BackgroundIn recent years, the non-invasive management of non cavitated caries lesions using remineralization systems to repair the enamel have received more attention from the scientific community. Aim: To quantitatively evaluate the remineralization potential of Casein phosphopeptide-amorphous calcium phosphate-fluoride(CPP-ACPF), Tri-calcium phosphate(TCP) & Nano-hydroxyapatite(nHAP) using Scanning Electron Microscopy(SEM) and Energy dispersive X-ray Analysis(EDX).Material and Methods40 enamel specimens were prepared, and immersed in demineralising solution at a pH of 4.4 for 96 hours at 37°C, to induce artificial carious lesions. Remineralization was carried out for a period of 30 days using CPP-ACPF, TCP, nHAP. The specimens were evaluated for calcium and phosphorus content using SEM-EDX.ResultsThe Ca/P mass % after remineralization was significantly higher with CPP-ACP-F and TCP-F followed by nHAP.ConclusionsCPP-ACP-F and TCP can promote significant remineralization of incipient carious lesions. These are excellent delivery vehicles available in a slow release amorphous form to localize calcium, phosphate and fluoride at the tooth surface.
Key words:Remineralization, in vitro; CPP-ACP fluoride, Nano-hydroxyapatite, Tri-calcium phosphate, SEM/ EDX.
A common primary bone malignancy in childhood and adolescence is Ewing’s sarcoma. Here we report multidisciplinary approach in the management of chronic hyperplastic candidiasis and xerostomia secondary to chemotherapy with vincristine, doxorubicin and cyclophosphamide (VDC) in a pediatric male patient with Ewing’s sarcoma of Ethmoid sinus. The initial diagnosed oral lesion was treated with topical clotrimazole 1%w/v for two weeks and Sucralfate 1g/10mL oral rinse for one month. Upon subsequent VDC chemotherapy cycle, the patient developed grade IV oral mucositis, severe neutropenia and associated oesophageal candidiasis. Treatment included combination of topical clotrimazole 1%w/v and Fluconazole 300mg/day (IV for 5 days and Tablet for 14 days). To prevent caries risk, pit and fissure sealants were applied and topical fluoride therapy was given; patient was encouraged to have frequent sips of water and prescribed kids xylitol gum for 15 days to minimize xerostomia. At 5-week follow up, reduction in burning sensation and resolution of white lesion was noted.
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