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, 13 (1), 42-6

Remineralization Potential of Fluoride and Amorphous Calcium Phosphate-Casein Phospho Peptide on Enamel Lesions: An in Vitro Comparative Evaluation


Remineralization Potential of Fluoride and Amorphous Calcium Phosphate-Casein Phospho Peptide on Enamel Lesions: An in Vitro Comparative Evaluation

S Lata et al. J Conserv Dent.


Aim: This in vitro study was conducted on enamel blocks of human premolars with the aim of evaluating the remineralization potential of fluoride and ACP-CPP and the combination of ACP-CPP and fluoride on early enamel lesions.

Materials and methods: Fifteen intact carious free human premolars were selected. The coronal part of each tooth was sectioned into four parts to make 4 enamel blocks. The baseline SMH (surface microhardness) was measured for all the enamel specimens using Vickers microhardness (VHN) testing machine. Artificial enamel carious lesions were created by inserting the specimens in demineralization solution for 3 consecutive days. The SMH of the demineralised specimens was evaluated. Then the four enamel sections of each tooth were subjected to various surface treatments, i.e. Group 1- Fluoride varnish, Group 2- ACP-CPP cream, Group 3- Fluoride + ACP-CPP & Group 4- Control (No surface treatment). A caries progression test (pH cycling) was carried out, which consisted of alternative demineralization (3hours) and remineralization with artificial saliva (21 hours) for five consecutive days. After pH cycling again SMH of each specimen was assessed to evaluate the remineralization potential of each surface treatment agent. Then, to asses the remineralization potential of various surface treatments at the subsurface level, each enamel specimen was longitudinally sectioned through the centre to expose the subsurface enamel area. Cross-sectional microhardness (CSMH) was evaluated to assess any subsurface remineralization

Results: Statistical analysis using one-way ANOVA followed by multiple comparisons test was applied to detect significant differences at P </= 0.05 levels between various surface treatments at different phases.

Conclusions: With in the limits, the present study concludes that; ACP-CPP cream is effective, but to a lesser extent than fluoride in remineralizing early enamel caries at surface level. Combination of fluoride and ACP-CPP does not provide any additive remineralization potential compared to fluoride alone. Fluoride, ACP-CPP and their combination are not effective in remineralizing the early enamel caries at the subsurface level.

Keywords: ACP-CPP; demineralization-remineralization; fluoride.

Conflict of interest statement

Conflict of Interest: None declared.


Graph 1
Graph 1
Percentage recovery of surface microhardness

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    1. Silverstone LM, Hicks MJ, Featerstone MJ. Dynamic factors affecting lesion initiation and progression in human dental enamel, 2 Surface morphology of sound enamel and caries like lesions of enamel. Quintessence Int. 1988;19:773–85. - PubMed
    1. Marsh PD. The oral microflora and biofilm on the teeth. In: Fejerskov O, Kidd E, editors. Dental caries: The disease and its clinical management. Blackwell and Munksgaard: Oxford (UK); 2003. pp. 29–47.
    1. Larsen MJ. Dissolution of enamel. Scand J Dental Research. 1973;81:518–22. - PubMed
    1. Ten Cate JM “in vitro” studies on the effects of fluoride on de and remineralization (special issue) J Dental Research. 1990;69:614–9. - PubMed
    1. Reynolds EC. Additional aids to remineralization of the tooth structure. In: Mount GJ, Hume WR, editors. Preservation and restoration of tooth structure. 2nd ed. Brisbane Australia: Knowledge Books and Software; 2005. pp. 111–8.