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VOLUME 16 , ISSUE S1 ( August, 2023 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study

Samarpreet Kaur

Keywords : Casein phosphopeptide-amorphous calcium phosphate, Fluoride varnish, In vitro study, Remineralizing agents, Remineralizing efficacy, Silver diamine fluoride, Surface microhardness

Citation Information :

DOI: 10.5005/jp-journals-10005-2622

License: CC BY-NC 4.0

Published Online: 29-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives: The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods: A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results: The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion: Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth.

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  1. Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet 2007;369(9555):51–59. DOI: 10.1016/S0140-6736(07)60031-2
  2. Usha C, R S. Dental caries – a complete changeover (part I). J Conserv Dent 2009;12(2):48–54. DOI: 10.4103/0972-0707.55617
  3. Featherstone JD. Dental caries: a dynamic disease process. Aust Dent J 2008;53(3):286–291. DOI: 10.1111/j.1834-7819.2008.00064.x
  4. Chu CH, Lo EC. A review of sodium fluoride varnish. Gen Dent 2006;54(4):247–253.
  5. De Bryun H, Buskes H. Caries preventive effectiveness of Fluor Protector and fluoride lacquer, Duraphat under very cariogenic conditions. OralProphylaxe 1988;10(2):61–67. PMID: 3273780.
  6. Reynolds EC, Cai F, Cochrane NJ, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res 2008;87(4):344–348. DOI: 10.1177/154405910808700420
  7. Goswami M, Saha S, Chaitra TR. Latest developments in non-fluoridated remineralizing technologies. J Indian Soc Pedod Prev Dent 2012;30(1):2–6. DOI: 10.4103/0970-4388.95561. PMID: 22565510
  8. Indrapriyadharshini K, Madan Kumar PD, Sharma K, et al. Remineralizing potential of CPP-ACP in white spot lesions – a systemic review. Indian J Dent Res 2018;29(4):487–496. DOI: 10.4103/ijdr.IJDR_364_17
  9. Duraisamy V, Xavier A, Nayak UA, et al. An in vitro evaluation of the demineralization inhibitory effect of F−varnish and casein phosphopeptide-amorphous calcium phosphate on enamel in young permanent teeth. J Pharm Bioallied Sci 2015;7(suppl 2):S513–S517. DOI: 10.4103/0975-7406.163521
  10. Kargul B, Altinok B, Welbury R. The effect of casein phosphopeptide-amorphous calcium phosphate on enamel surface rehardening. An in vitro study. Eur J Paediatr. Dent 2012;13(2):123–127. PMID: 22762174.
  11. Attiguppe P, Malik N, Ballal S, et al. CPP-ACP and fluoride: a synergism to combat caries. Int J Clin Pediatr Dent 2019;12(2):120–125. DOI: 10.5005/jp-journals-10005-1608
  12. Shah S, Bhaskar V, Venkatraghavan K, et al. Silver diamine fluoride: a review and current applications. J Adv Oral Res 2014;5(1):25–35. DOI: https://doi.org/10.1177/2229411220140106
  13. Rosenblatt A, Stamford TC, Niederman R. silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res 2009;88(2):116–125. DOI: 10.1177/0022034508329406
  14. Chu CH, Mei L, Seneviratne CJ, et al. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent 2012;22:2–10. DOI: https://doi.org/10.1111/j.1365-263X.2011.01149.x
  15. Horst JA, Ellenikiotis H, Milgrom PL. UCSF Protocol for caries arrest using silver Diamine fluoride: rationale, indications and consent. J Calif Dent Assoc 2016;44(1):16–28. PMID: 26897901.
  16. Wang LJ, Tang R, Bonstein T, et al. Enamel demineralization in primary and permanent teeth. J Dent Res 2006;85(4):359–363. DOI: 10.1177/154405910608500415
  17. Hicks J, Wild T, Flaitz CM, et al. Fluoride varnishes and caries development in primary tooth enamel: an in vitro study. ASDC J Dent Child 2001;68(5–6):304–310, 300. PMID: 11985188.
  18. Vieira AE, Delbem AC, Sassaki KT, et al. Fluoride dose response in pH-cycling models using bovine enamel. Caries Res 2005;39(6):514–520. DOI: 10.1159/000088189
  19. Bandekar S, Patil S, Dudulwar D, et al. Remineralization potential of fluoride, amorphous calcium phosphate-casein phosphopeptide, and combination of hydroxyapatite and fluoride on enamel lesions: an in vitro comparative evaluation. J Conserv Dent 2019;22(3):305–309. DOI: 10.4103/JCD.JCD_13_19
