An in vitro study to evaluate and compare the remineralizing potential among Casein Phosphopeptide-amorphous Calcium Phosphate (CPP-ACP) with fluoride and surface pre-reacted glass (S-PRG) fillers using quantitative analysis. Comparison between two types of remineralizing agents.
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Abstract
Background- Early treatment of white spot lesions is essential to prevent the progression of the lesion.
Aim - To evaluate and compare the remineralizing potential of CPP-ACP with fluoride (Casein Phospho Peptide-Amorphous Calcium Phosphate) and S-PRG fillers (Surface Pre reacted glass fillers) using atomic absorption spectroscopy and colorimetric method.
Materials and methods- Forty sound human premolars were used in this study. They were divided into two groups (A & B), consisting of 20 samples in each. White spot lesions (WSLs) were established on the window (4x4 mm2) created on the buccal surfaces of the samples. Samples in group A were treated with casein phosphopeptide amorphous calcium phosphate (CPP-ACP) with fluoride, those of group B were treated with S-PRG Fillers. The sample teeth were immersed in a demineralizing solution for 4 days. All the samples were subjected to loss of mineral content (wt %), i.e., calcium, using atomic absorption spectroscopy and phosphorus using the colorimetric method.
Results- Statistical analysis was performed using one?way analysis of variance, Tukey’s and paired t?tests. Group A exhibited the highest remineralizing potential, followed by Group B. Statistically, a significant difference (p=0.001) was observed between the two groups.
Conclusion- There was a significant difference in remineralizing potential of CPP-ACP with fluoride and S-PRG Fillers. CPP-ACP with fluoride appears to be an effective technique in the remineralization of white spot lesions.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
- Gamea SA, Etman WM, Abdalla AI, Saudi HI. In-vitro quantitative evaluation of the effectiveness of different techniques on the of incipient enamel demineralization. Tanta Dent J. 2017;14(1):30-39. https://doi.org/10.4103/tdj.tdj_64_16
- Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89(11):1187-97. https://doi.org/10.1177/0022034510376046
- Subramaniam P, Babu KG, Lakhotia D. Evaluation of penetration depth of a commercially available resin infiltrate into artificially created enamel lesions: An in vitro study. J Conserv Dent. 2014;17(2):146-149. https://doi.org/10.4103/0972-0707.128054
- Pitts NB, Zero D. White paper on dental caries prevention and management. FDI World Dental Federation. 2016:3-9.
- Chaudhary I, Tripathi AM, Yadav G, Saha S. Effect of Casein Phosphopeptide-amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Artificial Carious Lesions: An in vitro Study. Int J Clin Pediatr Dent. 2017;10(3):261-266. https://doi.org/10.5005/jp-journals-10005-1447
- Shivanna V, Shivakumar B. Novel treatment of white spot lesions: A report of two cases. J Conserv Dent. 2011;14(4):423-26. https://doi.org/10.4103/0972-0707.87217
- Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries–a review: report of a FDI task group. Int Dent J. 2012;62(5):223-43. https://doi.org/10.1111/idj.12007
- Babu KG, Subramaniam P, Teleti S. Remineralization potential of varnish containing casein phosphopeptides-amorphous calcium phosphate with fluoride and varnish containing only fluoride: A comparative study. Saudi J Oral Sci. 2018;5(1):35-40. https://doi.org/10.4103/sjos.SJOralSci_44_17
- Arends J, Ten Cate JM. Tooth enamel remineralization. J Cryst Growth. 1981; 53:135-147. https://doi.org/10.1016/0022-0248(81)90060-9
- Almeida MQ, Costa OX, Ferreira JM, Menezes VA, Leal RB, Sampaio FC. Therapeutic potential of Brazilian fluoride varnishes: an in vivo study. Braz Dent J. 2011;22(3):193-7. https://doi.org/10.1590/S0103-64402011000300003
- Kariya S, Sato T, Sakaguchi Y, Yoshii E. Fluoride effect on acid resistance capacity of CPP-ACP containing material. General Session of the IADR, Honolulu, Hawaii. 2004.
- Wakamatsu N, Ogika M, Okano T, Murabayashi C, Kondo T, Iinuma M. Effect of tooth surface coating material containing S-PRG filler on white spot lesions of young permanent teeth. Pediatr Dent J. 2018;28(1):40-5. https://doi.org/10.1016/j.pdj.2017.09.001
- Assiry AA. Evaluation of remineralization potential of casein phospho-peptide with amorphous calcium phosphate fluoride (CPP-ACPF) on demineralised enamel surfaces. Biomed Res. 2019;30(4): 628-32. https://doi.org/10.35841/biomedicalresearch.30-19-291
- Torres CR, Borges AB, Torres LM, Gomes IS, de Oliveira RS. Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions. J Dent. 2011;39 (3):202-7. https://doi.org/10.1016/j.jdent.2010.12.004
- Baafif HA, Alibrahim IF, Alotaibi SH, Alharbi HG, Shubaily MN, Elkwatehy WM. The efficacy of resin infiltrant and casein phosphopeptide–amorphous calcium fluoride phosphate in treatment of white spot lesions (comparative study). J Int Soc Prevent Communit Dent. 2020;10(4):438-44. https://doi.org/10.4103/jispcd.JISPCD_483_19
- Shiiya T, Kataoka A, Fujino F, Tomiyama K, Iizuka J, Hasegawa H, Kuramochi E, Ohashi K, Nihei T, Mukai Y. Anti-demineralization effect of novel S-PRG filler containing varnishes on dentin. Dent Mater. 2015(31):e20. https://doi.org/10.1016/j.dental.2015.08.047