scholarly journals Comparison of the Efficacy of Different Fluoride Varnishes on Dentin Remineralization During a Critical pH Exposure Using Quantitative X-Ray Microtomography

2018 ◽  
Vol 43 (6) ◽  
pp. E308-E316
Author(s):  
A Sleibi ◽  
A Tappuni ◽  
D Mills ◽  
GR Davis ◽  
A Baysan

SUMMARY Objectives: The objective of this in vitro study was to quantify the amount of mineral change in demineralized dentin at pH 5.5 after the application of dental varnishes containing fluoride with casein phosphopeptide–amorphous calcium phosphate, fluoride and bioglass, or fluoride alone. Methods and Materials: A total of 12 extracted human sound mandibular premolar root samples were coated with an acid-resistant varnish, leaving a 2 × 3 mm window at the outer root surface. These root specimens were then randomly divided into four groups and separately subjected to the demineralizing cycle at a pH of 4.8 for five days to create artificial caries-like lesions in dentin. Subsequently, each sample was imaged using quantitative x-ray microtomography (XMT) at a 15-μm voxel size. Each test group then received one of the following treatments: dental varnish containing casein phosphopeptide–amorphous calcium phosphate and fluoride (CPP-ACP, MI varnish, GC Europe), bioglass and fluoride (BGA, Experimental, Dentsply Sirona), or fluoride alone (NUPRO, Dentsply Sirona), as well as a control group, which received no treatment. These samples were kept in deionized water for 12 hours. The thin layer of varnish was then removed. All samples including the nonvarnish group were subjected to the second demineralizing cycle at pH 5.5 for five days. The final XMT imaging was then carried out following the second demineralizing cycle. XMT scan was also carried out to varnish samples at 25 μm voxel size. The change in mineral concentration in the demineralized teeth was assessed using both qualitative and quantitative image analysis. Results: There was an increase in radiopacity in the subtracted images of all varnish groups; a significant increase in mineral content, 12% for the CPP-ACP and fluoride (p≤0.05 and p≤0.001), 25% BGA (p≤0.001), and 104% fluoride alone varnish (p≤0.001). There was an increase in the size of radiolucency in the lesion area with a significant decrease in mineral content in the nonvarnish group, 10% (p≤0.05 and p≤0.001). Conclusions: There was encouraging evidence of a remineralization effect following the application of dental varnish on dentin and also an observed resistance to demineralization during the acidic challenge in all cases. However, a dental varnish containing fluoride alone appeared to have a much greater effect on dentin remineralization when compared with CPP-ACP with fluoride and bioglass with fluoride.

2018 ◽  
Vol 89 (1) ◽  
pp. 10-15
Author(s):  
Moufida Abufarwa ◽  
Amal Noureldin ◽  
Phillip M Campbell ◽  
Peter H Buschang

ABSTRACT Objectives: To test how long casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) fluoride varnish prevents enamel demineralization in vitro. Materials and Methods: Human molars and premolars were sectioned buccolingually and randomly assigned to two groups. Standardized pretreatment images of enamel surfaces were obtained using FluoreCam. The control group received no treatment, and the experimental group received an application of CPP-ACP fluoride varnish. Over simulated periods of 2, 4, 8, and 12 weeks, specimens were placed in a toothbrushing simulator, thermocycled, subjected to 9 days of pH cycling, and imaged with FluoreCam. Samples were sectioned and polished for polarized light microscope (PLM) evaluation. Results: There were statistically significant time (P < .001) and varnish (P < .001) effects on area, intensity, and impact of enamel demineralization. The control group showed significant and progressive demineralization over the 12 weeks (P < .001). The experimental group revealed no significant demineralization during the first 4 weeks (P > .05) and significant (P < .001) increases thereafter. Experimental demineralization after 12 weeks was comparable to 2-week demineralization in the controls, with significant between-group differences (P < .001) in enamel demineralization at all time points. PLM of the control and experimental groups revealed lesion depths of 90 ± 34 μm and 37 ± 9 μm, respectively. Conclusions: Within the limitations of this in vitro study, CPP-ACP fluoride varnish prevents enamel demineralization for at least 4 weeks and limits demineralization up to 12 weeks.


