Young Permanent Teeth Research Articles

EVALUATION OF MATUROGENESIS AND APEXIFICATION TECHNIQUES IN THE MANAGEMENT OF TRAUMATIZED NON-VITAL IMMATURE PERMANENT INCISORS

Introduction: Regenerative endodontics is a promising alternative treatment for immature teeth with necrotic pulps. Aim of the study: The present study was performed to assess healing potential of young permanent immature teeth with necrotic pulp after the following treatment protocols: (1) Calcium hydroxide apexification, (2) the regenerative endodontic protocol (blood clot scaffold). Materials and Methods: Immature necrotic permanent maxillary central incisors (n = 48) were divided into 2 groups according to the treatment protocol: the apexification group (calcium hydroxide), the REG group (regenerative endodontic protocol). Follow-up was done up to 18 months. Standardized radiographs were digitally evaluated for an increase in root length and thickness, a decrease in the apical diameter Follow-up was done up to 18 months. Results: After a follow-up period of 18 months, most of the cases showed radiographic evidence of periapical healing. Groups showed a progressive increase in root length and width and a decrease in apical diameter. Conclusions: The regenerative endodontic procedure allowed the continued development of roots in teeth with necrotic pulps.

Histological evaluation of the effect of trichloroacetic acid and mineral trioxide aggregate on human teeth pulp

Objective: The objective of this study was to compare between the effects of two medicaments [trichloroacetic acid (TCA) and mineral trioxide aggregate (MTA)] on the remaining pulp tissue of the young permanent teeth after pulpotomy. Materials and methods: The present study comprised 30 premolars. Pulpotomy procedure was performed. The radicular pulp was capped with MTA in premolar in one side and with TCA in those of the other side. Premolars were reviewed after successive periods (1 week, 1, and 3 months). Teeth were extracted after examination periods. Sections was then stained by standard hematoxylin and eosin stain. Results and conclusion: Bridge formation was seen in TCA group after 3 months which is a desirable finding in pulpotomy procedures, whereas MTA is superior to TCA in treating pulps in human teeth.

The effects of temperature on extracted teeth of different age groups: A pilot study.

Context:Type of dentition and age related changes may affect the behavior of dental hard tissues under thermal stress.Aim:This study was conducted to analyze the effects of varying temperatures on extracted teeth of different age groups in a simulated laboratory set up.Settings and Design:Experimental pilot study.Methods and Material:Extracted teeth from three age groups (deciduous, young permanent and adult permanent) were collected and were exposed to three different temperatures (400°C, 700°C and 1000°C) in a laboratory set up. Post-test changes were analyzed visually and radiographically.Results:(1) The colour changes of the teeth may serve as an indicator for the temperature to which they were exposed. (2) Deciduous teeth tolerated thermal stress with lesser morphological changes compared to young and adult permanent teeth. (3) Coronal dentin of elderly permanent teeth appeared to be more resistant to thermal stress compared to that of young permanent teeth. (4) The root portion of the teeth showed better tolerance to temperature while crown was fragmented easily under thermal stress.Conclusion:The age factor and type of the dentition may influence the heat induced changes in teeth. These variables should be taken into consideration while applying comparative dental identification methods where dental hard tissues are exposed to extreme temperatures.

Pulp Response to Lyophilized Bone in Rat Teeth

Background: This article will review different materials for the treatment of pulps of primary and young permanent teeth. However, innovations in materials and advances in biology suggest that there may soon be a convergence of therapies for teeth of either dentition needing pulp treatment. Objectives: The objective of this study was evaluated the pulp and liver response to biocompatible agents such as lyophilized bone in comparison with classical formocresol. Materials and Methods: Treatment was applied to the upper right and left first molar of each animal, for a total of 120 teeth. Six groups were established according to the agent used and the time elapsed (30, 45 and 60 days). In each group five livers were selected, and a control group subjected to no treatment was also evaluated. At the end of the study the rats were sacrificed and the samples were processed for histological evaluation. Analysis of variance (ANOVA) for repeated measures was used. Results: Dentinal bridge formation and reparative dentin reached higher values in the group treated with lyophilized bone. The formocresol treatment group showed increased inflammation and necrosis. Conclusions: Lyophilized bone afforded improved pulp tissue response. No histological evidence of liver damage was observed in any of the hepatic samples studied.

