International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 13 , ISSUE S1 ( Supplement, 2020 ) > List of Articles

Original Article

Evaluation and Comparison of Self-applied Remineralizing Agents Using Confocal Microscopy: An In Vitro Study

Tarun Goel, Anubhuti Singhal, Indu Singh, Pranav K Singh, Ganiga Channaiah Shivakumar

Keywords : Confocal microscopy, Nanohydroxyapatite, Self-applied remineralizing agents

Citation Information :

DOI: 10.5005/jp-journals-10005-1863

License: CC BY-NC 4.0

Published Online: 00-00-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Aim and objective: The study was conducted to assess and compare the remineralization ability of fluoride varnish, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF), bioactive glass-ceramic, and nanohydroxyapatite crystals using a confocal microscope. Materials and methods: Eighty premolars and 80 deciduous central incisors were included in this study. Two windows of approximately 3 × 3 mm were created on the labial surface of the premolars and 2 × 2 mm on deciduous maxillary incisors. Artificial caries like lesions was created by demineralizing the sample windows. The teeth sections were then randomly assigned into four groups (n = 20). Specimens of the first group were once painted with fluoride varnish, while those in CPP-ACPF, bioactive glass-ceramic, and nanohydroxyapatite were brushed twice daily for 2 minutes each for 40 days, respectively. 150–200 μm longitudinal sections were obtained and were photographed under a confocal laser scanning microscope. They were quantified using a computerized imaging system for demineralization and later for remineralization. The recorded values were tabulated and analyzed using Fisher\'s test, analysis of variance (ANOVA), and post hoc Bonferroni\'s test. Results: All the materials used in the study showed remineralization potential at the end of 40 days in both permanent and deciduous teeth. The highest remineralization potential was observed in the fluoride varnish group followed by bioactive glass, CPP-ACFP, and nanohydroxyapatite in both permanent and deciduous teeth. In permanent teeth, the difference in the remineralization potential of fluoride varnish and bioactive glass was not statistically significant. Conclusion: The present study showed that self-applied bioactive glass has similar remineralization potential to fluoride varnish in permanent teeth. Therefore, bioactive glass can be used for the management of incipient caries lesions daily.

PDF Share
  1. Anh VTMy. An enhanced in vitro model to study the effectiveness of dentinal fluid on remineralization. Oral Dis 2008;10:249–257.
  2. Cochrane NJ, Cai F, Hug NL, et al. New approaches to enhanced remineralization of tooth enamel. J Dent Res 2010;89(11):1187–1197. DOI: 10.1177/0022034510376046.
  3. Shashikala K, Sheela NV. Qualitative analysis of re mineralized carious lesions subjected to fluoride supplement through confocal laser scanning microscope. Open J Stomatol 2011;1(03):55–60. DOI: 10.4236/ojst.2011.13010.
  4. Chadd O, Hazzelrig, Dean JA, et al. Fluoride varnish concentration gradient and its effects on enamel demineralization. Pediatr Dent 2003;25:119–126.
  5. Petersson LG. On topical application of fluorides and its inhibiting effect on caries. Odontol Revy Suppl 1975;34:1–36.
  6. Azarpazhooh A, Limeback H. Clinical efficacy of casein derivatives: a systematic review of the literature. J Am Dent Assoc 2008;139(7):915–924. DOI: 10.14219/jada.archive.2008.0278.
  7. Burwell AK, Likwoski LJ. Calcium sodium phosphosilicate (Novamin): remineralization potential. ADR 2009;21(1):35–39. DOI: 10.1177/0895937409335621.
  8. Huang SB, Gao SS, Yu HY. Effect of nano-hydroxyapatite concentration on remineralization of initial enamel lesion in vitro. Biomed Mater 2009;4(3):034104. DOI: 10.1088/1748-6041/4/3/034104.
  9. Tschoppe P, Zandim DL, Martus P. Enamel and dentin remineralization by nano-hydroxyapatite toothpastes. J Dentis 2011;39(6):430–437. DOI: 10.1016/j.jdent.2011.03.008.
  10. Sabel N, Robertson A, Nietzsche S, et al. Demineralization of enamel in primary second molars related to properties of the enamel. Scienti World J 2012;2012:587254. DOI: 10.1100/2012/587254.
  11. Agarwal N, Shashikiran ND, Singla S, et al. Atomic force microscopic comparison of remineraliztion with casein phosphopeptide amorphous calcium phosphate, acidulated phosphate fluoride gel and iron supplement in primary and permanent teeth: an invitro study. Contemp Clin Dent 2014;5(1):75–80. DOI: 10.4103/0976-237X.128672.
  12. Mendis FM, Braga MM. Caries detection in primary teeth is less challenging than permanent teeth. Dent Hypothesis 2013;4(1):17–20. DOI: 10.4103/2155-8213.110185.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.