Evaluation of three remineralizing agents on surface roughness of enamel.
Keywords:Surface roughness, White spot lesions, MI paste plus
Background and Objective: This study aimed to assess and compare, in vitro, the efficacy of Casien phosphopeptide-Amorphous calcium phosphate fluoride (CPP-ACP F), Sodium fluoride (NaF) mouth rinse and orthokin tooth paste in treatment of white spot lesions (WSLs) by examining changes in surface roughness of the enamel teeth following pH cycling.
Methods: This in vitro experimental study was conducted on Forty (N=40) extracted sound maxillary premolars which were extracted for orthodontic purposes. Each tooth was soaked in demineralizing solution at 37oC for14 days to produce a white spot lesion. Then samples were coded from 1 to 40 for identification purposes and middle of buccal surface were subjected to profilometric analysis for obtaining enamel surface roughness parameters prior to any treatment (1st roughness recording). Afterward, specimens were randomly divided into four groups of 10 teeth. Each group was immersed and kept in an artificial saliva solution. In group 1 Specimens were treated with ortho kin toothpaste, in group 2 samples were immersed in 10 ml of 0.05% NaF mouthwash, every specimen in group 3 (control group) was immersed in 10ml artificial saliva and in group 4 specimens were treated with MI Paste Plus. After completion of 14 days application of remineralizing agents, a new assessment of enamel surface roughness was obtained by using profilometeric analysis.
Results: The enamel surface roughness of all specimens was decreased after remineralization. There was a statistically significant difference between the roughness measured before and after the application of an experiment in GC group and ortho Kin group. The results showed that both Group 4 (GC, MI paste) and Group 2 (Mouth wash) group had a significant effect on the surface roughness when compared to other two groups. However, the remineralizing effect of Group 1 (Kin toothpaste) and control group were not significant.
Conclusions: Within the limitations of this in vitro study, the results showed that MI Paste Plus and NaF are effective for the treatment of WSLs. Although Kin toothpaste had an efficacy superior to artificial saliva, its remineralizing effect seems to be inconsistent.
Walsh T, Worthington HV, Glenny AM, Appelbe P, Marinho V, Shi X. Fluoride toothpastes of different concentrations for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2010;(1):CD007868.
Øgaard B. Prevalence of white spot lesions in 19-near-olds: A study on untreated and orthodontically treated persons 5 years after treatment. Am J Orthod Dentofacial Orthop. 1989;96:423–7.
Bishara SE, Ostby AW. White spot lesions: formation, prevention, and treatment. Semin Orthod. 2008;14(3):174–82.
Sudjalim TR, Woods MG, Manton DJ, Reynolds EC. Prevention of demineralization around orthodontic brackets in vitro. Am J Orthod Dentofacial Orthop. 2007;131(6):705.e1–9.
Ballard RW, Hagan JL, Phaup AN, Sarkar N, Townsend JA, Armbruster PC. Evaluation of 3 commercially available materials for resolution of white spot lesions. Am J Orthod Dentofacial Orthop. 2013;143(4 Suppl):S78–84.
Gontijo L, Cruz RDA, Brandão PRG. Dental enamel around fixed orthodontic appliances after fluoride varnish application. Braz Dent J. 2007;18:49–53.
Chapman JA, Roberts WE, Eckert GJ, Kula KS, González-Cabezas C. Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. Am J Orthod Dentofac Orthop. 2010;138:188–94.
Sudjalim TR, Woods MG, Manton DJ. Prevention of white spot lesions in orthodontic practice: a contemporary review. Aust Dent J. 2006;51:284–9; quiz 347.
Baysan A, Lynch E, Ellwood R, Davies R, Petersson L, Borsboom P. Reversal of primary root caries using dentifrices containing 5,000 and 1,100 ppm fluoride. Caries Res. 2001;35:41–6.
Schirrmeister JF, Gebrande JP, Altenburger MJ, Mönting JS, Hellwig E. Effect of dentifrice containing 5000 ppm fluoride on non-cavitated fissure carious lesions in vivo after 2 weeks. Am J Dent 2007;20:212–6.
Cate Jt. Review on fluoride, with special emphasis on calcium fluo-ride mechanisms in caries prevention. Eur J Oral Sci. 1997;105:461–5.
Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res. 1997;76(9):1587–95.
Shen R, 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. 2001;80(12):2066–70.
Cochrane NJ, Saranathan S, Cai F, Cross KJ, Reynolds EC. Enamel subsurface lesion remineralisation with casein phosphopeptide stabilised solutions of calcium, phosphate and fluoride. Caries Res. 2008;42(2):88–97.
Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008;87(4):344–8.
Shanthraj R, Jose B, Joshy K. Evaluation of three commercially available tooth paste/creams resolution of white spot lesion. IJARIIT. 2019;5(2):2056–59.
