Casein Phosphopeptide-amorphous Calcium Phosphate Paste Research Articles

An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

Remineralization potential of strontium-doped nano-hydroxyapatite dentifrice and casein phosphopeptide-amorphous calcium phosphate cream on white spot lesions in enamel following orthodontic debonding - a randomized controlled trial.

This study was intended to compare and determine the potency of strontium-doped nano-hydroxyapatite paste against a topical cream containing casein phosphopeptide-amorphous calcium phosphate and a regular dentifrice for remineralization of white spot lesions of enamel following orthodontic debonding. Ninety individuals with white spot lesions on their enamel who visited the orthodontic department for de-bonding were selected for the research. Patients were randomly assigned to three distinct groups with each group consisting of 30 patients. Group 1 served as the control and received regular dentifrice, Group 2 received strontium-doped nano-hydroxyapatite paste, and Group 3 received casein phosphopeptide-amorphous calcium phosphate topical cream. Patients were instructed to locally apply a specified amount of the prescribed preparation twice daily for six weeks. The data were analysed using the statistical programme SPSS 22.0 (SPSS Inc., Chicago, IL, USA), and the level of significance had been set at p < 0.05. Group 1 did not show any change in the enamel following the application of toothpaste. Both Group 2 and 3 demonstrated higher post-treatment scores, indicating effective remineralization potential (p < 0.001). However, Group 2 (strontium-doped nano-hydroxyapatite paste) displayed significantly greater remineralization capacity when compared to group 3 (casein phosphopeptide-amorphous calcium phosphate topical cream). Compared to conventional dentifrice and casein phosphopeptide-amorphous calcium phosphate paste, strontium-doped nano-hydroxyapatite preparation demonstrated greater enamel remineralization of the white spot lesions and favourable surface alterations in the enamel surface. strontium-doped nano-hydroxyapatite can be utilised safely and efficiently to treat early caries and remineralise white spot lesions on the enamel.

Comparative Evaluation on the Effect of Different Remineralizing Agents on Enamel-Bracket Shear Bond Strength: An In Vitro Study.

This study aimed to compare the effects of applying various remineralizing agents before and after acid etching on the enamel-bracket shear bond strength (SBS) in vitro. These agents included silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 5% sodium fluoride (5% NaF). All the selected teeth were divided equally into six subgroups depending on before and after acid etching and one separate control group for the in vitro study design. Eighty-four extracted premolar teeth (12 teeth in each group x seven groups, including the control group). Before acid etching, teeth in groups A1, B1, and C1 were given SDF, CPP-ACP paste, and 5% NaF, respectively. Following acid etching, all of the teeth in Groups A2, B2, and C2 received the same preventative treatments. After that, the SBSof the bonded brackets to the enamel was evaluated. The CPP-ACP group, control group, and SDF group had the highest values for SBS prior to acid etching.The 5% NaF group had the weakest bonds, and the difference between the groups was statistically significant. The CPP-ACP group had the highest SBS following acid etching, followed by the 5% NaF group. The least bond strength was seen in the SDF group, and the difference between the three groups was significant. When it comes to bonding orthodontic brackets, the CPP-ACP pretreatment is superior to fluoride pretreatment in terms of effectiveness. The use of these remineralizing agents resulted in favorable values that did not have any effect on the SBS and were therefore safe to use with orthodontic brackets.

Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison.

This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy. The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05. The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days. Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.

Synthesis and characterization of nano bioactive glass for improving enamel remineralization ability of casein phosphopeptide–amorphous calcium phosphate (CPP-ACP)