2013 ◽  
Vol 18 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Sissy Maria Mendes Machado ◽  
Diego Bruno Pinho do Nascimento ◽  
Robson Costa Silva ◽  
Sandro Cordeiro Loretto ◽  
David Normando

OBJECTIVE: To evaluate in vitro the effects of tooth whitening using gel with Amorphous Calcium Phosphate (ACP) on the bond strength of metal brackets. METHODS: Thirty-six bovine incisors were sectioned at the crown-root interface, and the crowns were then placed in PVC cylinders. The specimens were divided into 3 groups (n = 12) according to whitening treatment and type of gel used, as follows: G1 (control) = no whitening; G2 = whitening with gel not containing ACP (Whiteness Perfect - FGM), G3 = whitening with gel containing ACP (Nite White ACP - Discus Dental). Groups G2 and G3 were subjected to 14 cycles of whitening followed by an interval of 15 days before the bonding of metal brackets. Shear bond strength testing was performed on a Kratos universal test machine at a speed of 0.5 mm/min. After the mechanical test, the specimens were assessed to determine the adhesive remnant index (ARI). The results were subjected to ANOVA, Tukey's test and Kruskal-Wallis test (5%). RESULTS: Significant differences were noted between the groups. Control group (G1 = 11.10 MPa) showed a statistically higher shear bond strength than the groups that underwent whitening (G2 = 5.40 Mpa, G3 = 3.73 MPa), which did not differ from each other. There were no significant differences between the groups in terms of ARI. CONCLUSION: Tooth whitening reduces the bond strength of metal brackets, whereas the presence of ACP in the whitening gel has no bearing on the results.


2011 ◽  
Vol 36 (4) ◽  
pp. 372-379 ◽  
Author(s):  
M Khoroushi ◽  
H Mazaheri ◽  
AE Manoochehri

Clinical Relevance In the absence of saliva, flexural strength of the bovine enamel-dentin complex decreases after in vitro simulation of both at-home and in-office bleaching procedures. Application of Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) subsequent to both bleaching regimens could compensate for this decrease.


2014 ◽  
Vol 38 (4) ◽  
pp. 302-306 ◽  
Author(s):  
Arzu Aykut-Yetkiner ◽  
Nazan Kara ◽  
Mustafa Ateş ◽  
Nazan Ersin ◽  
Fahinur Ertuğrul

Objective: The aim of this study was to evaluate the remineralization effect of Casein Phosphopeptid Amorphous Calcium Phosphate (CPP-ACP) on white spot lesions (WSL) and its inhibitory effect on Streptococcus mutans colonization. Study design: The study group consisted of 60 children exhibiting at least 1-WSL. Subjects were randomly divided into 2 groups: a test group of using CPP-ACP cream (Tooth Mousse, GC Europe N.V., Leuven, Belgium) and a control group using only fluoride containing toothpaste for a period of 3-months. Baseline WSLs were scored using DIAGNOdent device (KaVo Germany) and the saliva samples were collected to measure S. mutans counts. After the 3-month period the WSLs were again recorded and the saliva sample collection was repeated. Wilcoxon Signed Ranks Test was used for statistical analysis. Results: DIAGNOdent measurements were increased by time (p=0.002) in control group and no statistically significant difference (p=0.217) was found in test group by the 3-month period. In both groups, the mutans counts were decreased in 3-month experimental period. Conclusions: These clinical and laboratory results suggested that CPP-ACP containing cream had a slight remineralization effect on the WSL in the 3-month evaluation period however longer observation is recommended to confirm whether the greater change in WSLs is maintained.


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