl~ed profess1Ona11y or are obta1ned by a prescr~ptlon, mouthwashes or r~nses. troches, chew~ng gums, lozenges, and the l~ke contaln from about 0.05X to about 15X
water-soluble calc~um salt, from about 0.05X to 15X water-soluble phosphate salt, 7f des1red from about O.Ol~ to 5.0X fluor~de releaslng agent, and su1table pH ad~ust1ng compounds, l.e., ac~ds or bases, such that the pH 1s between about 4.5 and 10.0, and preferrably between about 5.0 and 7Ø Compos~t1Ons may be appl1ed d1rectly to the teeth and solub111zed w~th sal1va or are m1xed w1th water, solub111zed and 1mmed1ately appl1ed to the teeth be1ng treated. It has been found that such comblnat1Ons produce rap~d rem1neral1zat1On of les1Ons and are much more effect~ve than convent1Onal fluor~de conta~n~ng toothpastes 1n rem~neral1zlng teeth.
W O 97/05854 PCT~US96/12189 The stable, s~ngle-part system may also be ~n the form of a dry-m~x concentrated product wh~ch may be d~luted w~th water to prepare a mouthwash or otherw~se treated or m~xed to make other products. The dry-m~x product may be ~n the form of a powder, granular mater~al, flake, tablet or the l~ke. Th~s embod~ment conta~ns from about l.OS to 80.0X of the calc~um salt and the phosphate salt. Other ad~uvants may, of course, be ~ncluded.
The compos~t~ons of the ~nvent~on g~ve substant~ally lmproved rem1neral~zat~on and preventton of dem~neral~zat~on of human teeth as compared wlth pr~or art compos~t~ons.
The d~sadvantages of the pr~or art methods are overcome by the present ~nvent~on wh~ch effects subsurface rem~neral~zat~on rather than surface remlneral~zat~on. S~nce dental car~es beg~ns as a subsurface dem~nerallzat10n of the dental enamel, subsurface rem~neral~zat~on arrests and repa~rs the car~ous les~on before any permanent structural damage to the tooth occurs. The present ~nvent~on does not requ1re preparat~on of the enamel surface, capp~ng of the tooth, or removal of decay products. Further, the present ~nvent~on may be conven~ently pract~ced by the publ~c w~thout substant~ally chang~ng the~r dental care habits.
DESCRIPTION OF THE INVENTION
The present ~nvent~on l~es ~n the d~scovery that dental enamel may be remtneral~zed by the appl~cat~on of certa~n soluble salts y~eld~ng ~ons whlch w111 react to form a des1rable rem~neral~z~ng precip~tate. The crux of the ~nvent~on cons~sts of the use of a stable, one-part system ~n the form of paste, gel, granules, powder, f lakes, non-aqueous solutlon, etc, conta~n~ng water-soluble salts whlch are placed ~n contact wtth the tooth surface. Sal1va ~n the mouth causes d~ssolut~on of the soluble salts allow~ng the selected cat~ons and an~ons to d~ffuse through the tooth lS surface to the dem~neral~zed subsurface w~th the cat~ons and an~ons form~ng a prec~p1tate wh~ch ~s bound to the tooth structure. As a result, the tooth's subsurface ~s rem~neral~zed when an effecttve amount of the rem~neral~zat~on system 1s ut~l~zed.
As d~scussed above, the compos~t~ons of the ~nventlon are preferably non-aqueous. By ~non-aqueous~ ~s meant that the compos~ttons do not ~nclude water In such an amount that ~t w~ll adversely affect the stab~l~ty requ1red by the rem~neral~zation compos~t~on of the ~nvent~on, WO 97/05854 PCT~US96/12189 l.e., the components of the composltlons of the lnventlon do not contaln slgn~flcant quantlt~es - of free water. However, they may contaln salts wlth water of hydrat~on. Preferably, the composltlons of the lnventlon lnclude elther no water or only traces of water.
By "effectlve amount of remlnerallzlng system or agent" ls meant an amount when used ln accordance w~th thls lnventlon will brlng about the remlnerallz~ng of teeth havlng car10us leslons, or the mlneral~zlng of normal teeth to prevent carles from form1ng and to ~nhlb~t hypersens1tlvity by utlllzlng a toothpaste, gel, or mouthwash havlng the varlous components ln the amounts set forth below.
Concentrat~ons of the soluble salt are from about O.OS to 15X or the l~mlt of solubll~ty of the salt. Excess salt can be present, ~f deslred. Concentratlons from about zo O.lOX to lOX are preferred. The concentrat~ons of the soluble salts contaln~ng the des~red an~ons are essentlally the same as those for the water-soluble salts contaln~ng the deslred cat~ons.
Although many prec~p~tates are w~thln the broad scope of thls lnventlon, by depos~tlng a preclpltate less soluble than the orlglnal enamel, the remlnerallzed subsurface can be made WO 97/05854 PCT~US96/12189 to be more res~stant to dem~neral~zat~on than was the orlg~nal enamel. When a fluor~de salt ls ut~l~zed which y~elds fluor~de tons, the remlnerallzed enamel ~s even more reslstant to dem1neral~zat~on than was the or1glnal enamel.
The concentratlon of salt contalnlng fluor~de lon ln the solutlon may be from about O.OlX to 5.0X, but from about 0.02~ to 2.0~ ls preferred.
~n order to effect rem1nerallzat~on of the dental enamel. an effectlve amount of the deslred cat~ons and a lons must be employed 1n the oral cav1ty. ~he amount of solutlon ln the mouth must conta1n at least 100 ppm of des~red catlons and 100 ppm of des~red anlons and preferably conta~ns more than 1,000 ppm of deslred catlons and 1,000 ppm of deslred anlons.
It ls preferred to prov~de a level of fluor~de lons between about 20 ppm to 5,000 ppm ln the oral cavlty from the dent~fr~ce or profess~onally appl~ed or prescr~bed gel.
Wh~le the length of t~me of contact between the dlssolved salts and the tooth's surface ~s not cr~t~cal, lt ~s necessary for the length of t~me to be great enough to allow dlffuslon of the ~ons through the tooth's surface to the demlneral~zed subsurface. It ls submltted that at least ten seconds ls requlred for th~s d~ffus~on and preferably ~t should be W 097/05854 PCT~US96/12189 greater than th~rty seconds and even longer ~f poss~ble.
After d~ssolv1ng ~n the sal~va the solut~on should have a pH of from about 4.5 to 10.0 and preferably between about 5.0 and 7.0 before and after the prec~p~tatlon react~on, and be otherw~se compat~ble ~n the oral env~ronment.
~h~le some prec~p~tatlon may occur upon solub~l~zat~on or upon appl~cat~on to the teeth, not all of the ~ons should comb~ne prematurely ~n the solut~on to form a prec~p~tate, but must be able to d~ffuse through the surface of the tooth to a dem~neraltzed subsurface area and be able to form an ~nsoluble salt wlth the~r respect~ve counter~ons.
The compos~t~ons ut~l~zed and the ~nsoluble prec~p~tates must have acceptable levels of tox~c~ty t~.e., the part~cular ~ons, ~n the amounts used 1n the rem1neral~zat~on process, must be non-tox~c).
