Comparison of the remineralization potential of CPP-ACP and CPP-ACP with 900 ppm fluoride on eroded human enamel: An in situ study

Efficiency of casein phosphopeptide amorphous calcium phosphate versus topical fluorides on remineralizing early enamel carious lesions - A systematic review and meta analysis

Objective

To assess the remineralizing efficiency of caesin phosphopepdide amorphous calcium phosphate (CPP-ACP) versus topical fluorides on early enamel lesions in vivo.

Data sources

PubMed, Web of Science, Scopus, EBSCO were searched based on the PICOS criteria up to December 2022 with English language restriction. All relevant studies were subjected to two separate reviews before being included at the title, abstract, and full text levels.

Study selection

41 studies were reviewed and 11 selected for inclusion in the final sample for the review. All were randomized clinical trials with the follow-up period of the studies ranging from 3 to 12 months. Out of the 11 studies, only two are with low risk of bias on assessment with Cochrane risk of bias assessment tool, while the other nine articles were with the moderate and high risk of bias.

Conclusions

Conflicting evidence exists on the clinical efficacy of CPP-ACP compared to the various fluoride forms tested, and no adverse effect associated with CPP-ACP use was discovered in comparison to fluorides that had certain detrimental health impacts. Although, the review results in favor of both fluorides and CPP-ACP with similar clinical efficiency, when ill effects are considered the CPP-ACP can be a choice of remineralizing early enamel lesions. However, before concrete suggestions can be given, high-quality, well-designed clinical research in this area are still necessary.

Clinical significance

A considerable remineralizing impact has been shown in both in vitro and in vivo experiments, making CPP-ACP/CPP-ACPF a more promising remineralizing agent than fluorides. Therefore, this can be applied clinically to early enamel carious lesion.

Spice Production, Marketing, and Value Chain in Ethiopia

The purpose of this paper was to document and organize spice production, marketing, and value chain in Ethiopia. Spice is the most essential farming product. Several native and exotic spices are grown by smallholder farmers across the country because Ethiopia has diverse agroecology and favorable climate conditions. The spice subsector has great potential for the country's economic development and poverty alleviation, cultivation, preparation, transport, and merchandising of spices and herbs. Spice market indicates the commodity value of spices. The major problems regarding the marketing system of spices were lack of communication between farmers and users, lack of linkage between sellers and buyers, and lack of postharvest management, storage facilities, regulated and cooperative markets, transportation, and knowledge of market news. The escalating value of spices is superficially envisioned, extending from smallholder production to partial handling, which seems to be the everyday value chain.

Restorative Dental Resin Functionalized with Calcium Methacrylate with a Hydroxyapatite Remineralization Capacity

The ability of dental materials to induce the mineralization of enamel like hydroxyapatite (HA) is of great importance. In this article, a novel kind of dental restorative material characterized by a mineralization ability was fabricated by photopolymerization. Calcium methacrylate (CMA) was introduced into the classical bisphenol A-glycidyl methacrylate (Bis-GMA) and triethylene glycol dimethacrylate (TEGDMA) dental resin formulation. This functional dental resin (BTCM) was calcium-rich and can be prepared simply by one-step photopolymerization. The influence of CMA on the photopolymerization kinetics, the dental resin's mechanical properties, and its capacity to induce dynamic in situ HA mineralization were examined. Real-time FTIR, compression modulus, scanning electron microscopy, X-ray spectroscopy, MTT assay, and cell attachment test were carried out. The obtained data were analyzed for statistical significance using analysis of variance (ANOVA). Double bond conversion could be completed in less than 300 s, while the compression modulus of BTCM decreased with the increase in CMA content (30 wt%, 40 wt%, and 50 wt%). After being soaked in Ca(NO3)2 and Na2HPO4 solutions alternatively, dense HA crystals were found on the surface of the dental resin which contained CMA. The amount of HA increased with the increase in CMA content. The MTT results indicated that BTCM possesses good biocompatibility, while the cell adhesion and proliferation investigation demonstrated that L929 cells can adhere and proliferate well on the surface of BTM. Thus, our approach provides a straightforward, cost-effective, and environmentally friendly solution that has the potential for immediate clinical use.

Improving Oral Health with Fluoride-Free Calcium-Phosphate-Based Biomimetic Toothpastes: An Update of the Clinical Evidence

As the demand for clinically effective fluoride-free oral care products for consumers increases, it is important to document which types of toothpastes have been shown in clinical studies to be effective in improving oral health. In this review, we included different indications, i.e., caries prevention, improving periodontal health, reducing dentin hypersensitivity, protecting against dental erosion, and safely improving tooth whitening in defining what constitutes improvement in oral health. While there are several professional and consumer fluoride-containing formulations fortified with calcium-phosphate-based ingredients, this review focuses on fluoride-free toothpastes containing biomimetic calcium-phosphate-based molecules as the primary active ingredients. Several databases were searched, and only clinical trials in human subjects were included; in vitro and animal studies were excluded. There were 62 oral health clinical trials on biomimetic hydroxyapatite (HAP), 57 on casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), 26 on calcium sodium phosphosilicate (CSPS, or so called Bioglass), and 2 on β-tricalcium phosphate (β-TCP). HAP formulations were tested the most in clinical trials for benefits in preventing caries, dentin hypersensitivity, improving periodontal health, and tooth whitening. Based on the current clinical evidence to date, fluoride-free HAP toothpaste formulations are the most versatile of the calcium phosphate active ingredients in toothpastes for improving oral health.

Analysis of Dental Enamel Remineralization: A Systematic Review of Technique Comparisons

The demineralization process conditions the structure of the enamel and begins with a superficial decalcification procedure that makes the enamel surface porous and gives it a chalky appearance. White spot lesions (WSLs) are the first clinical sign that can be appreciated before caries evolves into cavitated lesions. The years of research have led to the testing of several remineralization techniques. This study's objective is to investigate and assess the various methods for remineralizing enamel. The dental enamel remineralization techniques have been evaluated. A literature search on PubMed, Scopus, and Web of Science was performed. After screening, identification, and eligibility processes 17 papers were selected for the qualitative analysis. This systematic review identified several materials that, whether used singly or in combination, can be effective in the process of remineralizing enamel. All methods have a potential for remineralization when they come into contact with tooth enamel surfaces that have early-stage caries (white spot lesions). From the studies conducted in the test, all of the substances used to which fluoride has been added contribute to remineralization. It is believed that by developing and researching new remineralization techniques, this process might develop even more successfully.