  20. Chuenarrom C, Benjakul P, Daosodsai P. Effect of indentation load and time on vickers microhardness tests for enamel and dentin. Mater Res 2019;12(4):473–476. DOI: https://doi.org/10.1590/S1516-14392009000400016
  21. Babu KLG, Subramaniam P, Teleti S. Effect of varnish containing casein phosphopeptide-amorphous calcium phosphate and fluoride on surface microhardness of enamel – An in vitro study. Saudi J Oral Sci 2019;7(1):29–34. DOI: 10.4103/sjos.SJOralSci_43_19
  22. Gutierrez-Salazar M, Reyes-Gasga J. Microhardness and chemical composition of human tooth. Mater Res 2003;6(3):367–373. DOI: 10.1590/S1516-14392003000300011
  23. Buzalaf MA, Hannas AR, Magalhães AC, et al. pH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations. J Appl Oral Sci 2010;18(4):316–334. DOI: 10.1590/s1678-77572010000400002
  24. Krishnan G, George S, Anandaraj S, et al. Efficacy of four remineralizing agents on primary teeth: in vitro evaluation using microhardness testing and quantitative light-induced fluorescence. Pediatr Dent 2017;39(3):233–237. PMID: 28583249.
  25. Mohammadi N, Farahmand Far MH. Effect of fluoridated varnish and silver diamine fluoride on enamel demineralization resistance in primary dentition. J Indian Soc Pedod Prev Dent 2018;36(3)257–261. DOI: 10.4103/JISPPD.JISPPD_4_18
  26. Delbem AC, Bergamaschi M, Sassaki KT, et al. Effect of fluoridated varnish and silver diamine fluoride solution on enamel demineralization: pH-cycling study. J Appl Oral Sci 2006;14(2):88–92. DOI: 10.1590/s1678-77572006000200005
  27. Argenta RM, Tabchoury CP, Cury JA. A modified pH-cycling model to evaluate fluoride effect on enamel demineralization. Pesqui Odontol Bras 2003;17(3):241–246. DOI: 10.1590/s1517-74912003000300008
  28. Featherstone JD, Ten cate JM, Shariati M, et al. Comparison of artificial caries-like lesions by quantitative microradiography and microhardness profiles. Caries Res 1983;17(5):385–391. DOI: 10.1159/000260692
  29. White DJ. Reactivity of fluoride dentifrices with artificial caries. I. Effects on early lesions: F uptake, surface hardening and remineralization. Caries Res 1987;21(2):126–140. DOI: 10.1159/000261013
  30. Oliveira BH, Salazar M, Carvalho DM, et al. Biannual fluoride varnish applications and caries incidence in preschoolers: a 24-month follow-up randomized placebo-controlled clinical trial. Caries Res 2014;48(3):228–236. DOI: 10.1159/000356863
  31. Mei ML, Lo ECM, Chu CH. Arresting dentine caries with silver diamine fluoride: what's behind it? J Dent Res 2018;97(7):751–758. DOI: 10.1177/0022034518774783
  32. Liu BY, Lo EC, Chu CH, et al. Randomized trial on fluorides and sealants for fissure caries prevention. J Dent Res 2012;91(8):753–758. DOI: 10.1177/0022034512452278
  33. Llorda JC, Rodriguez A, Ferrer B, et al. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of school children: 36-month clinical trial. J Dent Res 2005;84(8):721–724. DOI: 10.1177/154405910508400807
  34. Mortimer KV. The relationship of deciduous enamel structure to dental disease. Caries Res 1970;4(3):206–223. DOI: 10.1159/000259643
  35. Braga MM, Mendes FM, De Benedetto MS, et al. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. ASDC J Dent Child 2009;76(1):28–33. PMID: 19341576.
  36. Bailey DL, Adams GG, Tsao CE, et al. Regression of Post-orthodontic Lesions by a Remineralizing Cream. J Dent Res 2009;88(12):1148–1153. DOI: 10.1177/0022034509347168
  37. Rezvani MB, Karimi M, Rasoolzade R, et al. Comparing the effects of whey extract and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on enamel microhardness. J Dent (Shiraz) 2015;16(1):49–53. PMID: 25759858.
  38. Lewis C. Fluoride and dental caries prevention in children. Pediatr Rev 2014;35(1):3–15. DOI: 10.1542/pir.35-1-3
  39. Brunn C, Bille J, Hansen KT, et al. Three-year caries increments after fluoride rinses or topical applications with a fluoride varnish. Community Dent Oral Epidemiol 1985;13(6):299–303. DOI: 10.1111/j.1600-0528.1985.tb00460.x
  40. Axelsson P, Paulander J, Nordkvist K, et al. Effect of fluoride containing dentifrice, mouthrinsing, and varnish on approximal dental caries in a 3-year clinical trial. Community Dent Oral Epidemiol 1987;15(4):177–180. DOI: 10.1111/j.1600-0528.1987.tb00513.x
  41. Nanci A 2018, Ten Cate's oral histology: development, structure and function,. Elsevier, St. Louis.
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