In a preferred embod1ment of the present ~nvent~on, the stable, one-part, non-aqueous rem~neral~z~ng compos~tton conta1ns about 0.05X to 15X, preferably about O.lOX to lOX of a water-soluble calc~um salt y~eld1ng calc~um ~ons, from about O.OSX to 15X, preferably about O.lOX to lO~, of a water-soluble phosphate salt y~eld~ng phosphate lons and from a~out O.OlX to 5.0X, preferably from about 0.02~ to 2.0X, of a soluble fluorlde - salt yield1ng fluor1de ~ons ~n a hyroph~l~c, non-aqueous veh1c1e wh1ch ~s water-soluble. The pH of the compos1t~on ~n the oral caY1ty ~s between about 4.5 and 10.0, preferably between about 5.0 and 7Ø
The result~ng preclp~tate ~s a calc1um phosphate or hydroxyapat~te, the natural const~tuent of tooth enamel, with ~ncorporated fluor~de lons. Not only does thls process result 1n rem1neral1zed enamel, but the rem1neralized enamel may be more res~stant to subsequent dem~neral1zat~on than was the or~g~nal enamel.
As the calclum compound ~t ~s, ~n pr~nc~ple, poss1ble to employ, 1n the preparat~ons of the 1nYent~on, all water-soluble tox~colog~cally harmless calc~um compounds. A
compound ~s cons~dered to be water-soluble when at least 0.25 gram thereof d1ssolYes 1n 100 ml of H20 at 20~ C.
Su~table water-soluble calclum compounds are, for example, calc~um chlorlde, calc~um brom1de, calc~um n~trate, calc~um acetate, calc~um gluconate, calc1um benzoate, calc~um glycerophosphate, calc~um formate, calcium fumarate, calc1um lactate, calclum butyrate and calc~um ~sobutyrate, calc1um malate, calclum maleate, calc1um prop10nate, - calc1um valerate or m1xtures of water-soluble calc1um compounds. Calctum n1trate 1s preferred.
In the compos1t10ns of the ~nvent10n for the remtneral1zat10n of human dental enamel, at least about 100 ppm of calc1um 10ns should be present; the upper l~m~t 1s about 35,000 ppm of calc1um 10ns.
Su1table water-soluble 1norgan1c phosphates with1n the scope of the present 1nvent10n are, for example, alkall salts and ammon1um salts of orthophosphorlc ac1d, such as potass1um, sod1um or ammonlum orthophosphate, monopotass1um phosphate, d1potass1um phosphate, tr1potass1um phosphate, monosod1um phosphate, d1sod1um phosphate and tr~sod1um phosphate. The concentrat10n of the phosphate 10ns 1s preferably about 100 ppm to 40,000 ppm;
solub111ty 1n water 1s def1ned as ~n the case of the calc~um compounds.
If deslred, water-soluble salts y1eld1ng both calc~um and phosphate 10ns, such as monobas1c-calc~um orthophosphate, may be employed. The compos~t10ns of the 1nvent10n for the rem1neral1zat10n or preYent1on of dem1neral1zat10n of human teeth preferably also conta1n water-soluble fluor~de compounds, the car1es-prophylact~c act1v1ty of wh1ch has for a long t1me been cons~dered to be establ1shed.
Su~table fluor~de compounds are the alkall fluor~des such as sod~um. potass~um, llth~um or ammon~um fluorlde. t~n fluor1de, ~nd~um fluor~de, z~rcon~um fluor~de, copper fluorlde, n~ckel fluor~de, pallad~um fluor~de, fluoroz1rconates such as sodlum, potass~um or ammonlum fluoroz~rconate or t~n fluoroz~rconate, fluoros~l~cates, fluoroborates, fluorostann~tes.
Organ~c fluor1des, such as the known amine fluor~des are also su~table for use ~n the compositlons of the ~nvent~on.
Water-soluble alkal~ metal monofluor-ophosphates such as sod~um monofluorophosphate, l~th~um monofluorophosphate and potasslum monofluorophosphate. preferably, sod~um monofluorophosphate may be employed. In add~t~on other water-soluble monofluorophosphate salts may be employed ~nclud~ng ammon~um monofluoro-phosphate alum~num monofluorophosphate, and the l~ke.
Su1table hydrophll~c, non-aqueous veh~cles for use ~n the present ~nvent~on include polyalkylene glycols, the humectant polyols such as glycerine, propylene glycol, d~propylene glycol and hexylene glycol.
Glycer~n, propylene glycol and polyethylene glycol are preferred. As used here~n, ~propylene glycol~ lncludes l,2-propylene glycol and 1,3-propylene glycol.
WO 97/05854 PCT~US96/12189 For a mouthwash ethyl alcohol could also be used as a veh~cle. Such a product would be added to water 1mmedlately before be~ng used.
Non-lontc surfactants could be used as the hydrophlllc, non-aqueous vehlcle ln the toothpaste or gel compos~tlon of the lnventlon 1nclude materlals such as polyoxyethylene sorbltan fatty acld esters. Polyoxyethylene fatty acld esters are also su1table for use as the vehlcle ln the composlt~ons of the lnventlon. Another sultable class of non-~onlc surfactants for use ~n the vehlcle ln the present lnventlon are polyoxyethyne fatty ethers.
The hydrophll~c, non-aqueous, water-soluble vehlcles preferably provlde a vlscoslty for the composttlon sultable for lts use as a toothpaste or gel, e.g., between about 50,000 cps. to 600,000 cps. If the selected veh~cle does not ltself provlde the deslred vlscoslty, vlscoslty modlflers, and/or other veh~cle agents can be lncluded to provlde such deslred vlscos~ty. The use of hlgher molecular welght polyethylene glycol such as Carbowax 8000 ls one preferred means of ~ncreaslng the vlscoslty of a non-aqueous system.
Other sultable thlckenlng agents are water-soluble salts of cellulose ethers, such as W 097/05854 PCTAUS96/121~9 sod~um carboxymethyl cellulose, hydroxy methyl cellulose, hydroxypropyl cellulose, and hydroxyethyl cellulose. Hatural gums such as gum karaya, gum arab1c, carrageenan and gum tragacanth, can also be used. Colloldal magnes~um alum~num sll~cate, s~l~ca aerogels, sil~ca xerogels, fumed s~l~ca, or other f~nely divlded s~l~ca can be used as part of the th~cken1ng agent for further ~mproved texture.
Typlcally, hydroph~l~c, non-aqueous, water-soluble veh~cles employed ~n the toothpaste or gel compos~t~ons of the Invent~on are present ~n an amount of from about 20X to 80S. Preferably, the veh~cles are present ~n an amount of from about 30X to 70S. The amount of hydroph~l~c, non-aqueous, water-soluble veh~cle employed 1n l~quld format~ons, e.g., mouthwashes, r~nses, sprays, and the l~ke is from about 50S to 95X.
In add~t10n to the rem~neral~z~ng ~ngred~ents of the ~nvent~on, su1table non-aqueous toothpastes and gels can be made by employing ~n the toothpaste or gel, from about 0.5X to 50~, preferably from about 5X to 40%, of an abras~ve, from about O.ZX to 5S of a suds~ng agent, from about O.IX to 5X of a b~nd1ng agent, and the balance, hydroph~l1c, non-aqueous veh1cle and m~nors, such as flavor, sweetner, color~ng, etc.