Remineralization effect of three different agents on initial caries and erosive lesions: a micro-computed tomography and scanning electron microscopy analysis

BACKGROUND

This study aimed to investigate the remineralization efficiency of Sensodyne Promine containing Sodium flouride (NaF), GC Tooth Mousse containing CPP-ACP, and Agarta herbal toothpaste on initial caries and erosion using micro-computed tomography (CT) and scanning electron microscopy (SEM).

METHODS

Forty-five third-molar teeth for micro-CT were divided into three main groups after initial scans (T₁) were completed. Artificial caries lesions were created with the demineralization cycle (group 1, n = 15) and artificial erosion lesions were created with orange juice (group 2, n = 15) and Cola (group 3, n = 15), and second scans (T₂) were performed. The groups were divided into three subgroups within themselves. Sensodyne Promine toothpaste (subgroup 1a, 2a, 3a), GC Tooth Mousse topical cream (subgroup 1b, 2b, 3b), and Agarta herbal toothpaste (subgroup 1c, 2c, 3c) were applied using soft-tipped brushes for 2 min, twice per day for 15 days, and then a third scan (T₃) was performed. Mineral density, surface area, and lesion volume and depth were calculated using micro-CT. Changes in the surface morphology of the teeth were examined using SEM in 13 samples representing each group, subgroup, and healthy enamel. In the analysis of the data obtained from the scans performed at three different times (T₁, T₂, T₃), one-way analysis of variance (ANOVA) with the post-hoc Tukey test, repeated measures ANOVA with the post-hoc Bonferroni test, and paired sample t-test analyses were used.

RESULTS

All three agents caused a statistically significant increase in mineral density, and a decrease in surface area and lesion volume and depth (p < 0.05). There was no statistically significant difference between the groups in remineralization efficiency (p > 0.05). A statistically significant difference was found between the groups regarding the mineral density of the tissue that increased after remineralization (NaF > CPP-ACP > He; p < 0.05).

CONCLUSION

The remineralization efficacy of herbal toothpaste as an alternative to NaF and CPP-ACP was found to be successful.

Comparative Efficacy of Novel Biomimetic Remineralising Technologies

Biomimetic technologies for the remineralisation of enamel subsurface lesions (ESLs) have been developed and include: fluorocalcium phosphosilicate bioglass (BG/F); casein phosphopeptide-amorphous calcium phosphate (CPP−ACP) and with fluoride (CPP−ACFP); and self-assembling oligopeptide P11-4 (SAP). The aim of this study was to compare the remineralisation of ESLs in vitro using these technologies. Human enamel slabs with ESLs were cut into two half-slabs; one half-slab was untreated (control), and the other half was treated by exposure to one of the four technologies with artificial saliva (AS) or AS alone for 14 days at 37 °C. The technologies were applied to the ESL surface according to the manufacturer’s instructions. At the completion of each treatment, the treated half-slabs and their paired control half-slabs were embedded, sectioned and the mineral content was determined using transverse microradiography. The change in mineral content (remineralisation) between treatments was statistically analysed using one-way ANOVA. The order from highest to lowest remineralisation was CPP−ACFP (52.6 ± 2.6%) > CPP−ACP (43.0 ± 4.9%) > BG/F (13.2 ± 2.5%) > SAP (5.8 ± 1.6%) > AS (2.1 ± 0.5%). Only CPP−ACFP and CPP−ACP produced remineralisation throughout the body of the lesions. All four biomimetic technologies had some effect on the remineralisation of ESLs; however, CPP−ACFP with calcium, phosphate and fluoride ions stabilised by CPP was superior in the level and pattern of remineralisation obtained.

Effects of an orthodontic primer containing amorphous fluorinated calcium phosphate nanoparticles on enamel white spot lesions

OBJECTIVES

The study investigated the effects of an orthodontic primer containing amorphous fluorinated calcium phosphate (AFCP) nanoparticles on enamel white spot lesions (WSLs).

MATERIALS AND METHODS

The AFCP nanoparticles were prepared and incorporated into Transbond XT Primer. Thirty-two human enamel slices were highly polished and randomly divided into four groups: no part covered (control), half covered with a primer containing 0 wt%, 25 wt%, and 35 wt% AFCP. Subsequently, samples were challenged by a modified pH-cycling and characterized by color measurement, micro-computed tomography, and scanning electron microscope (SEM). The bonding properties of the primers containing AFCP were assessed using shear bond strength test, and the mouse fibroblasts (L929) were employed to evaluate the cytotoxicity.

RESULTS

When the enamel was challenged by pH cycling, 25 wt% and 35 wt% AFCP groups exhibited less color change (ΔE) and less mineral loss than the control and 0 wt% AFCP groups. The SEM images showed that the original microstructural integrity and mineral deposition rate of the enamel surface were better in the 25 wt% and 35 wt% AFCP groups. In particular, the 35 wt% AFCP group exhibited the best performance after 3 weeks of pH cycling. The shear bond strength and cell viability revealed no significant difference among the tested groups (P > 0.05).

CONCLUSION

Using the primer containing 35 wt% AFCP might be a promising strategy for preventing the occurrence and development of WSLs during orthodontic treatment.

Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review

A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

The power of weak ion-exchange resins assisted by amelogenin for natural remineralization of dental enamel: an in vitro study

This study aims to develop an innovative dental product to remineralize dental enamel by a proper combination of ion-exchange resins as controlled release of mineral ions that form dental enamel, in the presence of amelogenin to guide the appropriate crystal growth. The novel product proposed consists of a combination of ion-exchange resins (weak acid and weak base) individually loaded with the remineralizing ions: Ca²⁺, PO₄^3- and F^-, also including Zn²⁺ in a minor amount as antibacterial, together with the protein amelogenin. Such cocktail provides onsite controlled release of the ions necessary for enamel remineralization due to the weak character of the resins and at the same time, a guiding tool for related crystal growth by the indicated protein. Amelogenin protein is involved in the structural development of natural enamel and takes a key role in controlling the crystal growth morphology and alignment at the enamel surface. Bovine teeth were treated by applying the resins and protein together with artificial saliva. Treated teeth were evaluated with nanoindentation, scanning electron microscopy and energy-dispersive X-ray spectroscopy. The innovative material induces the dental remineralization creating a fluorapatite layer with a hardness equivalent to sound enamel, with the appropriate alignment of corresponding nanocrystals, being the fluorapatite more acid resistant than the original mineral. Our results suggest that the new product shows potential for promoting long-term remineralization leading to the inhibition of caries and protection of dental structures.

