Development of Strontium-Doped Nano Hydroxyapatite Dentifrice and Compare its Remineralising Potential with a Topical Cream Containing Casein Phosphopeptide- Amorphous Calcium Phosphate – An In Vitro Study

Abstract

Aim: To develop and evaluate the efficacy of synthesised strontium-doped nano hydroxyapatite dentifrice and compare its remineralizing potential with a topical cream containing Casein Phospho Peptide – Amorphous Calcium Phosphate, in remineralizing artificial carious lesion on enamel. Materials and Methods: Enamel specimens of 4 × 4 × 1 mm were prepared from 90 freshly extracted teeth. Specimens were divided into 3 groups of 30 samples each, based on the type of dentifrice applied that is a control group (Group I) and two experimental groups (Groups II, III). Surface topography and the calcium/phosphorous ratio of all sound specimen were evaluated using Scanning electron microscope and Energy Dispersive X-ray Analysis (SEM-EDAX). The samples in group I and each of the experimental groups were subjected to demineralisation and the calcium/phosphorous ratio of the demineralized specimen were analysed. The samples were then subjected to remineralisation using different agents in each group. Samples in the control group (Group I) were brushed with a conventional dentifrice. In the experimental groups, Group II topical cream with Casein Phosphopeptide and Amorphous Calcium phosphate (CPP-ACP) was used and in Group III laboratory synthesized Strontium-doped nanohydroxyapatite paste (Sr-nHAP), respectively for 28 consecutive days. The samples in the both the control and the two experimental groups were again subjected to SEM-EDAX analysis to analyse the calcium phosphorus ratio following remineralisation cycle. Groupwise comparison of the data was done with one way ANOVA followed by Tukeys Post hoc Test. Results: Both experimental groups (II, III) showed statistically significant remineralisation potential after demineralisation, compared to the control group I. Intergroup comparison showed that the samples in Group III showed the higher remineralisation potential than Group II and was statistically significant. Conclusion: Both CPP- ACP containing tooth cream as well as Sr doped nHAp showed remineralisation potential. Sr doped nanohydroxyapatite showed better remineralisation than CPP ACP and can be considered for enamel repair in incipient carious lesions.

Remineralization potential of strontium-doped nano-hydroxyapatite dentifrice and casein phosphopeptide-amorphous calcium phosphate cream on white spot lesions in enamel following orthodontic debonding – a randomized controlled trial

“…SEM EDAX analysis of the surface topography and the calcium/phosphorous ratio of tooth specimens treated with Casein Phosphopeptide, CPP-ACP and SrnHAP for 28 consecutive days has revealed that strontium-doped nano-hydroxyapatite showed better remineralisation than CPP-ACP and can be considered for enamel repair in incipient carious lesions. 25 Similar outcomes were seen in research by Krishnan et al, 23 which determined that SrnHAp in solution was superior to CPP-ACP cream and nHAp toothpaste for recuperation of demineralized enamel surface. According to the research, adding strontium enhanced the dissolving ability and retention of material on to the tooth surface, making it more effective than CPP-ACP in remineralising and restoring enamel.…”

Comparative Evaluation of Remineralizing Potential of Topical Cream Containing Casein Phosphopeptide-Amorphous Calcium Phosphate and Casein Phosphopeptide-Amorphous Calcium Phosphate with Fluoride: An In Vitro Study

“…[ 9 ] The result of a study which investigated the potential of CPP-ACP, unveiled the remineralizing property when used in early carious lesions and also proved the efficacy over other remineralizing agents used in the particular research. [ 10 ]…”

“…Both the agents were proven to have remineralizing capacity through various studies. [ 10 11 ] The samples were evaluated for Ca and P levels in normal (sound), demineralized and remineralized conditions. Group I showed no remineralizing potential as only normal toothpaste was used.…”

A Systematic Review on the Effect of Strontium-Doped Nanohydroxyapatite in Remineralizing Early Caries Lesion

“…The outcome of the study showed that SrnHAP presented better remineralization compared to conventional toothpaste. In another study, SrnHAP was compared with CPP-ACP and conventional toothpaste, and the results showed that SrnHAP had better remineralization [ 16 , 17 ].…”

“…After remineralization and demineralization, the mean calcium and phosphorus contents of the specimens were measured using SEM and EDX and compared to CPP-ACP for remineralization and repair of enamel demineralization. The presence of strontium indicated higher solubility and better adhesion to the tooth surface [ 17 ].…”