The pH of a of the toothpaste or gel conta~n~ng the active cat10n~c ~ngred~ents must have a pH of from about 4.5 to about 10.0 and, preferably, between about 5.0 and 7.0 when d~ssolved ~n sal~va.
Su~table abrastves ~nclude s~l~ca xerogels. Other convent~onal toothpaste abras~ves can be used ~n the compos~t~ons of th~s ~nventlon, and ~nclude beta-phase calc~um pyrophosphate, d~calc~um phosphate d~hydrate, anhydrous calcium phosphate, calc~um carbonate, z~ron~um s~l~cate, and thermosett1ng polymer1zed res~ns. S~l~ca aerogels and the ~nsoluble metaphosphates such as ~nsoluble sod~um metaphosphate can be used. M~xtures of abras~ves can be also be used. S~l~ca xerogel abras~ves are preferred.
Su~table sudslng agents are those wh~ch are reasonably stable and form suds throughout the per~od of appl~cat~on.
Preferably, non-soap an~on~c or non~on~c organ~c synthet~c detergents are employed. Examples of such agents are water-soluble salts of alkyl sulfate hav~ng from 10 to 18 carbon atoms ~n the alkyl rad~cal, such as sod~um lauryl sulfate, water-soluble salts of sulfonated monoglycer~des of fatty ac~ds hav~ng from 10 to 18 carbon atoms, such as sod~um monoglycer~de sulfonate, -WO 97/05854 PCT~US96/12189 -salts of Clo-C1g fatty acld am1des of taur1ne, such as sod1um N-methyl taurate, salts of Clo-Clg fatty ac~d esters of 1seth10n1c ac1d, and substant1ally saturated al1phat1c acyl am1des of saturated monoam1nocarboxyllc ac1ds hav1ng 2 to 6 carbon atoms, and tn whlch the acyl rad~cal conta1ns 12 to 16 carbon atoms, such as sod1um-N-lauryl sarcos1de. Mlxtures of two or more suds1ng agents can be used.
Toothpaste or gel compos1t10ns may also conta1n flaYorlng agents such as o11 of w1ntergreen, o11 of pepperment, o11 of spearm1nt, o11 of sassafras, and o11 of clove.
Toothpaste or gel compos1t10ns may also contaln sweeten1ng agents such as sacchar1n, dextrose, levulose, sod1um cyclamate. and aspartame M~xtures of sugar ~th a sweetner, e.g., sucralose, are contemplated.
It 1s, of course, also poss1ble to manufacture the dent1fr1ce compos~t10n 1n the form of a transparent or translucent gel. Th1s 1s accompl1shed by matchlng the refract~Ye 1ndex of the veh~cle w1th the abras1Yes or 1norgan1c th1ckeners, ~f used.
The non-aqueous rem~neral~z~ng systems here1n can also be prov~ded ~n the form of a mouthwash or s1m11ar product e.g., a mouthr~nse product. The mouthwash can be made 1n accordance WO 97/05854 PCT~US96/12189 w~th the follow1ng. Mouthwashes generally compr1se an alcohol, e.g., ethyl alcohol and flavor~ng mater~als. The alcohol prov~des an ant~bacter~al effect, solub~l~zes the flavor~ng mater~als and prov~des a pleasant mouth feel~ng.
Alcohol-free mouthwashes are now, however, ga~n1ng ~n popularlty.
An alcohol-free mouthwash would best be provlded ln the form of a dry powder or tablets wh1ch are added to water ~mmedlately before use. Such a product would conta1n 10 to g5~ rem1neral1ztng salts and the balance would be flavors, sweeteners, and opt~onally ant1bacter1al, efferves~ng agents etc.
Examples of sultable flavor~ng agents 1nclude hel10tropyl nltr~le, w1ntergreen o11 (methyl sal~cylate), oll of pepperm~nt, o11 of ass~a, o~l of an1se, o~l of c~nnamon, and m1xtures thereof. Su~table sweetenlng agents 1nclude sacchar~n, glycer~ne, sorb~tol, levulose, and 6-(tr~bluoromethyl)-tryptophane and aspartyl phenylalan~ne methyl ester.
It has been found that w1th the non-aqueous systems used 1n the present 1nvent~on some react~on between the calc~um and phosphate 10ns may, ~n fact, take place and cause some format~on of ~nsoluble calc~um phosphate, etc. dur~ng storage. The present W 097/OS8~4 PCTAUS96/12189 1nvent10n opt10nally overcomes th~s problem by 1ncludlng su~table stab~l~zers wh~ch prevent react~on of the calc~um ~ons wtth the phosphate 10ns and also w~th the fluor~de ~ons ~f they are present.
Any orally acceptable mater~al that stab~l1zes one or more of the calc~um, phosphate and/or fluor~de salts dur~ng storage of the non-aqueous compos1t1on ~n a closed conta~ner can be ewployed 1n the present compos1t~on.
Examples of su1table stab11~z~ng agents ~nclude desslcat1ng agents, coat~ng or encapsulating mater1als and m~xtures of such stab~l1z~ng agents.
Examples of su~table dess~catlng agents 1nclude magnes1um sulfate, sod1um sulfate, calc~um sulfate, calc~um chlor1de and collo~dal s111ca, e.g., collo1dal s~l1ca part~cles s~ntered together 1n chalnl1ke format10ns hav~ng surface areas of from about 50 to about 400 square meters per gram such as mater1als sold under the trademark Cab-0-S11 by Cabot Corp. It ~s bel~eved that such mater~als act 1n stab~l1z1ng the composlt1ons of the 1nvent~on by, for examp1e, absorb1ng any exlst1ng water e1ther present 1n or contacted w~th the compos~t~on so as to prevent react10n of the calc1um, phosphate and/or fluorlde salts.
-The stab~l~z~ng mater1al ~s 1ncluded ~n the compos~t~on of the ~nvent1On ~n an amount effect~ve so as to tnh~b~t react~on between the - calc1um, phosphate and/or fluor~de salts 1n the compos~t1On dur~ng storage ~n a closed conta~ner, but so as to allow release of suff~c~ent calc~um phosphate and/or fluor~de ~ons when the compos~tion ~s contacted w~th sal1va, e.g., dur~ng brush~ng of teeth.
Typ~cally, the stab~l~z~ng mater~al ~s ~ncluded ~n the compos~t~ons of the present ~nvent~on ~n an amount of up to about 7.5X, preferably from about O.lX to 5.0X.
In an embodlment of th~s ~nvent~on there ls prov1ded a stable slngle-part non-aqueous dent~fr~ce product for rem~neral~z~ng dental enamel compr~s~ng~
from about O.OSX to 15.0X, preferably about O.lOX to IO.OX, water-soluble calc~um salt; (~) from about 0.05X to 15.0X, preferably about O.IOX to IO.OX water-soluble phosphate salt, opt~onally together w~th from about O.OlX to lO.OX and preferably from about 0.02X to S.OX
water-soluble fluor1de salt, (~) from about 0 to 7.5X of an orally acceptable dess~cat~ng agent; and (~v~ wherein when the salts are contacted w~th water or sal~va the pH ~s between about 4.5 and 10.0 and preferably between about 5.0 and 7Ø
W O 97/05854 PCTrUS96/12189 Another method for ~nh~b~tlng premature react~on of the calc~um, phosphate and/or fluorlde salts ~n the dentifrlce composltions of the present lnvent~on ~s to provlde a coatlng on or encapsulatlon thereof, e.g., wlth an oleophll~c or, preferably, a polymer~c mater~al, whlch prevents reactlon between the act~ve mater~als. The presence of the coatlng on the varlous salts ~n the compos~t~ons of the present ~nventlon preYents react~ons of the act~ve mater~al by other substances, for example, by traces of water ~n or absorbed ~nto the system. Preferably, the coat~ng ~s an ed~ble coat~ng. Su~table encapsulat~ng or coat~ng mater1als ~nclude oleoph~l~c and other mater~als such as conventlonal edlble gums, polymers whlch exhlb~t proportlon rang1ng from hydroph~l~c to hydrophob~c (water-lnsoluble). reslns, waxes and mlneral o~ls. The coatlng ls preferably r1nsable from the mouth.