Sealing Occlusal Dentin Caries in Permanent Molars: 7-Year Results of a Randomized Controlled Trial.

The purpose of this study was to investigate the possibility of postponing restorative intervention of manifest occlusal caries in young, permanent dentition by non-invasive sealing. This RCT-designed study included 521 occlusal lesions in 521 patients aged 6 to 17 y. Based on clinical and radiographic assessments, all lesions required restorative treatment. After randomization (ratio 2:1), 368 resin sealings and 153 composite-resin restorations were performed by 68 dentists in 9 municipalities. The primary aims were to 1) analyze survival of sealings until replacement by restoration, 2) compare longevity of sealings and restorations until retreatments, and 3) compare effectiveness of sealings and restorations to halt caries progression in sealed lesions and beneath restorations. Furthermore, we aimed to identify factors influencing longevity and the effectiveness of sealings and restorations. Treatments were annually controlled, clinically and radiographically. After 7 y, the drop out rate was 8%, and 54% of the treatments were completed due to age. Of the sealings, 48% were retreated, including 31% replaced by restorations; 12% were still functioning. Of the restorations, 7% were repaired/renewed and 20% were still functioning. No endodontics was performed. Kaplan-Meier and Cox regression survival analyses were performed on 341 sealings and 152 restorations in first and second molar teeth. The 7-y survival was 37% (CI, 29% to 45%) for sealings and 91% (CI, 85% to 96%) for restorations (P < 0.001). The median survival time for sealings not replaced by restorations was 7.3 y (CI, 6.4 y to NA). Survival of sealings was increased in patients with low caries risk and/or excellent oral hygiene, second molars compared with first molars, and lesions not extending the middle one-third of the dentin. Survival of sealings was not influenced by municipality, sex, eruption stage or clinical surface cavitation. The results underline that it is possible to postpone or avoid restorative intervention of occlusal dentin caries lesions in young permanent teeth by non-invasive sealing. Knowledge Transfer Statement: The first restoration can ultimately be fatal for a young permanent tooth. A restoration may not be the final treatment but the start of an ongoing treatment with still more loss of tooth substance. The present study shows the possibility of treating occlusal dentin caries lesions with non-invasive resin sealings instead of conventional resin composite restorations in children and adolescents. Improved oral health can be expected.

Efficacy and Stability of Two in-Office Bleaching Agents in Adolescents: 12 Months Follow-Up

Although there are several clinical studies on in office vital bleaching in adults, there are no Randomized Clinical Trials for the efficacy of this application in adolescents. The aim the study was to evaluate the efficiency of two bleaching systems on adolescents for twelve-months follow-up. Twenty-eight volunteers, aged between 13-18, randomly divided into two groups. Two commercial in-office bleaching systems were used: G1 (n=14): Zoom2 25 % HP with UV light and G2 (n=14): Beaming White 36% HP with LED light in a single 3 x 15 minute procedure. The color assessment was made with a spectrophometer; before and after bleaching; 48 hours; 1, 6 and 12 months later. Color enhancement and maintenance of two techniques over 12 months were compared by two ways ANOVA and Student's t test. Sensitivity was evaluated on a scale with Wilcoxon test. Both groups demonstrated similar and significant tooth color enhancement and did not reveal any statistically significant differences between them. However, a relapse of the tooth shade was observed with the low concentration agent/ultraviolet light system. No sensitivity was observed in any patients. Two in-office bleaching systems can be used successfully on young permanent teeth. For long-term successful results, high concentration/LED light may be more effective.

