Quantitative measurements of remineralization of incipient caries

Abstract

White demineralized areas after the removal of orthodontic appliances remain a problem for clinicians and patients. The main objective of this study is to assess clinical photography as a method for the evaluation of caries and white spots and the in vivo study of remineralization of carious lesions. The secondary objective was to compare the effect of different levels of both experimental and commercial fluoride solutions on the remineralization of enamel carious lesions. White spot lesions were created with an acid solution on extracted permanent human teeth, and the lesions were remineralized in remineralizing solutions with or without fluoride ions. The changes in the enamel surface during the demineralization and the remineralization processes were recorded with a 35 mm clinical camera. Photographs were taken of the experimentally created white spots, the samples were sectioned for microradiography testing, and the actual mineral contents of the white spot lesions were calculated from the microradiographs. The enamel lesions were further analyzed by powder x-ray diffraction to confirm whether fluoride was incorporated into the lesions during the remineralization period. From this experiment it can be concluded: (1) clinical photography as currently practiced is not an adequate method of monitoring the remineralization of white spots with large lesion depths and (2) the experimental solution that contains 50 ppm fluoride had a higher efficacy for remineralization than the control solution or the commercial mouth rinse, which contained 225 ppm fluoride.