In accordance wlth the ~nvent~on a polymer employed for coat1ng the water-soluble calc~um and/or phosphate salt part~cles and the l~ke of the ~nvent~on ls selected from hydrophlllc organ1c polymers and hydrophoblc (water-~nsoluble) organlc polymers and m~xtures thereof.
-A hydroph~l~c polymer employed for coat~ng the rem1neral~z~ng salt part~cles ls selected from water-soluble and water-d~spers1ble oraan~c polymers. A m~xture of polymers can be employed, and a content of between about 5.0X to 95.0~ of a water-~nsoluble polymer, based on the coat~ng we~ght, can be ~ncluded w~th a hydroph~l~c polymer.
The term "hydroph~l~c" as employed here~n refers to an organlc polymer wh~ch has a water-solub~l~ty of at least about one gram per 100 grams of water at 25~C. The term nhydrophob~c~ or ~water-~nsoluble" as employed here~n refers to an organ~c polymer wh~ch has a IS water solub~l~ty of less than about one gram per 100 grams of water at 25~C.
Su~table hydroph~l~c polymers for coattng rem~neral~z~ng salt partlcles ~nclude gum arab~c, gum karaya, gum tragacanth, guar gum, locust bean gum, xanthan gum, carrageenan, alg~nate salt, case~n, dextran, pect~n, agar, sorb~tol, 2-hydroxyethyl starch, 2-am~noethyl starch, maltodextr~n, amylodextrtn, 2-hydroxyethyl cellulose, methyl cellulose, carboxymethyl cellulose salt, cellulose sulfate salt, polyv~nylpyrrol~done, polyethylene glycol, polypropylene glycol, polyethylene ox~de, polyv~nyl alcohol/acetate, and the l~ke.
-WO 97/05854 PCT~US96/12189 Polyv1nyl acetate ~s tllustrat1ve of a water-1nsoluble polymer whlch can be 1ncluded as ~ an add1ttonal coattng component to moderate the hydrophtl1ctty of a hydroph111c polymer coat~ng.
Su1table water-tnsoluble polymers, alone or 1n combtnatton wlth one or more other components, for coattng rem~neraltzlng salt part1cles 1nclude polyvtnyl acetate, polyacrylamtde, polyv1nyl chlortde, polystyrene, polyethylene, polyurethane, and the 11ke.
The appl1catlon of the polymer coat1ng to the blend of calc1um, phosphate, and other salt part1cles of the tnvent10n process ts accompl1shed by convent10nal means such as pan coat1ng, flutd1zed coat1ng, centr1fugtl flutdtzed coat1ng, and the l~ke. The coat~ng polymer usually ts dtssolYed 1n a suttable solvent such as water, methanol, ethanol, acetone, tetrahydrofuran, ethyl acetate, dtmethylformam1de, and the 11ke, as appropr1ate for a selected polymer spectes. A coattng polymer also can be appl1ed 1n the form of an emulsion or suspenslon. After the coatlng med~um ts appl1ed to the part~cles, the solvent med~um ts removed by evaporatton, thereby formtng a conttnuous f~lm coat~ng whlch encapsulates the dtscrete crystall1te parttcles.
The coat~ng th~ckness on the surface of the salt typ1cally w111 Yary 1n the range between about 0.1-20 m1crons. The coat1ng can cons1st of a s1ngle layer or mult1ple layers.
- The polymerlc coat1ng can const1tute between about 5.0X to 50.0X of the total dry we19ht of the coated part1cles.
For purposes of release of the core matr1x rem~nerallz1ng calc1um phosphate and, 1f des1red, fluor1de salts 1n the encapsulated part1cles when 1ntroduced 1nto the aqueous env1ronment, a surface coat1ng of water-1nsoluble polymer of the oral cav1ty may have a content between about 5.0X to 30.0X
we19ht percent of a part1culate water-extractable organ1c or 1norgan1c f111er, such as sod1um monosacchar1de or d1saccharlde, sorb1tol powder, mann1tol, and the 11ke.
The rate of release of rem1neral1z1ng salt core matr1x content of the encapsulated part1cles under aqueous cond~t1Ons can be controlled by the quant1ty and type of polymer coat1ng on the part1cle surface.
Low molecular we19ht hydroph111c polymers w111 release the part1cle core matr1x content at a relatlvely fast rate 1n the presence of mo1sture. H19h molecular we1ght polymers wh1ch are less hydroph111c w111 release at a relat1vely slow rate. Add~t~onal rate -contro1 ~s obta1ned by employ~ng m~xtures of polymer components of var~ed hydroph~l~clty.
Polyethylene glyco1 (M.~. of 4000) or polyv1nyl alcohol will release the part1cle core matr1x content at a relat~vely fast rate.
Polyethylene ox~de (M.W. of 4,000,000) or part1ally hydrolyzed polyv~nyl acetate wlll release at a relat1Yely slow rate.
Polyv~nylpyrrol~done wlll release the part~cle core matr1x content at an 1mmed1ate rate, when the encapsulated part~cles lncorporated 1nto a dent1fr1ce, e.g., toothpaste or gel, are appl~ed to the teeth.
A present ~nvent10n encapsulated rem~nerallzlng salt part~cle compos1t~on exh~b1ts a un1que comb~nat10n of propert1es because of the novel phys~cal form of the free-flow~ng, but substant~ally ~nert, polymer-coated partlcles when ut111zed as an ~ngred~ent 1n a dent1fr1ce.
Examples of su~table oleoph11~c coat1ngs or enscapsulat1ng mater1als ~nclude paraffln, m~neral o~l, edlble olls such as peanut o11, coconut o~l. palm o11, or safflower oll, oleoph~llc organ1c esters such as ~sopropyl slloxane myr1state or ~sopropyl palm1tate, ed~ble polys~loxanes, and the 11ke.
EncapsulAt~ng salts w1th a m1xture of par~ff~n and waxes ~s also su1table.
W O 97/05854 PCT~US96/12189 -8y employ1ng m~neral o11 as an oleoph~l~c coat~ng mater~al for the calc~um, phosphate and/or fluor~de salts ~n the compos~t~ons of the ~nventton, one other S advantageous character~st~c ~s prov~ded.
Spec~f~cally, oral bacter~a known to be adversely affected by oleoph~l~c mater~als.
Thus, the m~neral o~l used ~n the compos1t~ons of the ~nventton will help ~n remov~ng undes~red bacter1a dur~ng the course of treatment.
