Comparative Evaluation of the Increase in Enamel Hardness Post-External Bleaching after Using Casein Phosphopeptide Amorphous Calcium Phosphate Fluoride (CPP-ACPF) and 5% Sodium Fluoride (NaF) Remineralizing Agents

Abstract

Objective The purpose of this study was to analyze the increase in enamel hardness post-external bleaching after remineralized with casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) and 5% sodium fluoride (NaF) and the difference in increased enamel hardness between CPP-ACPF and NaF materials. Materials and Methods The study was true experimental in vitro using 30 samples of mandibular premolars. All samples were bleached using 40% hydrogen peroxide. The samples were divided into three groups of 10 samples each; group I as a control without application of remineralization material, group II was given an application of CPP-ACPF (GC Tooth Mousse Plus: GC Europe, Lot #201130B), and group III was given an application of 5% NaF (Clinpro White Varnish: 3M ESPE, Lot #NA62322) Then the entire samples were stored in artificial saliva. The hardness of the samples was measured using a Vickers hardness tester before bleaching, after bleaching, and after remineralization for 7, 14, and 21 days. Statistical Analysis Analysis of the data used was an analysis of variance test to assess differences in the increase in enamel hardness between groups and paired t-tests and to determine differences in enamel hardness in each group. Results This study showed that there was an increase in the enamel hardness after bleaching which was remineralized with CPP-ACPF and 5% NaF. There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% NaF. The enamel hardness of CPP-ACPF was higher compared with 5% NaF after remineralization of 7, 14, and 21 days. Conclusion There was an increase in the enamel hardness after external bleaching that was remineralized with CPP-ACPF and 5% sodium fluoride (NaF). There was a difference in the increased enamel hardness between teeth remineralized with CPP-ACPF and 5% sodium fluoride (NaF). CPP-ACPF showed a higher enamel hardness value than 5% NaF.

Do Different Tooth Bleaching–Remineralizing Regimens Affect the Bleaching Effectiveness and Enamel Microhardness In Vitro?

“…The reduction in peroxide diffusion and enamel microhardness was confirmed by Torres et al [ 34 ] when the bleaching gel containing calcium and fluoride was investigated. Irmaleny et al [ 36 ] have observed that there was an increase in the enamel hardness when bleached enamel is remineralized with CPP-ACPF and 5% sodium fluoride (NaF). Melo et al [ 37 ] found that application of remineralizing products (Tooth Mousse, Remin-Pro, Colgate Pro-Relif, Mirafluor) generates a significant increase in enamel microhardness.…”

The Efficacy of Silver Diamine Fluoride as a Caries Preventive Agent on Permanent Teeth: A Scoping Review

“…39 Topical fluoride application leads to the formation of a layer of calcium fluoride, which subsequently diffuses to the enamel surface to form fluorapatite, thus aiding in enhancing remineralization and enamel hardness. 46 SDF can penetrate more easily on proximal surfaces compared to occlusal surfaces due to the smoother topographical nature of the proximal surface and the absence of pits and fissures. 42 SDF is a topical fluoride solution that has the ability to inhibit the metabolism of S. mutans, which is the main cause of dental caries, 40,60 and promote the remineralization of hydroxyapatite in enamel.…”

Natural Materials' Potential as Alternative Teeth Remineralization Agents: A Scoping Review

“… 6 Other studies calculated the increase of enamel hardness of CPP-ACP, and it was discovered that the increase ranged around 33%, which amplifies that Theobroma cacao extract yields a better outcome. 29 30 31 …”

“…6 Other studies calculated the increase of enamel hardness of CPP-ACP, and it was discovered that the increase ranged around 33%, which amplifies that Theobroma cacao extract yields a better outcome. [29][30][31] The limitation of this scoping review involves the heterogeneous articles regarding the samples, the study designs, and the results due to the inclusion and exclusion criteria. Therefore, further study is required to analyze natural materials' type, dosage form, and effectiveness.…”