In-vitro comparative study for three different strategies to treat enamel demineralized white spot lesion

Abstract

Objectives: The current invitro study aimed at exploring the underlying mechanism of action of the self-assembling peptide P11-4 (Curodont™ Repair), Borate glass resin adhesive system, Fluoride gel (1.23 % acidulated-phosphate-fluoride.) and infiltrating resin (Icon) to treat demineralized enamel subsurface (White spot lesions "WSL") to provide the clinicians with a comprehensive guide that may help in choosing the suitable material.

Materials and methods: 100 freshly extracted human teeth were equally divided into five groups: (Control group), (Fluoride group), (Icon group), (Curodont group) and (Borate group). A base line (T0) colorimetric analysis was done using Rayplicker Handy. The teeth were labelled numerically and randomly distributed utilizing an excel program. Then, the specimens were subjected to artificial demineralization solution pH 4.5 for four days and colorimetric analysis was measured after the induction of WSLs (T1). After that, materials were applied and stored for 40 days followed by colorimetric analysis at (T2). Finally, 10 specimens from each group were assessed using Transverse Microradiography (TMR) . The data were analyzed statistically using Kruskal-Wallis test to compare the colorimetric analysis and One way ANOVA followed by Tukey post hoc test for TMR examination (p < 0.05).

Results: Kruskal Wallis test showed that ∆E values of the tested lesions improved by the following percentages; 33.6 % in (Curodont group), 37 % (Borate group), 10.7 % (Fluoride group), 38.3 % (Icon group) and 4.4 %(Control group) (p < 0.05). Furthermore, TMR examination revealed that Curodont and Borate groups exhibited significantly low values for lesion depth and for mineral loss when compared to the other groups (p < 0.05).

Conclusion: The Icon group, Curodont and Borate groups significantly enhanced esthetic qualities of the white spot lesions, however significant remineralization capacity of the enamel subsurface was only associated with applying Curodont and Borate adhesive system.

Clinical significance: Icon can conceal WSLs next to orthodontic fixed appliances, however, Curodont and Borate adhesive system can significantly remineralize, and subsequently enhance the WSLs esthetic qualities.

Keywords: Borate glass resin adhesive system; Orthodontics; Remineralization; Self-assembling peptide P11–4.