The coat~ng should be of a th1ckness and compos~tion so that ~t elther readlly d~ssolves, d~sperses or emuls~f~es ~n water, e.g., ~n the mouth dur~ng brush~ng, or d1s~ntegrates durtng such act~on to release the act~ve mater~als, ~.e., one or more salts.
~ f the oleoph~l~c materlal used for the coat~ng 1s water ~nsoluble, such as mlneral o~l, the coat~ng phase can be pre-emuls~f~ed w~th a non-ionic, non-aqueous surfactant such as a hydroph~l~c ethoxylated sorbltan monooleate, e.g., the mater~al sold under the trademark Tween. In th~s manner, when the compos~t~on ls placed ~n water. the m~neral o~l or other oleph~llc coat~ng on the part~cles ~s emuls~f~ed more read~ly than without the emuls~f~cat~on agent be1ng present. Other s~m~lar surfactants can be employed such as sod~um lauryl sulfate and other non-~on~c surfactants.
CA 02226448 l998-0l-07 WO 97/05854 PCT~US96J12189 In an embod~ment of th~s ~nvent~on there ~s prov~ded a stable s~ngle-part non-aqueous dent~fr~ce product for rem1neral~zlng dental enamel compr~s1ng~
from about 0.05X to 15.0X, preferablY about O.lOX to lO.OX, water-soluble calc1um salt; (~) from about 0.05X to 15.0X, preferablY about O.lOX to lO.OX water-soluble phosphate salt, opt~onally together w~th from about O.OlX to lO.OZ and preferably from about 0.02X to 5.0X
water-solub1e fluor~de salt. (~) where~n there ~s an encapsulat~ng coat1ng on at least one of the water-soluble salts that e1ther read~ly d~ssolves, d~sposes or emuls~f~es ~n water, e.g., sal~va, and ~v) wherein when the salts are contacted w1th water and/or sal~va the pH ~s between about 4.5 and 10.0 and preferably between about 5.0 and 7Ø
In another embod~ment of th~s ~nvent~on there ~s prov~ded a stable, s~ngle-part non-aqueous product for rem~neral~zatlon wh1ch can be reconst~tuted lnto a mouthwash by add~t1On of water or tnto other products from the concentrate-l~ke product.
Accord~ngly the product compr1ses from about l.OX to 80.0X of a calclum salt, from about 1.0X
to 80.0X of a phosphate salt, from about O.lX to 20.0X of a stab~l~zer compr~s~ng a mater1al WO 97/058~4 PCT/US96/12189 selected from at least one member of the group cons~st~ng of a desslcat1ng agent and a coat1ng of at least one of the water-soluble salts that e~ther read~ly d~ssolves, d~sperses or emuls~f~es ~n water, from about O.QlX to 20.0X
of a flavor, from about O.OlX to 30.X of a sweetener, from 0 to about lO.OX of a fluor~de salt, from 0 to about 5.0X of a surfactant and where~n when the concentrate ~s m~xed w~th water the pH of the result~ng m~xture is between about 4.5 and 10Ø
In st~ll another embodlment of th~s ~nvent~on there ~s prov~ded a stable s~ngle-part non-aqueous product for remlneral~z1ng dental enamel comprls~ng: (~) from about 0.05X to 15.0X, preferably about O.lOX to lOX, water-soluble calc~um salt; (~) from about 0.05X to 15.0X, preferably about O.lOX to lOX
water-soluble phosphate salt, opt~onally together w~th from about O.OlX to 10.0X and preferably from about 0.02X to 5.0X fluor1de releas~ng agent, (~i~) from about 0 to 7.5X of an orally acceptable dess~cat~ng agent;
(~v) a hydroph~l1c, non-aqueous veh~cle wh~ch ~s water-soluble; and (v) where~n when the salts are contacted w~th water or sal~va the pH ~s between about 4.5 and lO.0 and preferably between about 5.0 and 7Ø
W097t0~854 PCTAUS96/12189 A plural1ty of packag1ng methods may be employed 1n order to conta~n or store the components and prov1de effect1ve d1spenslng thereof into the oral cav~ty.
Thus, the components of a toothpaste, gel, cream, or the 11ke, may be s1multaneously d1spensed from separate collaps1ble tubes preferably made of plast1c, a plastlc and metal lam1nate, etc.
The tubes of the above embod~ments are usually f111ed from the bottom and are subsequently sealed together by conventlonal techn~ques.
Another alternat1ve packag1ng arrangement compr1ses of a pressur1zed conta1ner wh1ch 1s prov1ded w1th a compartment and a spout. The 1nternal pressure of the compartment 1s ma~nta1ned by a pressur1zed gas, l.e., n1trogen, at the bottom of the compartment.
Operat~on of a mechanlcal actuator actuates a valve wh1ch releases the contents of the compartment through the spout caus1ng d1scharge of the paste or gel components onto a brush.
The mouthwash or r~nse and sim11ar Z5 11qu1d embod~ments are ma~nta~ned 1n a manner s1m11ar to the pastes or gels 1n that dur~ng storage, each of the components are stab11~zed w1th regards to one another to prevent premature -react~on. Upon d1spensing, the components m~x and react ~n the oral cav~ty to effect rem~neral~zat~on of dental enamel. The llqu~d - components can therefore be stored ln the compartment of a d~spenser. The d~spenser usually 1ncludes a closure system compr~s~ng for example, an tncl~ned crown port~on, a pour~ng spout extend~ng upwardly from an upper surface of the crown port~on and a cover for securement to the crown port~on. The cover ~s provided w~th closure means, for example, depend~ng plugs, to close the closure. The pour~ng spout ~s preferably prov1ded w~th a vent open~ng ~n add~t~on to a product or~f~ce ~n the spouts.
Transparent contalners have proven to be the most satisfactory. Transparency a~ds a person's ab11~ty to accurately and controllably d~spense relat~vely exact volumes from a d~spenser.
Transparent walled conta~ners also serve as a wlndow funct~on for gaug1ng the amounts of l~qu~d rema~n~ng ~n the d~spenser. The walls of the conta~ners can be scr~bed or otherw~se cal~brated to ass~st ~n d1spens~ng the correct rem~nerallzlng amount of product.
~h~le appl~cants do not w~sh the scope of the present ~nvent~on to be l~m~ted by theory, ~t ~s bel~eved that the calc~um, phosphate, and fluor~de ~ons d~ffuse through the W097/05854 PCT~US96/12189 tooth surface to the dem~neral~zed subsurface and preclp~tate ~n the dem~neral~zed subsurface where they rem~neral~ze the tooth structure.
Th1s ~s surpr~slng because suff~c1ent calc~um, phosphate, and fluoride ~ons rema~n soluble for a per~od of t~me sufftc~ent to permtt the~r d~ffuslon ~nto the dem~neral~zed subsurface of the dental enamel. Th~s ~s accompl~shed by allow~ng the product to m~x w~th sal~va when applled to the teeth or by comb~n~ng the part~cular ~ons just pr~or to the~r appl~cat~on to the teeth in a solut10n hav~ng a pH of about 4.5 to 10 and preferably from about 5.0 to 7 at wh~ch pH enough of the calc~um, phosphate, and fluor~de ~ons rema~n soluble for the per~od of t~me requ~red to rem~neral~ze the les~ons of the dental enamel. As here~nbefore descr~bed, salts y~eld~ng the calclum lons, phosphate ~ons, and ~f des1red, fluor~de ~ons are stored ~n a hydroph~l~c, non-aqueous veh~cle andJor are stab~l~zed against react~on to avo~d the premature prec~p~tat~on of calc~um phosphate.