Influence of Age and Apical Diameter on the Success of Endodontic Regeneration Procedures

IntroductionTreatment of immature permanent teeth with necrotic pulp and apical pathosis constitutes a challenge for endodontists. The present study was done to evaluate the effect of age and apical diameter on the regenerative potential of young permanent immature teeth with necrotic pulps. MethodsImmature necrotic permanent maxillary incisors (n = 40) of patients 9–18 years old were divided into 2 groups according to the treatment protocol: group Y (younger age group), 9–13 years and group O (older age group), 14–18 years. Each group was further subdivided into 2 subgroups according to apical diameter, subgroup (n) (narrower diameter) between 0.5 and 1 mm and subgroup (w) (wider diameter) equal to or greater than 1 mm. Revascularization procedures were performed for all patients. Follow-up was done for up to 12 months. Standardized radiographs were digitally evaluated for increase in root length and thickness and decrease in apical diameter. ResultsAfter the follow-up period, most of the cases demonstrated radiographic evidence of periapical healing. Group Y showed significant progressive increase in root length and width and decrease in apical diameter. Subgroup (w) representing wider apical diameter showed significant progress as well. ConclusionsIt was found that revascularization procedures can be implemented in any age ranging from 9 to 18 years; however, younger age groups were better candidates for revascularization procedure than older ones. Regarding the apical diameter, regeneration procedures were successful with apical diameters as small as 0.5 mm. However, teeth with preoperative wider diameters (≥1 mm) demonstrated greater increase in root thickness, length, and apical narrowing.

Investigation of adult stainless steel crown longevity as an interim restoration in pediatric patients.

Preformed metal crowns, also known as stainless steel crowns (SSC), are utilized for providing full coverage to young permanent teeth and have been used extensively as restorations of primary teeth for approximately 65 years. Evaluate permanent tooth SSC longevity as an interim restoration for teeth requiring full coverage restoration in pediatric patients. Retrospective chart review from 2006 through 2014 in a hospital-based dental clinic for permanent tooth pre-fabricated crown longevity. One hundred and fifty-five SSCs were evaluated with regard to: age of patient at restoration placement, diagnoses, and duration of crown service. Duration service was further categorized as successful or failed. Of 155 SSCs, 137 were considered successfully functioning. Total failures were 18. The overall combined success rate for the study group was observed to be 88% with an average service period of 45.18 months. Significant success was noted in patients less than 9 years of age, and significant failure was observed in patients 12 years and older. Stainless steel crowns are a viable option for interim restoration needs, with an 88% overall success rate during an average service period of 45.18 months.

Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a retrospective study.

The aim of this retrospective university-based study has been to evaluate the longevity and factors associated with failures of adhesive restorations performed in deep carious lesions of permanent molars after complete (CCR) and selective caries removal (SCR). The sample was composed of composite resin and resin-modified glass ionomer cement (RMGIC) restorations placed in permanent molars of children attending a university dental service who were followed up for up to 36months. Information collected retrospectively from clinical records was used for analyzing data. The following factors were investigated: gender, caries experience, visible plaque and gingival bleeding indexes, operator's experiences, number of restored surfaces, and type of capping and restorative materials. The Kaplan-Meier survival test was used to analyze the longevity of the restorations. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05). Four hundred seventy-seven restorations carried out in 297 children (9.1 ± 1.7years) were included in the analysis. The survival of the restorations reached 57.9% up to 36months follow-up with an overall annual failure rate of 16.7%. There was no difference in restoration longevity when CCR or SCR was performed (p = 0.163); however, CCR presented more pulp exposure (p < 0.001). Multi-surface restorations showed more failures than single-surface (HR 3.22, 95% CI 1.49; 6.97), and teeth restored with RMGIC had a lower survival rate than those restored with composite resin (HR 4.11, 95% CI 1.91; 8.81). Patients with evidence of gingivitis had more risk of failure in their restorations (HR 2.88, 95% CI 1.33; 6.24). Overall, adhesive restorations performed in young permanent molars of high caries risk children presented limited survival, regardless of the caries removal technique. Risk factors for failure were identified as multi-surface fillings, RMGIC restorative material, and poor oral hygiene, reflected by gingival bleeding. Composite fillings associated with a strict caries preventive regimen may play an important role in the survival of restorations placed in high caries risk children.

The role of cacao extract in reduction of the number of mutans streptococci colonies in the saliva of 12-14 year-old-children.

