Remineralization of enamel sub-surface lesion using casein phosphopeptide amorphous calcium phosphate (CPP-ACP) - a quantitative energy dispersive X-ray analysis (EDAX)

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.

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A COMPARATIVE STUDY OF BLEACHING WITH HYDROGEN PEROXIDE VERSUS CARBAMIDE PEROXIDE ON ENAMEL SURFACE AND THE EFFECT OF AMORPHOUS CALCIUM PHOSPHATE APPLICATION FOLLOWING BLEACHING (SCANNING ELECTRON MICROSCOPE ATTACHED WITH ENERGY DISPERSIVE X-RAY ANALYZER STUDY).

International Journal of Advanced Research ◽

10.21474/ijar01/8155 ◽

2018 ◽

Vol 6 (12) ◽

pp. 422-431

Author(s):

Rehame MAmeen ◽

◽

Rania AAwwad ◽

Ethar SMohamed ◽

◽

...

Keyword(s):

Hydrogen Peroxide ◽

Electron Microscope ◽

Calcium Phosphate ◽

Scanning Electron Microscope ◽

Comparative Study ◽

Amorphous Calcium Phosphate ◽

Energy Dispersive ◽

Carbamide Peroxide ◽

X Ray ◽

Scanning Electron

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Kemampuan Bioaktif Glass (Novamin) dan Casein Peptide Amorphous Calcium Phosphate (CPP-ACP) terhadap Demineralisasi Enamel

Conservative Dentistry Journal ◽

10.20473/cdj.v7i2.2017.111-119 ◽

2019 ◽

Vol 7 (2) ◽

pp. 111

Author(s):

Jeanny Kathleen H ◽

Cecilia G.J. Lunardhi ◽

Ari Subiyanto

Keyword(s):

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Pathological State ◽

X Ray ◽

Group A ◽

Ph Cycling ◽

Casein Phosphopeptide ◽

Group D ◽

Scanning Electron ◽

Better Than

Background: Oral cavity is always associated with a dynamic atmosphere where the process of demineralization and remineralization will continue to occur. Caries is a pathological state of continuous demineralization process. Prevention of the occurrence of demineralization process can be done by enhancing remineralization, materials that can be used materials that can trigger a process of remineralization include fluoride, cpp-acp, and novamin. Purpose: The aim of this study was to evaluate and compare the potential of bioactive-Glass (Novamin) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing dentifrice on enamel demineralization. Method: A total of 24 sound human premolars were divided into 4 groups and continued into pH cycling regime to be evaluated with Scanning Electron Microscope – Energy Dispersive X-Ray. Result: Group D showed significantly higher values (P < 0.05) when compared with less demineralization lesion than Group A, B, and C. Conclusions: The ability of Novamin on demineralization lesions better than CPP-ACP.

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Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia

Caries Research ◽

10.1159/000516176 ◽

2021 ◽

pp. 1-10

Author(s):

Ahmed Sleibi ◽

Anwar R. Tappuni ◽

Aylin Baysan

Keyword(s):

Calcium Phosphate ◽

Amorphous Calcium Phosphate ◽

Primary Root ◽

Severity Index ◽

Salivary Flow ◽

Root Caries ◽

Carious Lesions ◽

Group 2 ◽

Casein Phosphopeptide ◽

Group 1

Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45–92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of <0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.

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