Comparative analysis of the remineralization potential of CPP-ACP with Fluoride, Tri-Calcium Phosphate and Nano Hydroxyapatite using SEM/EDX - An in vitro study.

C Thimmaiah,S Natarajan,Sb Shetty,Na Thomas,P Shetty

doi:10.4317/jced.55941

Abstract

BackgroundIn recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX).Material and Methods40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX.ResultsThe Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP.ConclusionsCPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface. Key words:Remineralization, in vitro; CPP-ACP fluoride, Nano-hydroxyapatite, Tri-calcium phosphate, SEM/ EDX.

Highlights

The current concept of caries process is based on accumulation of numerous episodes of demineralization and remineralization, rather than a unidirectional demineralization process [1]
Greater deposits were observed in CPP-ACPF group quantitatively (Fig. 4A) .There was an increase in the Ca/P mass percentage post remineralization when compared to demineralization (Fig. 4B)
Post Hoc Analysis was done for each group at three different intervals which showed that the comparison of difference between mean values of Ca/P mass % after demineralization and remineralization was highest in TCP with Fluoride (0.183).This difference was statistically significant with a P Value

Summary

Introduction

The current concept of caries process is based on accumulation of numerous episodes of demineralization and remineralization, rather than a unidirectional demineralization process [1]. The non-invasive treatment of early carious lesions by remineralization has the potential to be a major advance in clinical management of dental caries [3]. Scanning Electron Microscopy has been a useful tool in dentistry for research, it allows the visualization of images at high magnification (50X-10.000X and above) It is used in conjunction with Energy dispersive X-ray analysis, a micro analytical technique to quantitatively estimate the amount of calcium phosphate ratio [9]. Aim: To quantitatively evaluate the remineralization potential of Casein Phosphopeptide-Amorphous Calcium phosphate-Fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(n-Hap) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX). Conclusions: CPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface

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Conclusion