A Comparison of NovaMin™ and Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride on Enamel Remineralization - An In vitro Study Using Scanning Electron Microscope and DIAGNOdent®

Aim:

The aim of this study was to compare the efficacy of NovaMin^™ (SHY-NM) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) (tooth mousse plus^™) on enamel remineralization using DIAGNOdent^® and scanning electron microscope (SEM).

Methodology:

Eighty-six natural permanent maxillary first premolars were selected and randomly divided into two groups of 43 each, Group A (NovaMin^™) and Group B (CPP-ACPF). All the samples were assessed using DIAGNOdent^® (KaVo) at the baseline, after demineralization, and remineralization after 7 days. Two samples were randomly selected from each group after remineralization to evaluate the surface changes using SEM at × 1000 and × 2000.

Results:

The mean value of remineralization was highest for Group A NovaMin^™ (6.56 ± 0.93) compared to Group B, CPP-ACPF (tooth mousse plus^™) (6.02 ± 1.09). The maximum demineralization to remineralization value within the groups showed that the mean values in Group B CPP-ACPF (7.02 ± 3.02) was higher than Group A NovaMin^™ (6.42 ± 2.21). The difference in remineralizing potential between the groups and demineralization to remineralization value in within-group comparison was not found to be statistically significant.

Conclusion:

On comparing Group A NovaMin^™ and Group B CPP-ACPF, Group B CPP-ACPF showed a higher amount of remineralization than Group A NovaMin^™. From the present study, it can be inferred that both the experimental groups have the potential for remineralization.

Evaluation of the protective effect on enamel demineralization of CPP-ACP paste and ROCS by vibrational spectroscopy and SAXS: An in vitro study

The aim of this study was to investigate human dental enamel surfaces using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR), Raman spectroscopy, and small angle X-ray scattering (SAXS) techniques concerning differences between the demineralized enamel surface and remineralized enamel surface by casein phosphopeptide amorphous calcium phosphate, Tooth mousse® (CPP-ACP) and remineralizing oral care systems (ROCS®) agents within the same tooth. For this purpose, 20 freshly extracted human maxillary central incisors without caries and defects were used. Labial surfaces of each of the teeth were divided into four sections, which were marked as follows: Group 1, normal enamel; Group 2, demineralized enamel with demineralization solution; Group 3, demineralized enamel + remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth); and Group 4, remineralization agent (ROCS for 10 teeth, CPP-ACP for 10 teeth). To describe the changes in tooth enamel, the phosphate group concentration within enamel was used as an indicator of the degree of mineralization. The phosphate and carbonate bands in the FTIR and Raman spectra were used to investigate the structural changes in the demineralized and remineralized enamel. Spectroscopic data were statistically analyzed in terms of CPP-ACP and ROCS using one-way analysis of variance. The carbonate content of demineralized enamel was higher than the carbonate content in the other groups (p < .03). The apatite carbonate-phosphate balance in the samples with only remineralizing agent-especially ROCS applied-changed significantly (p < .05) compared to the normal group. The average FTIR spectra of the groups were subjected to multivariate hierarchical cluster analysis (HCA) conducted with the use of the OPUS 5.5 software. Nanosized surface morphologies of the samples were compared using pair distance distributions obtained through SAXS analyses. According to the SAXS analyses, applications of CCP + ACP and ROCS agents were effective on nanostructures for all groups.

Remineralization and fluoride uptake of white spot lesions under dental varnishes

INTRODUCTION

The aim of this study was to evaluate white spot lesion (WSL) remineralization and fluoride uptake by the application of fluoride varnishes directly onto artificial WSLs in vitro.

METHODS

MI varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and 2.26% fluoride and Duraphat varnish containing 2.26% fluoride (no added calcium) were compared with a placebo varnish (no added calcium or fluoride). Two WSLs were prepared in enamel slabs and varnish applied to cover one of the two lesions. Each slab was immersed in artificial saliva for 14 days at 37°C. Mineral content was determined using transverse microradiography and fluoride uptake using electron probe microanalysis. The data were statistically analysed using a linear mixed model.

RESULTS

Both MI and Duraphat varnishes significantly remineralized the covered and uncovered WSLs when compared with the placebo varnish (P < 0.001). The WSLs covered with varnish showed greater remineralization than those uncovered. MI varnish produced the highest level of remineralization and significantly greater fluoride uptake (0.44 ± 0.08 wt%) compared with Duraphat (0.24 ± 0.03 wt%) and the placebo varnish (0.06 ± 0.05 wt%).

CONCLUSION

Varnish containing fluoride and CPP-ACP was superior to varnish containing fluoride alone in promoting WSL remineralization and fluoride uptake.

The Efficacy of Resin Infiltrant and Casein Phosphopeptide-amorphous Calcium Fluoride Phosphate in Treatment of White Spot Lesions (Comparative Study)

Background:

White spot lesions (WSLs) are considered as the first sign of the progression of dental caries that can be reversed. Casein phosphopeptide–amorphous calcium fluoride phosphate (CPP-ACFP) varnish can promote remineralization process of the demineralized tooth structure. Also, WSLs can be managed by using caries infiltrant (ICON), which infiltrates etched enamel surface of the WSLs.

Objectives:

The main aim was to evaluate and compare the efficacy of ICON versus CPP-ACFP varnish to treat WSLs in the same oral environments.