ObjectiveNanomaterials with superior properties such as high surface area over volume ratio are widely used in dentistry and medicine. This in vitro study was performed to synthesize and characterize nano bioactive glass (nBG) and to evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing nBG (CPP-ACP@nBG) on enamel remineralization by its application to pH-cycled, synthetically demineralized enamel surfaces.Materials and methodsnBG particles were prepared by sol-gel method. X-ray diffraction pattern (XRD), Fourier-transform infrared spectroscopy (FTIR) and transmittance electron microscopy (TEM) were used for nBG characterization. Synthetic CPP-ACP paste was prepared and nBG particles were added to it. To evaluate the degree of remineralization, 32 healthy human premolars were selected. The samples were randomly divided into 4 groups as: Group 1: Commercial CPP-ACFP (MI paste plus), Group 2: Synthetic casein phosphopeptide-amorphous calcium phosphate containing fluoride (CPP-ACP@F), Group 3: Synthetic CPP/ACP containing nBG (CPP-ACP@nBG), and Group 4: Control (received no treatment). The pastes were then applied on the tooth surfaces for 28 days. The Vickers microhardness of enamel surfaces was evaluated, and enamel surface morphology was assessed using scanning electron microscopy (SEM).ResultsX-Ray diffraction pattern (XRD) of the synthesized nBG show its crystalline nature with the Larnite crystalline mode. Transmittance electron microscope (TEM) microimage of the synthesized nBG shows its formation as less that 100 nm spherical nanoparticle with partial agglomeration. Fourier transform infrared spectroscopy (FTIR) confirm the success formation of nBG with high purity. The results of this study showed that microhardness of the experimental groups was significantly higher than the control group (p ≥ 0.05). SEM images showed a layer of hydroxyapatite in the CPP-ACP@nBG, synthetic and commercial CPP-ACP@F remineralized groups.ConclusionThe results of this study demonstrated that CPP-ACP@F and CPP-ACP@nBG remineralize the surface of the demineralized enamel. Microhardness of the remineralized enamel in the CPP-ACP@nBG group was higher than synthetic and commercial CPP-ACP@F groups.

Long-term evaluation of early-enamel lesions treated with novel experimental tricalcium silicate paste: A 2-year randomized clinical trial.

The aim of the current study is to evaluate the remineralization potential of experimental tricalcium silicate (TCS) paste in comparison with more popular remineralizing agents like silver diamine fluoride potassium iodide (SDF-KI) and casein phosphopeptide amorphous calcium phosphate (CPP-ACP) on early enamel lesions. Forty-five patients in the age range of 15-50 years had early enamel lesions on the buccal surface of molar teeth. The patients were randomly divided into three treatment groups (SDF-KI, CPP-ACP, and TCS group) with 15 patients per group. Lesions were evaluated clinically by DIAGNOdent pen immediately and after 3,6,12, and 24 months of treatment. The study was completed with 45 patients and 92 teeth. Twice-daily application of CPP-ACP and TCS paste showed a significant remineralization effect on early enamel lesions after 24 months (p< 0.001). Also, annual application of SDF-KI showed a significant remineralization effect after 24 months (p< 0.001). There was a significant difference between (SDF-KI and CPP-ACP) and (SDF-KI and TCS) at the different follow-up periods 3,6,12, and 24 months (p< 0.001). Meanwhile, there was no significant difference between CPP-ACP and TCS at the mentioned follow-up periods (p> 0.05). TCS showed potential remineralization for early enamel lesions. Experimental TCS is a promising remineralizing agent for management of early enamel lesions.

Influence of diode laser treatment and casein phosphopeptide-amorphous calcium phosphate paste on eroded root dentin.

It is still unclear whether the pretreatment for dentin hypersensitivity can interfere with the adhesive-dentin bonding strength. This study aimed to evaluate in vitro the effect of pretreatment with a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste and diode laser on the shear bond strength of the etch-and-rinse adhesive system in the adhesive-dentin interface. Seventy-five bovine root specimens were randomly divided into five experimental groups (n = 15). Samples were eroded by six cycles of immersion in hydrochloric acid solution (0.01M; pH = 1.2) for 20 s each, at 45 min intervals, and treated with: G2 - no treatment, G3 - CPP-ACP, G4 - diode laser (970 nm), and G5 - CPP-ACP + Diode laser. After treatments, the morphology of the specimens was analyzed. The fracture mode of each group was evaluated after restoration with composite resins in the treated area. Data were analyzed by the one-way ANOVA and Tukey's test (P < 0.05). G3 showed the highest values for shear bond strength; there was no significant difference among G1, G3, and G5 (P > 0.05). The adhesive fracture was predominant for all groups. The use of desensitizers containing CPP-ACP, associated or not with a diode laser, increased the bond strength of the etch-and-rinse adhesive system on eroded root dentin.

