Biocompability profile of different remineralization agents

Aims and Objectives:The aim of this study was to compare the in vitro efficacy of different remineralization (RM) agents on RM of artificial caries by evaluating the density, light reflection, and the crystal size of the newly formed mineral in primary and permanent teeth.Materials and Methods:Caries-free primary and permanent molars were divided into seven groups (n = 20) and treated with: G1 – Deionized water, G2 – Colgate Cavity Protection, G3 – Sensodyne Rapid Relief, G4 – GC MI Paste Plus, G5 – Clinpro Tooth Creme, G6 – Clinpro 5000, and G7 – Sensodyne Repair and Protect. Lesion depths were evaluated using laser fluorescence (DIAGNOdent), and polarized light microscopy (PLM), and the minerals were evaluated using X-ray diffractometry (XRD).Results:The highest decrease in laser fluorescence readings was observed in G6 for both primary and permanent teeth. No significant difference was observed between G2, G4, G5, and G6 in permanent teeth and G4 and G6 in primary teeth (P > 0.05). In PLM analyses, lesions depths were found to be lower in G6 compared to the other groups. No significant difference was observed between G2, G4, and G6 (P < 0.05). XRD evaluation showed that the newly formed mineral in G6 was denser and highly crystallized compared to the other groups.Conclusion:This in vitro study demonstrated that Clinpro 5000 is more efficient in remineralizing incipient enamel lesions compared to the other agents tested.

BACKGROUND AND AIM: The first clinical symptom of tooth decay is the appearance of a white spot lesion (WSL) on the tooth surface. This study is performed with the aim to evaluate the efficacy of six different remineralization agents in vitro with the DIAGNOdent laser fluorescence method. METHODS: In this study, 44 extracted, impacted human wisdom teeth (88 specimens) without caries were used to obtain standard demineralized enamel surfaces. The teeth were divided into eight groups consisting of two control (positive and negative) and six experimental groups [Fluoride (F) gel, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) cream, CPPACP + F cream, NovaMin + F toothpaste, Xylitol-Hydroxyapatite + F cream, and Ozone + F]. De-/re-mineralization solutions were applied with a pH-cycle approach to areas of 3 × 3 mm on the buccal/lingual surfaces of the teeth for 9 days. The remineralization agents were applied to the demineralized areas and the samples were then kept in artificial saliva. The DIAGNOdent measurements were performed before and after the application of the remineralization agents. The Wilcoxon and Kruskal-Wallis tests were used for analysis of the data. RESULTS: The mean scores obtained after the DIAGNOdent measurements were 3.82 and 6.91 in the negative-control and positive-control groups, respectively. There were significant differences in the scores before and after the remineralization procedure in all experimental groups (P < 0.050). When the mean differences before and after treatment were compared between the groups, CPP-ACP + F provided significantly more remineralization than other experimental groups (P < 0.050). CONCLUSION: Remineralization of demineralized areas was achieved in all experimental groups. The highest degree of remineralization according to the DIAGNOdent scores before and after the procedure was observed in the CPP-ACP + F group.

ObjectiveThe aim of this study was to evaluate the effect of different remineralization agents-Proshield Fluoride Varnish (FV), GC MI Varnish (MI), and ROCS Medical Mineral Gel (ROCS MMG)-on the shear bond strength (SBS) of orthodontic brackets after application at various time intervals.MethodsA total of 120 human premolar teeth were divided into 10 groups (n = 12). The experimental groups received different remineralization agents (FV, MI, ROCS MMG) at time intervals of 1, 15, and 30 days, while the control group received no application. The enamel surfaces were etched, and metal orthodontic brackets were bonded using a light-cured composite adhesive. SBS was measured using a universal testing machine, and adhesive remnant index (ARI) scores were assessed after bracket debonding.ResultsNo statistically significant differences were observed in SBS among all experimental groups and the control group (P = 0.307). SBS values for the FV, MI, and ROCS MMG groups did not differ significantly at the 1, 15, or 30-day intervals. ARI scores also showed no significant differences between groups (P = 0.370).ConclusionThe application of Proshield Fluoride Varnish, GC MI Varnish, and ROCS Medical Mineral Gel at different time intervals did not affect the shear bond strength of orthodontic brackets. These remineralization agents can be safely used to prevent white spot lesions and caries before orthodontic treatment at time intervals of 1, 15, and 30 days without compromising bond strength.Clinical relevanceProshield FV, GC MI Varnish, and ROCS MMG safely prevent white spot lesions and caries without affecting bracket bond strength.

