Micro-ct Evaluation of the Remineralization Effect of Toothpastes with Different Ingredients on Artificial Initial Enamel Lesions: An ex-vivo study.

Sevil Uysal; Özlem Beren Satılmış; Firdevs Tulga Öz

doi:10.7126/cumudj.1579129

EN

Micro-ct Evaluation of the Remineralization Effect of Toothpastes with Different Ingredients on Artificial Initial Enamel Lesions: An ex-vivo study.

Abstract

Objectives: It was aimed to evaluate the change in mineral density after the application of toothpastes containing fluoride, CPP-ACP, nHAp and CaGP to artificial caries lesions in primary teeth using Micro-CT. Materials and Methods: A total of 40 non-caries primary anterior teeth were randomly divided into 4 groups. A healthy enamel area of 3x1 mm in the center of the 3x3 mm area on the buccal enamel surfaces was used as a control group. The area on the left was covered with nail polish after demineralization. After pH cycling, remineralization materials were applied to the area on the right. Initial enamel lesions were formed on the prepared enamel surfaces using a demineralization solution. The remineralization agents used in the treatment of initial caries lesions were sodium fluoride (NaF), casein phosphopeptide amorphous-calcium phosphate (CPP-ACP), nano-hydroxyapatite (nHAp) and calcium glycerophosphate (CaGP). The changes in mineral density caused by the remineralization agents applied to enamel samples with artificial caries lesions were evaluated by micro-computed tomography (Micro-ct). Data were evaluated with Friedman's Two Way ANOVA test. Results: There was no statistically significant difference between the initial and post-demineralization mineral density values obtained from all groups. There was no statistically significant difference between the remineralization and control groups in terms of mineral density. Conclusions: CPP-ACP, nHAp and CaGP can be used as an alternative to fluoride by supporting remineralization in initial caries lesions of primary teeth.

Keywords

References

1. Çelik EU, Yazkan B, Katırcı G. Treatment of incipient carious lesions. J Dent Fac Atatürk Uni. 2011;1:48-56.
2. Longbottom C, Ekstrand K, Zero D, Kambara M. Novel preventive treatment options. Monogr Oral Sci. 2009;21:156-163.
3. Iijima Y, Takagi O, Ruben J, Arends J. In vitro remineralization of in vivo and in vitro formed enamel lesions. Caries Res. May-Jun 1999;33(3):206-213.
4. 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. Sep 2011;21(5):374-381.
5. Shen P, Cai F, Nowicki A, Vincent J, Reynolds EC. Remineralization of enamel subsurface lesions by sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate. J Dent Res. Dec 2001;80(12):2066-2070.
6. Reynolds EC, Cai F, Cochrane NJ, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. Apr 2008;87(4):344-348.
7. Kucuk EB, Malkoc S, Demir A. Microcomputed tomography evaluation of white spot lesion remineralization with various procedures. Am J Orthod Dentofacial Orthop. Sep 2016;150(3):483-490.
8. Arends J, ten Bosch JJ. Demineralization and remineralization evaluation techniques. J Dent Res. Apr 1992;71 Spec No:924-928.

