In vitro evaluation of the effect of tricalcium phosphate and GC tooth mouth Plus pastes on white spot enamel remineralization.
Abstract
Objective the main purpose of this study was to compare the effects of casein phosphopeptide amorphous calcium phosphate fluride (CPP-ACPF) and tricalcium phosphate on artificial early enamel carious lesions.
Materials and Methods 45 sound extracted premolars were divided, and placed in the demineralization solution (pH=4.5) for 96 hours, divided randomly in 3 groups (TCP-MI paste Plus-Control) then they were exposed with the treating materials for 5 minutes once a day in 30 days. After mounting in the resin blocks and polishing, they were subjected to micro hardness test in 3 different depths from the surface of enamel. Data were analyzed using ANOVA test. The significance was set at 0.05.
Results the average volume percent mineral (VPM) showed that in 30, 60 and 90 µm depths there was a significant difference (P Value<0.0001) between both TCP and CPP-ACPF and control group. In 30 µm depth, CPP-ACPF was more effective (P Value<0.0001) than TCP. In 60 and 90 µm depths there was no significant difference between the two groups.
Conclusion In this study we concluded that both CPP-ACPF and TCP have a significant effect on the remineralization of white spot lesions of dental enamel.
1. Marchisio O, Esposito M, Genovesi A. Salivary pH level and bacterial plaque evaluation in orthodontic patients treated with Recaldent® products. Int J Dent Hyg. 2010 Aug;8(3):232-6.
2. Lara-Carrillo E, Montiel-Bastida N-M, Sánchez-Pérez L, Alanís-Tavira J. Effect of orthodontic treatment on saliva, plaque and the levels of Streptococcus mutans and Lactobacillus. Med Oral Patol Oral Cir Bucal. 2010 Nov;15(6):e924-9.
3. Cildir SK, Germec D, Sandalli N, Ozdemir FI, Arun T, Twetman S, et al. Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria. Eur J Orthod. 2009 Aug;31(4):407-11.
4. Rajendran R, Kunjusankaran RN, Sandhya R, Anilkumar A, Santhosh R, Patil SR. Comparative evaluation of remineralizing potential of a paste containing bioactive glass and a topical cream containing casein phosphopeptide-amorphous calcium phosphate: An in vitro study. Pesqui. Bras. Odontopediatria Clín. Integr. 2019 Oct; 19:e4668.
5. Azrak B, Callaway A, Knözinger S, Willershausen B. Reduction of the pH-values of whole saliva after the intake of apple juice containing beverages in children and adults. Oral Health Prev Dent. 2003 Jun;1(3):229-36.
6. Kohn WG, Maas WR, Malvitz DM, Presson SM, Shaddix KK. Recommendations for using fluoride to prevent and control dental caries in the United States. 2001.
7. Chu C, Mei ML, Lo E. Use of fluorides in dental caries management. Gen Dent. 2010 Jan-Feb;58(1):37-43; quiz 44-5, 79-80.
8. Walsh LJ. Contemporary technologies for remineralization therapies: A review. Int Dent SA. 2009 Jan;11(6):6-16.
9. Cury JA, Tenuta LMA. Enamel remineralization: controlling the caries disease or treating early caries lesions? Braz Oral Res. 2009;23:23-30.
10. Reynolds E. Calcium phosphate‐based remineralization systems: scientific evidence? Aust Dent J. 2008 Sep;53(3):268-73.
11. Karlinsey R, Pfarrer A. Fluoride plus functionalized β-TCP: a promising combination for robust remineralization. Adv Dent Res. 2012 Sep;24(2):48-52.
12. Leamy P, Brown P, TenHuisen K, Randall C. Fluoride uptake by hydroxyapatite formed by the hydrolysis of α‐tricalcium phosphate. J Biomed Mater Res A. 1998 Dec;42(3):458-64.
13. Karlinsey RL, Mackey AC, Walker ER, Frederick KE. Surfactant-modified β-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions. J Mater Sci Mater Med. 2010 Jul;21(7):2009-20.
14. Rirattanapong P, Vongsavan K, Saengsirinavin C, Phuekcharoen P. Efficacy of fluoride mouthrinse containing tricalcium phosphate on primary enamel lesions: a polarized light microscopic study. Southeast Asian J Trop Med Public Health. 2015 Jan;46(1):168-74.
