Effect of CPP-ACP on enamel eroded extrinsically: in vitro study

Iandara De Lima Scardini,Martha Chiabai Cupertino De Castro,Ana Paula Albuquerque Guedes,Marcella Kretli Neves Dias,Letícia Monteiro Peixoto

doi:10.1590/1981-863720180001000033193

Iandara De Lima Scardini, Martha Chiabai Cupertino De Castro + Show 3 more

Open Access

https://doi.org/10.1590/1981-863720180001000033193

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Abstract

ABSTRACT Objective: The aim of this study was to evaluate the remineralization effect of CPP-ACP on tooth enamel that is eroded extrinsically. Methods: Sixty freshly extracted bovine teeth were stored in a solution of thymol (0.1%), cut into enamel blocks (6x6mm), abraded with silicon carbide sandpaper (600, 800 and 1200 grit) and polished with felt. The specimens were randomly divided into 4 groups (n=15), varying the immersion medium , deionized water or citric acid, and the optional use of CPP-ACP. (G1: deionized water; G2: citric acid; G3: deionized water + CPP-ACP; G4: citric acid + CPP-ACP). The samples were subjected to 4 cycles of erosion every day, comprising 5 minutes immersion in one medium and 2 hours of immersion in artificial saliva, for 5 consecutive days. After each erosive cycle, 20 uL of the MI Paste was applied for 5 minutes on one half of the samples and washed with deionized water. Before and after the erosive cycling, the measurements of Vickers hardness and surface roughness were taken. Results: The results were evaluated through statistical testing. The final hardness and roughness values showed no statistically significant difference between G2 and G4. The paste in G4 did not promote an increase in hardness values nor a decrease in roughness values. Conclusion: It was concluded that CPP-ACP was unable to remineralize enamel subjected to extrinsic erosion, being ineffective in preventing erosion of enamel and in the remineralization of the eroded enamel.

Highlights

Dental erosion is a new risk factor for oral health, prompted by modern-day lifestyles and eating habits
It was concluded that casein phosphopeptides (CPP)-ACP was unable to remineralize enamel subjected to extrinsic erosion, being ineffective in preventing erosion of enamel and in the remineralization of the eroded enamel
CPP has the ability to stabilize the phosphate and the calcium, keeping them in an amorphous or soluble form known as ACP, providing a reservoir of ions during an acid attack on the tooth surface, saliva and biofilm[8]

Summary

Introduction

Dental erosion is a new risk factor for oral health, prompted by modern-day lifestyles and eating habits. It is defined as the irreversible loss of dental tissue resulting from frequent and long lasting, non-bacterial, chemical attacks, that is, involving acidic substances of either extrinsic or intrinsic etiology[1,2]. CPP has the ability to stabilize the phosphate and the calcium, keeping them in an amorphous or soluble form known as ACP (amorphous calcium and phosphate), providing a reservoir of ions during an acid attack on the tooth surface, saliva and biofilm[8]. It is proposed that a fine layer of this phosphoprotein forming on the surface of the tooth may act as a barrier, restricting the access of hydrogen ions, preventing the loss of calcium and phosphate in the hydroxyapatite crystals[9,10,11]

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