EFFECT OF TWO REMINERALIZING AGENTS ON MICROHARDNESS OF INITIAL ENAMEL CARIESLIKE LESIONS IN YOUNG PERMANENT TEETH

Document Type : Original Article

Authors

1 B.D.S. Faculty of Dentistry Alexandria University

2 Professor of Pediatric and Dental Public Health Department

3 Assistant Professor of Pediatric and Dental Public Health Department

Abstract

INTRODUCTION: Dental caries in enamel is unique amongst diseases as enamel is both acellular and avascular. Thus, in contrast to other tissues, enamel cannot heal itself by a cellular repair mechanism. Nonetheless, it is now well established that the formation of incipient enamel caries is a reversible process where periods of progression alternates with periods of remineralization. OBJECTIVES: The purpose of this study was to compare the effect of Nano-hydroxyapatite paste and casein phosphopeptide-amorphous calcium phosphate fluoride paste remineralizing capacity on initial enamel carious lesions of young permanent teeth. MATERIALS AND METHODS: Sixty extracted young permanent teeth with a standardized window on enamel were immersed in a demineralizing solution for 48 hours to produce subsurface enamel lesions. They were divided into three groups according to remineralizing agents (N=20): group I: Nano-hydroxyapatite paste; group II: casein phosphopeptide-amorphous calcium phosphate fluoride paste; and group III: control (untreated). The enamel surface microhardness (SMH) was measured at baseline, after incipient enamel lesion formation and after treatment. RESULTS: The mean surface microhardness (201.46) was found to be higher in teeth treated with Nano-hydroxyapatite paste than mean surface microhardness (195.61) in those treated with casein phosphopeptide-amorphous calcium phosphate fluoride paste. However, this difference was not statistically significant P=0.26. CONCLUSIONS: Both Nano-hydroxyapatite paste and casein phosphopeptide-amorphous calcium phosphate fluoride paste were effective for remineralization of early caries-like lesions of young permanent teeth.