Chemtcally equ~valent concentrat~ons are not necessary as long as the molar rat~o of calc~um and phosphate ~ons ~n the mixture is from about 0.01 to U? to 100 to 1. It ~s preferred that the rat~o ~s from about 0.2 to 1 up to 5 to 1, and ~t ~s most preferred that the W 097/05854 PCTrUS96/12189 rat~o ts between about 1 to 1 and 1.~67 to 1; the rat~o of calc1um to phosphate ~n ~nsoluble calc~um phosphate salts.
W~th regard to the length of t~me of exposure to the teeth of the solut~ons applled to, or formed ~n, the oral cavtty ~t ~s neces5ary that the per~od of t~me be great enough to allow d1ffus~on of the ~ons lnto the dem~neral~zed subsurface. At least about ten seconds are requtred for th~s d~ffus10n. The paste, gel, or aqueous solut10n ~s preferably appl~ed to the teeth for from about 10 seconds to about S mlnutes. The pH of the solut~on rema~ns relat~vely constant after ~ts ~ntroduct~on ~nto the oral cav~ty. Calc~um phosphate may prec~p~tate at th~s pH, but most surpr1s~ngly wh~le some of the prec~pttat~on may occur ~mmed~ately and some small amount even before appllcat~on to the teeth, suff~c~ent calclum, phosphate and fluor~de ~ons rema~n ~n solut~on to d~ffuse ~nto the teeth and rem~neral~ze the dem~neral~zed dental enamel. It ~s bel1eved that the ab~l~ty of the solut~ons to provlde ~ons for remlneral~zat~on ~s greatest upon the~r f~rst ~ntroduct~on 1nto the oral cav~ty, thereafter decreas~ng.
~ lth a toothpaste, gel, and the l~ke, m~x~ng ~s achleved on the surface to the teeth W 097/05854 PCTAUS96/lZ189 whtle brush1ng and w1th a l~quid non-aqueous mouthwash upon ~ntroduct~on 1nto the oral cav~ty. The essence of the present ~nvent~on 11es with the stable, s1ngle part product; ~n the m1xing of the product components 1n the mouth; and the qu1ck and t~mely appl~cat10n of the result1ng aqueous solut10n wh1ch w111 prec1p1tate calc1um phosphate, calctum fluor~de, and calc1um fluoro-apatlte ~n the subsurface enamel of the teeth. Before such preclpltat10n occurs, the m1xture comprls1ng the aqueous solut10n must qu1ckly be appl~ed to the teeth.
Surpr1slngly, the solut~on can have a pH of about 4.5 to 10, but preferably about 5.0 to 7 to ach1eve th1s result. At a pH below about 3, dem1neral1zatton occurs rap~dly. A pH below 2.5 ls generally undeslrable from a safety standpo1nt.
The pH of the solut~ons of the present lnvent10n may be adjusted to the pH des1red by methods well known 1n the art. The pH may be controlled by the add1t10n of any ac1d whlch 1s safe for use 1n the oral cav~ty and wh1ch y1elds the des1red pH at the amount employed. Examples of suitable ac~ds are acet1c ac1d, phosphor~c ac1d, hydrochlor1c ac1d, c1tr1c ac1d and maltc ac1d; by the add1t10n of a base, for example.
sod~um hydrox~de; or buffered, for example with WO 97/05854 PCT~US96/12189 sod~um c~trate benzoate, carbonate, or b1carbonate, d~sodlum hydrogen phosphate, sod~um d~hydrogen phosphate, etc. Preferably the rem~neral~z~ng salts employed can be selected to obta~n the des~red pH. Usually a comblnat~on of monobas~c, d~bas~c and/or tr~bas~c alkal~ metal phosphate salt ~s selected to provide the target pH.
The follow~ng Examples ~llustrate the ~nvent~on: In the Examples and elsewhere here~n parts and percent are by welght unless otherw~se stated.
In th1s example a non-aqueous product for testlng was prepared and m1xed with water ~ust prev10us to testlng. The testlng procedure was as follows:
Artlf1clal les~ons, about 50 u deep, were formed ln one surface of bovine enamel chlps us1ng a demineral1zlng Carbopol gel, wh1ch was used to treat the speclmens for 72 hours. The surface hardness of the surface to be treated was then measured.
The reglmen cycle cons1sted of a 30 m1nute dem1neral1zatlon ln a standard demlneral1zlng solut10n followed by a 5 minute treatment of the test products d11uted 1 part product to two parts human sal1va, followed by a 60 m~nute remlneral1zatlon 1n human sal1va. Overn1ght, wh1ch was every flfth cycle, the speclmens were kept w1th a layer of sallva and stored ~n a cold room. The test ran for three days, from a total of 15 dem1nerallzat10n:treatment:rem~neral1zat10n cycles.
For the treatment cycle, the rem1neraliz1ng test agent of the example was d11uted 1 part product to 2 parts sal1va and mtxed together 1mmed1ately before 1mmers~on of the enamel spec1mens.
The non-aqueous oral remlneral1zlng test agent was prepared as follows:
Calclum n1trate 4 25 Dipotass1um phosphate 8.00 Sodlum fluor1de 0.55 Glycerln 50 Acetlc ac~d To ad~ust pH of A ~ B mlxture of 5.5 ~0 lmmedlately after mlxlng.
The above product was then mlxed w1th 137.45 parts of water to solubll1ze the salts and then was d11uted wlth sal1va as descr1bed above.
WO 97/05854 PCT~US96/12189 (V1ckers Hardness Units) 1200 ppm Fluor~de at ExamPle 1 Crest pH 5.5Placebo 5 cycles17.0 + 1.9 11.8 + 1.4 10 cycles23.6 + 1.413.0 + 3.6 13.7 + 2.3 3.9 + 0.7 15 cycles34.8 + 2.811.2 + 1.7 20 cycl~s48.2 + 2.817.5 + 2.2 (ug/cm3~
1200 ppm Fluor~de at Example 1 Crest PH 5.5Placebo 5 cycles 2433 1879 10 cycles 3523 Z082 2928 244 15 cycles 4431 2196 20 cycles 4749 2964 The results show much greater rem~neral~zat~on, as measured by hardness ~ncrease and fluor~de ~ptake, due to treatment wlth the product of Example 1 than Crest, fluor~de solut1On or placebo.
