Abstract
BackgroundThis study aimed to investigate the effects of a fluoride varnish with added Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) treatments on acid resistance of primary teeth enamel.MethodsEnamel specimens obtained from 40 primary incisors (for surface microhardness testing) and 40 primary molars (for demineralization depth measurement) were randomly divided into four groups (n = 10 incisors and 10 molars) each according to surface treatment: no treatment (control), MI varnish (1–8 % sodium fluoride and 1–5 % CPP-ACP), Clinpro White (1–5 % sodium fluoride and <5 % modified tricalcium phosphate), Duraphat (<5 % sodium fluoride). Specimens were stored for 24 h in a moist environment. After varnish residues were removed, specimens were subjected to pH cycling. The effects of fluoride varnishes were evaluated according to surface microhardness, lesion depth and structural changes. Results were analyzed by ANOVA and Tukey’s tests.ResultsThe lowest changes in surface microhardness and lesion depth occurred in MI varnish group, followed by the Clinpro White, Duraphat and no treatment (control) group (for percentage of loss surface microhardness −20.80, −34.60, −57.80 and −73.40; for lesion depth values 23.60 μm ± 3.36, 29.85 μm ± 3.27, 40.37 μm ± 3.41 and 54.56 μm ± 4.16, respectively). Statistically significant differences in both surface microhardness and lesion depth were observed among all groups (P < 0.05).ConclusionsWithin the limitations of this in vitro study, fluoride varnish containing CPP-ACP was more effective in increasing the acid resistance of primary enamel than other fluoride varnishes. However, further clinical research is needed to confirm these in vitro results.
Highlights
This study aimed to investigate the effects of a fluoride varnish with added Casein PhosphopeptideAmorphous Calcium Phosphate (CPP-ACP) treatments on acid resistance of primary teeth enamel
Since the formation of these reservoirs is limited by the availability of calcium and fluoride ions [6], calcium ions have been added to fluoride varnishes in an attempt to increase the retention of both fluoride and calcium ions in the oral environment
Given that the remineralization potential of saliva is limited by the amount of available calcium [7], the addition of calcium and phosphate ions from sources such as varnishes can enhance the remineralization of early lesions
Summary
This study aimed to investigate the effects of a fluoride varnish with added Casein PhosphopeptideAmorphous Calcium Phosphate (CPP-ACP) treatments on acid resistance of primary teeth enamel. One of the key factors in preventing dental caries has been recognized to be increasing the resistance of teeth to acid encouraging the development of remineralization mechanisms on the enamel surface [2]. More advanced fluoride varnishes with added casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) have been developed [8]. Administered CPP-ACP buffers free calcium and phosphate ion activity, maintaining a state of supersaturation with respect to tooth enamel that helps prevent demineralization and facilitate remineralization [7,8,9,10]
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