Casein Phosphopeptide-amorphous Calcium Phosphate Fluoride Research Articles

Efficacy of Three Remineralizing Agents on Erosion of Root Dentin by Cola Drink: An In Vitro Study

Abstract Objective The aim of the study was to investigate the effects of silver diamine fluoride (38% SDF), sodium fluoride (NaF) varnish, and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) on cola-eroded root dentin microhardness and mineral alteration in vitro. Materials and Methods Forty human root dentin slabs were exposed to alternating 10 cycles of cola drink and artificial saliva, repeated 3 times at 6-hour intervals. Specimens were randomly assigned to four groups: control (deionized water), 38% SDF, NaF varnish, and CPP-ACPF. All specimens underwent the second erosion process. Microhardness was measured at baseline (KHN0), pretreatment (KHN1), and posttreatment (KHN2). The mean difference of microhardness (ΔKHN2-1) was analyzed using one-way analysis of variance (ANOVA) and Tukey's post hoc tests (α = 0.05). The chemical composition and surface morphology were assessed using energy dispersive spectroscopy (EDS) and scanning electron microscope (SEM). Results All experimental groups exhibited dentinal tubule occlusion. Both 38% SDF and NaF varnish demonstrated a statistically significant increase in microhardness compared to CPP-ACPF. However, CPP-ACPF was comparable to the control group. EDS analysis showed an increase in weight percentage of fluorine in all groups. Furthermore, silver and chlorine were detected in the 38% SDF group. Conclusion All treatments enhanced eroded root dentin microhardness, with 38% SDF and NaF varnish demonstrating superior acid resistance and preventing morphological changes induced by cola re-immersion.

Preventive efficacy of 38% silver diamine fluoride and CPP-ACP fluoride varnish on molars affected by molar incisor hypomineralization in children: A randomized controlled trial

Background This randomized controlled trial aimed to compare the efficacy of silver diamine fluoride (SDF) and Casein Phosphopeptide-Amorphous Calcium Phosphate fluoride Varnish (CPP-ACPFV) in preventing caries development, enamel breakdown, and sensitivity on molars affected by molar incisor hypomineralization (MIH) in children. Methods A total of 100 children aged 6 to 9 years were enrolled in the study with two contralateral permanent molars mildly affected by MIH. Affected molars were randomly and equally assigned to receive either SDF or CPP-ACPFV treatment. The interventions were applied at four different time points (baseline, 3, 6, 9 months), and the incidence of caries, caries progression, enamel breakdown, and sensitivity were assessed. Results The findings of this study revealed significant differences in the incidence of caries between the groups treated with SDF and CPP-ACPFV (P-value < 0.05). Similarly, there was a significant difference in caries progression between the two groups (P-value < 0.05). However, no significant differences were observed in enamel breakdown scores between the treatment groups, as the majority of teeth in both groups exhibited a score of 0. Furthermore, there were no significant differences in sensitivity between the treatment groups throughout the study period. Conclusions In conclusion, the results of this study provide evidence that molars treated with SDF demonstrated a lower incidence of caries and a higher rate of caries arrest compared to those treated with CPP-ACPFV. Both interventions showed promise in preventing enamel breakdown and improving sensitivity. These findings highlight the potential of SDF and CPP-ACPFV as effective treatments for caries prevention and management, emphasizing the importance of early intervention and appropriate dental care strategies in maintaining oral health. Trial registration ISRCTN54243749 (13/01/2022).

Comparative evaluation of remineralization potential of four different remineralization agents on human enamel: An in vitro study.

