Remineralization potential of fluoride, amorphous calcium phosphate-casein phosphopeptide, and combination of hydroxylapatite and fluoride on enamel lesions: An in vitro comparative evaluation

J Conserv Dent. 2019 May-Jun;22(3):305-309. doi: 10.4103/JCD.JCD_13_19.

Abstract

Aim: The purpose of this study was to evaluate and compare remineralization potential of fluoride, amorphous calcium phosphate-casein phosphopeptide (ACP-CPP), and combination of hydroxyapatite (HAP) and fluoride on enamel lesions.

Materials and methodology: Ten intact caries-free human premolars were selected. The coronal portion of each tooth was sectioned into four parts to make four enamel blocks. The baseline surface microhardness (SMH) was measured for all the enamel specimens using Vickers microhardness testing machine. The artificial carious lesion was created by immersing the specimens in demineralizing solution for 3 consecutive days at 35° The SMH of each specimen was evaluated. All the four enamel sections of each tooth were subjected to various surface treatments, i.e., Group A - Fluoride varnish, Group B - ACP-CPP, Group C - Combination of HAP and fluoride (Clinpro), and Group D - Control group; no surface treatment. A carious progress test (pH cycle) was carried out which consisted of alternative demineralization (3 h) and remineralization using artificial saliva (21 h.) for 5 consecutive days. After pH cycling, SMH readings of each specimen were again assessed to evaluate remineralization potential of each surface treatment agent.

Results: Data obtained were statistically analyzed using one-way ANOVA followed by Tukey-Kramer multiple comparison test which was applied to detect significant differences between different surface treatments at different phases of studies.

Conclusion: Fluoride varnish shows higher remineralization potential of early carious lesion compare to ACP-CPP and Clinpro.

Keywords: Amorphous calcium phosphate-casein phosphopeptide; Clinpro; demineralization-remineralization; fluoride.