Objective: The purpose of this study is to evaluate the remineralization potential of the self-assembling peptideP11-4 (Curodont repair) versus highly concentrated fluoride agent (Enamelast) after single & double applications (Atomic Force Microscopy study) and to evaluate the clinical efficacy of both agents in patients with early carious lesions. Materials and methods: Twenty children ranging from 10-16 years of age were selected with at least 2 white lesions (WSL) detected clinically on the buccal surface of permanent anterior teeth, one on each side. Patients were randomly assignedinto 2 groups according to the re-mineralizing agent applied. A1: 20 WSL re-mineralized with Curodont. A2: 20 WSL re-mineralized with Fluoride varnish. Each group was further subdivided into 2 subgroups according to the number of applications with (A1B1):10 WSL treated with Curodont single application, (A1B2): 10 WSL treated with Curodont double applications, (A2B1): 10 WSL treated with fluoride single application and (A2B2): 10 WSL treated with fluoride double applications. Also this study was carried on 40 freshly extracted young upper or lower premolars. Teeth were extracted from patients ranging from 14 to 20 years, for orthodontic purpose. Forty enamel samples were prepared from teeth and then examined before and after demineralization and after remineralization with Atomic Force Microscopy (AFM). Results: Both remineralizing agents showed decrease in enamel average roughness after remineralization, howevergroup (A1: Curodont) showed the lowest results. Both groups show gradual decrease in the International Caries Detection Assessment System scores (ICDAS) from the base line to reach the lowest level after 6 months. The best results of ICDAS scores were recorded in subgroup (A1B2: Curodont double application). Both subgroups of curodont repair revealed an extremely significant higher percent increase of radiodensity percentage in comparison to fluoride subgroups. No significant difference between the 2 remineralizaing agents on the pH of saliva. Conclusion: Self-assembling peptides(Curodont repair) was successful as a remineralizing agent in young permanent teeth with white spot lesions.

This study evaluated the efficacy of grape seed extract (GSE) on the remineralization of primary tooth enamel alone or in combination with remineralizing agents. The initial microhardness value of 90 primary tooth enamel samples was calculated; then, the samples were demineralized. The post-demineralization hardness of the samples was measured and the samples were randomly divided into 6 groups as follows: G1: negative control, G2: GSE, G3: NaF, G4:Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), G5: GSE+NaF, and G6: GSE+CPP-ACP (n=15). Oral environment pH cycle was applied and hardness measurements were repeated after treatments. The samples were stained with 1% rhodamine B dye and sectioned, and the lesion depth was measured. Statistical significance was set at P<0.05. The hardness decrease of the GSE and GSE+NaF groups was less than the other groups (P<0.05). The decrease was also less in the other groups than in the control group (P>0.05). GSE showed a positive effect when combined with NaF in maintaining microhardness but did not show the same effect when combined with CPP-ACP (P<0.05). Concerning penetration depth, all the groups had statistically lower values than the control group (P<0.05). The lowest penetration rates were observed in the GSE+NaF and GSE+CPP-ACP groups (P<0.05). The lowest hardness decrease was observed in the GSE and GSE+NaF groups, and the lowest penetration rates were observed in the GSE+NaF and GSE+CPP-ACP groups. It has been determined that a 15% GSE solution might be used as an alternative to fluoride in primary tooth remineralization and can increase the effectiveness of fluoride when used together.