The study aimed to assess the remineralizing potential of four different commercially available agents using a Scanning Electron Microscope (SEM), energy dispersive X-ray (EDX) analysis, and Vickers Microhardness (VMH) Test. Forty-four specimens (n = 11 per group) were prepared from extracted teeth. A window of 6 mm × 4 mm was made on all the specimens that represented three zones, namely, sound enamel, demineralized enamel, and remineralized enamel. The zone for demineralized enamel was subjected to four different remineralizing agents; casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), calcium sucrose phosphate (CSP), and self-assembling peptide (P11-4). Remineralization (REM) was assessed using VMH; the structural changes were assessed using SEM that was analyzed using EDX analysis. The specimens were subjected to a newer regimen of demineralization. One-way ANOVA followed by post hoc Tukey test was used with a level of significance at P ≤ 0.05. There were no significant differences in VMH between the groups for sound enamel (P = 0.472) and demineralized enamel (P = 0.116). VMH was statistically significantly more for P11-4 and the least for CPP-ACPF (P = 0.011). A post hoc analysis revealed higher VMH for P11-4 compared to CPP-ACPF (P = 0.014) and TCP-F (P = 0.035). SEM showed a homogeneous layer of minerals for all groups except CPP-ACPF. TCP-F reported a higher degree of REM, followed by P11-4 as assessed using EDX analysis. Self-assembling peptide (P11-4) exhibited a higher degree of REM than other remineralizing agents followed by CSP.

Effect of silver diamine fluoride/potassium iodide treatment on the prevention of dental erosion in primary teeth: an in vitro study

IntroductionDental erosion has a great effect on oral health, when diagnosed it is irreversible, this sets the importance of different preventive measures being investigated against dental erosion.AimThis in vitro study aims to evaluate the effectiveness of silver diamine fluoride and Potassium iodide (SDF-KI) in comparison to casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) varnish, sodium fluoride (NaF) varnish, silver diamine fluoride (SDF) alone and deionized water as a control group in the prevention of dental erosion in primary teeth and assessing its staining effect.Materials and methodsForty deciduous teeth enamel specimens were randomly allocated into the five study groups. Tested materials were applied. An erosive challenge was done by immersing the specimens in a citric acid-containing soft drink with pH 2.85, for 5 min, 4 times/day, for 5 days. Changes in surface microhardness, mineral loss, and color change were evaluated besides recording of the surface topography and surface roughness for selected specimens.ResultsThe highest decrease in surface microhardness was recorded in the control group (−85.21 ± 10.60%), with a statistically significant difference (p = 0.002). SDF-KI group (−61.49 ± 21.08%) showed no statistically significant difference when compared to CPP-ACPF, NaF, and SDF groups. For calcium and phosphorous loss, control group was statistically significantly higher compared to the treatment groups (p = 0.003) and (p < 0.001) respectively, while there was no statistically significant difference between the tested treatment groups. The highest mean value for color change was recorded in SDF group (26.26 ± 10.31), followed by SDF-KI group (21.22 ± 12.87) with no statistically significant difference between groups.ConclusionsSDF-KI is as effective as CPP-ACPF, NaF varnishes and SDF in the prevention of dental erosion in primary teeth, there was no statistically significant difference regarding its staining potential.

Impact of Various Remineralizing Agents on Artificial White Spot Lesion on Primary Teeth-A Comparative Study.

The aim of the current research was to assess the effectiveness of different remineralizing substances on artificial white spot lesions on deciduous teeth. 45 deciduous teeth without dental caries constituted the study group for this in vitro research. A 3 mm by 3 mm window of enamel was uncovered at the occluso-gingival midpoint of the coronal labial surface; an acid-resistant nail varnish was coated alongside the uncovered enamel surface of all specimens, employing vertical strokes. Demineralization was executed for the tenure of 72 hours at 37°C temperature in an incubator. The forty-five specimens, fifteen in each group, were assigned to the investigational groups plus a control group as: Group A: Control, Group B: Calcium sucrose phosphate (CaSP), Group C: Casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF). Microhardness tester was employed for testing the microhardness of the enamel surface using a Vickers diamond indenter laden with twenty-five milligrams for approximately ten seconds. Vickers hardness number (VHN) calculations for the microhardness were performed at baseline and on the fourteenth day. The CPP-ACPF group exhibited greater mean microhardness value at 236.14 ± 2.12, in pursuit by CaSP group with a score of 231.98 ± 3.16 and then the control group at 220.22 ± 5.08. An extremely statistically significant difference was seen amid the groups. The current research arrived at a conclusion that both the remineralizing substances were certainly efficient in handling early dental caries, and additionally, casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACPF) was found highly efficient as a remineralizing substance, in pursuit by calcium sucrose phosphate (CaSP).