Cacao bean husk ethanol extract (CBHEE) has polyphenol that acts as an antibacterial agent, specially anti-glucosyltransferase. This study is aimed to see the effectiveness of CBHEE to reduce the number of mutans streptococci colonies in the saliva of children (with young permanent teeth), when CBHE is used as mouth rinse. This study used cross-sectional study design with time-series experimental study and used simple random sampling on 30 subjects. The chosen subjects are those who have middle oral hygiene status (OHI-S). Each subject was given the same intervention; in the first step, saliva was collected from the subjects (prior to intervention), in the second step, the subjects were given 15 mL of CBHEE 0.1% mouth rinse to rinse their mouth for about 30 s. After intervention, their saliva was collected twice in 15 min and 30 min after intervention. Furthermore, the number of mutans streptococci colonies were measured in colony-forming units (CFU) and the data was statistically analyzed using analysis of variance (ANOVA) and paired t-test. The data was analyzed and processed using Statistical Package for the Social Sciences (SPSS) 22.0 for windows versions. The data statistically showed, significantly, the reduction of Streptococcus mutans colonies before and after 30 min of intervention. Before intervention, there were 59.10 CFU/mL of mutans streptococci, and after 15 min of intervention it showed reduction of mutans streptococci to 25.73 CFU/mL and after 30 min of intervention, the counts of mutans streptococci showed a reduction to 9.40 CFU/mL. From the test results, statistical value of this research was P = 0.000 (P < 0.05), which means that the reduction of the mutans streptococci count was significant. Using CBHEE as mouth rinse for children has been proven highly effective in reducing mutans streptococci colony counts in the mouth.

Clinical and radiographic assessment of mineral trioxide aggregate and calcium hydroxide as apexification agents in traumatized young permanent anterior teeth: A comparative study

To evaluate and compare the efficacy of mineral trioxide aggregate (MTA) and traditionally used calcium hydroxide (Ca(OH)2) in inducing root end formation of immature roots of traumatized young permanent anterior teeth. The study was carried out on 22 nonvital, immature permanent maxillary incisors. Samples were allotted into two groups - Group I MTA and Group II Ca(OH)2 Success rate was determined based upon the time duration required for apical barrier formation. The canals were obturated using gutta-percha points in MTA group, after 24 h, whereas in Ca(OH)2 group, obturation was carried out after radiographic confirmation of the apical barrier. The clinical and radiographic evaluation was carried out at a follow-up periods of 3, 6, and 9 months and statistical analysis was carried out by SPSS version 15.0 statistical analysis software (Chi-square test and fisher exact test). In MTA Group, barrier formation was observed in 90.90% of the patients after 9 months whereas in Ca(OH)2 Group, the same was observed in 81.81%. The mean time required for barrier formation in MTA group was 4.90 months and 5.33 months in Ca(OH)2 group. MTA and Ca(OH)2, as medicaments for apexification, were comparable in terms of the evaluation parameters. However, MTA was beneficial in terms of immediate obturation of immature roots with wide open apices.

Revascularization of immature necrotic teeth with platelet-rich fibrin and blood clot

Background: Endodontic treatment of immature permanent teeth with necrotic pulp, with or without apical pathosis, poses several clinical challenges. Regenerative endodontics is a promising alternative for the treatment of such immature necrotic permanent teeth. Aim: To assess the regenerative potential of young permanent teeth with necrotic pulps with platelet-rich fibrin (PRF) and blood clot using radiographic and clinical methods. Settings and Design: This was an experimental, in vivo study comparing the two groups. Materials and Methods: Immature necrotic permanent teeth (n = 14) in patients who belonged to the age group of 10-12 years were selected and divided into two groups. Group 1 was treated by conventional revascularization with blood clot and Group 2 with revascularization using PRF. Follow-up was done for 6 months. Standardized radiographs were analyzed for the periradicular healing and apical closure, and clinical analysis was performed using mobility index as compared to baseline values. Statistical Analysis Used: Results were analyzed using Friedman test, Wilcoxon test, and Mann-Whitney U-test. Results: There was increased periradicular healing and apical closure at 3 months and 6 months in Group 2 (PRF) when compared to Group 1 (conventional). Conclusions: Revascularization with PRF procedure leads to better and faster healing, reduced radiolucency, enhanced apical closure, and reduction in mobility of necrotic immature teeth.

