Comparative Evaluation of Remineralizing Effect of Casein Phosphopeptide – Amorphous Calcium Phosphate Fluoride and Silver Diamine Fluoride on Demineralized Enamel Surfaces ( An In Vitro Study)

Abstract

ABSTRACTIntroduction Caries initiation is associated with demineralization of the toothenamel surface. Calcium and phosphorous are lost from the subsurface enamel, resultingin the formation of a subsurface lesion. Aim: this study aimed to investigate and comparethe enamel surface ultramorphology and minerals content by Environmental ScanningElectron Microscope (ESEM) and Energy dispersive x-ray spectroscopy (EDX) and toassess micro-hardness (Vickers test) of demineralized enamel surface treated with CPPACPcasein Phosphopeptide-Amorphous Calcium Phosphate Flouride(MI Paste Plus)or SDF ( FAgamine). Materials and methods: This study was conducted on twentyeight human premolars ,were collected from the outpatient clinic of MaxillofacialDepartment, Faculty of Dentistry, Suez Canal University. The selected premolarsdistributed into three groups: Group I: consisted of 7 intact sound premolars,(controlgroup) Group II : consisted of 7 demineralized premolars,(demineralized group) while,Group III consisted of 14 premolars ( each one divided into 28 halves mesiodistally)then all 28 specimens of group III were demineralized and half of them were treatedby MI Paste plus ( subgroup IIIa) and other were treated by SDF( subgroup IIIb). AllGroups I,II&III were placed in artificial saliva for 7days at 37ᵒc. Results: There was astatistically significant difference between calcium and phosphorus values of the threegroups; subgroup IIIa showed the highest value followed by subgroup IIIb & group Iand finally the least value was related to group II .The highest value of fluoride contentrelated to subgroup IIIb. There was not statistically significant difference betweenmicrohardness values of group I and group III while group II revealed the lowestmicrohardness value. Conclusion: Both CPP-ACPF and SDF show areas of mineralizeddeposits and improvement of enamel ultrastructure. Also both CPP-ACPF and SDF areefficient remineralizing agent, but CPP-ACPF is more efficient as remineralizing agentthan SDF. CPP-ACPF shows better microhardness results than SDF.