Effect of self-assembling peptide and other remineralizing agents on preventing initial enamel lesions around orthodontic brackets: An in vitro comparative study

To investigate and compare the effect of self-assembling peptide SAP (P11-4), casein phosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF), and fluoride varnish (FV) on preventing enamel demineralization around orthodontic brackets. Orthodontic brackets were bonded to the buccal surfaces of 80 freshly extracted human maxillary premolars. Teeth were randomly assigned to four groups (n=20) according to the remineralizing agent used as follows: SAP (P11-4) group (Curodont™ Protect/Credentis), CPP-ACPF group (MI Paste Plus®/Recaldent™), fluoride varnish group (Profluoride varnish®/VOCO), and control group. All products were applied according to the manufacturer's instructions. Specimens were cycled in daily refreshed demineralizing and remineralizing solutions for 8h and 16h, respectively, for 28days. The calcium/phosphorus ratio (Ca/P) and surface microhardness (SMH) were evaluated at baseline and at two and four weeks. Two-way ANOVA (analysis of variance), one-way ANOVA and repeated measures ANOVA were used for statistical analysis. Two-way ANOVA demonstrated significant differences between remineralizing agents and time points. After 4weeks, the SAP (P11-4) group had had significantly higher Ca/P ratio and SMH (1.68±0.11 and 346.47±55.38) compared to other groups, followed by CPP-ACPF (1.52±0.19 and 283.53±64.75), FV (1.37±0.14 and 262.80±82.98), and the control group (1.31±0.10 and 213.00±41.95). Significantly higher Ca/P ratio and SMH were observed at 2weeks in the control group (1.44±0.10 and 269.63±57.37) and FV group (1.52±0.09 and 321.17±55.24) compared to 4weeks. No significant differences were found regarding Ca/P ratio and SMH at 2 weeks in the CPP-ACPF (1.55±0.15 and 295.14±53.88) and SAP P11-4 groups (1.64±0.10 and 320.18±58.04) compared to 4weeks. SAP (P11-4) had the greatest remineralizing efficacy compared to FV and CPP-ACPF. Moreover, extended period of time improved the preventive efficacy of SAP (P11-4) compared to the other regimens.

Evaluation of efficacy of various remineralizing agents on artificially demineralized human enamel – An in-vitro study

Currently much research revolves around remineralization as incidence of white spot lesions in patient undergoing orthodontic treatment is 2-96%. The objective of this study was to find out the efficacy of Casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), Functionalized tricalcium phosphate (f-TCP), Calcium sodium phosphosilicate (CSPS), Calcium sucrose phosphate (CSP), Nano hydroxyapatite (nHAP) and Fluoride (F) in remineralizing artificially demineralized enamel and DIAGNOdent and scanning electron microscope were used to record the changes. The study included 140 extracted premolars which were divided into 7 groups in which 6 were experimental groups: I (CPP-ACPF), II (f-TCP), III (CSPS), IV (CSP), V (nHAP), VI (F) and 1 control group: VII (C). All the samples were evaluated using DIAGNOdent at the baseline, post demineralization and post remineralization. One sample was randomly selected from each group for evaluation using SEM. Statistical analysis has shown that all the groups had higher amount of remineralization except control group. CSPS showed maximum remineralization. All the artificially demineralized samples treated with remineralizing agents for 3 weeks reduced the severity of lesions by forming calcific deposits. However CSPS showed marginally more amount of remineralization than others.

Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review.

Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.

Evaluation of different remineralization agents in the treatment of natural caries-affected dentin in permanent teeth.

In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS2) (Code3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5%NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.

Comparative Evaluation of the Increase in Enamel Hardness Post-External Bleaching after Using Casein Phosphopeptide Amorphous Calcium Phosphate Fluoride (CPP-ACPF) and 5% Sodium Fluoride (NaF) Remineralizing Agents.