The Effects of Casein Phosphopeptide-Amorphous Calcium Phosphate Paste and Tri-Calcium Phosphate Varnish in Preventing Enamel Demineralization: Roughness, Wettability, Ion-Selective Electrodes-Fluor and Hardness in Vitro

The Effects of Casein Phosphopeptide-Amorphous Calcium Phosphate Paste and Tri-Calcium Phosphate Varnish in Preventing Enamel Demineralization: Roughness, Wettability, Ion-Selective Electrodes-Fluor and Hardness in Vitro

Remineralization potential of grape seeds extract gel versus casein phosphopeptide-amorphous calcium phosphate in white spot lesions in post orthodontic patients: A randomized clinical trial

Aims: To determine the effectiveness of grape seed extract (GSE) gel compared to Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) application in managing white spot lesions (WSLs) in post orthodontic patients. Statistical analysis used: All statistical calculations were done using computer program IBM SPSS advanced statistics (Statistical Package for Social Sciences), version 25 (SPSS Inc., Chicago, IL). Methods and Material: This study was a single-blinded randomized clinical trial where 24 participants with white spot lesions in at least two teeth were included and randomized into two groups (12 patients each) to receive either GSE gel or CPP-ACP paste application. GSE gel was used on WSLs after orthodontic treatment every week, while CPP-ACP paste was applied twice daily by the patients themselves. Baseline and post-intervention measurements of quantitative changes of WSLs were measured by KaVo DIAGNOdent at 1, 3 and 6 months. Data for quantitative changes of WSLs were recorded and analyzed for each group. Results: There was no statistically significant difference in overall DIAGNOdent mean readings between GSE gel and CPP-ACP paste groups at P=0.360. Conclusions: Based on the data obtained in this study, it is suggested that GSE promotes remineralization of WSLs post orthodontic treatment and, thus, might be considered an effective natural agent for treatment of early enamel carious lesions.

REMINERALIZATION EFFECT OF EGGSHELL POWDER ON POST-ORTHODONTIC WHITE SPOT LESIONS COMPARED TO CPP-ACP: A RANDOMIZED CONTROLLED CLINICAL TRIAL

ABSTRACT: Aim: White spot lesions are the only carious process lesions that can be remineralized non-invasively. The focus of modern dentistry is stopping the caries process without unnecessary damaging the tooth structure. The present clinical trial aimed to assess the remineralizing effect of eggshell powder (ESP) compared to Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) in carious post-orthodontic white spot lesions orthodontic treatment. Methodology: Twenty-Four patients were selected from the Clinic of Orthodontic Dentistry Department, Faculty of Dentistry, Cairo University. Patients were divided into two groups according to the treatment received either ESP gel or CPP-ACP paste (GC Tooth-Mousse). The participants were instructed to use pea size eggshell powder gel or GC Tooth Mousse on the teeth surfaces using a clean finger twice daily after brushing their teeth with Colgate Total Original Care toothpaste. WSLs were assessed at baseline, 1 month, 3months and 6 months by DIAGNOdent (Kavo, Germany). Results: Data were analyzed using Two-way ANOVA showed that there was no statistically significant difference in overall DIAGNOdent mean readings between ESP and GC Tooth Mousse groups at (P=0.136). Conclusion: Based on the data obtained in this study, it is suggested that ESP is effective and has a promising future in the treatment of post-orthodontic WSLs.

Antibacterial Efficacy of Casein Phosphopeptide-Amorphous Calcium Phosphate Compared to Calcium Hydroxide as Intracanal Medicaments against Enterococcus faecalis: In-vitro Study

