Enhanced Proximal Caries Remineralization Using Cav-Aid®, a Novel Fluoride Delivery Device: An In Vitro Study

Abstract

Objective: This study evaluated the efficacy of a novel interproximal fluoride delivery device, Cav-Aid®, in remineralizing initial proximal caries, comparing it with conventional fluoride treatments. Methods: Initial caries lesions were produced on bovine enamel blocks by subjecting the blocks to a 3-day demineralization process by plaque growth in a mixed-species microbial caries model. After demineralization, the baseline surface microhardness (SMHb) was measured. The blocks were embedded into cavities prepared on the proximal surfaces of extracted human teeth to simulate natural interproximal contacts. The teeth were randomly assigned to six treatment groups (20/group): artificial saliva (AS), Cav-Aid® only (CA), Cav-Aid®/fluoride toothpaste (CA+F), fluoride varnish applied via flossing (FV-Floss), fluoride varnish applied via painting on the interdental cleavage (FV-Paint), and daily fluoride mouthrinse (F-Mouthrinse). The samples then underwent a 14-day pH cycling protocol to simulate remineralization conditions. The post-treatment SMH (SMHr) was measured. Statistical analysis comprised paired t-tests and ANOVA/Tukey’s post hoc comparisons (p < 0.05). Results: All fluoride-treated groups exhibited significant increases in SMHr compared with SMHb (p < 0.001). CA+F group showed the highest percentage remineralization (27.39%), followed by CA (22.16%), then the FV and mouthrinse groups (9.25–11.80%). The AS group exhibited the lowest remineralization (4.89%). CA+F demonstrated significantly greater remineralization than FV or mouthrinse (p < 0.05). However, there was no significant difference between CA alone and CA+F. Also, there was no significant difference between CA alone and FV-Floss or FV-Paint (p > 0.05). Conclusions: Within the limit of the present study, the Cav-Aid® targeted fluoride delivery system demonstrated greater efficacy than FV alone in interproximal remineralization. Dual-modality fluoride treatments (CA+F) provided the greatest remineralization benefits, highlighting the importance of sustained fluoride exposure.