Background: With rising demand for esthetic restorations, shade matching in dentistry blends art and scienceaffected by several external factors. While visual shade selection with a guide remains common for its simplicity, newer technologies like spectrophotometers and digital photography offer more objective, detailed color measurement and improved communication. Aim: The Aim of the study is to compare and evaluate the remineralizing ability of five different remineralizing agents on artificially created white spot lesions. Materials and Methods: Fifty maxillary premolars extracted for orthodontic purposes were taken for the study. Teeth are cleaned using ultrasonics and stored in 0.1 % thymol solution. 4 × 4 mm label placed on buccal surface of the crown. Remaining portion of tooth was painted with nail varnish. The samples were subjected to a demineralizing solution (0.264 gm of monosodium phosphate,0.244 gm of calcium chloride, 2.86 ml of acetic acid in 1l of deionised water) for 4 days to create an artificial white spot lesion. The samples are divided into 5 groups based on the remineralizing agent used. Group I : CPP-ACP; group 2: egg shell solution; group 3: red marine algae; group 4: bioactive glass nanoparticle solution; group 5: acclaim toothpaste. All the samples are sectioned to obtain the buccal cusp containing the experiment window and the EDAX analysis performed to obtain the ca, p and F values. The samples will be immersed in respective remineralising agents for 5 minutes, twice daily for a period of 6days and subjected to EDAX to obtain the ca p and f values after remineralization. The Ca, P and F values obtained after demineralization and remineralization will be compared. Results: Bioactive glass nanoparticle solution showed higher amount of remineralization compared to all the other study groups. The Ca, P and F values indicates the remineralization potential of all the study groups. Conclusion: Within the limits; the present study concluded that the Ca, P and F values of Bioactive glass nanoparticle solution have been increased significantly followed by Acclaim tooth paste, CPP ACP, Red marine algae and Egg shell solution

Aims and Objectives This in-vitro study aims to evaluate and compare the effects of remineralizing mouthwashes based on inorganic fluoride, organic fluoride, or zinc hydroxyapatite on the mechanical properties (yield strength (YS) and modulus of elasticity (ME)) of NiTi and CuNiTi archwires under loading and unloading. Materials and Methods A total of 200 samples of 0.016 × 0.022 NiTi and CuNiTi archwires were divided into four groups ( n = 50 per group) and immersed in 5 mL of different remineralization agents. The samples were incubated at 37°C for 1.5 h, then rinsed and tested using a universal testing machine. A three-point bending test was conducted to determine the YS and ME of the wires. Results Tukey’s post hoc test and one-way ANOVA were used to analyze differences between groups. The results showed that for NiTi wires, only the inorganic fluoridated mouthwash (Phos-Flur) significantly affected mechanical properties during loading. During unloading, both inorganic (Phos-Flur) and organic fluoridated (Amflor) mouthwashes had a significant effect. For CuNiTi wires, only the inorganic fluoridated mouthwash (Phos-Flur) showed a significant effect during unloading. The non-fluoridated zinc hydroxyapatite mouthwash did not affect either NiTi or CuNiTi wires during loading or unloading. Conclusion Non-fluoridated remineralizing zinc hydroxyapatite mouthwash did not affect the loading and unloading mechanical properties of both NiTi and CuNiTi wires when compared with fluoridated mouthwashes. Zinc hydroxyapatite-based mouthwashes may serve as a safer alternative without compromising remineralization effectiveness.

Comparative assessment of 638-nm Diode laser photobiomodulation against chemical remineralizing agents for primary caries-affected dentin: Mechanistic investigation of photothermal effects on bonding substrate quality.

Peer Review Report For: Efficacy of different remineralization agents on microhardness and chemical composition of enamel white spot lesion [version 1; peer review: 2 approved

Peer Review Report For: Efficacy of different remineralization agents on microhardness and chemical composition of enamel white spot lesion [version 1; peer review: 2 approved

In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS2) (Code3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5%NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.