The purpose of this study was to analyze the increase in enamel hardness post-external bleaching after remineralized with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and 5% sodium fluoride (NaF) and the difference in increased enamel hardness between CPP-ACPF and NaF materials. The study was true experimental in vitro using 30 samples of mandibular premolars. All samples were bleached using 40% hydrogen peroxide. The samples were divided into three groups of 10 samples each; group I as a control without application of remineralization material, group II was given an application of CPP-ACPF (GC Tooth Mousse Plus: GC Europe, Lot #201130B), and group III was given an application of 5% NaF (Clinpro White Varnish: 3M ESPE, Lot #NA62322) Then the entire samples were stored in artificial saliva. The hardness of the samples was measured using a Vickers hardness tester before bleaching, after bleaching, and after remineralization for 7, 14, and 21 days. Analysis of the data used was an analysis of variance test to assess differences in the increase in enamel hardness between groups and paired t-tests and to determine differences in enamel hardness in each group. This study showed that there was an increase in the enamel hardness after bleaching which was remineralized with CPP-ACPF and 5% NaF. There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% NaF. The enamel hardness of CPP-ACPF was higher compared with 5% NaF after remineralization of 7, 14, and 21 days. There was an increase in the enamel hardness after external bleaching that was remineralized with CPP-ACPF and 5% sodium fluoride (NaF). There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% sodium fluoride (NaF). CPP-ACPF showed a higher enamel hardness value than 5% NaF.

Potential Effect of Casein PhosphopeptideAmorphous Calcium Phosphate on Salivary Properties in Patients with Xerostomia: A Narrative Review

Changes in the makeup of saliva and/or a reduction in saliva flow are the two main causes of dry mouth. Dental caries, oral fungal infections, difficulty speaking and chewing or swallowing, mucositis, and burning mouth syndrome are associated with xerostomia, all of which have a detrimental effect on the quality of life associated with oral health. Although xerostomia is common in the general population, there are no standardised treatment standards. Recent research has indicated that topical treatments available without a prescription cannot be routinely recommended. Casein Phosphopeptide-Amorphous Calcium Phosphate complexes (CPP-ACP) and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride have been shown to play a significant role in reducing dental caries, plaque, and pathological microorganisms, maintaining pH, and treating hypersensitivity. There is insufficient evidence that CPP-ACPs can induce salivation in patients with hyposalivation. This article reviews recent studies on the effect of CPP-ACPs on salivary traits and their use in treating patients with xerostomia.

The Effect of Remin Pro and MI Paste Plus on Induced Demineralized Enamel in Primary Molars

Purpose: To evaluate the remineralization potential of (Remin pro) nano hydroxy apatite (in comparison with MI paste plus, (Casein PhosphoPeptide-Amorphous Calcium Phosphate Fluoride) on demineralized enamel in human primary teeth. Materials and Methods: 44 primary extracted or exfoliated human primary molars teeth were equally divided into 2 groups (Group A, Group B). (Group A) including 22 primary teeth were treated with professional toothpaste (MI past plus). (Group B) including 22 primary teeth were treated with professional toothpaste (Remin Pro). Scanning electron microscope (SEM) readings and energy dispersive X-ray (EDX) analysis were carried at premineralization. The samples were subjected to the test agents after inducing white spot lesions. The readings were repeated demineralization and postremineralization. Results: SEM evaluation showed favourable surface changes in all the two study groups after remineralization therapy. EDX readings showed no significant differences between MI Paste Plus and Remin Pro (P<0.005) in remineralization potential after 14 days. Conclusion: Use of MI Paste Plus and Remin Pro have a remineralizing effect on Induced demineralized enamel in primary molars.

Effect of casein phosphopeptide amorphous calcium fluoride phosphate and calcium glycerophosphate on incisors with molar-incisor hypomineralization: Across-over, randomized clinical trial.