15. Balakrishnan A, Jonathan R, Benin P, Kuumar A. Evaluation to determine the caries remineralization potential of three dentifrices: An in vitro study. J Conserv Dent. 2013 Jul;16(4):375-9.
16. Raphael S, Blinkhorn A. Is there a place for Tooth Mousse® in the prevention and treatment of early dental caries? A systematic review. BMC oral health. 2015 Sep;15(1):113.
17. Cochrane N, Reynolds E. Calcium phosphopeptides—mechanisms of action and evidence for clinical efficacy. Adv Dent Res. 2012 Sep;24(2):41-7.
18. Rirattanapong P, Vongsavan K, Saengsirinavin C, Pornmahala T. Effect of flouride varnishes containing different calcium phosphate sources on mineralization of initial pimary enamel lesions. Southeast Asian J Trop Med Public Health. 2014 Nov;45(6):1503-10.
19. Hegde MN, Moany A. Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: A quantitative energy dispersive X-ray analysis using scanning electron microscopy: An in vitro study. J Conserv Dent. 2012 Jan;15(1):61-7.
20. Hu W, Featherstone JD. Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant. Am J Orthod Dentofacial Orthop. 2005 Nov;128(5):592-600.
21. Knösel M, Bojes M, Jung K, Ziebolz D. Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area. Am J Orthod Dentofacial Orthop 2012 May;141(5):574-82.
22. Mitchell L. Decalcification during orthodontic treatment with fixed appliances—an overview. Br J Orthod. 1992 Aug;19(3):199-205.
23. Alagha E, Samy AM. Effect of different remineralizing agents on white spot lesions. Open Access Maced J Med Sci. 2021 Jan; 9(D):14-8.
24. Maia E, Baratieri LN, de Andrada MA, Monteiro Jr S, Vieira LC. The influence of two home-applied bleaching agents on enamel microhardness: an in situ study. J Dent. 2008 Jan;36(1):2-7.
25. Purdell-Lewis DJ, Groeneveld A, Arends J. Hardness tests on sound enamel and artificially demineralized white spot lesions. Caries Res. 1976 Nov;10(3):201-15.
26. Knoop F, Peters CG, Emerson WB. A sensitive pyramidal-diamond tool for indentation measurements. J Res Natl Bur Stand.1939 Jul;23(1):39.
27. Zenouz GA, Ezoji F, Enderami SA, Khafri S. Effect of fluoride, casein phosphopeptide–amorphous calcium phosphate and casein phosphopeptide–amorphous calcium phosphate fluoride on enamel surface microhardness after microabrasion: An in vitro study. J Dent (Tehran). 2015 Oct;12(10):705.
28. Rajan R, Krishnan R, Bhaskaran B, Kumar SV. A Polarized light microscopic study to comparatively evaluate four remineralizing agents on enamel viz CPP-ACPF, ReminPro, SHY-NM and colgate strong teeth. Int J Clin Pediatr Dent. 2015 Jan;8(1):42-7.
29. Chokshi K, Chokshi A, Konde S, Shetty SR, Chandra KN, Jana S, et al. An in vitro comparative evaluation of three remineralizing agents using confocal microscopy. J Clin Diagn Res. 2016 Jun;10(6):ZC39-42.
30. Sanosh KP, Chu MC, Balakrishnan A, Kim TN, Cho SJ. Sol–gel synthesis of pure nano sized β-tricalcium phosphate crystalline powders. Curr Appl Phys. 2010 Jan;10(1):68-71.
31. Karlinsey RL, Mackey AC, Walker ER, Frederick KE. Surfactant-modified β-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions. J Mater Sci Mater Med. 2010 Jul;21(7):2009-20.
32. Karlinsey RL, Mackey AC, Stookey GK, Pfarrer AM. In vitro assessments of experimental NaF dentifrices containing a prospective calcium phosphate technology. Am J Dent. 2009 Jun;22(3):180-4.
33. Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study. J Conserv Dent. 2013 Mar;16(2):116-20.
34. Balakrishnan A, Jonathan R, Benin P, Kuumar AJ. Evaluation to determine the caries remineralization potential of three dentifrices: An in vitro study. J Conserv Dent. 2013 Jul;16(4):375-9.
35. Shen P, Manton DJ, Cochrane NJ, Walker GD, Yuan Y, Reynolds C, et al. Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial. J Dent. 2011 Jul;39(7):518-25.
