Evaluation of remineralizing potential of hydroxyapatite, phosphopeptide-amorphous calcium phospahate and fluoride dentifrices using SEM/EDX analysis: A randomized controlled in-vitro study

Abstract

The aim of this study is to evaluate remineralization efficiency of hydroxyapatite (HA) containing dentifrices comparing to phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride (F) containing dentifrices using scanning electron microscope (SEM) and energy dispersive spectrometry (SEM/EDX). 3 × 3 mm 2 areas on the buccal surfaces of extracted primary second molars were divided vertically into 3 sections as demineralization , control and remineralization surfaces. Control surfaces (1/3 middle) coated without any application. 1/3 left and right surfaces were subjected to demineralization solution. After this application 1/3 right surfaces were coated as demineralization surfaces. Then teeth were randomly separated in 3 groups (n = 10): group HA (Natural toothpaste, Splat®, Russia); Group CPP-ACP (MI Paste ONE®, GC, U.S.); group F (Oral-B® Kids, Oral-B, Germany). 1/3 right surfaces were brushed with dentifrices twice a day for one week with pH cycle. Coatings were removed. Surface evaluations were conducted by SEM and EDX. Mann Whitney U and Kruskal Wallis tests were used for statistical analysis. Both atomic (at%) and weight (wt%) percentages of P values were statistically significant for F group in remineralization surfaces comparing to demineralization surfaces. Ca at%, P at% and P wt% values were statistically significant for CPP-ACP group in remineralization surfaces. P at% and P wt% values for F group were higher in remineralization surfaces compared to all. Remineralization was observed in all groups. Most homogeneous surface features were seen in group CPP-ACP. • Dentifrice containing hydroxyapatite showed favourable results comparable to fluoride containing dentifrice. • CPP-ACP containing dentifrice has not been evaluated before in any study. Most of the studies has assessed CPP-ACP varnishes. • It is important to know the efficacy of these materials in toothpaste formula. As pediatric dentists, we should be able to recommend toothpaste containing an effective remineralization agent for groups where fluoride supplementation or fluoride use is not preferred. • CPP-ACP dentifrice showed promising results compared to fluoride. • EDX analysis provides the opportunity to work without damaging the sample in remineralization studies. Primary teeth are valuable samples for studies.