Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study
Citation Information :
Bhol S, Singh NK, Kumar MS, Kakti A, Madhumitha M. Assessment of Remineralization Capacity of Various Remineralizing Agents on Artificial Enamel Lesions Using Confocal Laser Scanning Microscope: An In Vitro Study. J Contemp Dent Pract 2021; 22 (3):237-241.
Aim and objective: The present study aimed at evaluating the effectiveness of diverse remineralizing agents on artificial enamel lesion using confocal laser scanning microscope (CLSM).
Materials and methods: Totally 80 mandibular premolars which were single rooted were included. All teeth were suspended in a demineralizing solution to create artificial enamel lesions on the exposed enamel. The samples were separated randomly into four groups (20 each) depending on the application of the remineralizing agents as follows: group 1: control; group 2: calcium sucrose phosphate (CaSP); group 3: fluoride varnish; and group 4: casein phosphopeptides-amorphous calcium phosphate (CPP–ACP). The samples in individual group were treated with the corresponding remineralizing agent (except for the control group) two times a day for 14 days. The experimental and control groups were exposed to CLSM assessment to analyze the data of remineralization and demineralization.
Results: The mean depth of remineralization of fluoride varnish group was slightly more compared to other groups. The highest mean depth of remineralization was found in the fluoride varnish group (122.26 ± 0.28) followed by CaSP (110.58 ± 1.34), CPP–ACP (107.08 ± 0.48), and control (157.78 ± 0.46) groups. The different comparisons among the remineralization material groups showed a statistically significant difference (p < 0.05) in almost all groups except group 2 vs group 4.
Conclusion: This study concluded that improved remineralization of artificial enamel lesion could be achieved with the fluoride varnish group when compared to the CaSP and CPP–ACP groups.
Clinical significance: Remineralization as a treatment technique has received a lot of consideration from clinicians. The process of remineralization and demineralization is considered an active process categorized by the movement of calcium and phosphate in and out of the enamel. Presently, the attention has changed toward increasing the resistance of the tooth by applying remineralizing agents topically, which has led to the notable fall in dental caries.
Borges BC, De Souza Bezerra Araújo RF, Dantas RF, et al. Efficacy of a non-drilling approach to manage non-cavitated dentin occlusal caries in primary molars: a 12-month randomized controlled clinical trial. Int J Paediatr Dent 2012;22(1):44–51. DOI: 10.1111/j.1365-263X.2011.01156.x.
Advani S, Sogi S, Hugar S, et al. Remineralization effects of two pediatric dentifrices and one regular dentifrice on artificial carious lesion in primary teeth: an in vitro study. J Int Soc Prevent Communit Dent 2014;4(2):96–102. DOI: 10.4103/2231-0762.137627.
Chokshi K, Chokshi A, Konde S, et al. An in vitro comparative evaluation of three remineralizing agents using confocal microscopy. J Clin Diagn Res 2016 Jun;10(6):ZC39–ZC42. DOI: 10.7860/JCDR/2016/18191.7984.
Hegde MN, Shetty S, Pardal D. Remineralization of enamel subsurface lesion using CPP–ACP—a quantitative energy dispersive X-ray analysis. J Conserv Dent 2007;10(1):19–25.
Raksha B, Mithra H. An overview on remineralizing agents. Indian J Appl Res 2015;6(1):331–336. DOI: 10.36106/ijar.
Shashikala K, Sheela NV. Qualitative analysis of re mineralized carious lesions subjected to fluoride supplement through confocal laser scanning microscope. OJST 2011;1(3):55–60. DOI: 10.4236/ojst.2011.13010.
Patil N, Choudhari S, Kulkarni S, et al. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: an in vitro study. J Conserv Dent 2013;16(2):116–120. DOI: 10.4103/0972-0707.108185.
Anshul and Kishor Jha, K. Remineralization potential of GC Tooth Mousse and GC Tooth Mousse plus on initial caries like lesion of primary Teeth—an in-vitro comparative evaluation. Univ J Dent Sci 2020;6(2):3–10. DOI: 10.21276/ujds.2020.6.2.3.
Kishen A, Shrestha A, Rafique A. Fiber optic backscatter spectroscopic sensor to monitor enamel demineralization and remineralization in vitro. JConserv Dent 2008;11(2):63–70. DOI: 10.4103/0972-0707.44053.
Shirahatti RV, Ankola AV, Nagesh L, et al. The effects of three different pastes on enamel caries formation and lesion depth progression—an in vitro study. J Oral Health Comm Dent 2007;1(1):1–6. DOI: 10.5005/johcd-1-1-1.
Reynolds EC, Cai F, Cochrane NJ, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2008;87(4):344–348. DOI: 10.1177/154405910808700420.
Divyapriya GK, Yavagal PC, Veeresh DJ. Casein phosphopeptideamorphous calcium phosphate in dentistry: an update. Int J Oral Health Sci 2016;6(1):18–25. DOI: 10.4103/2231-6027.186660.
Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: an in vitro comparative evaluation. J Conserv Dent 2010;13(1):42–46. DOI: 10.4103/0972-0707.62634.
Menon LU, Varma RB, Kumaran P, et al. Efficacy of a calcium sucrose phosphate based toothpaste in elevating the level of calcium, phosphate ions in saliva and reducing plaque: a clinical trial. Contemp Clin Dent 2018;9(2):151–157. DOI: 10.4103/ccd.ccd_562_17.
Gangrade A, Gade V, Patil S, et al. In vitro evaluation of remineralization efficacy of different calcium- and fluoride-based delivery systems on artificially demineralized enamel surface. J Conserv Dent 2016;19(4):328–331. DOI: 10.4103/0972-0707.186449.
Kaur G, Sanap AU, Aggarwal SD, et al. Comparative evaluation of two different remineralizing agents on the microhardness of bleached enamel surface: results of an in vitro study. Indian J Dent Res 2015;26(2):176–179. DOI: 10.4103/0970-9290.159154.
Ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med 1991;2(3):283–296. DOI: 10.1177/10454411910020030101.
Takagi S, Liao H, Chow LC. Effect of tooth-bound fluoride on enamel demineralization/remineralization in vitro. Caries Res 2000;34(4):281–288. DOI: 10.1159/000016603.
