Effect of application sequence of fluoride and CPP-ACP on remineralization of white spot lesions in primary teeth: An in-vitro study |
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| Institution: | 1. Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité ? Universitätsmedizin Berlin, Germany, Aßmannshauser Str. 4-6, 14197 Berlin, Germany;2. Department of Operative and Preventive Dentistry, Charité ? Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany;3. Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia;4. Department of Oral Structural Biology, Charité ? Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany;1. Tissue Engineering & Biophotonics Research Division, King’s College London Dental Institute, King’s Health Partners, London, UK;2. Conservative & MI Dentistry, Dental Institute, King’s College London Dental Institute, King’s Health Partners, London, UK;3. Department of Health Services Research and School of Dentistry, University of Liverpool, Liverpool, UK;4. GlaxoSmithKline Consumer Healthcare, Weybridge, UK;1. Departament of Stomatology, Universitat de Valencia, Spain;2. Unit of Special Care in Dentistry and Cell Therapy and Hematopoietic Transplant Unit, Internal Medicine Department, IMIB-Arrixaca, University of Murcia, Murcia, Spain |
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| Abstract: | ObjectiveTo explore how application sequence of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride influences remineralization of enamel white spot lesions (WSL) in primary teeth.DesignIn this in-vitro study, artificial WSLs were created in 130 primary teeth. Teeth were divided into 4 groups (n = 27) and a control group (n = 22) and exposed to one of the following remineralization regimens for 10 weeks: Group-1; 500 ppm fluoride dentifrice; Group-2; 10% w/v CPP-ACP; Group-3; fluoride applied first, then CPP-ACP; Group-4; CPP-ACP applied first, then fluoride, and Group-5 was control. All groups were kept in a remineralizing solution. Mineral changes (ΔF) were quantified weekly using quantitative light-induced fluorescence. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0).ResultsRemineralization occurred in all groups to different degrees; changes from baseline were significant in groups 1–4 (P ≤ 0.05). Group-4 showed the earliest significant remineralization (after 2 weeks) among groups, (P < 0.001). Group-4 showed maximum changes in ΔF among groups; however, only differences with Groups 1 and 5 were significant (P < 0.05 and P < 0.01, respectively). Group-3 showed better remineralization than Groups 1, 2 and 5; however, the difference was only significant with Group-5 (P < 0.001). There were no significant differences between Group 1and 2, however, only Group 2 showed better remineralization than Group 5, (P < 0.01).ConclusionCombined treatment with CPP-ACP followed by fluoride exhibited the best remineralization of white spot lesions in primary teeth in this study. Combined treatment with fluoride followed by CPP-ACP showed a tendency towards better remineralization than fluoride or CPP-ACP alone. |
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| Keywords: | Fluoride(s) Enamel White spot lesions CPP-ACP Primary teeth |
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