Color Changes of Post-Debonding White Spot Lesion After Microabrasion Technique With Fluoride and Casein Phosphopeptide-Amorphous Calcium Phosphate Application

Abstract

Objective: The prevalence of enamel demineralization among patients after orthodontic treatment is about 50%, which begins with the formation of white spot lesions. The presence of these lesions causes esthetic problems. The aim of this study was to quantify the color changes in post-debonding white spot lesions after microabrasion technique with fluoride and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application. Materials and Methods:This study used 42 first premolar teeth that had been extracted, then were soaked for 96 h in a demineralization solution (pH 4, 37°C) to form an artificial white spot lesions. Samples were randomly divided into three treatment groups (n=14): (A) Microabrasion technique only; (B) microabrasion technique with 10% CPP-ACP paste application; and (C) microabrasion technique with 1.23% APF gel application. All groups were assigned to pH cycling for 10 days. The color change was determined using spectrophotometer at 3 different time points, which were measured before and after production of the artificial white spot lesions, and after the artificial white spot lesions were treated. Results:This study showed that there was a significant difference in the color of the artificial white spot lesions after microabrasion technique with CPP-ACP application. Conclusion:Microabrasion technique with CPP-ACP application was giving better result in changing the color of white spot lesions than only microabrasion technique and microabrasion technique with fluoride application.

Casein phosphopeptide amorphous calcium phosphate and universal adhesive resin as a complementary approach for management of white spot lesions: an in-vitro study

“…This is consistent with the finding by Anggani et al, which concluded that CPP-ACP application enhanced the esthetic of white spot lesions because of CPP-ACP's ability to fill the subsurface enamel pores. This supporting study applied CPP-ACP once/a day for 14 days [29]. Alternatively, our finding is in disagreement with a different study that stated the inability of CPP-ACP application to enhance the esthetic of post-debonding white spot lesions and correlated that to the short duration of CPP-ACP application, which was only once with follow-up after 6 weeks [30].…”

Strategies and Challenges in the Treatment of Dental Enamel

“…Several studies have been done on fluoride's effect on enamel remineralization (Table 1). Tooth decay that begins with a white spot lesion can be controlled with fluoride therapy (FT) [Anggani et al, 2021]. Fluoride can increase the strength of tooth enamel and prevent the acidic solubility of enamel and dentin.…”

Clareamento como complementação ao tratamento de lesões de cárie incipientes por meio de remineralização potencializada por fluoreto ou infiltração resinosa: avaliação da cor e da rugosidade superficial do esmalte bovino

“…Dentre os tratamentos para as LMB, tem-se disponíveis aqueles não invasivos, ou seja, que não resultam em remoção de estrutura dentária, tais quais aqueles remineralizadores (Schwendicke et al, 2019). Os mais comuns são a aplicação profissional de fluoreto em concentrações mais altas que as encontradas nos dentifrícios e bochechos de uso caseiro, seja ele na forma de gel, verniz ou espuma, que, independentemente da forma, irá potencializar o processo de remineralização (Knösel et al, 2007;Fernández-Ferrer et al, 2018;Dai et al, 2019;Anggani et al, 2021); e ainda, tem-se disponível o Fosfopeptídeo de Caseína com Fosfato de Cálcio Amorfo (CPP-ACP), no qual o paciente realiza autoaplicação, guiada pelo cirurgião-dentista. O CPP-ACP corresponde a um agente bioativo derivado do leite, que funciona como uma reserva de cálcio e fosfato, deixando o meio supersaturado diante uma queda de pH.…”

“…Por fim, considera-se que os tratamentos remineralizadores apresentados são capazes de remineralizar as LMB, contudo, não há evidência suficiente que mostre sua efetividade na melhoria estética (Anggani et al, 2021), sendo ainda, a literatura controversa em relação ao melhor tipo de tratamento remineralizador (Abdullah;John, 2016). Ademais, ressalta-se que alternativas microinvasivas parecem produzir melhor resultado estético, comparados àqueles não invasivos (Pliska et al, 2012;Youssef et al, 2020;Anggani et al, 2021).…”

“…Em alguns casos, as LMB podem não desaparecer por completo, seja por meio da remineralização natural ou daquela potencializada por fluoretos em altas concentrações, ou mesmo pela técnica de infiltração resinosa (Borges et al, 2017;Perdigão, 2020;Anggani et al, 2021). Assim, há que se estudar a possibilidade de associação entre os tratamentos não e/ou microinvasivos, a fim de que se consiga resultados de excelência quando estes não forem obtidos apenas com uma determinada técnica (Oliveira et al, 2020).…”