Abstract
Aim: The aim of the study is to compare the remineralization potential of monofluorophosphate, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and calcium sodium phosphosilicate on demineralized enamel lesions.Materials and methods: Enamel sections from 30 sound human premolar crowns were prepared and sectioned into quadrants. Early enamel lesions were created in each sample by immersion in a demineralizing solution for 72 hours. Of the four sections, the first quadrant (A) was not given any surface treatment, the second quadrant (B) was treated with monofluorophosphate dentifrice, the third (C) was treated with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and the fourth (D) was treated with calcium sodium phosphosilicate while being subjected to a five-day pH cycling protocol. The sections were further cross-sectioned to expose the lesion depth and were then viewed under the confocal laser scanning microscope after staining with 0.1 mM rhodamine B dye for 24 hours. The two parameters evaluated were the cross-sectional demineralized lesion area and total fluorescence.Results: Amongst the dentifrices tested, the lowest values for lesion area and total fluorescence were recorded by calcium sodium phosphosilicate (3874.1 µ2 and 107282.6, respectively), followed by casein phosphopeptide-amorphous calcium phosphate (5776.6 µ2 and 129470.8) and then by monofluorophosphate dentifrice (7371.2 µ2 and 233765.9) in increasing order. The highest values for lesion area and total fluorescence were recorded by the no treatment group (16449.2 µ2 and 759743.1). One-way analysis of variance (ANOVA) showed significant variations (p<0.01) between the groups and Scheffe multiple comparisons confirmed the significance (p<0.01) of intergroup variations.Conclusion: The results of this study suggest that, among the three agents tested, calcium sodium phosphosilicate is the most effective remineralizing agent followed by casein phosphopeptide-amorphous calcium phosphate. Monofluorophosphate is the least effective remineralizing agent when tested under the conditions mentioned in this study.
Highlights
Demineralization and remineralization occur in the mouth several times daily as a dynamic process, with the progression or reversal of dental caries being the end result
Amongst the dentifrices tested, the lowest values for lesion area and total fluorescence were recorded by calcium sodium phosphosilicate (3874.1 μ2 and 107282.6, respectively), followed by casein phosphopeptide-amorphous calcium phosphate (5776.6 μ2 and 129470.8) and by monofluorophosphate dentifrice (7371.2 μ2 and 233765.9) in increasing order
The results of this study suggest that, among the three agents tested, calcium sodium phosphosilicate is the most effective remineralizing agent followed by casein phosphopeptide-amorphous calcium phosphate
Summary
Demineralization and remineralization occur in the mouth several times daily as a dynamic process, with the progression or reversal of dental caries being the end result. Whether a lesion will progress, stay the same, or reverse is determined by the balance between protective factors and pathological factors [1]. If the pathological factors that lead to demineralization predominate, caries progresses. If the protective factors that lead to remineralization predominate, caries is halted or reversed. Though fluoride is the cornerstone of non-invasive caries management, its use predominantly leads to surface-only mineralization [2]. Surface-only remineralization does little to improve the aesthetics and structural properties of deeper lesions. A remineralization system should supply stabilized bioavailable calcium, phosphate, and fluoride ions that favor subsurface mineral gain rather than deposition only in the surface layer
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