EXAMPLES 2. 3. 4 and 5 Examples 2-S 111ustrate var~ous embod~ments of rem~neral1z~ng toothpaste formulat~on of the ~nvent~on as follows:
Example Glycer~n 55.560.00 0.00 59.54 Carbowax 400 Q.0038.15 0.00 0.00 Propylene glycol 0.00 0.00 42.80 0.00 S~l~ca abras1ve 15.000.00 0.00 12.00 S~l~ca thlckener 8.00 4.00 4.00 6.00 DCPDH* 0.0040.00 0.00 0.00 Calc~um chlor~de 5.00 0.00 0.00 5.00 Calc~um glycerophosphate0.007.50 3.50 5.00 D~sod~um phosphate3.707.50 6.50 10.00 Sod~um meta-phosphate 0.00 0.00 38.00 0.00 Sod~um lauryl sulfate 1.50 1.70 1.20 1.00 Sod~um fluor~de 0.24 0.00 0.00 0.00 Stannous fluorlde0.00 0.00 1.80 0.00 Sod1um MFP 0.00 0.00 0.00 0. 76 Flavor 0.80 0.90 0.90 0.70 Sacchar~n O.Z00. 20 0.30 0.20 *DCPDH = D~calclum phosphate d~hydrate Example 6 lllustrates an embod~ment of a remlnerallz~ng mouthwash formulat~on and Example 7 ~llustrates a dry-m~x concentrate su~table for d~lution as follows:
Example 6 ExamPle 7 61ycertn QS
Ethanol 5.00 Sod~um MFP 0.20 Calc~um nttrate 7.00 50 Monopotass~um phosphate4.00 41.725 Sod~um fluor~de 0.275 Spray dr~ed flavor1.0 5.0 Aspartame 0. 6 3.0 Example 7 ~s d~luted 59 to 100 9 -~ater before use.
Example 8-11 lllustrate dry-m~x concentrated formulat~ons wh~ch can be d~luted w~th water when they are to be employed.
Example Calc~um lactate pentahydrate 59.7 Calc~um acetate anhydrous 40.0 Calc~um gluconate 65.0 Encapsulated~ calc~um n1trate 97~ 45.4 10 Magnes~um chlor~de 10.0 Monopotass~um phosphate 30.0 Z8.0 21.0 D~potass~um phosphate 8.0 Monosod~um phosphate 12.5 D~sodium phosphate 2.5 7.0 15 Sod~um fluoride 0.3 Stannous fluor~de 2.5 Sod1um MFP 3.6 Flavor 6.0 4.0 5.0 15.0 Sacchar~n 3.0 2.5 8.0 20 Aspartame 20.0 *Cacl~um nitrate encapsulated w~th water soluble ethyl cellulose encapsulent Usage Concentrat~on 1.0 9 0.75 g 1.2 9 0.429 per oz per oz per oz per oz Examples 12-14 each ~llustrate a formulat10n wh~ch can be employed as an efferevercent mouthwash when dllutent w1th water.
Example 5 Calctum acetate anhydrous 30.0 Encapsulated* calc~um n1trate 97X 26.0 36.0 Monopotasstum phosphate 20.0 28.0 30.0 Mal~c acld 16.0 17.0 11.0 Magnes~um chlor~de 5,0 Sodlum bicarbonate lO.0 15.0 10.0 Sod1um fluorlde Z.0 2.0 Flavor 6.0 5.5 4.0 Saccharln 4.5 2.0 Aspartame 20.0 *Calc~um nltrate encapsulated w1th water soluble ethyl cellulose encapsulent Usage Concentrat1On 5.0 9 4.0 9 5.0 9 per oz per oz per oz
Claims (45)
1. A stable, single part, non-aqueous, dry-mix product which may be diluted with water to form an aqueous product for remineralizing lesions in teeth comprising:
(i) from about 1.0% to 80.0% of at least one water-soluble calcium salt;
(ii) from about 1.0% to 80.0% of at least one water-soluble phosphate salt; and (iii) a stabilizer comprising a material selected from at least one member of the group consisting of from about 0.1% to 20.0% of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water;
(iv) wherein when the components are diluted the pH of the aqueous product is between about 4.5 and 10Ø
(i) from about 1.0% to 80.0% of at least one water-soluble calcium salt;
(ii) from about 1.0% to 80.0% of at least one water-soluble phosphate salt; and (iii) a stabilizer comprising a material selected from at least one member of the group consisting of from about 0.1% to 20.0% of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water;
(iv) wherein when the components are diluted the pH of the aqueous product is between about 4.5 and 10Ø
2. The product according to claim 1 wherein the product contains up to about 10.0% of at least one water-soluble fluoride salt which yields fluoride ions.
3. The product according to claim 1 wherein the product contains from about 0.10% to 20.0% of a flavor.
4. The product according to claim 1 wherein the product contains from about 0.10% to 30.0% of a sweetner.
5. The product according to claim 1 wherein the product contains up to about 5.0% of a surfactant.
6. The product according to claim 1 wherein the pH of the mixture is from about 5.0 to 7.0 upon diluting.
7. The product according to claim 1 wherein said product is in the form of a powder, granular material, flake, or tablet.
8. A stable, single part, non-aqueous product for remineralizing lesions in teeth comprising:
(i) from about 0.05% to 15.0% of at least one water-soluble calcium salt;
(ii) from about 0.05% to 15.0% of at least one water-soluble phosphate salt; and (iii) a stabilizer comprising a material selected from at least one member of the group consisting of up to about 7.5% of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water;
(iv) wherein when the components are mixed with water or saliva the pH of the mixture is between about 4.5 and 10Ø
(i) from about 0.05% to 15.0% of at least one water-soluble calcium salt;
(ii) from about 0.05% to 15.0% of at least one water-soluble phosphate salt; and (iii) a stabilizer comprising a material selected from at least one member of the group consisting of up to about 7.5% of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water;
(iv) wherein when the components are mixed with water or saliva the pH of the mixture is between about 4.5 and 10Ø
9. The product according to claim 8 wherein the product contains from about 0.01% to 5.0% of at least one water-soluble fluoride salt which yields fluoride ions.
10. The product according to claim 8 wherein the product contains from about 0.10% to 10.0% of said calcium salt.
11. The product according to claim 8 wherein the product contains from about 0.10% to 10.0% of said phosphate salts.
12. The product according to claim 11 wherein the product contains from about 0.02% to 2.0% of said fluoride salt.
13. The product according to claim 8 wherein the pH of the mixture is from about 5.0 to 7.0 upon mixing.
14. The product according to claim 8 wherein the molar ratio of calcium and phosphate ions in the two components is from about 0.01 to 1 up to 100.0 to 1.
15. The product according to claim 14 wherein the molar ratio of calcium and phosphate ions in the two components is from about 0.2 to 1 up to 5.0 to 1.
16. The product according to claim 8 wherein said product is in the form of a powder, qranular material, flake, or tablet.
17. The product according to claim 8 wherein the said product contains from about 100 ppm to 35,000 ppm calcium ions and from about 100 ppm to 40,000 ppm phosphate ions.
18. The product according to claim 8 wherein said product contains from about 20 ppm to 5,000 ppm fluoride ions.
19. A stable, single part, non-aqueous product for remineralizing lesions in teeth comprising:
(i) from about 0.05% to 15.0% of at least one water-soluble calcium salt;
(ii) from about 0.05% to 15.0% of at least one water-soluble phosphate salt;
(iii) a hydrophilic, non-aqueous vehicle which is water-soluble; and (iv) wherein when the salts are contacted with water or saliva the pH
of the mixture is between about 4.5 and 10Ø
(i) from about 0.05% to 15.0% of at least one water-soluble calcium salt;
(ii) from about 0.05% to 15.0% of at least one water-soluble phosphate salt;
(iii) a hydrophilic, non-aqueous vehicle which is water-soluble; and (iv) wherein when the salts are contacted with water or saliva the pH
of the mixture is between about 4.5 and 10Ø
20. The product according to claim 19 wherein said product contains from about 0.01% to 5.0% of at least one water-soluble fluoride salt which yields fluoride ions.