Materials and Methods:

A total of 30 participants aged 20–40 years with at least two WSLs have participated in this trial. Split-mouth technique has been used in this trial where WSLs on the left side have been treated with ICON, whereas WSLs on the right side have been treated with CPP-ACFP varnish. Clinical evaluation using DIAGNOdent was carried out at baseline, 1 week, 1, 3, 6, and 12 months after application to determine the effectiveness of these materials in treating WSLs.

Results:

Significant differences were observed between all follow-up DIAGNOdent scores compared to baseline readings of both ICON and CPP-ACFP (P = 0.000 for all comparisons). Statistically significant differences were observed between DIAGNOdent scores of ICON compared to CPP-ACFP at all follow-up intervals (P = 0.006, 0.008, 0.045, 0.036, and 0.000).

Conclusion:

Both ICON and CPP-ACFP were effective in the treatment of WSLs of smooth surfaces but the efficacy of CPP-ACFP was better than ICON.

Evaluation of the Efficacy of Different Remineralizing Agents on Artificial Early Enamel Lesions of Primary Teeth: An In Vitro Study

Aim:

To analyze the remineralization efficacy of casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) and 8% arginine on artificial early enamel lesions on primary teeth enamel samples.

Materials and Methods:

In this in vitro study, artificial enamel lesions were created in 120 primary teeth. Teeth were randomly divided into 5 groups: group C: CPP–ACP paste; group CF: CPP–ACPF paste with 900 ppm flour; group A: paste with 8% arginine; group K+: 500 ppm NaF as a positive control; and group K–: deionized water as a negative control. After 4 weeks of the remineralization process, the effect of remineralization on samples of agents used the microhardness, atomic force microscope, and scanning electron microscope analyses. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0, SPSS Inc., Chicago, IL, USA). ANOVA and Tukey Post-Hoc multiple comparison test were applied ( p < .05).

Results:

Increasing percentage values of the microhardness at groups C, CF, and A were significantly better than group K– ( p < .05), whereas there is no statistically significant difference with group K+ ( p > .05). The average surface roughness values of groups C and CF were similar with group K+ in AFM analysis, whereas average surface roughness values of group A were significantly higher than K+ group.

Conclusion:

The CPP–ACP, CPP–ACPF, and arginine are effective agents for remineralization of early childhood caries lesions.

The Effect of the Er:YAG Laser and MI Paste Plus on the Treatment of White Spot Lesions

Introduction: White spot lesions (WSLs) occurring after orthodontic treatment lead to patient dissatisfaction and aesthetic problems. The role of calcium-phosphate demineralization systems and the Er:YAG laser in the treatment of these lesions has recently been taken into account. This study aimed to investigate the effect of the Er:YAG laser and MI Paste Plus on the treatment of WSLs. Methods: A total of 65 premolars extracted due to orthodontic treatment were studied in this research. To create enamel lesions, the teeth were placed in a demineralizing solution. The teeth were then randomly divided into five groups (n=13) as follows: first group, control; second group, saliva; third group, MI Paste Plus; fourth group, Er:YAG laser; and fifth group, MI Paste Plus together with the Er:YAG laser. The teeth were kept in artificial saliva between treatment processes. Artificial saliva was replaced daily with fresh artificial saliva. The teeth were sectioned longitudinally by a disc from the middle of the exposed enamel and each section was mounted in polyester resin. The surface of the samples was serially polished and the microhardness of the teeth was measured at depths of 0, 50, 100, and 150 µm. Results: The microhardness was significantly higher in the fifth group than other groups at depths of 50 and 150 µm (P <0.005). Using the laser or MI Paste Plus alone did not significantly increase the microhardness. Conclusions: The combined application of the Er:YAG laser and MI Paste Plus is effective in the treatment of WSLs.

Effective Preparation Method of Phosphopeptides from Phosvitin and the Analysis of Peptide Profiles Using Tandem Mass Spectrometry

The effect of high-temperature and mild-pressure (HTMP) pretreatment on the enzymatic hydrolysis of phosvitin and the structural characteristics of the phosphopeptides produced were analyzed using tandem mass spectrometry. The HTMP pretreatment hydrolyzed phosvitin at random sites and helped the subsequent enzyme hydrolysis of the peptides produced. With the HTMP pretreatment alone, 154 peptides were produced, while the use of trypsin, Protex 6L, and Multifect 14L in combination with the pretreatment produced 252, 280, and 164 peptides, respectively. The use of two enzyme combinations (trypsin + Protex 6L and trypsin + Multifect 14L) helped the hydrolysis further. The number of phosphopeptides produced increased when the modifications within the same amino acid sequences were considered. This study indicated that HTMP pretreatment was a breakthrough method to improve the enzymatic hydrolysis of phosvitin that enabled an easy production of phosvitin phosphopeptides for their subsequent functional characterizations.

Effects of treatment with three types of varnish remineralizing agents on the microhardness of demineralized enamel surface

Background

Remineralization of incipient caries is one of the goals in dental health care ,especially in pediatric dentistry. The present study aimed at comparing the effects of MI varnish (3M (United states)) , Nano paste( FGM(Brezil) ), 5% sodium fluoride varnish) DuraphatColgate (united states) ) on remineralization of enamel lesions.

Material and Methods

In this in-vitrostudy, 60 intact human pre-molars, were randomly allocated to four groups of 15. Baseline surface microhardness in three points in the center of the polished area was measured. After two days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 under-went treatment with MI varnish, nano paste, 5% sodium fluoride varnish and then again microhardness was measured. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Bonfreni table was used.

Results

Duraphat varnish in comparison with control group, significantly increased surface microhardness and in comparison with Nano and MI paste varnish groups significant differences was shown between groups. (P< 0.05). MI paste varnish and Nano paste similary showed more increases in surface microhardness in comparison with Duraphat varnish and control groups (P≈1).

Conclusions

According to the results of this study, all three varnishes, Duraphat , MI paste and Nano paste increase the enamel surface microhardness and remineralization of incipient caries. MI paste and Nano paste compared to Duraphat Varnish, significantly showed more increases in enamel surface microhardness but Nano paste and MI paste were almost the same. Key words:CPP-ACP, Nano varnish, fluoride varnish, microhardness, demineralization, remineralization.

Effect of surface treatments on staining and roughness of bleached enamel

Background

The objectives were to evaluate the effect of surface treatments and waiting time before contact with dye on bleached enamel staining and surface treatments on roughness.

