The aim of this study was to assess the remineralization of enamel caries lesions using the self-assembling peptide P 11 -4 associated with different materials. Artificial early enamel lesions were prepared on 154 primary teeth. The samples were randomly divided into eight groups: (1) control, (2) P 11 -4, (3) fluoridate toothpaste (FT), (4) P 11 -4 + FT, (5) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), ( 6) P 11 -4 + CPP-ACP, (7) fluoridate bioactive glass toothpaste (BT), and (8) P 11 -4 + BT. The surface enamel microhardness (EMH) and energy-dispersive Xray spectroscopy (EDS) of the teeth were then measured at the baseline, after demineralization, and after 28 days of remineralization. The enamel surfaces were assessed by field emission scanning electron microscopy (FESEM) and atomic force microscopy (AFM). The data were analyzed with one-way analysis of variance (ANOVA) (p < .05).EMH after demineralization was significantly lower than the baseline value (p < .001).The interventions led to an enhanced percentage of EMH recovery (%REMH), which was higher in Groups 6 and 7. There was no significant difference between Groups 3 and 4. Groups 1 and 2 had the lowest %REMH. The mean calcium/phosphate weight percentage ratio of P 11 -4 was significantly lower than the others (p < .001).The FESEM and AFM images revealed mineral deposition on the eroded enamel and reductions in surface roughness in Groups 5 and 7.

No abstract

Introduction: Management of dental caries during early stages is considered a clinical problem in young children. Objectives:The current in-vitro study assessed the influence of four home oral care products on re-mineralization of early caries lesions using enamel micro-hardness (EMH) test and morphological changes with scanning electron microscopy (SEM). Material and methods: Sixty primary canine teeth were selected and randomly divided into 5 groups (n = 12 in each group). Samples were de-mineralized, and toothpaste slurries were prepared to treat de-mineralized enamel with a pH-cycling model. The groups were divided as follows: Group 1. Control (no intervention); Group 2. Fluo ridated toothpaste; Group 3. Tooth mousse containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); Group 4. Toothpaste containing bio-active glass and fluoride; Group 5. Tooth cream containing nano-hydroxyapatite, fluoride, and xylitol. EMH was evaluated in fifty specimens (each group, n = 10) at three times: before and after de-mineralization, and after 28 days of pH-cycling and treatment. Two samples from each group were observed with SEM. Data were analyzed with multiple-sample repeated measures ANOVA and Tukey's HSD post-hoc tests (p < 0.05). Results: There was a significant difference in EMH between mean baseline values and de-mineralized enamel (p < 0.001). Re-mineralization significantly increased EMH in all treatment groups (p < 0.001). In group 5, the percent of EMH recovery was significantly greater than in other groups (p < 0.001). There were significant differences among the other three treatment groups (all p < 0.001). SEM images showed minerals deposited on the dissolved prismatic enamel in all groups. Conclusions: The nano-hydroxyapatite-based tooth cream was the most effective home oral care product for re-mineralization of primary tooth enamel.