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, 2019, 1271523
eCollection

Effects of Fluoride and Calcium Phosphate Materials on Remineralization of Mild and Severe White Spot Lesions

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Effects of Fluoride and Calcium Phosphate Materials on Remineralization of Mild and Severe White Spot Lesions

Zixiang Dai et al. Biomed Res Int.

Abstract

Fixed orthodontic treatments often lead to enamel demineralization and cause white spot lesions (WSLs). The aim of this study was to evaluate the mineralization degree of 2 types of WSLs based on ICDAS index and compare the remineralizing efficacy of 3 oral hygiene practices after 1 month and 3 months. 80 mild demineralized and 80 severe demineralized enamel specimens were randomized into three treatments: fluoride toothpaste (FT), fluoride varnish plus fluoride toothpaste (FV+FT), and CPP-ACP plus fluoride toothpaste (CPP-ACP+FT). Microhardness tester, DIAGNODent Pen 2190, and scanning electron microscope were used to evaluate the changes of mineralization degree. Both qualitative and quantitative indicators suggested that the mild and severe white spot lesions were different in the degree of mineralization. Severe WSLs demineralized much more seriously than mild lesions even after 3 months of treatment. Despite the variation in severity, both lesions had the same variation trend after each measure was applied: FT had weak therapeutic effect, FV + FT and CPP-ACP + FT were effective for remineralization. Their remineralizing efficacy was similar after 1 month, and combined use of CPP-ACP plus F toothpaste was more effective after 3 months. In order to fight WSLs, early diagnosis was of great importance, and examination of the tooth surface after air-dry for 5 seconds was recommended. Also, when WSLs were found, added remineralizing treatments were required.

Figures

Figure 1
Figure 1
Figure 2
Figure 2
The experimental procedure of this study.
Figure 3
Figure 3
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Figure 5
Figure 5
Typical intergroup comparison of enamel hardness and DIAGNODent Pen 2190 readings. Statistic difference could be found in every graph. (P<0.05).
Figure 6
Figure 6
The typical SEM image of mild lesions of each group. (a) Sound enamel (before demineralization); (b) mild lesions (after demineralization); (c) artificial saliva immersion for 1 month (Control, 1 month); (d) artificial saliva immersion for 3 months (Control, 3 months); (e) fluoride toothpaste brushing for 1 month and 3 months (FT, 1 m; FT, 3 m); (f) combined use of fluoride varnish plus fluoride toothpaste for 1 month (FV + FT, 1 month); (g) combined use of fluoride varnish plus fluoride toothpaste for 3 months (FV + FT, 3 months); (h) Combined use of CPP-ACP plus fluoride toothpaste for 1 month (CPP-ACP + FT, 1 month); (i) combined use of CPP-ACP plus fluoride toothpaste for 3 months (CPP-ACP + FT, 3 months).
Figure 7
Figure 7
The typical SEM image of severe lesions of each group. (a) Severe lesions (after demineralization); (b) artificial saliva immersion for 1 month (Control, 1 month); (c) Artificial saliva immersion for 3 months (Control, 3 months); (d) fluoride toothpaste brushing for 1 month (FT, 1 month); (e) fluoride toothpaste brushing for 3 month (FT, 3 months); (f) combined use of fluoride varnish plus fluoride toothpaste for 1 month (FV + FT, 1 month); (g) combined use of fluoride varnish plus fluoride toothpaste for 3 months (FV + FT, 3 months); (h) combined use of CPP-ACP plus fluoride toothpaste for 1 month (CPP-ACP + FT, 1 month); (i) combined use of CPP-ACP plus fluoride toothpaste for 3 months (CPP-ACP + FT, 3 months).

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