Background: Endodontic infection may persist despite root canal instrumentation. Thus, the use of intracanal medicaments plays an essential role in eliminating resistant bacteria like Enterococcus faecalis, known to be associated with persistent infections in endodontically treated teeth. Although calcium hydroxide is the gold standard intracanal medicament, it has been reported that Enterococcus faecalis is immune to its effects. Therefore, several studies assessed the efficacy of other intracanal medicaments, but none to date evaluated Casein Phosphopeptide-Amorphous Calcium Phosphate. Objectives: This in-vitro randomized controlled study aimed to assess the antibacterial efficacy of Casein phosphopeptide-amorphous calcium phosphate as an intracanal medicament against Enterococcus faecalis and compared it to calcium hydroxide. Methods: 60 extracted single root canal permanent teeth were prepared and later divided into three equal groups according to the intracanal medicament used. Group 1: No intracanal medicament (negative control), Group 2: Calcium hydroxide paste, and Group 3: Casein phosphopeptide-amorphous calcium phosphate paste. The intracanal medicaments were placed on the canals for 7 days. The outcome of this procedure was measured by counting colony-forming units. Statistical analysis was carried out using One-Way ANOVA and Tukey’s Post Hoc Test to determine significant differences between the groups. Results: The mean bacterial count for Group 2 was significantly lower than Group 1 and Group 3. Calcium hydroxide showed significantly more antibacterial efficacy against Enterococcus faecalis than Casein phosphopeptide-amorphous calcium phosphate and the negative control groups. Conclusion: Casein Phosphopeptide-amorphous calcium phosphate is ineffective in inhibiting Enterococcus faecalis growth compared to Calcium hydroxide.

The color improvement of postdebonding white spot lesions after fluoride and casein phosphopeptide- amorphous calcium phosphate application.

White spots are common side effects of orthodontic treatment, and their presence after debonding appears unesthetic. This study aimed to quantify and compare the visual improvement in postdebonding white spot lesions following fluoride and casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) application. The sample included 42 upper premolars extracted for orthodontic reasons. Universal premolar brackets were bonded to the facial surfaces of the teeth that were exposed to a demineralization solution to create artificial white spot lesions, after which the brackets were debonded. The specimens were randomly allocated to three treatment groups (n = 14, each): acidulated phosphate fluoride (APF) gel application group; CPP–ACP paste application group; and control group. pH cycling was conducted to all groups for 14 days. Quantitative measurements were carried out using a spectrophotometer at the following times: before and after the white spot lesions artificially formed and after treating them. All groups showed significant differences in color change before and after treatment. However, there was no significant difference in the color improvement between the APF gel and CPP–ACP paste application groups. Although CPP–ACP application improved the color of the white spot lesions, it did not differ significantly from that of fluoride application.

Scanning Electron Microscopic Evaluation of Erosive Potential of Pediatric Liquid Medicaments on Primary Teeth

Introduction: Pediatric liquid medicaments (PLMs) are the most accepted form of medication prescribed for children to treat different infirmities, however, their harmful effects on a child’s dental health are unaware for most of us. The present in vitro study was aimed to evaluate the erosive potential of two commonly used PLM’S on primary teeth and the remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on these erosive lesions. Materials and Methods: Forty deciduous teeth were randomly assigned to five groups (n = 8) in which group I samples were treated with Meftagesic-P, group II with Kofarest-PD, group III with Meftagesic P + CPP-ACP paste, group IV with Kofarest-PD + CPP-ACP paste, and group V samples were immersed in artificial saliva (control). Photomicrographs were taken at 2000× and 5000× magnification using a scanning electron microscope (SEM). Results: SEM photomicrographs elicited erosive changes in the enamel surface of all the samples in both groups I and II, however, the erosive changes in group II samples were more pronounced. The enamel surface of group III and IV samples that were treated with CPP-ACP after exposure to medicaments showed remineralization of erosed areas. Conclusion: Both the PLMs used in the study showed an erosive effect on the primary enamel surface. The severity of erosion increased with the exposure time. However, the application of CPP-ACP paste following the exposure to PLMs showed noticeable remineralization.

THE INCREASE OF TOOTH ENAMEL SURFACE HARDNESS AFTER APPLICATION BLOOD COCKLE SHELLS (ANADARA GRANOSA) PASTE AS REMINERALIZATION AGENT

Objective: To determine the increase of tooth enamel surface hardness after application hydroxyapatite paste that was synthesized from blood cockle shells (Anadara granosa) as a remineralization agent. Methods: Laboratory experimental study using twenty-seven maxillary first premolar and randomly divided into 3 groups. All of the samples were immersed in the non-cola carbonated drink (2 min). Thereafter, samples in each group were treated (6 min) with application of blood cockle shells paste that has been synthesized (group 1), casein phosphopeptide-amorphous calcium phosphate paste (GC Tooth Mousse®) (group 2) as a positive control, and stored in saline solution (NaCl) (group 3) as a negative control. Vickers Hardness Number (VHN) measurement was performed at baseline, after immersing in non-cola carbonated drink and after completing of the respective treatment. Results: Immersion in non-cola carbonated drink reduced the enamel surface hardness significantly. Significant re-hardening after treated occurred in group 1 and 2 also baseline hardness of both groups were achieved. But statistically no significant differences between group 1 and 2 in re-hardening enamel surface hardness (final hardness-hardness after immersion). Conclusion: Application of blood cockle shells paste as a remineralization agent could increase tooth enamel surface hardness which is nearly the same effective as CPP-ACP paste.