Local anesthetics induce autophagy in young permanent tooth pulp cells.

Pulp cells are essential for tooth development, and dentin repair and regeneration. In addition these cells have been identified as an important stem cell source. Local anesthetics are widely used in dental clinics, as well as the other clinical disciplines and have been suggested to interfere with human permanent tooth development and induce tooth agenesis through unknown mechanisms. Using pig model and human young permanent tooth pulp cells, our research has identified that the local anesthetics commonly used in clinics can affect cell proliferation. Molecular pathway profiling suggested that LC3II is one of the earliest molecules induced by the agents and p62 is the only common downstream target identified for all the drugs tested. The effect of the drugs could be partially recovered by V-ATPase inhibitor only if early intervention is performed. Our results provide novel evidence that local anesthetics could affect tooth cell growth that potentially can have impacts on tooth development.

Permanent teeth pulpotomy survival analysis: retrospective follow-up

ObjectivesThe aim of the present study is to evaluate risk factors influencing the success rates of pulpotomies both in young and adult populations. MethodsPulpotomies (n=273) performed by a single endodontic specialist were analyzed, and data on success rates were collected. Additionally, possible explanatory variables were noted such as: age, gender, clinical findings (teeth, type of restoration after pulpotomy), radiographic findings (dentin bridge formation) and systemic conditions. The follow-up period varied from 1 to 29 years, and the results were analyzed by Kaplan–Meier survival curves and also by Cox regression. ResultsAge at the time of pulpotomy ranged from 8 to 79 and had not influenced the success rates (p=0.35). The formation of dentin bridge had a strong protective effect (hazard ratio—HR=0.16, p<0.001). The prosthetic crown restorations following pulpotomy had the smallest failure rate, and amalgam has not increased the risk of failure significantly in relation to prosthesis. Resin composite restorations following pulpotomy increased in 263% the risk of failure (HR=3.63, p<0.001). ConclusionThis study allowed inferences that pulpotomy may be a successful treatment at any age, and not only for young permanent teeth. It was also possible to conclude that the use of direct composite restorations following pulpotomies is associated with higher failure rates.

The Scope of Regenerative Endodontics on Open-Apices in Young Permanent Teeth

Numerous challenges in treating permanent dentition are encountered, especially in treating immature teeth with pulp necrosis. Historically, calcium hydroxide application during long periods of time was used to induce the formation of a calcific barrier across the open apex. In 2004, a new treatment modality for the management of the open apex was introduced. This treatment was named as `revascularization` and gained acceptance among dentists. The protocol was different from the traditional apexification techniques in that the canal was irrigated and disinfected with a combination of three antibiotics (ciprofloxacin, metronidazole and minocycline). At the next appointment, bleeding was induced and the canal was sealed with MTA. Successful regenerative endodontic treatment of necrotic immature permanent teeth can provide continued root development, increased thickness in the dentinal walls and apical closure. These developments of a functional pulp-dentin complex have a promising impact on retaining the natural teeth, the goal of the dental health care.

Effects of mineral trioxide aggregate on proliferation and differentiation of dental pulp stem cells from young permanent teeth in vitro

Objective To investigate the effects of the different concentration of mineral trioxide aggregate (MTA) on the proliferation and differentiation of dental pulp stem cells (DPSCs) from the young permanent teeth. Methods DPSCs were isolated from the young permanent teeth and cultured by tissue explant method. The expression of STRO-1 was detected by using immunofluorescence technology. DPSCs were cultured with different concentrations of MTA (0.02, 0.20, 2.00, 20.00 g/L). Cell proliferation was detected by MTT array. Cells were cultured in the appropriate concentration of MTA for 4 weeks, and then stained by Alizarin red to detect their mineralized nodule formation capacity. The cells were cultured with the appropriate concentration of MTA and collected after 12, 24, 36, 48 h. The mRNA expression of ALP, BSP, OC and DSP after the treatment of MTA were detected by quantitative PCR. Results DPSCs were positive for STRO-1. The capacity of 0.20 g/L MTA promoting the proliferation of DPSCs was stronger than other concentrations. After 4 weeks, the mineralized nodules of DPSCs were observed after alizarin red staining. The PCR showed that with increasing induction time, the expression levels of DSP and OC were up-regulated. But that of ALP and BSP was increased first and then decreased. Conclusions In this study, MTA can promote the proliferation of DPSCs at 0.02, 0.20, 2.00 g/L concentration. It can induce odontoblast differentiation effectively by 0.20 g/L MTA. Key words: Mineral trioxide aggregate; Dental pulp; Stem cells; Permanent teeth