36. Bajaj M, Poornima P, Praveen S, Nagaveni N, Roopa K, Neena I, et al. Comparison of CPP-ACP, tri-calcium phosphate and hydroxyapatite on remineralization of artificial caries like lesions on primary enamel-An in vitro study. J Clin Pediatr Dent. 2016 Jun;40(5):404-9.
2. Lara-Carrillo E, Montiel-Bastida N-M, Sánchez-Pérez L, Alanís-Tavira J. Effect of orthodontic treatment on saliva, plaque and the levels of Streptococcus mutans and Lactobacillus. Med Oral Patol Oral Cir Bucal. 2010 Nov;15(6):e924-9.
3. Cildir SK, Germec D, Sandalli N, Ozdemir FI, Arun T, Twetman S, et al. Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria. Eur J Orthod. 2009 Aug;31(4):407-11.
4. Rajendran R, Kunjusankaran RN, Sandhya R, Anilkumar A, Santhosh R, Patil SR. Comparative evaluation of remineralizing potential of a paste containing bioactive glass and a topical cream containing casein phosphopeptide-amorphous calcium phosphate: An in vitro study. Pesqui. Bras. Odontopediatria Clín. Integr. 2019 Oct; 19:e4668.
5. Azrak B, Callaway A, Knözinger S, Willershausen B. Reduction of the pH-values of whole saliva after the intake of apple juice containing beverages in children and adults. Oral Health Prev Dent. 2003 Jun;1(3):229-36.
6. Kohn WG, Maas WR, Malvitz DM, Presson SM, Shaddix KK. Recommendations for using fluoride to prevent and control dental caries in the United States. 2001.
7. Chu C, Mei ML, Lo E. Use of fluorides in dental caries management. Gen Dent. 2010 Jan-Feb;58(1):37-43; quiz 44-5, 79-80.
8. Walsh LJ. Contemporary technologies for remineralization therapies: A review. Int Dent SA. 2009 Jan;11(6):6-16.
9. Cury JA, Tenuta LMA. Enamel remineralization: controlling the caries disease or treating early caries lesions? Braz Oral Res. 2009;23:23-30.
10. Reynolds E. Calcium phosphate‐based remineralization systems: scientific evidence? Aust Dent J. 2008 Sep;53(3):268-73.
11. Karlinsey R, Pfarrer A. Fluoride plus functionalized β-TCP: a promising combination for robust remineralization. Adv Dent Res. 2012 Sep;24(2):48-52.
12. Leamy P, Brown P, TenHuisen K, Randall C. Fluoride uptake by hydroxyapatite formed by the hydrolysis of α‐tricalcium phosphate. J Biomed Mater Res A. 1998 Dec;42(3):458-64.
13. Karlinsey RL, Mackey AC, Walker ER, Frederick KE. Surfactant-modified β-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions. J Mater Sci Mater Med. 2010 Jul;21(7):2009-20.
14. Rirattanapong P, Vongsavan K, Saengsirinavin C, Phuekcharoen P. Efficacy of fluoride mouthrinse containing tricalcium phosphate on primary enamel lesions: a polarized light microscopic study. Southeast Asian J Trop Med Public Health. 2015 Jan;46(1):168-74.
15. Balakrishnan A, Jonathan R, Benin P, Kuumar A. Evaluation to determine the caries remineralization potential of three dentifrices: An in vitro study. J Conserv Dent. 2013 Jul;16(4):375-9.
16. Raphael S, Blinkhorn A. Is there a place for Tooth Mousse® in the prevention and treatment of early dental caries? A systematic review. BMC oral health. 2015 Sep;15(1):113.
17. Cochrane N, Reynolds E. Calcium phosphopeptides—mechanisms of action and evidence for clinical efficacy. Adv Dent Res. 2012 Sep;24(2):41-7.
18. Rirattanapong P, Vongsavan K, Saengsirinavin C, Pornmahala T. Effect of flouride varnishes containing different calcium phosphate sources on mineralization of initial pimary enamel lesions. Southeast Asian J Trop Med Public Health. 2014 Nov;45(6):1503-10.
19. Hegde MN, Moany A. Remineralization of enamel subsurface lesions with casein phosphopeptide-amorphous calcium phosphate: A quantitative energy dispersive X-ray analysis using scanning electron microscopy: An in vitro study. J Conserv Dent. 2012 Jan;15(1):61-7.