Evaluation of Different Pretreatment Efficacy with Fluoride-releasing Material on Shear Bond Strength of Orthodontic Bracket: An In Vitro Study

The aim of this study was to assess the efficacy of different pretreatments with fluoride-releasing material on shear bond strength (SBS) of orthodontic bracket. A total of 60 human mandibular premolars were taken in this study. These samples were stored in periodically changed distilled water at room temperature so as to stop bacterial growth. All samples were randomized to three pretreatment groups: group I, acid etching; group II, fluoride varnish; group III, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste. Later, Transbond XT was applied on brackets made of stainless steel and brackets were centered buccally and then light-cured. The INSTRON universal machine was used to measure SBS. Based on the values, the adhesive remnant index (ARI) was estimated. The maximum SBS was seen in group III (18.84 μ 1.04), followed by group II (14.18 μ 0.23), and the minimum bond strength was found in group I (13.90 μ 1.22). The one-way analysis of variance (ANOVA) showed high statistically significant difference within the pretreatment groups. The pretreatment group comparisons showed statistically significant difference between group I vs group III and group II vs group III. Score 0 was more in group III [8 (40%)] followed by group II [4 (20%)] and group I [2 (10%)]. The lowest number of score 3 was found in CPP-ACP paste group. After comparing the ARI scores within the groups, the Chi-square test showed a probability of 0.001 which was statistically significant. Our study established that the CPP-ACP paste pretreatment improves the SBS of orthodontic bracket significantly followed by fluoride varnish and acid etching. The bond strength of orthodontic brackets that were bonded should be adequate to resist orthodontic forces applied during treatment. The effect of the adhesive material to improve the adequate bond strength depends on the efficient pretreatment methods.

Effect of different concentration of casein phosphopeptide-amorphous calcium phosphate paste added to home bleaching gel on surface roughness of enamel (In-vitro)

Effect of different concentration of casein phosphopeptide-amorphous calcium phosphate paste added to home bleaching gel on surface roughness of enamel (In-vitro)

Effects of CPP-ACP paste application on surface roughness of resin-modified glass ionomer cement (RM-GIC) immersed in Coca-Cola®®

This study describes the effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on the surface roughness of resin-modified glass ionomer cement (RM-GIC) immersed in Coca-Cola® for 30 min. RM-GIC specimens were evaluated under different conditions: immersion in aquabidest (control, group 1); immersion in Coca-Cola® (group 2); immersion in Coca-Cola® immediately after smearing with CPP-ACP paste (group 3); and immersion in Coca-Cola® 30 min after smearing with CPP-ACP paste (group 4). There was a significant increase in the surface roughness of the specimens in group 2, an obvious but insignificant decrease in the surface roughness of the specimens in group 3, and a significant decrease in the surface roughness of the specimens in group 4. The results showed that the treatment of RM-GIC specimens with CPP-ACP paste with or without a 30-min delay results in no significant change in surface roughness from immersion in Coca-Cola®.

COLOR CHANGES OF POST-DEBONDING WHITE SPOT LESION AFTER MICROABRASION TECHNIQUE WITH FLUORIDE AND CASEIN PHOSPHOPEPTIDE-AMORPHOUS CALCIUM PHOSPHATE APPLICATION