Methods

One hundred bleached teeth were randomly assigned to G1 artificial saliva, G2 2% sodium fluoride (Flugel, Nova DFL), G3 casein phosphopeptide-amorphous calcium phosphate fluoride paste (MI Paste Plus, GC America), G4 rinse for bleached color maintenance (Keep White Rinse, DMC), and G5 polishing with impregnated disks (SuperBuff Disk, Shofu). Fifty specimens were immersed in coffee immediately after treatment; the others 1 h after. Color difference (ΔE) was evaluated with a spectrophotometer (Vita EasyShade) and roughness (Ra, Rq) with an optical profilometer (NewView 7300). Effects were analyzed with two-way ANOVA, Friedman, and Kruskal-Wallis test (P < 0.05).

Results

Surface treatments (P = 0.878), waiting time (P = 0.105), and interaction (P = 0.145) were not significant to bleached color maintenance. Roughness was different among the evaluation time points (2^nd evaluation >1^st evaluation >3^rd evaluation) (P < 0.001); not among surface treatments (G1, G2, G3, G4, G5) (P > 0.05).

Conclusions

Surface treatments were similar to saliva for bleached enamel color maintenance. Immediate or 1-h postponed contact with coffee did not affect bleached enamel color. Bleaching increased enamel roughness; surface treatments and artificial saliva decreased it.

Effect of Cpp-aCp and Cpp-aCpf pastes on the Surface Hardness of Initial Dental Erosion Lesions: an In Situ Study

To analyze the effect of intra-oral application of CPP-ACP and CPP-ACPF pastes on the surface hardness of initial dental erosion lesions.Bovine enamel specimens were randomly assigned into 6 volunteers in 3 treatment groups: GI: CPP-ACP paste, GII: CPP-ACPF paste and GIII (Control): Placebo paste without CPP-ACP and without fluoride. Enamel specimens were selected by surface hardness (SHi), in vitro eroded by immersion in hydrochloric acid for 30 seconds (SHdes) and randomized between treatment groups and volunteers, who used the palatal intraoral device for 2 hours, applied the treatment on the specimens and used the palatal intraoral device for an additional 3 hours in 3 crossed phases, interspersed with a 7-day washout period. Subsequently, the surface hardness (SHre) was measured to estimate the re-hardening potential of the softened enamel promoted by treatments. Data were analyzed using the t-test and one-way ANOVA, adopting 5% significance level. Mean final and post-erosion hardness values were statistically significant for pastes tested (p<0.05), which presented re-hardening effect of the softened enamel, but with no difference between them and placebo (p>0.05). CPP-ACP and CPP-ACPF pastes did not demonstrate higher efficacy in re-hardening the eroded enamel compared to placebo paste.

In vitro and in vivo evaluation of electrophoresis-aided casein phosphopeptide-amorphous calcium phosphate remineralisation system on pH-cycling and acid-etching demineralised enamel

Casein phosphate-amorphous calcium phosphate (CPP-ACP), as a remineralisation agent, is extensively used in managing demineralised enamel; however, its remineralisation kinetics is low. This study aimed to improve remineralisation kinetics of CPP-ACP by introducing a rapid remineralisation method with electrophoresis. In vitro, a pH-cycling enamel model was used to test remineralisation potentials of electrophoresis-aided CPP-ACP. For verifying remineralisation potentials of electrophoresis-aided CPP-ACP in vivo in a rabbit model, acid-etched enamel surface on rabbit maxillary incisors was remineralised by electrophoresis-aided CPP-ACP with 1.0 mA (group A) or 0.5 mA (group B). Both in vitro and in vivo, it was observed that electrophoresis was benefit to improve remineralisation kinetics of CPP-ACP, and the demineralised enamel was completely remineralised after 5 h. The Ca/P ratio in remineralised enamel consisted with that of hydroxyapatite, the microstructure in native enamel. Meanwhile, in vivo the micro-hardness of acid-etched enamel in group A (322.55 ± 31.90) and group B (322.55 ± 31.90) recovered up to the value of native enamel after 5 h remineralisation (p > 0.05). The Hematoxylin-eosin stain demonstrated that the electric field used in this study was safe on rabbit dental pulp. Therefore, this efficient and safe method has the potential to be applied in treating enamel deminerlisation.

Remineralizing potential of a 60-s in vitro application of Tooth Mousse Plus

BACKGROUND

No published studies exist on the remineralizing potential of Tooth Mousse Plus^® (TMP) when applied for less than 3 min.

AIM

To evaluate (i) the remineralizing potential of TMP on artificial carious lesions, when applied thrice daily for 60 s, and (ii) the benefit of using a fluoridated dentifrice prior to TMP application.

DESIGN

Carious lesions, 120-200 μm deep, were produced by placing molars in demineralizing solution for 96 h, and sections 100-150 μm thick were then randomly assigned to four groups. Specimens were treated thrice daily with a non-fluoridated (Group A), or 1000 ppm F dentifrice (Group B), or TMP (Group C), or a 1000 ppm F dentifrice followed by TMP application (Group D), and then subjected to a 10-day pH cycling model. Lesion evaluation involved polarizing light microscopy and microradiography.

RESULTS

Post-treatment maximum mineral content at the surface zone (V_max ) was significantly increased and lesion depth (LD) significantly decreased in Group C, while only the V_max increased in Group D. Increase in LD was observed in Group B; however, no significant differences were noted in percentage LD changes between groups B, C, and D (P > 0.05).

CONCLUSIONS

TMP applied for 60 s significantly remineralized the artificial carious lesions. No additional benefit was evident when TMP was preceded by treatment with 1000 ppm F dentifrice.

The effects of three remineralizing agents on regression of white spot lesions in children: A two-week, single-blind, randomized clinical trial

BACKGROUND

This study investigated the effect of three remineralizing agents on improving white spot lesions (WSLs).