21. The product according to claim 19 wherein the product contains from about 0.10% to 10.0% of said calcium salt.
22. The product according to claim 19 wherein the product contains from about 0.10% to 10.0% of said phosphate salt.
23. The product according to claim 22 wherein the product contains from about 0.02% to 2.0% of said fluoride salt.
24. The product according to claim 19 wherein the pH of the mixture is from about 5.0 to 7.0 upon mixing the two components.
25. The product according to claim 19 wherein the molar ratio of calcium and phosphate ions is from about 0.01 to 1 up to 100.0 to 1.
26. The product according to claim 25 wherein the molar ratio of calcium and phosphate ions is from about 0.02 to to 1 up to 5.0 to 1.
27. The product according to claim 19 wherein the product is a non-aqueous paste, a gel or a professional gel.
28. The product according to claim 19 wherein the product is a non-aqueous liquid mouthwash or rinse.
29. The product according to claim 19 wherein the product contains from about 100 ppm to 35,000 ppm calcium ions and from about 100 ppm to 40,000 ppm phosphate ions.
30. The product according to claim 19 wherein the product contains from about 20 ppm to 5,000 ppm fluoride ions.
31. A method for remineralizing lesions in teeth comprising:
(i) applying to the teeth a stable, single part, non-aqueous composition comprising from about 0.05% to 15.0% of at least one water-soluble calcium salt;
from about 0.05% to 15.0% of at least one water-soluble phosphate salt; and a stabilizer comprising of a material selected from at least one member of the group consisting of up to about 7.5%
of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water (ii) contacting the composition with an aqueous solvent for the salts comprised of water or saliva wherein the resulting mixture has a pH of from about 4.5 to 10.0; and (ii) applying said mixture as an aqueous solution to the teeth for a sufficient time that the calcium and phosphate ions from each of the salts diffuse into the subsurface of demineralized enamel and subsequently precipitate to form hydroxyapatite and remineralize the dental enamel.
(i) applying to the teeth a stable, single part, non-aqueous composition comprising from about 0.05% to 15.0% of at least one water-soluble calcium salt;
from about 0.05% to 15.0% of at least one water-soluble phosphate salt; and a stabilizer comprising of a material selected from at least one member of the group consisting of up to about 7.5%
of a dessicating agent and a coating on at least one of the water-soluble salts that either readily dissolves, disperses or emulsifies in water (ii) contacting the composition with an aqueous solvent for the salts comprised of water or saliva wherein the resulting mixture has a pH of from about 4.5 to 10.0; and (ii) applying said mixture as an aqueous solution to the teeth for a sufficient time that the calcium and phosphate ions from each of the salts diffuse into the subsurface of demineralized enamel and subsequently precipitate to form hydroxyapatite and remineralize the dental enamel.
32. The method according to claim 31 wherein the product is in the form of a powder, granular material. flake, or tablet.
33. The method according to claim 31 wherein the product contains a hydrophilic, non-aqueous vehicle which is water-soluble.
34. The method according to claim 33 wherein the product applied to the teeth is a non-aqueous paste, a gel, or a professional gel and is extruded onto a toothbrush.
35. The method according to claim 31 wherein the product applied to the teeth is a non-aqueous mouthwash or rinse.
36. The method according to claim 31 wherein the period of application of calcium and phosphate ions to the teeth is from about 10 seconds up to 15 minutes.
37. The method according to claim 31 wherein the product contains from about 0.10% to 10.0% of said calcium salt.
38. The method according to claim 31 wherein the product contains from about 0.10% to 10.0% of said phosphate salt.
39. The product according to claim 31 wherein the product contains from about 0.01% to 4.0% of at least one water-soluble fluoride salt which yields fluoride ions.
40. The method according to claim 39 wherein the product contains from about 0.02% to 2.0% of said water-soluble fluoride salt.
41. The method according to claim 31 wherein the resulting dissolved product has a pH of from about 5.0 to 7Ø
42. The method according to claim 31 wherein the molar ratio of calcium and phosphate ions is from about 0.01 to 1 up to 100.0 to 1.
43. The method according to claim 42 wherein the molar ratio of calcium and phosphate ions is from about 0.2 to 1 up to 5.0 to 1.
44. The method according to claim 31 wherein the product contains from about 100 ppm to 35,000 ppm calcium ions and from about 100 ppm to 40,000 ppm phosphate ions.
45. The method according to claim 31 wherein the product contain from about 20 ppm to 5,000 ppm fluoride ions.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US08/512,287 US5571502A (en) | 1995-08-08 | 1995-08-08 | Stable single-part compositions and the use thereof for remineralization of lesions in teeth |
US08/512,287 | 1995-08-08 |
Publications (1)
Publication Number | Publication Date |
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CA2226448A1 true CA2226448A1 (en) | 1997-02-20 |
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Application Number | Title | Priority Date | Filing Date |
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CA002226448A Abandoned CA2226448A1 (en) | 1995-08-08 | 1996-07-26 | Composition and method for remineralization of teeth |
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US (3) | US5571502A (en) |
EP (1) | EP0850042A4 (en) |
JP (1) | JPH10510550A (en) |
KR (1) | KR100255920B1 (en) |
CN (1) | CN1192673A (en) |
AU (1) | AU698534B2 (en) |
BR (1) | BR9609829A (en) |
CA (1) | CA2226448A1 (en) |
MX (1) | MX9801062A (en) |
WO (1) | WO1997005854A1 (en) |
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-
1995
- 1995-08-08 US US08/512,287 patent/US5571502A/en not_active Expired - Lifetime
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1996
- 1996-07-26 MX MX9801062A patent/MX9801062A/en unknown
- 1996-07-26 CN CN96196125A patent/CN1192673A/en active Pending
- 1996-07-26 KR KR1019980700846A patent/KR100255920B1/en not_active IP Right Cessation
- 1996-07-26 EP EP96927250A patent/EP0850042A4/en not_active Withdrawn
- 1996-07-26 BR BR9609829A patent/BR9609829A/en unknown
- 1996-07-26 WO PCT/US1996/012189 patent/WO1997005854A1/en not_active Application Discontinuation
- 1996-07-26 JP JP9508454A patent/JPH10510550A/en not_active Withdrawn
- 1996-07-26 AU AU67133/96A patent/AU698534B2/en not_active Ceased
- 1996-07-26 CA CA002226448A patent/CA2226448A1/en not_active Abandoned
- 1996-08-02 US US08/691,328 patent/US5614175A/en not_active Expired - Lifetime
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1997
- 1997-01-21 US US08/786,211 patent/US5866102A/en not_active Expired - Lifetime
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AU698534B2 (en) | 1998-10-29 |
KR19990036178A (en) | 1999-05-25 |
BR9609829A (en) | 1999-03-09 |
US5571502A (en) | 1996-11-05 |
US5866102A (en) | 1999-02-02 |
EP0850042A1 (en) | 1998-07-01 |
EP0850042A4 (en) | 2000-01-05 |
CN1192673A (en) | 1998-09-09 |
JPH10510550A (en) | 1998-10-13 |
US5614175A (en) | 1997-03-25 |
WO1997005854A1 (en) | 1997-02-20 |
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