Effect of Different Biomimetic Materials on White Spot Lesions in Enamel (A split-mouth clinical trial)

Abstract

Purpose: To assess the remineralizing effect and clinical effectiveness of different biomimetic materials (Zinc carbonate hydroxyapatite microparticles (Zn CHA), bioactive glass nanoparticles (BAG) and Poly-amido amine (PAMAM)) on white spot lesions in enamel (WSLs). Materials and Methods: A number of 84 teeth (21 patients) were assigned into 3 groups of 28 teeth (7 patients) in accordance to the time of assessment (immediately B1, after one-month B2 and after two months B3). According to the tested material; every patient had a split mouth (four quadrants). Zn CHA was used in the first group A1, BAG was used in the second group A2, PAMAM was used for the third groupA3, whereas in the fourth group A4; no treatment was carried out (control). Standardized periapical radiographs were obtained for assessment of re-mineralization using measurements of radiodensity (%). Standardized digital photography was obtained for colour change assessment. Results: The change between the study groups has statistical significance (pvalue=0.00) at all times grouping (for Radiodensity % and the colour changes). Moreover; results revealed nonsignificant change between BAG and PAMAM groups (at all time groups). Also; difference between Zn CHA and BAG was not statistically significant at two months only (Radiodensity %). Conclusions: All the tested materials have a remineralizing effect and improved the appearance of the WSLs. Zn-CHA needs longer time (2 months) as a biomimetic remineralizing agent. Time is an important issue for biomimetic re-mineralization. Biomimetic re-mineralization can be achieved by regular use of biomimetic toothpaste.