MATERIAL AND METHODS

This clinical trial included children who had at least one WSL on anterior teeth of upper or lower jaws. The participants were randomly assigned to 4 groups by treatment: 1) a cream containing casein phosphopeptide-amorphous calcium phosphate and fluoride (MI Paste Plus); 2) a cream containing hydroxyapatite and fluoride (Remin Pro); 3) a 2% sodium fluoride gel; and 4) usual home care (control). The treatment was performed for 3 times over 10 days using special trays for retaining remineralizing agents. The area and mineral content of WSLs were measured at baseline (T1) and 1 day after finishing treatment (T2). Blinding was applied for outcome assessment.

RESULTS

Eighty patients were assigned to MI Paste Plus, Remin Pro, NaF or control groups. The application of all remineralizing agents caused a significant decrease in area and a significant increase in mineral content of WSLs (p<0.05), whereas the control patients did not experience any significant alteration (p>0.05). At T2, the area of WSLs was significantly lower in three experimental groups compared to the control group (p=0.023), but between-group difference in mineral content of WSLs failed to achieve statistical significance (p=0.08).

CONCLUSIONS

The in-office application of either MI Paste Plus or Remin Pro was as effective as 2% NaF for reducing area and increasing mineral content of WSLs. MI Paste Plus and Remin Pro could be recommended as suitable alternatives to NaF for managing WSLs. Key words:White spot lesion, caries, casein phosphopeptide-amorphous calcium phosphate, hydroxyapatite, sodium fluoride, CPP-ACP, MPlus, Remin Pro, NaF.

Assessment of Enamel Remineralisation After Treatment with Four Different Remineralising Agents: A Scanning Electron Microscopy (SEM) Study

INTRODUCTION

Decades of research has helped to increase our knowledge of dental caries and reduce its prevalence. However, according to World Oral Health report, dental caries still remains a major dental disease. Fluoride therapy has been utilised in a big way to halt caries progression, but has been met with limitations. This has paved the way for the development of newer preventive agents that can function as an adjunct to fluoride or independent of it.

AIM

The purpose of the present study was to evaluate the ability of Casein Phosphopeptide-Amorphous Calcium Phosphate Fluoride (CPP ACPF), Bioactive Glass (BAG), fluoride enhanced Hydroxyapatite (HA) gel and self-assembling peptide P₁₁-4 to remineralise artificial carious lesions in enamel in vitro using a 30 day pH cycling model through surface microhardness analysis and SEM.

MATERIALS AND METHODS

Sixty enamel samples were divided into five groups of 12 samples each. The control Group A consisted of intact enamel samples, Group B: CPP-ACPF (Tooth Mousse Plus), Group C: BAG (SHY- NM), Group D: fluoride enhanced HA gel (ReminPro) and Group E: Self-assembling peptide P₁₁-4 (Curodont Protect). All groups excluding the control group were subjected to demineralisation following which four of these groups were remineralised using the four remineralising agents. The treated groups were subjected to pH cycling over a period of 30 days. This was followed by assessment of surface microhardness and SEM for qualitative evaluation of surface changes. The results were analysed by One-Way Analysis Of Variance (ANOVA). Multiple comparisons between groups were performed by paired t-test and post-hoc Tukey test.

RESULTS

The results of the study revealed that remineralisation of enamel was the highest in samples of Group E (Self assembling peptide P₁₁-4) followed by Group B (CPP-ACPF), Group C (BAG) and Group D (fluoride enhanced HA gel). There was a significant difference (p<0.05) in the remineralising ability between the self assembling peptide P₁₁-4 group and BAG and fluoride enhanced HA gel group. Although no significant difference was observed between the self assembling peptide P₁₁-4 and CPP-ACPF group, the self assembling peptide P₁₁-4 remineralised the enamel lesions more effectively. SEM photomicrographs of the test groups demonstrated either amorphous crystals or particles scattered on the surface or lines of remineralisation along the prismatic borders.

CONCLUSION

Self assembling peptide P₁₁-4 demonstrated promising results by effectively and significantly remineralising the enamel lesions as compared to other test agents.

Effectiveness of sodium bicarbonate combined with hydrogen peroxide and CPP-ACPF in whitening and microhardness of enamel

Background

This study investigated the effects of sodium bicarbonate (NaHCO3) combined with 1.5% hydrogen peroxide (H2O2) and casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) on color and microhardness of enamel.

Material and Methods

Seventy-five bovine incisors were immersed in a tea solution for 7.5 days. The specimens were randomly divided into five groups according to the whitening agent applied: 1) 94% NaHCO3, 2) a blend of 94% NaHCO3 and CPP-ACPF, 3) a blend of 94% NaHCO3 and 1.5% H2O2, 4) a blend of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF, 5) control. The whitening procedure was performed for 10 times over 10 days. At each day, the buccal surfaces were covered with whitening agents for 5 minutes and then brushed for 30 seconds. After the 10 days, the teeth were again immersed in a tea solution for 10 minutes. Color assessment was performed at baseline (T1), after the first staining process (T2), after the whitening procedure (T3), and after the second staining process (T4). Finally, the specimens were subjected to microhardness test.

Results

There was a statistically significant difference in the color change between T2 and T3 stages among the study groups (p<0.05), with the greatest improvement observed in group 4. Microhardness was significantly greater in groups 2 and 4, as compared to the other groups (p<0.05).

Conclusions

The combination of 94% NaHCO3, 1.5% H2O2 and CPP-ACPF was effective in improving color and microhardness of teeth with extrinsic stains and could be recommended in the clinical situation.

Is It Necessary to Prepare the Enamel before Dental Bleaching?

The aim of this in vitro study was to assess the influence of distinct surface treatments on the microhardness and color of enamel that will be bleached. Surface treatments are tested, accordingly: G1, no treatment; G2, 2% sodium fluoride; G3, casein phosphopeptide paste; G4, 2% fluoride+Nd:YAG laser. Forty blocks from bovine teeth composed the sample that were tested in Knoop microhardness (n = 10) and in color change (n = 10). After 24 h, bleaching with 35% hydrogen peroxide was performed for 45 min. Microhardness and color changes (using parameters ΔE, ΔL, Δa, and Δb) were assessed before and after bleaching. The data were analyzed by two-way ANOVA and Tukey's test (p < 0.05). Despite all surface treatments, a reduction of enamel microhardness occurred immediately after bleaching in all groups, being greater in G1. Enamel color changed in all groups. Immediately after bleaching, there was a decrease on enamel microhardness. However, after 7 days, some of those specimens previously treated before bleaching significantly recovered their initial microhardness without influencing the esthetic results of bleaching.