Objective: The prevalence of enamel demineralization among patients after orthodontic treatment is about 50%, which begins with the formation of white spot lesions. The presence of these lesions causes esthetic problems. The aim of this study was to quantify the color changes in post-debonding white spot lesions after microabrasion technique with fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application.Materials and Methods: This study used 42 first premolar teeth that had been extracted, then were soaked for 96 h in a demineralization solution (pH 4, 37°C) to form an artificial white spot lesions. Samples were randomly divided into three treatment groups (n=14): (A) Microabrasion technique only; (B) microabrasion technique with 10% CPP-ACP paste application; and (C) microabrasion technique with 1.23% APF gel application. All groups were assigned to pH cycling for 10 days. The color change was determined using spectrophotometer at 3 different time points, which were measured before and after production of the artificial white spot lesions, and after the artificial white spot lesions were treated.Results: This study showed that there was a significant difference in the color of the artificial white spot lesions after microabrasion technique with CPP-ACP application.Conclusion: Microabrasion technique with CPP-ACP application was giving better result in changing the color of white spot lesions than only microabrasion technique and microabrasion technique with fluoride application.

Influence of CO2 Laser Irradiation and CPPACP Paste Application on Demineralized Enamel Microhardness.

Introduction: It has been suggested that the application of casein phosphopeptide-amorphous calcium phosphate paste (CPP-ACP) and CO2 laser irradiation on enamel could increase the resistance of enamel to caries and acid attacks. The aim of the current study was to compare the influence of CPP-ACP paste application and irradiation of CO2 laser on microhardness of demineralized enamel. Methods: Thirty sound maxillary extracted premolars were selected. The crowns were cut at the cervical line and were split into facial and palatal halves. Specimens were mounted in selfcure acrylic blocks in such way that the enamel surface was exposed to 4×4 mm. After a pH cycling of the specimens, they were randomly divided into 4 groups (n=15), as follows: CG: Control group, LAS: CO2 laser, CP: CPP-ACP and LASCP: laser combined CPP-ACP treatment. The Vickers microhardness of the specimens was measured (500 g load, 5 seconds, 3 points). Data were analyzed using one-way ANOVA and post hoc Tukey tests (α =0.05). Results: The lowest mean Vickers microhardness value was observed in CG group (192.57±50.87 kg/mm2 ) and the highest in LASCP group (361.86±22.22 kg/mm2 ). There were significant differences between groups (P<0.001). The pairwise comparison of the groups revealed that there were significant differences between these groups: CG versus LAS, CP, LASCP (P<0.05) and LASCP versus LAS and CP (P<0.05). No significant difference between LAS group versus CP group (P>0.05) was observed. Conclusion: The results of the current study revealed that CO2 laser and CCP-ACP were effective for improvement of enamel hardness value after demineralization. Incorporation of CO2 laser irradiation and CCP-ACP paste application provides additional remineralizing potential for demineralized enamel.

Evaluation of Remineralization Potential of Beverages modified with Casein Phosphopeptide-Amorphous Calcium Phosphate on Primary and Permanent Enamel: A Laser Profiler Study.

PurposeTo assess the erosive potential of carbonated beverages and the remineralization potential of beverages with added casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste on primary and permanent enamel.Materials and methodsA total of 32 primary and 32 permanent enamel specimens were immersed for 5, 10, and 30 minutes, respectively, in beverages, i.e., Coke, Sprite, Mirinda, and Mountain Dew, with and without added 0.2% CPP-ACP. Samples were profiled before immersion and after immersion under laser profiler.ResultsCoke was found to be highly erosive at it caused significant enamel erosion at both 10 and 30 minutes of immersion (p < 0.05) for both primary and permanent enamel. The 30-minute immersion caused significant amount of reminerali-zation over primary enamel in all groups, whereas permanent enamel remineralization was significant in Sprite and Mountain Dew at 30 minutes in all the groups (p < 0.05).ConclusionThis study demonstrated that enamel erosion occurred after immersion in carbonated beverages. Remineralization of enamel was observed after immersion in beverages modified with CPP-ACP paste. Primary enamel was susceptible to remineralization compared with permanent enamel. Within the limitations of this in vitro study, the application of CPP-ACP paste may enhance the remineralization after an erosive challenge and thus offer some protection for patients who are at risk for erosion.How to cite this article: Rai N, Sandhu M, Sachdev V, Sharma R. Evaluation of Remineralization Potential of Beverages modified with Casein Phosphopeptide-Amorphous Calcium Phosphate on Primary and Permanent Enamel: A Laser Profiler Study. Int J Clin Pediatr Dent 2018;11(1):7-12.