Hydroxyapatite is an inorganic material that is commonly used as a re-mineralizing agent. Adding natural ingredients such as green betel leaf can increase the antibacterial properties due to the presence of phenolic compounds, flavonoids, and tannins. This study aims to determine the physical and chemical characteristics of the formulation of hydroxyapatite-betel leaf extract and the antibacterial activity against Streptococcus mutans. To characterize the combination of hydroxyapatite-betel leaf extract, XRD, PSA and FTIR analyses were performed. Particle size analysis showed the smallest results in the variation of betel 0.3 g, which is 690.08 nm. FTIR characterization showed the presence of OH, PO43− and CO32− functional groups from hydroxyapatite and C=O derived from betel leaf extract. In addition, in vitro and in vivo analyses were performed to assess the antibacterial activity of this formulation. The in vitro antibacterial activity test against S. mutans showed strong inhibitory activity. Our finding suggests that the formulation has the potential to be used as a medication or prevention agent for dental caries.

Objectives : The aim of this investigation was to evaluate the remineralization effect of Bamboo salt and NaF+Bamboo salt solutions on bovine enamel formed incipient artificial enamel caries by microcomputed tomography (micro CT). Methods : Experimental solutions were distilled water(negative control), 2% sodium fluoride solution (2% NaF group), 3% bamboo salt solution (3% BS group) and the solution mixed 2% sodium fluoride solution and 3% bamboo salt solution (2% NaF+3% BS group). Specimens were prepared from extracted bovine teeth and divided into 4 groups of 10 specimens each by randomized blocks according to density. Then the specimens surface were divided equally into three parts to observe sound enamel area, incipient enamel carious area and remineralized enamel area. Only one-third of specimen surface was coated with nail varnish and these were exposed to a lactate carbopol buffer system for 72 hours. Then one-half of the demineralized enamel area was coated with nail varnish. The specimens were carried out under pH cycling model for 14 days as follows; samples were immersed in each experimental solution for 2 mins 3 times per day, demineralized for 4 hours and in mixed saliva for the remaining hours. After pH cycling, density was measured using micro CT. Results : All experimental groups showed remineralization effects except for negative control group(p<0.05). The differences of density after experimental solution treatment were statistically significant difference among 4 groups (p<0.01). The density difference values of groups were <TEX>$0.04{\pm}0.01$</TEX> in negative control group, <TEX>$0.19{\pm}0.01$</TEX> in 2% NaF group, <TEX>$0.14{\pm}0.01$</TEX> in 3% BS group, and <TEX>$0.21{\pm}0.01$</TEX> in 2% NaF+3% BS group. Conclusions : The bamboo salt solution showed remineralization effects on incipient artificial enamel caries and the solution mixed sodium fluoride solution and bamboo salt solution showed more remineralization effects than the bamboo salt solution. Thus, it is suggested that bamboo salt can be used as remineralization agent in incipient enamel caries lesion.

This study aims to compare the use of different remineralization agents before in-office bleaching for decreasing bleaching induced sensitivity. A total of 64 volunteers were randomly divided into four groups. Before undergoing in-office bleaching with 38% hydrogen peroxide gel (three applications of 15min each, one session), clinicians applied a placebo gel (control group), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), neutral sodium fluoride gel (NSF) or nano-hydroxyapatite solution (n-HAP) on all buccal surfaces of teeth. The gel was left undisturbed for 4min. The efficacy of tooth whitening was assessed by determining the colour change using SGU. Patients recorded their tooth sensitivities on the VAS scale. Kruskal-Wallis test followed by Mann-Whitney U test was used to compare changes in tooth colour and intensity of tooth sensitivity between groups. Overall, there was no significant difference in shade change between the groups. Control and CPP-ACP groups showed significantly higher rates of hypersensitivity than NSF and the n-HAP group (p<0.05). The use of a remineralization agent (n-HAP/NSF) before in-office bleaching did not affect the bleaching efficacy but did reduce tooth sensitivity. The before bleaching treatment use of an n-HAP solution can be suitable for reducing bleaching born sensitivity as well as commonly used NSF remineralizing gel before in-office tooth bleaching can reduce tooth sensitivity, the most common side effect associated with this procedure.

Fluoride-containing bleaching gels have better whitening potential than gels not containing fluoride [6] and can accelerate the hardness of the bleached