Vertical root fracture associated with prolonged use of calcium hydroxide during apexification. A case report

Apexification is a procedure performed in young permanent teeth seeking an apical closure and root elongation, when the epithelial sheath of Hertwig unmeet irreversibly affected. The aim of this article is to relate to vertical root fracture as a complication during apexification to work for long time with calcium hydroxide. Female patient, student, 9, attended at the Faculty of Dentistry at the University Andres Bello campus Concepcion, presented severe and spontaneous pain, pressure and swelling of the left cheek. Clinically fund lobby edematous around lower left first molar (3.6) and purulent content. Radiographically was observed apical lesions and the presence of open apices. The diagnosis was Pulp necrosis and Acute Apical Abscess, was trepanned for intracanal drainage and oral antibiotic medication was prescribed, before being sent to the specialty of endodontics, where the selected treatment was Apexification with calcium hydroxide until it observed the formation of apical barrier. Upon completion of the objective, a vertical root fracture was discovered, confirming that this use should not be prolonged because processes of dehydration leads to weakening of the walls and therefore of the tooth.

A systematic map of systematic reviews in pediatric dentistry--what do we really know?

ObjectivesTo identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry.MethodsA systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. s and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps.ResultsOut of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low.ConclusionThere is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.

Micro-computed tomography evaluation of root canal preparation using rotary system and hand instrument in young permanent molars

The aim of this study was to evaluate the shaping potentials of the ProTaper system and nickel-titanium (Ni-Ti) hand-files using micro-computed tomography (μCT) in young permanent teeth. Thirty-second permanent molar teeth extracted from patients 15 to 18 years of age were divided into two groups with 15 samples of each. Group I: were instrumented using the traditional step-back technique by Ni-Ti K-files. Group II were instrumented using the crown-down technique by ProTaper rotary instruments. Before and after root canal preparation, the μCT data were analyzed for the canal volume changes, the percentage differences between these volumes and unprepared surface area ratio of the total surfaces. At all root canals in both groups, the difference between the percentage of the root canal volume before-after preparation was significant (P 0.05). There was no difference between the systems in terms of shaping ability. Considering the shortening session time of the child patient ProTaper system appeared to be beneficial.

An in vitro evaluation of the demineralization inhibitory effect of F(-) varnish and casein phosphopeptide-amorphous calcium phosphate on enamel in young permanent teeth.

Aims and Objectives:To determine the demineralization inhibitory potential of fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and to compare and evaluate the additive effect of fluoride varnish + CPP-ACP.Materials and Methods:Ten healthy premolar teeth that were extracted for orthodontic purposes were collected, and each tooth was longitudinally sectioned buccolingually and mesiodistally into four sections. The teeth were then assigned to four different treatment groups namely fluoride varnish, CPP-ACP, F− varnish followed by CPP-ACP and control. The prepared enamel samples were suspended in an artificial caries challenge for 10 days. The demineralizing inhibitory effects of the groups were recorded using polarized light microscopy.Statistical Analysis Used:Statistical analysis was carried out using analysis of variance and Duncan's multiple range tests.Results:The mean lesion depths of all the groups were Group 1 (fluoride varnish): 104.71, Group 2 (CPP-ACP): 127.09, Group 3: (F− varnish + CPP-ACP): 82.34, Group 4 (control): 146.93.Conclusion:Demineralization inhibitory potential on the additive use of F− varnish and casein phosphopeptide was superior to fluoride varnish or CPP-ACP applied alone on the enamel of young permanent teeth.