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Abstract

Objective: The acidic pH of remineralizing agents is beneficial in etching the enamel to facilitate increased remineralization. This study aims to modify the pH of Casein Phosphopeptide Amorphous Calcium phosphate to acidic and evaluate the enamel surface microhardness exposed to acidified CPP ACPF, acidulated phosphate fluoride (APF gel), and conventional CPP ACPF. Methods: The pH of conventional CPP ACPF (GC Tooth Mousse) is acidified. 24 tooth samples were assigned into three groups receiving as follows: Group 1 (n = 8) acidified CPP ACPF, Group 2 (n = 8) APF gel, and Group 3 (n = 8) CPP ACPF for four minutes. Baseline and post-exposure microhardness values were evaluated using Vicker’s microhardness number. Descriptive and inferential statistics were done. Results: The mean post-surface microhardness was highest in the acidified CPP ACPF group (323 ± 26.0) while lowest in the CPP ACPF group (307 ± 31). The APF gel group had a 312.4±18.6. A one-way ANOVA test between the groups showed statistical significance (p value 0.054), post hoc Tuckey test showed significance between the acidified CPP ACPF and CPP ACPF groups (p value 0.05). Conclusion: Acidified CPP ACPF increased the surface microhardness less than APF gel in a single exposure for four minutes.