Chen H, Liu X, Dai J, Jiang Z, Guo T, Ding Y. Effect of remineralizing agents on white spot lesions after orthodontic treatment: a systematic review. Am J Orthod Dentofacial Orthop. 2013;143(3):376–82.
Featherstone JD. Dental caries: a dynamic disease process. Aust Dent J. 2008;53(3):286–91.
Ten Cate JM, Duijsters PP. Alternating demineralization and remineralization of artificial enamel lesions. Caries Res. 1982;16(3):201–10.
van Dijk JW, Borggreven JM, Driessens FC. Chemical and mathematical simulation of caries. Caries Res. 1979;13(3):169–80.
Mohan AG, Ebenezar AV, Ghani MF, Martina L, Narayanan A, Mony B. Surface and mineralchanges of enamel with different remineralizing agents in conjunction with carbon-dioxidelaser. Eur J Dent. 2014;8(1):118–23.
Protection. Care. Conservation: Remin Pro (not available in CAN!). Available at: www.voco.com/us/product/Remin_Pro/index.html. Accessed June 1, 2015.
Behroozibakhsh M, Shafiei F, Hooshmand T, Moztarzadeh F, Tahriri M, Bagheri Gorgani H. Effect of a synthetic nanocrystallinefluorohydroxyapatite on the eroded enamel lesions. Dent Mater. 2014;30(Supplement 1):e117– e8.
Bergstrand F, Twetman S. A review on prevention and treatment of post-orthodontic white spot lesions-evidence-based methods and emerging technologies. Open Dent J. 2011;5:158-62.
Abbas HM, Hamza HM, Ahmed HM. Minimal intervention approaches in remineralizing early caries lesion. Jor of Ame Sci. 2012;8(3):709–17.
Shetty S, Hegde MN, Bopanna TP. Enamel remineralization assessment after treatment with three different remineralizing agents using surface microhardness: An inVitro study. J Conserv Dent. 2014;17(1):49–52.
O'Reilly MM, Featherstone JD. Demineralization and remineralization around orthodontic appliances: an in vivo study. Am J Orthod Dentofacial Orthop. 1987;92:33–40.
Mount G J and W R Hume 2005 Preservation and Restoration of Tooth Structure (Queensland: Kowledge Books and Software) pp 22–41.
Nakashima S, Yoshie M, Sano H, Bahar A. Effect of a test dentifrice containing nanosized calcium carbonate on remineralization of enamel lesions in vitro. J Oral Sci. 2009;169–77.
Ricketts J, Ekstrand K, Martignon S, Ellwood R, Alatsaris M, Nugent Z. Accuracy and reproducibility of conventional radiographic assessment and subtraction radiography in detecting demineralization in occlusal surfaces. Caries Res. 2007;41:121–8.
Rolla G. On the role of calcium fluoride in the cariostatic mechanism of fluoride. Acta Odontol Scand. 1988;46:341–345.
Uysal T, Amasyali M, Koyuturk AE, Ozcan S. Effects of different topical agents on enamel demineralization around orthodontic brackets: an in vivo and in vitro study. Aust Dent J. 2010;55:268–74.
Srinivasan N, Kavitha M, Loganathan SC. Comparison of the remineralization potential of CPPACP and CPP-ACP with 900 ppm fluoride on eroded human enamel: an in situ study. Arch Oral Biol. 2010;55:541–4.
Wu G, Liu X, Hou Y. Analysis of the effect of CPPACP tooth mousse on enamel remineralization by circular polarized images. Angle Orthod. 2010;80:933–8.
Robertson MA, Kau CH, English JD, Lee RP, Powers J, Nguyen JT. MI Paste Plus to prevent demineralization in orthodontic patients: a prospective randomised controlled trial. Am J Orthod. 2011;140:660–8.
Hamba H, Nikaido T, Inoue G, Sadr A, Tagami J. Effects of CPP-ACP with sodium fluorides on inhibition of bovine enamel demineralization: a quantitative assessment using micro-computed tomography. J Dent. 2011;39:405–13.
Jayarajan J, Janardhanam P, Jayakumar P, Deepika P. Efficacy of CPP-ACP and CPP-ACPF on enamel remineralization: an in vitro study using scanning electron microscope and DIAGNOdent. Indian J Dent Res. 2011;22:77–82.
Huang GJ, Roloff-Chiang B, Mills BE, Shalchi S, Spiekerman C, Korpak AM, et al. Effectiveness of MI Paste Plus and PreviDent fluoride varnish for treatment of white spot lesions: a randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013;143:31–41.
How to Cite
Copyright (c) 2022 Vian O. Majeed, Hemn M. Sarmamy, Rebin A. Mohammedamin (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Erbil Dental Journal is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).