Remineralization Efficacy of Four Remineralizing Agents on Artificial Enamel Lesions: SEM-EDS Investigation

Abstract

Dental remineralization represents the process of depositing calcium and phosphate ions into crystal voids in demineralized enamel, producing net mineral gain and preventing early enamel lesions progression. The aim of the present study was to qualitatively and quantitatively compare the remineralizing effectiveness of four commercially available agents on enamel artificial lesions using Scanning Electron Microscopy (SEM) combined with Energy Dispersive Spectroscopy (EDS) techniques. Thirty-six extracted third molars were collected and randomly assigned to six groups (n = 6), five of which were suspended in demineralizing solution for 72 h to create enamel artificial lesions, and one serving as control: G1, treated with a mousse of casein phosphopeptide and amorphous calcium–phosphate (CPP-ACP); G2, treated with a gel containing nano-hydroxyapatite; G3, treated with a 5% SF varnish; G4, treated with a toothpaste containing ACP functionalized with fluoride and carbonate-coated with citrate; G5, not-treated artificial enamel lesions; G6, not demineralized and not treated sound enamel. G1–G4 were subjected to pH cycling over a period of seven days. Analyses of the specimens’ enamel surfaces morphology were performed by SEM and EDS. Data were statistically analyzed for multiple group comparison by one-way ANOVA/Tukey’s test (p < 0.05). The results show that the Ca/P ratio of the G5 (2.00 ± 0.07) was statistically different (p < 0.05) from G1 (1.73 ± 0.05), G2 (1.76 ± 0.01), G3 (1.88 ± 0.06) and G6 (1.74 ± 0.04), while there were no differences (p > 0.05) between G1, G2 and G6 and between G4 (2.01 ± 0.06) and G5. We concluded that G1 and G2 showed better surface remineralization than G3 and G4, after 7 days of treatment.

Assessment of the Remineralizing Potential of Biomimetic Materials on Early Artificial Caries Lesions after 28 Days: An In Vitro Study

“…Indeed, Balakrishnan et al evaluated the remineralization potential of various toothpastes over a period of 30 days and concluded that the extent of remineralization achieved was dose-dependent and increased with increasing the time of exposure and duration of the study [ 49 ]. In fact, our previous study, which evaluated the efficacy of these RA, showed that, after 7 days of treatment, a complete remineralization was not obtained; instead, only an initial reorganization of the enamel structure was observed [ 29 ].…”

“…The study was conducted at the Department of Clinical Sciences and Stomatology of Università Politecnica delle Marche (Ancona, Italy). Thirty-six human third molars extracted for orthodontic and periodontal reasons were collected [ 29 ]. All patients were informed in advance that their extracted teeth would be used for scientific purposes, and written consent was obtained before the experiment.…”

“…Our previous study evaluated short-term RA effects, over a period of 7 days, demonstrating that a complete remineralization of the enamel surface was not achieved [ 29 ]. Therefore, as a continuation of this work, the aim of the present study was to evaluate for the first time the remineralizing performance of four different RA, containing CPP-ACP, n-HA, NaF, and F-ACP, respectively, on early artificial enamel lesions after a 28-day pH-cycling protocol using SEM-EDX analysis.…”

Polyphenols for Preventing Dental Erosion in Pre-clinical Studies with in situ Designs and Simulated Acid Attack

“…Unfortunately, although there is evidence that these fluoride products reduce erosive and abrasive wear, it is essential to control the causal factors to prevent the progression of lesions [6]. However, the initial enamel demineralization surface may be treated with topical use of remineralizing agents containing fluoride, calcium and phosphate ions, achieving almost complete remineralization of the surface and a reorganization of the prismatic structure of the enamel [7], avoiding surface loss in the continuous demineralization-remineralization process.…”

“…enamel demineralization surface may be treated with topical use of remineralizing agents containing fluoride, calcium, and phosphate ions, achieving almost complete remineralization of the surface and a reorganization of the prismatic structure of the enamel [7], avoiding surface loss in the continuous demineralization-remineralization process.…”