Within the scope of minimally invasive dentistry, the use of different biocompatible remineralization agents on incisors affected by molar-incisor hypomineralization (MIH) gains importance. To evaluate the effect of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and calcium glycerophosphate (CaGP) in mineral density (MD) of white/creamy and yellow/brown demarcated opacities on incisors affected by MIH by means laser fluorescence (LF). As a cross-over, randomized trial, twenty-two children with 167 incisors affected by MIH were recruited and randomly assigned to one of the two different agents and crossed over to other agents with two weeks washout in between. Incisors were examined by using LF at all before and after three months periods. The results of the paired t-tests for determining the period effect between the baseline findings showed significant difference in white/creamy and yellow/brown demarcated opacities of LF values for both groups (p <0.05). The difference between both groups according to after categorization of 20% increasing in MD in the percent of change before and after application on LF values; was not found statistically significant in white/creamy (p =0.970) and yellow/brown (p =0.948) opacities. The primary outcome was CPP-ACFP and CaGP had a positive effect in decreasing hypomineralization on MIH-affected enamel for three months period.

Effect of three different remineralizing agents on artificial erosive lesions of primary teeth.

This study aimed to investigate the efficacy of three remineralizing agents on dental erosion in primary teeth. Forty primary molars were randomly divided into four groups (n = 10 each): self-assembling peptide (P11-4 ), casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), sodium fluoride (NaF) and artificial saliva (AS; control). The erosion-like formation was created by immersing the samples in citric acid (4 × 2 min, pH 2.3) and AS (4 × 2 h, pH 7). The eroded samples were then treated with remineralizing agents and subjected to further erosion consisting of 15 cycles (3x/8-h interval) of immersion in citric acid and AS for 6 s each. Alterations in the mineral content and morphology of the samples were quantified using a microhardness tester and atomic force microscope. All agents had a significant remineralization effect on eroded primary tooth enamel. After further erosive challenge, enamel loss in the CPP-ACFP group was found to be significantly lower than in all other groups, and no significant difference was found between the P11-4 and NaF groups. This study showed that all tested materials had remineralization ability, and CPP-ACFP had a superior effect in inhibiting enamel loss due to dental erosion in primary teeth. © 2022 Australian Dental Association.

Effect of Remineralization Agents on Molar-Incisor Hypomineralization-Affected Incisors: A Randomized Controlled Clinical Trial.

The objective of this study was to evaluate the remineralization effect of two different mineral containing agents on white/creamy and yellow/brown demarcated opacities in incisors in children with molar-incisor hypomineralization (MIH) by using laser fluoresence (LF). Fifty-three children (n=401 lesions) with MIH were randomly divided into three groups: (1)calcium glycerophosphate (CaGP), (2)casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and, (3)control (1450 ppm fluoride toothpaste). Remineralization was evaluated by means of LF, at baseline, after one and threemonths. Anova Test for Repeated Measurements in intra-group comparisons in evaluating the effectiveness of remineralization agents. One-way Variance Analysis (ANOVA) and Tukey-Kramer Multiple Comparison test were used in the comparisons between groups and, Student Newman Keuls Multpile Comparison Test was used to determine the differences between the measurement averages in case of p<0.05. There was a significant improvement in MIH-lesions over time in all groups (p<0.001), with no differences between groups. The highest percentage of change was observed in CPP-ACFP in lesions LF≤20 scores and the mean percentage of change LF>20 scores, the highest percentage changes in CaGP. There was no significant difference between the groups over the time for all the used outcome measures (p>0.05). The additional use of both mineral containing agents in MIH-affected teeth improved these hypomineralized lesions with mineral deposition. Even if both agents could be used in the hypomineralized teeth with demarcated opacities, future studies are recommended the long-term effect of these mineral containing agents with longer observation and a larger sample size.