References

  1. Abdel-Hakim SM, Metwalli N, El Askary F, Wassel MO. Microhardness, SEM and color change analysis of artificial enamel lesions in primary teeth treated with resin infiltration, CPP-ACP or fluoride gel: An in vitro study. Egypt Dent J. 2016; 62(4):3735-44.
  2. Torres CR, Rosa PC, Ferreira NS, Borges AB. Effect of caries infiltration technique and fluoride therapy on microhardness of enamel carious lesions. Oper Dent. 2012; 37(4):363-9.
  3. Reyes-Gasga J, Becerril NV. Electron microscopy analysis of the thermal phase transition from hydroxyapatita to β-TCP observed in human teeth. J Microsc. 2019; 276(2):89-97.
  4. Chukhray NL, Vynar VA. Microhardness of tooth enamel with different level of resistance. Ukr Dent Almanac. 2017; 3(3):5-9.
  5. Domenyuk DA, Chukov SZ, Arutyunova AG, Ivanuta OO, Yesaulenko EE, Dmitrienko SV. Evaluation of the caries resistance of tooth enamel according to a study on the chemical composition and microstructure of the tooth surface during its physiological maturation. Kuban Sci MedBull. 2019; 26(2):26-41. Russian.
  6. Danilina TF, Bag mutov V P, Slavskiĭ IuI. Mikrotverdost’ tkaneĭ zuba kak pokazatel’ ikh funktsional’noĭ ustoĭchivosti v norme i pri patologicheskikh sostoianiiakh [The microhardness of dental tissues as an index of their normal functional stability and in pathological states]. Stomatologiia (Mosk). 1998; 77(3):9-11. Russian.
  7. Featherstone JD. The science and practice of caries prevention. J Am Dent Assoc. 2000; 131(7):887-99.
  8. Ribeiro TR, Duarte RM, Medeiros e Silva FDSC, Forte FDS, Sampaio FC, Barbosa JKG. In vitro evaluation of enamel microhardness adjacent to restorations after cariogenic challenge. Revista Odonto Ciencia. 2009; 24(1):49-53.
  9. Özveren N, Özalp Ş. Microhardness and SEM-EDX analysis of permanent enamel surface adjacent to fluoride-releasing restorative materials under severe cariogenic challenges. Oral Health Prev Dent. 2018; 16(5):417-24.
  10. Salama FS, Elmallakh BF, Pedo C. Effect of apf application on the microhardness of lightactivated restorative material. J Sau Dent. 1996; 8:81-6.
  11. Larsen MJ, Fejerskov O. Surface etching and subsurface demineralization of dental enamel induced by a strong acid. Scand J Dent Res. 1977; 85(5):320-6.
  12. Zhang WG. [The mechanism of topical applied ion supplemented acidulated phosphate fluoride gel effects on dental enamel demineralization: an in vitro study]. Zhonghua Kou Qiang Yi Xue Za Zhi. 1992; 27(6):367-9, 385. Chinese.
  13. Soares LES, da Silva Magalhães J, Marciano FR, Lobo AO. Surface characteristics of a modified acidulated phosphate f luoride gel with nano-hydroxyapatite coating applied on bovine enamel subjected to an erosive environment. Microsc Res Tech. 2018; 81(12):1456-66.
  14. Reynolds EC. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: A review. Spec Care Dentist. 1998; 18(1):8-16.
  15. Gurunathan D, Somasundaram S, Kumar S. Casein phosphopeptide-amorphous calcium phosphate: A remineralizing agent of enamel. Aust Dent J. 2012; 57(4):404-8.
  16. Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ. Electroencephalographic biofeedback in the treatment of attention-deficit/ hyperactivity disorder. Appl Psychophysiol Biofeedback. 2005; 30(2):95-114.
  17. Imani MM, Safaei M, Afnaniesfandabad A, Moradpoor H, Sadeghi M, Golshah A, Sharifi R, Mozaffari HR. Efficacy of CPP-ACP and CPP-ACPF for prevention and remineralization of white spot lesions in orthodontic patients: A systematic review of randomized controlled clinical trials. Acta Inform Med. 2019; 27(3):199-204.
  18. Sitthisettapong T, Doi T, Nishida Y, Kambara M, Phantumvanit P. Effect of CPP-ACP paste on enamel carious lesion of primary upper anterior teeth assessed by quantitative light-induced fluorescence: A one-year clinical trial. Caries Res. 2015; 49(4):434-41.
  19. Sitthisettapong T, Phantumvanit P, Huebner C, Derouen T. Effect of CPP-ACP paste on dental caries in primary teeth: A randomized trial. J Dent Res. 2012; 91(9):847-52.
  20. Güçlü ZA, Alaçam A, Coleman NJ. A 12-week assessment of the treatment of white spot lesions with cpp-acp paste and/or fluoride varnish. Biomed Res Int. 2016; 2016:8357621.
  21. Chindane AA, Patil AT, Sandhyarani B. Effect of CPP-ACPF, resin infiltration, and colloidal silica infiltration on surface microhardness of artificial white spot lesions in primary teeth: An in vitro study. Dent Res J (Isfahan). 2022; 19:52.
  22. Tan TM, Arango EL, Labarcena BR. Characteristics of enamel and the role of saliva as risk factors of dental caries. Revista Progaleno. 2019; 2(3):224-35.
  23. shaw JH. Nutritional factors in dental caries. Bull N Y Acad Med. 1952; 28(7):478-9.
  24. Westerman GH, Ellis RW, Latta MA, Powell GL. An in vitro study of enamel surface microhardness following argon laser irradiation and acidulated phosphate fluoride treatment. Pediatr Dent. 2003; 25(5):497-500.
  25. Feagin F, Koulourides T, Pigman W. The characterization of enamel surface demineralization, remineralization, and associated hardness changes in human and bovine material. Arch Oral Biol. 1969; 14(12):1407-17.
  26. Marinho VC, Higgins JP, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2004; 2004(1):CD002781.
  27. Calvo AF, Tabchoury CP, Del Bel Cury AA, Tenuta LM, da Silva WJ, Cury JA. Effect of acidulated phosphate fluoride gel application time on enamel demineralization of deciduous and permanent teeth. Caries Res. 2012; 46(1):31-7.
  28. Daniel LC, Araújo FC, Zancopé BR, Hanashiro FS, Nobre-dos-Santos M, Youssef MN, Souza-Zaroni WC. Effect of a CO2 laser on the inhibition of root surface caries adjacent to restorations of glass ionomer cement or composite resin: An in vitro study. ScientificWorldJournal. 2015; 2015:298575.
  29. Azadi P, Sarlak H, Nourmohammadi S. Comparing enamel microhardness in decidous teeth with primary carious lesions after applying three fluoride containing materials in vitro. J Arak Uni Med Sci. 2021; 24(2):256-66. Persian.
  30. Tantbirojn D, Huang A, Ericson MD, Poolthong S. Change in surface hardness of enamel by a cola drink and a CPP-ACP paste. J Dent. 2008; 36(1):74-9.
  31. Khamverdi Z, Kordestani M, Panahandeh N, Naderi F, Kasraei S. Influence of CO2 laser irradiation and CPPACP paste application on demineralized enamel microhardness. J Lasers Med Sci. 2018; 9(2):144-8.
  32. Singh RD, Ram SM, Shetty O, Chand P, Yadav R. Efficacy of casein phosphopeptide-amorphous calcium phosphate to prevent stain absorption on freshly bleached enamel: An in vitro study. J Conserv Dent. 2010; 13(2):76-9.
  33. Attin T, Kielbassa AM, Schwanenberg M, Hellwig E. Effect of fluoride treatment on remineralization of bleached enamel. J Oral Rehabil. 1997; 24(4):282- 6.
  34. Bayrak S, Tunc ES, Sonmez IS, Egilmez T, Ozmen B. Effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on enamel microhardness after bleaching. Am J Dent. 2009; 22(6):393-6.
  35. Milnar FJ. Considering biomodification and remineralization techniques as adjuncts to vital tooth-bleaching regimens. Compend Contin Educ Dent. 2007; 28(5):234-6, 238-40.
  36. Bandekar S, Patil S, Dudulwar D, Moogi PP, Ghosh S, Kshirsagar S. Remineralization potential of f luoride, amorphous calcium phosphate-casein phosphopeptide, and combination of hydroxylapatite and fluoride on enamel lesions: An in vitro comparative evaluation. J Conserv Dent. 2019; 22(3):305-9.

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