Effect of Fluoride Varnish Containing CPP-ACP on Preventing Enamel Erosion

This study aimed to investigate the effect of a fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate treatment on the prevention of enamel erosion, and it compared the results with those of other fluoride varnishes. Fifty enamel specimens obtained from bovine incisors were randomly divided into five groups (n = 10) based on the type of surface pretreatment used: intact enamel (Group 1); intact enamel+erosive cycles (Group 2); intact enamel+MI varnish+erosive cycles (Group 3); intact enamel+Clinpro White varnish+erosive cycles (Group 4); and intact enamel+Duraphat varnish+erosive cycles (Group 5). The specimens were subjected to erosive cycles for five days. The surface roughness was evaluated using atomic force microscopy. The results were statistically analyzed using one-way ANOVA and Tukey's tests. Group 1 had the smoothest surfaces. After the erosive cycles, the greatest surface roughness values were observed in Group 2, followed by Groups 5, 4, and 3, respectively. Statistically significant differences were observed among all groups (p < 0.05). The application of fluoride varnishes had some positive effects on preventing enamel erosion; however, the most effective agent was fluoride varnish with added casein phosphopeptide-amorphous calcium phosphate.

Evaluation of the remineralization capacity of CPP-ACP containing fluoride varnish by different quantitative methods

Objective

The aim of this study was to evaluate the efficacy of CPP-ACP containing fluoride varnish for remineralizing white spot lesions (WSLs) with four different quantitative methods.

Material and Methods

Four windows (3x3 mm) were created on the enamel surfaces of bovine incisor teeth. A control window was covered with nail varnish, and WSLs were created on the other windows (after demineralization, first week and fourth week) in acidified gel system. The test material (MI Varnish) was applied on the demineralized areas, and the treated enamel samples were stored in artificial saliva. At the fourth week, the enamel surfaces were tested by surface microhardness (SMH), quantitative light-induced fluorescence-digital (QLF-D), energy-dispersive spectroscopy (EDS) and laser fluorescence (LF pen). The data were statistically analyzed (α=0.05).

Results

While the LF pen measurements showed significant differences at baseline, after demineralization, and after the one-week remineralization period (p<0.05), the difference between the 1- and 4-week was not significant (p>0.05). With regards to the SMH and QLF-D analyses, statistically significant differences were found among all the phases (p<0.05). After the 1- and 4-week treatment periods, the calcium (Ca) and phosphate (P) concentrations and Ca/P ratio were higher compared to those of the demineralization surfaces (p<0.05).

Conclusion

CPP-ACP containing fluoride varnish provides remineralization of WSLs after a single application and seems suitable for clinical use.

Fracture toughness of bleached enamel: Effect of applying three different nanobiomaterials by nanoindentation test

Background:

Despite the absence of dispute about the efficacy of bleaching agents, a prime concern is about their compromising effect on the enamel structure. This in vitro study investigated whether the addition of three different biomaterials, including nano-bioactive glass (n-BG)/nano-hydroxy apetite (n-HA)/nano-amorphous calcium phosphate (n-ACP), to bleaching agents can affect the fracture toughness (FT) and vickers hardness number (VHN) of bovine enamel.

Materials and Methods:

The crowns of the newly extracted permanent bovine incisors teeth were separated from the root and sectioned along their central line; one half serving as the control specimen and the other half as the test specimen. After mounting and polishing procedure, all the control specimens (C) were subjected to nano-indentation test to obtain the baseline values of FT. Then, the control specimens were exposed to a 38% hydrogen peroxide for four times, each time for 10 min. The test specimens were divided into three groups and treated as follows, with the same protocol used for the control specimens: Group 1; ACP + hydrogen peroxide (HP) mixed gel; Group 2 BG + HP mixed gel; and Group 3 HA + HP mixed gel. FT measurements with nano-indentation were carried out subsequent to bleaching experiments. Data were analyzed using SPSS and Kruskal–Wallis test (α = 0.05).

Results:

A significant difference in young's modulus (YM), VHN, and FT at baseline and subsequent to bleaching in control group was observed. However, no significant differences were found in YM, VHN, and FT between the test groups, compared to the respective baseline values.

Conclusion:

Under the limitations of the current study, it can be concluded that the n-HA, n-ACP, and n-BG could be potential biomaterials used to reduce the adverse effects of tooth bleaching.

Casein phosphopeptide-amorphous calcium phosphate products in caries prevention

Data sourcesMedline, Embase, PreMedline and Cochrane Central Register of Controlled Trials.Study selectionClinical trials, investigating only clinical caries outcomes on participants of any age comparing the use of Tooth Mousse(®) or Tooth Mousse Plus(®) to a routine oral care regimen for the prevention of dental caries with or without comparison to additional preventive products. Studies that used other formulations of CCP-ACP were excluded. Trials using split-mouth design were also excluded. Only English language papers were considered.Data extraction and synthesisPapers were assessed independently by both authors using the Cochrane Collaboration tool for assessing risk of bias in randomised trials.1 Meta-analysis was not possible due to study heterogeneity.ResultsTwelve studies were available for the final review; three studies on caries prevention were assessed as having low risk of bias. The remaining nine studies, with high risk of bias, reported on treatment or regression of early carious lesions. Two RCTs reported no significant benefits in the use of Tooth Mousse(®) over brushing with a fluoride toothpaste, a third study demonstrated a statistically significant increase in enamel microhardness for the Tooth Mousse(®) group compared to control group but no difference to the group who had fluoride gel treatment. Overall the authors concluded that Tooth Mousse(®) performs no better than fluoride in the prevention of carious lesions.Seven of nine studies evaluated caries lesion severity in orthodontic patients, with four demonstrating statistically significant white spot regression. Two trials in non-orthodontic patients showed statistically significant remineralising potential of Tooth Mousse(®) over fluoride mouthrinse or the regular use of fluoride toothpaste in 14-30 days.ConclusionsThe authors found no evidence to support the use of Tooth Mousse(®) over brushing with a fluoride toothpaste for the prevention of early caries. ToothMousse(®) appeared to benefit regression of white spot lesions associated with orthodontic treatment but the evidence is limited. Effectiveness of Tooth Mousse(®) was not significantly increased by the addition of fluoride in Tooth Mousse Plus(®) and evidence is still lacking to support the use of one over another. High quality randomised clinical trials are needed before these products can be recommended for the prevention and treatment of early carious lesions in the general population.Source of fundingThe publication was funded by Colgate Palmolive, Australia.