In Vitro Evaluation of the Efficacy of Three Different Remineralizing Agents on Artificial Enamel Lesions in Primary Teeth: A Comparative Study

The aim of the present study was to assess the effectiveness of three various remineralizing agents on artificial enamel lesions in deciduous teeth. Eighty primary teeth that were implicated for extraction were taken from patients of 4 to 14 years of age. Every specimen was subjected to air drying followed by the creation of 3 × 3 mm window positioned on the central surface of the coronal portion of the tooth to restrict the area of investigation. A digital pH meter was utilized to formulate a demineralizing solution by checking the pH before and following formulation of the solution. A total of 80 specimens (20 in every group) were allocated to three of the following experimental groups and one control group: group I: control, group II: tricalcium phosphate, group III: casein phosphopeptide-amorphous calcium phosphatefluoride (CPP-ACPF), and group IV: calcium sucrose phosphate (CaSP). Specimens in every group were subjected to treatment with the assigned remineralizing substance once in 24 hours for 14 days. Confocal laser scanning microscopic (CLSM) evaluation of the samples was performed to assess the baseline and posttreatment remineralization as well as demineralization. CPP-ACPF group (110.73 ± 0.11) displayed the greatest mean remineralization depth, in pursuit by the calcium orthophosphate complex (CaSP) group (122.19 ± 0.28), tricalcium phosphate group (126.87 ± 0.15) as well as the control group (158.46 ± 0.07). These differences amid the investigational groups for remineralization were significant. The greatest depth µ area of remineralization was seen in the CPP-ACPF group (50.29 ± 0.06) in pursuit by the CaSP group (36.70 ± 0.17) as well as the tricalcium phosphate group (33.29 ± 0.06). This difference amid the remineralizing agents was statistically significant. Amid the confines of the limitations of the current research, it may be concluded that the three remineralizing agents studied, exhibited a remineralization capability on the artificially induced lesions in enamel. CPP-ACPF exhibited the greatest remineralization capability in comparison with the CaSP and tricalcium phosphate groups. Dental caries is an unalterable course that leads to everlasting loss of dental hard tissues with eventual formation of a cavity. Off late, numerous techniques have centered on applying remineralizing substances to early lesions due to dental caries, aiming at arresting demineralization while encouraging remineralization. Such remineralizing substances form an atmosphere that is superconcentrated with calcium and phosphate, thereby forcing these ions to diffuse into the unoccupied areas, thereby avoiding further loss of minerals.

An in vitro comparative evaluation of casein phosphopeptide-amorphous calcium phosphate fluoride, tricalcium phosphate and grape seed extract on remineralization of artificial caries lesion in primary enamel.

To evaluate and compare the remineralization potential of casein phosphopeptide-amorphous calcium phosphate fluoride, tricalcium phosphate and grape seed extract on artificial caries lesions in primary enamel. A sample of 40 non-carious, primary molar teeth was collected and cut in longitudinal sections into three equal halves. Those 120 samples were divided into four equal groups. Group A: Sections treated with casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), Group B: Sections treated with tricalcium phosphate, Group C: Sections treated with grape seed extract Group D: Sections treated with deionized water (control group). Samples were evaluated for change in surface characteristics, mineral content using Scanning electron microscopy-energy dispersive X-ray analysis (SEM-EDX) and microhardness using Vicker's microhardness tester. Cavitated lesions were evaluated for Cone beam computer tomography to obtain baseline data post remineralization. The remineralization potential of grape seed extract was found to be greater compared to tricalcium phosphate followed by CPP-ACPF. All the three groups viz. CPP-ACPF, tricalcium phosphate and grape seed extract showed remineralization under the in vitro pH cycling model, while grape seed extract group showed significantly greater remineralization compared to the CPP-ACPF and tricalcium phosphate groups.

Comparative evaluation of the remineralizing potential of different calcium and fluoride-based delivery systems on artificially demineralized enamel surface; an in vitro study.