20. Hu W, Featherstone JD. Prevention of enamel demineralization: an in-vitro study using light-cured filled sealant. Am J Orthod Dentofacial Orthop. 2005 Nov;128(5):592-600.
21. Knösel M, Bojes M, Jung K, Ziebolz D. Increased susceptibility for white spot lesions by surplus orthodontic etching exceeding bracket base area. Am J Orthod Dentofacial Orthop 2012 May;141(5):574-82.
22. Mitchell L. Decalcification during orthodontic treatment with fixed appliances—an overview. Br J Orthod. 1992 Aug;19(3):199-205.
23. Alagha E, Samy AM. Effect of different remineralizing agents on white spot lesions. Open Access Maced J Med Sci. 2021 Jan; 9(D):14-8.
24. Maia E, Baratieri LN, de Andrada MA, Monteiro Jr S, Vieira LC. The influence of two home-applied bleaching agents on enamel microhardness: an in situ study. J Dent. 2008 Jan;36(1):2-7.
25. Purdell-Lewis DJ, Groeneveld A, Arends J. Hardness tests on sound enamel and artificially demineralized white spot lesions. Caries Res. 1976 Nov;10(3):201-15.
26. Knoop F, Peters CG, Emerson WB. A sensitive pyramidal-diamond tool for indentation measurements. J Res Natl Bur Stand.1939 Jul;23(1):39.
27. Zenouz GA, Ezoji F, Enderami SA, Khafri S. Effect of fluoride, casein phosphopeptide–amorphous calcium phosphate and casein phosphopeptide–amorphous calcium phosphate fluoride on enamel surface microhardness after microabrasion: An in vitro study. J Dent (Tehran). 2015 Oct;12(10):705.
28. Rajan R, Krishnan R, Bhaskaran B, Kumar SV. A Polarized light microscopic study to comparatively evaluate four remineralizing agents on enamel viz CPP-ACPF, ReminPro, SHY-NM and colgate strong teeth. Int J Clin Pediatr Dent. 2015 Jan;8(1):42-7.
29. Chokshi K, Chokshi A, Konde S, Shetty SR, Chandra KN, Jana S, et al. An in vitro comparative evaluation of three remineralizing agents using confocal microscopy. J Clin Diagn Res. 2016 Jun;10(6):ZC39-42.
30. Sanosh KP, Chu MC, Balakrishnan A, Kim TN, Cho SJ. Sol–gel synthesis of pure nano sized β-tricalcium phosphate crystalline powders. Curr Appl Phys. 2010 Jan;10(1):68-71.
31. Karlinsey RL, Mackey AC, Walker ER, Frederick KE. Surfactant-modified β-TCP: structure, properties, and in vitro remineralization of subsurface enamel lesions. J Mater Sci Mater Med. 2010 Jul;21(7):2009-20.
32. Karlinsey RL, Mackey AC, Stookey GK, Pfarrer AM. In vitro assessments of experimental NaF dentifrices containing a prospective calcium phosphate technology. Am J Dent. 2009 Jun;22(3):180-4.
33. Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: An in vitro study. J Conserv Dent. 2013 Mar;16(2):116-20.
34. Balakrishnan A, Jonathan R, Benin P, Kuumar AJ. Evaluation to determine the caries remineralization potential of three dentifrices: An in vitro study. J Conserv Dent. 2013 Jul;16(4):375-9.
35. Shen P, Manton DJ, Cochrane NJ, Walker GD, Yuan Y, Reynolds C, et al. Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial. J Dent. 2011 Jul;39(7):518-25.
36. Bajaj M, Poornima P, Praveen S, Nagaveni N, Roopa K, Neena I, et al. Comparison of CPP-ACP, tri-calcium phosphate and hydroxyapatite on remineralization of artificial caries like lesions on primary enamel-An in vitro study. J Clin Pediatr Dent. 2016 Jun;40(5):404-9.
| Issue | Vol 21 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v21i33.16436 | |
| Keywords | ||
| Casein Phosphopeptide-Amorphous Calcium Phosphate Nanocomplex Tricalcium Phosphate Tooth Remineralization | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Haerian A, Yasaei S, Rafiei E, Malek Hosseini SV, Karimi N. In vitro evaluation of the effect of tricalcium phosphate and GC tooth mouth Plus pastes on white spot enamel remineralization. Front Dent. 2024;21.