Effects of energy and sports drinks on tooth structures and restorative materials

Sports and energy drinks are consumed by more people than ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their over-consumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The over-consumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.

Effects of Treatment with Various Remineralizing Agents on the Microhardness of Demineralized Enamel Surface

Background and aims. Remineralization of incipient caries is one of the goals in dental health care. The present study aimed at comparing the effects of casein phosphopeptide-amorphous calcium phosphate complex (CPP-ACP), Remin Pro^®, and 5% sodium fluoride varnish on remineralization of enamel lesions.

Materials and methods. In this in vitro study, 60 enamel samples were randomly allocated to six groups of 10. After four days of immersion in demineralizing solution, microhardness of all samples was measured. Afterward, groups 1-3 underwent one-time treatment with fluoride varnish, CPP-ACP, and Remin Pro^®, respectively. Microhardness of groups 4-6 was measured not only after one-month treatment with the above-mentioned materials (for eight hours a day), but also after re-exposing to the demineralizing solution. The results were analyzed by one-way analysis of variance (ANOVA), repeated measures ANOVA, and Fisher’s least significant difference (LSD) test.

Results. None of the regimens could increase microhardness in groups 1-3. However, one-month treatment regimens in groups 4-6 caused a significant increase in microhardness. The greatest microhardness was detected in the group treated with CPP-ACP (P = 0.001). In addition, although microhardness reduced following re-demineralization in all three groups, the mean reduction was minimum in the CPP-ACP-treated group (P < 0.001).

Conclusion. While long-term repeated application of all compounds improved microhardness, the remineralization potential of CPP-ACP was significantly higher than that of Remin Pro^® and sodium fluoride varnish.

The Future of Fluorides and Other Protective Agents in Erosion Prevention

The effectiveness of fluoride in caries prevention has been convincingly proven. In recent years, researchers have investigated the preventive effects of different fluoride formulations on erosive tooth wear with positive results, but their action on caries and erosion prevention must be based on different requirements, because there is no sheltered area in the erosive process as there is in the subsurface carious lesions. Thus, any protective mechanism from fluoride concerning erosion is limited to the surface or the near surface layer of enamel. However, reports on other protective agents show superior preventive results. The mechanism of action of tin-containing products is related to tin deposition onto the tooth surface, as well as the incorporation of tin into the near-surface layer of enamel. These tin-rich deposits are less susceptible to dissolution and may result in enhanced protection of the underlying tooth. Titanium tetrafluoride forms a protective layer on the tooth surface. It is believed that this layer is made up of hydrated hydrogen titanium phosphate. Products containing phosphates and/or proteins may adsorb either to the pellicle, rendering it more protective against demineralization, or directly to the dental hard tissue, probably competing with H+ at specific sites on the tooth surface. Other substances may further enhance precipitation of calcium phosphates on the enamel surface, protecting it from additional acid impacts. Hence, the future of fluoride alone in erosion prevention looks grim, but the combination of fluoride with protective agents, such as polyvalent metal ions and some polymers, has much brighter prospects.

Remineralizing potential of various agents on dental erosion

AIM

The purpose of this study is to compare the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP, Tooth Mousse) containing and casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF, Tooth Mousse Plus) containing pastes on dental erosion.

MATERIALS AND METHODS

Thirty permanent non-carious premolars indicated for orthodontic extraction were included in this study and were sectioned in mesiodistal direction vertically. After immersion in the carbonated drink for 14 min, samples were treated with various remineralizing pastes which were CPP-ACP containing paste (Tooth Mousse) and CPP-ACPF containing paste (Tooth Mousse Plus) according to the manufacturer's instructions. Vickers Microhardness was recorded at baseline, after exposure to erosive drink and after treatment with remineralizing pastes. Data obtained was statistically analysed using Student t-test with a level of significance set at p < 0.05.

RESULTS

CPP-ACP (Tooth Mousse) and CPP-ACP with fluoride (Tooth Mousse Plus) resulted in 30.52% and 38.98% increase in post-erosion microhardness values respectively. The remineralizing potential of CPP-ACP with fluoride containing paste (Tooth Mousse Plus) was significantly better than that of CPP-ACP containing paste (Tooth Mousse) (p < 0.05).

CONCLUSION

Casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF, Tooth Mousse Plus) can be recommended to be used in preventing erosive tooth wear from acidic beverages.

The effect of 30% ethanolic extract of Indian propolis on replica of human dentin compared against commercially available desensitizing agent: A methodological SEM study in vitro

Objective:

This study evaluated the ability of 30% ethanolic extract of Indian propolis on dentinal tubule occlusion comparatively against CPP-ACP containing desensitizing agent GC tooth mousse.

Methodology:

The specimens were prepared from 30 freshly extracted sound human third molars stored in 10% formalin (pH 7.0) at a room temperature. From each specimen, a sectioned sample (5 mm length × 5 mm width × 3.5 mm depth) was obtained including the cervical area. Samples were smoothened and wet-polished with 1000- and 1200-grit aluminum oxide abrasive paper and diamond pastes, in order to stimulate the clinical aspect of hypersensitive dentin cervical surfaces. All the specimens were randomly assigned to three groups (n = 10), according to dentin surface treatments. Negative control: Untreated specimens (n = 4) and pretreated with 6% citric acid (n = 6); Test Group: 30% ethanolic extract of Indian propolis (n = 10); Positive Group: GC Tooth Mousse (n =10). All the specimens were prepared for SEM analysis.

Results:

GC tooth mousse promoted tubule occlusion by crystal-like deposits in the lumen of the tubules. While propolis created a thin, smooth layer over dentin surface.

Conclusion:

According to the SEM analysis, both desensitizing agent were able to occlude the dentinal tubules.