Background:Enamel is the hardest and vastly mineralized structure of the human body. Inorganic salts make up the majority of it. Water and ions pass right through the enamel. The enamel undergoes demineralization and remineralization cycle throughout life. Recently, the interest in the development of calcium, phosphate, and fluoride remineralization technology has been increased leading to the development and reintroduction of various remineralizing agents such as fluoride, casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), nano-hydroxyapatite (nano-HA), xylitol, bioglass, Ozone, etc.Aim:The aim of this study is to evaluate and compare the potential remineralization of CPP-ACPF, calcium sucrose phosphate (CaSP), amine fluoride (AmF), and nano-HA.Settings and Design:The design of this research is experimental. This is an in vitro study. The research was carried out at the Dental Teaching Institute. This study involved human teeth. No demographic data were obtained. One hundred and twenty premolars were selected from the tooth bank of the Department of Oral and Maxillofacial Surgery. The teeth included in the study were noncarious, nonrestored, and nonfractured extracted teeth. Teeth excluded from the study were extracted teeth with any visible or detectable caries, white spot lesions, microcracks, attrition, abrasion, erosion, or abfraction.Materials and Methods:One hundred and twenty enamel samples were taken; they were divided into six groups (n = 20). The demineralization process was carried out on Groups II, III, IV, V, and VI. The remineralization process was carried out on Groups III, IV, V, and VI for 14 days using CASP, AmF, and nano-HA, respectively. No surface treatment was performed in Group I causing it a positive control group, whereas Group II was considered a negative control with only enamel surface demineralization and no remineralization. The microhardness of enamel was measured using Vickers microhardness testing machine after a 14-day remineralization regimen.Statistical Analysis:In the statistical analysis, one-way analysis of variance and post hoc Tukey's tests were performed.Results:The mean microhardness values in declining order: positive control > nano-HA > AmF > CaSP > CPP-ACPF > negative control.Conclusion:All remineralizing agents exhibited enhanced surface remineralization. Nano-HA showed the highest remineralization potential followed by AmF, CaSP, and CPPACPF.

Spectrophotometric Evaluation of the Color Change of Artificial White Spot Lesions Treated with Three Different Commercially Available Remineralizing Agents: An In Vitro Study

Introduction: This study evaluated the color changes induced by the treatment of intact and demineralized enamel surfaces with casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and sodium fluoride. Material and Methods: Ninety-six sound teeth were collected. The samples were divided into “intact” and “demineralized” groups and then subjected to different treatments (CPP-ACFP, sodium fluoride, and CPP-ACP). After the treatment phase, the colors of samples were evaluated and compared with the pretreatment values. Results: Both demineralized and intact enamel samples underwent increased whiteness (L*) and reduced yellowness (b*) upon treatment with any of the agents (P < 0.001). More pronounced results were achieved with CPP-ACP. Conclusion: These treatments generally make the teeth look whiter, brighter, and clearer with a more natural appearance.

Orthodontic brackets’ shear bond strengths after applying remineralizing agents

Aim: The aim of this in vitro study was to measure the effects of white spot lesions treatment agents on the shear bond strengths (SBSs) and adhesive residual indexes (ARIs) of orthodontic brackets.&#x0D; Methodology: This study used 100 human premolar teeth randomly divided into five groups. Group 1 comprised those with intact enamel, Group 2 comprised those with demineralized enamel and Groups 3–5 comprised those demineralized enamel that was treated with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), fluoride varnish and a resin infiltrant, respectively. Brackets were bonded to the teeth using the conventional method, then the samples were thermocycled and tested for SBS using a universal testing machine. The adhesive remnant indexes (ARI) of the brackets were also evaluated. One-way ANOVA and post-hoc Tukey tests were used to compare the groups’ SBSs and the Kruskal–Wallis test was used to evaluate the groups’ ARI scores. Results were considered statistically significant if p was less than 0.05.&#x0D; Results: Statistically significant differences were found between the groups (F was 6.895 and p was less than 0.001). The SBSs of the brackets in Group 4 were significantly lower than those of the other groups (the mean was 13.44 ± 6.37 MPa). Group 5 had the highest mean SBS value (22.11 ± 6.56 MPa). Additionally, the ARI scores of the four groups were significantly different (p was less than 0.001).&#x0D; Conclusion: Resin infiltration and CPP-ACPF applications can improve bonds to demineralized enamel, while fluoride varnish applications are not recommended for such enamel.&#x0D;  &#x0D; How to cite this article: Özant Y, Ay Ünüvar Y. Orthodontic brackets’ shear bond strengths after applying remineralizing agents. Int Dent Res 2021;11(2):67-74. https://doi.org/10.5577/intdentres.2021.vol11.no2.3&#x0D;  &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.