Effect of application sequence of fluoride and CPP-ACP on remineralization of white spot lesions in primary teeth: An in-vitro study. 2017

Ola B Al-Batayneh, and Reem A Jbarat, and Susan N Al-Khateeb
Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan. Electronic address: olabt@just.edu.jo.

OBJECTIVE To 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. METHODS In 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; 500ppm 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). RESULTS Remineralization 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). CONCLUSIONS Combined 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.

UI MeSH Term Description Entries
D002327 Cariostatic Agents Substances that inhibit or arrest DENTAL CARIES formation. (Boucher's Clinical Dental Terminology, 4th ed) Cariostatic Effect,Cariostatic Effects,Agent, Cariostatic,Agents, Cariostatic,Cariostatic Agent,Effect, Cariostatic,Effects, Cariostatic
D002364 Caseins A mixture of related phosphoproteins occurring in milk and cheese. The group is characterized as one of the most nutritive milk proteins, containing all of the common amino acids and rich in the essential ones. alpha-Casein,gamma-Casein,AD beta-Casein,Acetylated, Dephosphorylated beta-Casein,Casein,Casein A,K-Casein,Sodium Caseinate,alpha(S1)-Casein,alpha(S1)-Casein A,alpha(S1)-Casein B,alpha(S1)-Casein C,alpha(S2)-Casein,alpha-Caseins,beta-Casein,beta-Caseins,epsilon-Casein,gamma-Caseins,kappa-Casein,kappa-Caseins,AD beta Casein,Caseinate, Sodium,K Casein,alpha Casein,alpha Caseins,beta Casein,beta Caseins,beta-Casein Acetylated, Dephosphorylated,beta-Casein, AD,epsilon Casein,gamma Casein,gamma Caseins,kappa Casein,kappa Caseins
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005453 Fluorescence The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis.
D005459 Fluorides Inorganic salts of hydrofluoric acid, HF, in which the fluorine atom is in the -1 oxidation state. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Sodium and stannous salts are commonly used in dentifrices. Fluoride
D014089 Tooth Remineralization Therapeutic technique for replacement of minerals in partially decalcified teeth. Remineralization, Tooth
D014094 Tooth, Deciduous The teeth of the first dentition, which are shed and replaced by the permanent teeth. Primary Tooth,Tooth, Primary,Baby Teeth,Baby Tooth,Dentition, Deciduous,Dentition, Primary,Milk Teeth,Milk Tooth,Primary Teeth,Teeth, Deciduous,Teeth, Primary,Deciduous Dentition,Deciduous Dentitions,Deciduous Teeth,Deciduous Tooth,Dentitions, Deciduous,Dentitions, Primary,Primary Dentition,Primary Dentitions,Teeth, Baby,Teeth, Milk,Tooth, Baby,Tooth, Milk
D066298 In Vitro Techniques Methods to study reactions or processes taking place in an artificial environment outside the living organism. In Vitro Test,In Vitro Testing,In Vitro Tests,In Vitro as Topic,In Vitro,In Vitro Technique,In Vitro Testings,Technique, In Vitro,Techniques, In Vitro,Test, In Vitro,Testing, In Vitro,Testings, In Vitro,Tests, In Vitro,Vitro Testing, In

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