Abstract
Introduction Nanohydroxyapatite (nano-HA) has been utilized as an alternative agent for dental enamel remineralization. This study compared remineralization potential of nano-HA toothpaste (NHT), functionalized tricalcium phosphate toothpaste (TCPT), and fluoride toothpaste (FT) on carious lesions. Materials and Methods Sixty extracted human premolars were prepared for artificial carious lesions with synthetic polymer gel. Samples were divided into four groups according to testing agents: NHT, TCPT, FT, and one group with no treatment (NT). Each group was subjected to pH-cycling with the application of toothpaste in slurry form twice a day (2-min each) for 10 days. Surface microhardness was measured before demineralization, after demineralization, and after pH-cycling. Hardness at different periods, percentage of hardness recovery (% HR), and percentage of remineralization potential (%RP) were determined and statistically analyzed with ANOVA and Tukey comparisons (α = 0.05). Polarized light microscopy (PLM) was utilized to assess lesion depth. Results Significant remineralization of carious lesions was observed among different toothpastes compared to NT (p < 0.05). No significant difference in remineralization potential was found among NHT, TCPT, and FT (p > 0.05). No significant difference in % HR and % RP was seen among NHT, TCPT, and FT (p > 0.05). PLM indicated a greater decrease in carious depth upon using NHT compared to TCPT and FT, with minimal increase in depth for NT. Conclusions NHT has comparable capability to TCPT and FT in hardness recovery. However, decrease in carious depth was evidenced with PLM for NHT more than TCPT and FT. Thus, NHT was suggested as a potential remineralization product for treating initial carious lesions. Clinical Significance. The study showed that NHT had the potential to remineralize artificial carious lesion. It was confirmed in potential in the lesion depth reduction and forming a new enamel layer. NHT showed its capability as an alternative for dental caries therapeutic.
Highlights
Nanohydroxyapatite has been utilized as an alternative agent for dental enamel remineralization. is study compared remineralization potential of nano-HA toothpaste (NHT), functionalized tricalcium phosphate toothpaste (TCPT), and fluoride toothpaste (FT) on carious lesions
In the first phase of enamel demineralization, the aprismatic mineral content is removed, which is subsequently followed by a well-defined surface layer formation that accounts for an early caries lesion [3]. e enamel demineralization process is slow in its progression, which permits the possible reversal of mechanism if the process is detected early and managed adequately
To separate the crowns from the roots [Figure 1(a)-(1)], the teeth were cut with the precision cutting machine (Mecatome T180, Presi, Eybens, France). e crowns [Figure 1(a)-(2)] were embedded in an epoxy resin block with the enamel above being exposed to the epoxy resin. e surface of the enamel was covered with an acid-resistant varnish (Revlon, New York, NY, USA) except for a surface area of 4 × 4 mm [Figure 1(a)-(3)]. e unpainted area of enamel was ground flat with a silicon carbide abrasive (Buehler, Tokyo, Japan) # 1,000, 2000, and 4000 grit, respectively, in a polishing machine (Ecomet, Buehler, Tokyo, Japan) [Figure 1(b)(4)]. e specimens were cleaned and kept in 37°C deionized water for 24 hours
Summary
One of the most common diseases that has affected the oral health of people around the world is dental caries. Fluoride inhibits mineral loss from the enamel surface by inducing surface adsorption on the partially demineralized crystals and attracting Ca2+ and PO24− ions from oral fluid as well as forming fluorapatite on enamel surface, thereby increasing enamel resistance to acid attack. E nano-HA toothpaste can promote remineralization comparable to fluoride toothpaste and, inhibit the progression of demineralization It was capable of reducing the rate of carious progression and increasing the surface hardness of enamel [24]. E specimens were submerged in an individual sterile container containing demineralization gel and kept in a humidified environment for 12 hours, following which, they were cleaned with deionized water in order to produce a consistent subsurface artificial carious lesion on the enamel. Vickers indenter of 100 g load for 15 seconds of lodging time with a digitalized hardness testing
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