Keywords

Main Subjects


  1. Zero DT. Dental caries process Dent. Clin North Am. 1999; 43: 635-64.
  2. Tenuta LMA, Cury JA. Fluoride: its role in dentistry. Braz Oral Res. 2010; 24: 9-17.
  3. Ten Cate JM. Current concepts on the theories of the mechanism of action of fluoride. Acta Odontol Scand. 1999; 57: 325-9.
  4. Minah G, Lin C, Coors S, Rambob I, Tinanoff N, Grossman LK. Evaluation of an early childhood caries prevention program at an urban pediatric clinic. Pediatr Dent. 2008; 30: 499-504.
  5. O’Keefe E. Fluoride varnish may be effective in preschoolers. Evid Based Dent. 2011; 12: 41-2.
  6. Azarpazhooh A, Main PA. Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review. J Can Dent Assoc. 2008; 74: 73-9.
  7. 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: 193-7.
  8. de Amorim RG, Leal SC, Bezerra AC, de Amorim FP, de Toledo OA. Association of chlorhexidine and fluoride for plaque control and white spot lesion remineralization in primary dentition. Int J Paediatr Dent. 2008; 18: 446-51.
  9. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009; 67: 321-32.
  10. Huang SB, Gao SS, Cheng L, Yu HY. Combined effects of nano-hydroxyapatite and Gallachinensis on remineralization of initial enamel lesion in vitro. J Dent. 2010; 38: 811-9.
  11. Huang S, Gao S, Cheng L, Yu H. Remineralization potential of nano-hydroxyapatite on initial enamel lesions: an in vitro study. Caries Res. 2011; 45: 460-68.
  12. Cross KJ, Huq NL, Palamara JE, Perich JW, Reynolds EC. Physicochemical characterization of casein phosphopeptide-amorphous calcium phosphate nanocomplexes. J Biol Chem. 2005; 280:15362-15369.
  13. Llena C, Forner L, Baca P. Anticariogenicity of casein phosphopeptide amorphous calcium phos- phate: a review of literature. J Contemp Dent Pract. 2009; 10: 1-9.
  14. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009; 67: 321-32.
  15. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res. 1997; 76: 1587-95.
  16. Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphatecasein phosphopeptide on enamel lesions: an in vitro comparative evaluation. J Conserv Dent. 2010; 13: 42-6.
  17. RehderNeto FC, Maeda FA, Turssi CP, Serra MC. Potential agents to control enamel caries-like lesions. J Dent. 2009; 37: 786-90.
  18. Zhang Q, Zou J, Yang R, Zhou X. Remineralization effects of casein phosphopeptide-amorphous calcium phosphate creme on artificial early enamel lesions of primary teeth. Int J Paediatr Dent. 2011; 21: 374-81.
  19. Rollings S, Greene L, Borrie F, Lamont T. Small trial finds beneficial effect for MI Paste in preventing white spot lesions during orthodontic treatment. Evid Based Dent. 2012; 13: 117-8.
  20. Baroni C, Marchionni S, Bazzocchi MG, Cadenaro M, Nucci C, Manton DJ. A SEM and non-contact surface white light profilometry in vivo study of the effect of a crème containing CPP-ACP and fluoride on young etched enamel. Scanning. 2014; 36: 270-7.
  21. De Carvalho FG, Vieira BR, Santos RL, Carlo HL, Lopes PQ, De Lima B. In Vitro Effects of Nano-Hydroxyapatite Paste on Initial Enamel Carious Lesions. Pediatr Dent. 2014; 36: 85-9.
  22. Ramli RA, Adnan R, Bakar MA, Masudi SM. Synthesis and characterization of pure nanoporous hydroxyapatite. J Phys Sci. 2011; 22: 25-37.
  23. Yamagishi K, Onuma K, Suzuki T, Okada F, Tagami J, Otsuki M, et al. A synthetic enamel for rapid tooth repair. Nature. 2005; 24: 433-819.
  24. Kim MY, Kwon HK, Choi CH, Kim BI. Combined effects of nano-hydroxyapatite and NaF on remineralization of early caries lesion. Key Eng Mater. 2007; 330-2, 1347-50.
  25. Lu KL, Zhang JX, Meng XC, Li XY. Remineralization effect of the nano-HA toothpaste on artificial caries. Key Eng Mater. 2007; 330-2, 267-70.
  26. IBM. SPSS Statistics for Windows. Version 21.0. Armonk, NY: IBM; 2012.
  27. Cem G, Ebru C, Seval Ö. Remineralizing effect of different topical agents on occlusal surfaces with or without caries: an in vitro evaluation study using electrical resistance measurements.Clin Dent and Res. 2012; 36: 4-9.
  28. Kumar VL, Itthagarun A, King NM. The effect of casein phosphopeptide-amorphous calcium phosphate on remineralization of artificial caries-like lesions: an in vitro study. Aust Dent J. 2008; 53: 34-40.
  29. Kawai K, Heaven TJ, Retief DH. In vitro dentine fluoride uptake from three fluoride-containing composites and their acid resistance. J Dent. 1997; 25: 291-6.
  30. Vieira AEM, Delbem ACB, Sassaki KT, Rodrigues E, Cury JA, Cunha RF. Fluoride dose response in pH-cycling models using bovine enamel. Caries Res. 2005; 39: 514-20.
  31. Kruskal WH, Wallis WA. Use of Ranks in One-Criterion Variance Analysis. J Am Stat Assoc. 1952; 47: 583-621.
  32. Friedman M. The use of ranks to avoid the assumption of normality implicit in the analysis of variance. J Am Stat Assoc. 1937; 32: 675-701.
  33. Srinivasan N, Kavitha M, Loganathan SC. Comparison of the remineralization potential of CPP–ACP and CPP–ACP with 900 ppm fluoride on eroded human enamel: An in situ study. Arch Oral Biol. 2010; 55: 541-4.
  34. El Zayat A. The effect of casein phosphopeptideamorphous calcium phosphate on remineralization of caries-like lesions in primary teeth. MS thesis; Faculty of Dentistry, Alexandria University; 2012.
  35. Talaat DM, Mahmoud A. Acid resistance of enamel subsurface lesions treated with casein phosphopeptide amorphous calcium phosphate fluoride. J Dent Child. 2015; 82: 70-5.
  36. Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater. 2009; 4: 034104.
  37. Haghgoo R, Rezvani MB, Zeinabadi MS. Comparison of nano-hydroxyapatite and sodium fluoride mouth rinse for remineralization of incipient carious lesions. J Dent. 2014; 11: 406-10.
  38. De Carvalho GF, Brasil V, Filho T, Carlo H, Santos R, de Lima B. Protective effect of calcium nanophosphate and ACP-CPP agents on enamel erosin. Braz Oral Res. 2013; 27: 463-70.