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, 15 (1), 61-7

Remineralization of Enamel Subsurface Lesions With Casein Phosphopeptide-Amorphous Calcium Phosphate: A Quantitative Energy Dispersive X-ray Analysis Using Scanning Electron Microscopy: An in Vitro Study

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Remineralization of Enamel Subsurface Lesions With Casein Phosphopeptide-Amorphous Calcium Phosphate: A Quantitative Energy Dispersive X-ray Analysis Using Scanning Electron Microscopy: An in Vitro Study

Mithra N Hegde et al. J Conserv Dent.

Abstract

Aim: The objective of this study was to quantitatively evaluate the remineralization potential of casein phosphopeptide-amor-phous calcium phosphate paste on enamel subsurface lesions using scanning electron microscopy with energy dispersive X-ray analysis (SEM-EDX).

Materials and methods: Ninety enamel specimens were prepared from extracted human molars. All specimens were evaluated for mineral content (% weight) using SEM-EDX. The specimens were placed in demineralizing solution for four days to produce artificial carious lesions. The mineral content (calcium/phosphorus ratios, Ca/P ratios) was remeasured using SEM-EDX. The specimens were then randomly assigned to five study groups and one control group of 15 specimens per group. Except for the control group, all group specimens were incubated in remineralizing paste (CPP-ACP paste) for 7, 14, 21, 28, and 35 days twice daily for three minutes. The control group received no treatment with remineralizing paste. All the 90 specimens were stored in artificial saliva at 37°C. After remineralization, the mineral content (% weight) of the samples was measured using SEM-EDX.

Results: All the study groups showed very highly significant differences between Ca/P ratios of the demineralized and remineralized samples. There was no significant difference seen in the control group.

Conclusion: CPP-ACP paste could significantly remineralize the artificial enamel subsurface lesions in vitro: the remineralizing rates increasing with the time for which the samples were kept in the remineralizing paste. Energy dispersive X-ray analysis is an efficient way to quantitatively assess the changes in mineral content during demineralization and in vitro remineralization processes.

Keywords: CPP-ACP; Ca/P ratios; demineralization; remineralization; scanning electron microscopy with energy dispersive X-ray analysis.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Elemental analysis of sound enamel sample by EDX
Figure 2
Figure 2
Elemental analysis of demineralized enamel sample by EDX
Figure 3
Figure 3
Elemental analysis of enamel sample by EDX, after 7 days of remineralization
Figure 4
Figure 4
Elemental analysis of enamel sample by EDX, after 14 days of remineralization
Figure 5
Figure 5
Elemental analysis of enamel sample by SEM, after 21 days of remineralization
Figure 6
Figure 6
Elemental analysis of enamel sample by SEM, after 28 days of remineralization
Figure 7
Figure 7
Elemental analysis of enamel sample by SEM, after 35 days of remineralization
Figure 8
Figure 8
Relationship between demineralization and the remineralization potential of study groups
Figure 9
Figure 9
Structural analysis of sound enamel sample by SEM
Figure 10
Figure 10
Structural analysis of demineralized enamel sample by SEM
Figure 11
Figure 11
Structural analysis of enamel sample by SEM, after 7 days of remineralization
Figure 12
Figure 12
Structural analysis of enamel sample by SEM, after 14 days of remineralization
Figure 13
Figure 13
Structural analysis of enamel sample by SEM, after 21 days of remineralization
Figure 14
Figure 14
Structural analysis of enamel sample by SEM, after 28 days of remineralization
Figure 15
Figure 15
Structural analysis of enamel sample by SEM, after 35 days of remineralization

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