9. Huang TT, Jones AS, He LH, Darendeliler MA, Swain MV. Characterisation of enamel white spot lesions using X-ray micro-tomography. J Dent. Sep 2007;35(9):737-743.
10. Lussi A, Megert B, Longbottom C, Reich E, Francescut P. Clinical performance of a laser fluorescence device for detection of occlusal caries lesions. Eur J Oral Sci. Feb 2001;109(1):14-19.
11. Swain MV, Xue J. State of the art of Micro-CT applications in dental research. Int J Oral Sci. Dec 2009;1(4):177-188.
12. Schwass DR, Swain MV, Purton DG, Leichter JW. A system of calibrating microtomography for use in caries research. Caries Res. 2009;43(4):314-321.
13. Davis GR, Wong FS. X-ray microtomography of bones and teeth. Physiol Meas. Aug 1996;17(3):121-146.
14. Daghrery A, Yaman P, Lynch M, Dennison J. Evaluation of micro-CT in the assessment of microleakage under bulk fill composite restorations. Am J Dent. Jun 2022;35(2):128-132.
15. Bijle MN, Mallineni SK, Tsoi J. Qualitative and Quantitative Micro-CT Analysis of Natal and Neonatal Teeth. Children (Basel). Apr 14 2022;9(4).
16. Cheng L, ten Cate JM. Effect of Galla chinensis on the in vitro remineralization of advanced enamel lesions. Int J Oral Sci. Mar 2010;2(1):15-20.
17. ten Cate JM, Duijsters PP. Alternating demineralization and remineralization of artificial enamel lesions. Caries Res. 1982;16(3):201-210.
18. Itthagarun A, Wei SH, Wefel JS. The effect of different commercial dentifrices on enamel lesion progression: an in vitro pH-cycling study. Int Dent J. Feb 2000;50(1):21-28.
19. Seredin P, Goloshchapov D, Prutskij T, Ippolitov Y. Phase transformations in a human tooth tissue at the initial stage of caries. PLoS One. 2015;10(4):e0124008.
20. Rao SK, Bhat GS, Aradhya S, Devi A, Bhat M. Study of the Efficacy of Toothpaste Containing Casein Phosphopeptide in the Prevention of Dental Caries: a Randomized Controlled Trial in 12- to 15-Year-Old High Caries Risk Children in Bangalore, India. Caries Research. 2009;43(6):430-435.
21. Hatibović-Kofman Š, El-Kassem M, Inocencio F, Selimovic M, Raimundo L. Evidence Based Effectiveness of Pit and Fissure Sealants Applied by Students and Paediatric Dentists After Five Years. Acta Stomatol. Croat. 2008;42(3)
22. Huang S, Gao S, Cheng L, Yu H. Combined effects of nano-hydroxyapatite and Galla chinensis on remineralisation of initial enamel lesion in vitro. J Dent. Oct 2010;38(10):811-819.
23. 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. Jul 2010;55(7):541-544.
24. Mehta AB, Kumari V, Jose R, Izadikhah V. Remineralization potential of bioactive glass and casein phosphopeptide-amorphous calcium phosphate on initial carious lesion: An in-vitro pH-cycling study. J Conserv Dent. Jan 2014;17(1):3-7.
25. Santos AP, Soviero VM. Caries prevalence and risk factors among children aged 0 to 36 months. Pesqui Odontol Bras. Jul-Sep 2002;16(3):203-208.
26. Cochrane NJ, Anderson P, Davis GR, Adams GG, Stacey MA, Reynolds EC. An X-ray microtomographic study of natural white-spot enamel lesions. J Dent Res. Feb 2012;91(2):185-191.
27. Reynolds EC, Cain CJ, Webber FL, et al. Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat. J Dent Res. Jun 1995;74(6):1272-1279.
28. King N, Itthagarun A, Cheung M. Remineralization by Nanohydroxyapatite Containing Dentifrice: a pH Cycling Study Using Slurry. J Dental Res. 2006;85.
29. Lv KL, Zhang JX, Meng XC, Li XY. Remineralization effect of the nano-HA toothpaste on artificial caries. Key Engineering Materials. 2007;330:267-270.
30. Yamagishi K, Onuma K, Suzuki T, et al. Materials chemistry: a synthetic enamel for rapid tooth repair. Nature. Feb 24 2005;433(7028):819.
31. C K, BN Y, N Ö. Effects of nano-hydroxyapatite dentifrices with and without fluoride on primary teeth enamel: a Micro-ct and a SEM study. Cumhuriyet Dent J. 2020;23(3):191-199.
32. Freire IR, Pessan JP, Amaral JG, Martinhon CC, Cunha RF, Delbem AC. Anticaries effect of low-fluoride dentifrices with phosphates in children: A randomized, controlled trial. J Dent. Jul 2016;50:37-42.
33. Zaze AC, Dias AP, Sassaki KT, Delbem AC. The effects of low-fluoride toothpaste supplemented with calcium glycerophosphate on enamel demineralization. Clin Oral Investig. Jul 2014;18(6):1619-1624.
34. Akkuc S, Duruk G, Keles A. Remineralization effect of three different agents on initial caries and erosive lesions: a micro-computed tomography and scanning electron microscopy analysis. BMC Oral Health. Feb 16 2023;23(1):106.
35. Kırzıoğlu Z, Özkul Önol S. Alternative materials used to prevent tooth decay. J Dent Fac Atatürk Uni. February 2015;24(-3):104-112.

Details

Primary Language

English

Subjects

Paedodontics

Journal Section

Research Article

Authors

Sevil Uysal
0000-0002-3780-8463
Türkiye

Özlem Beren Satılmış ^*
0000-0002-5609-1963
Türkiye

Firdevs Tulga Öz
0000-0002-8731-5907
Türkiye

Publication Date

March 28, 2025

Submission Date

November 4, 2024

Acceptance Date

February 5, 2025

Published in Issue

Year 2025 Volume: 28 Number: 1

DOI

https://doi.org/10.7126/cumudj.1579129

IZ

https://izlik.org/JA69NC94PU

Cite

RIS / Bibtex

EndNote

Uysal S, Satılmış ÖB, Tulga Öz F (March 1, 2025) Micro-ct Evaluation of the Remineralization Effect of Toothpastes with Different Ingredients on Artificial Initial Enamel Lesions: An ex-vivo study. Cumhuriyet Dental Journal 28 1 70–78.