A Comparison between Two Different Remineralizing Agents against White Spot Lesions: An In Vitro Study

Abstract

Enamel demineralization and white-spot lesions (WSLs) around the orthodontic brackets are common clinical complications after orthodontic fixed appliance therapy. WSLs form mainly due to plaque deposition around the brackets during the orthodontic treatment period. This study was designed to compare and evaluate the efficacy of two different remineralization agents on WSLs, which are “Clinpro 5000 and Colgate Sensitive Pro-Relief”. 27 caries-free human premolar teeth were collected after extraction for orthodontic purposes. The crowns were set in acrylic resin, and the entire surfaces were coated with nail varnish apart from an area of 4 × 4 mm on the buccal surface. The surface microhardness (SMH) was measured using the Vickers microhardness testing machine at baseline, after demineralization, and after treatment. Then, the different SMH values were statistically analyzed using mixed-effects linear regression. All samples were immersed in demineralizing solution for ten days to create WSLs, and then the teeth were allocated randomly into one of the three groups: Group 1 (control group-immersed in artificial saliva), Group 2 (treated with Colgate sensitive Pro-Relief toothpaste), and Group 3 (Clinpro 5000 toothpaste). Cycles of treatment were done for 5 minutes every 12 hours for 14 days. The samples were stored in freshly prepared artificial saliva between cycles. The mixed-effects model was used to quantify the effect of different remineralization agents. All statistics were computed using STATA software (version14.1; Stata, College Station, TX). All statistical tests were two-tailed and interpreted at the 0.05 significance level. Both agents improved the surface hardness. Clinpro 5000 improved the surface hardness by 12.7 ( P value 0.012), and Colgate Sensitive Pro-Relief improved surface hardness by 18.2 ( P value <0.0001), However when both treatments are compared with each other, there was no statistical significance among them. When compared to the control group, both treatments “Clinpro™ 5000 and Colgate Sensitive Pro-Relief” have significantly improved enamel’s SMH.

Effectiveness of Natural Remineralizing Agents on Initial Enamel Caries: In Vitro Study

“…Laser fluorescence was tested three times, At baseline(T0) and after the creation of Initial enamel lesions(T1) and after 10 days of remineralizing surface treatments(T2) (5) , respectively using Diode laser fluorescence device (DIAGNOdent). At each time interval in the study, the Laser fluorescence was assessed three times for each specimen and the mean value was calculated and recorded.…”

“…A demineralizing solution was prepared (2.2 mm calcium chloride, 2.2 mM monopotassium phosphate, 0.05 mM acetic acid having pH adjusted to 4.4 and 1M potassium hydroxide) and all the samples were immersed in this demineralizing solution for 4 days without stirring to create artificial initial enamel carious lesions the pH meter was used to detect the pH value daily (5) . After the specified period, all samples were removed from the solution and washed for 5 minutes under tap water, then washed again under distilled water for 30 s and dried with air spray free of oil to be visualized for their chalky white appearance (6).…”

Nano‐hydroxyapatite‐induced remineralization of artificial white spot lesions after bleaching treatment with 10% carbamide peroxide

“…White spot lesions (WSL) are often diagnosed after the orthodontic appliances removal, with a 30%-70% incidence, affecting the anterior and posterior teeth. [1][2][3][4] The WSL is the first sign of enamel demineralization, arising from the local pH decrease caused by the acidogenic plaque-bacterias metabolization by-products. 5,6 Considering these lesions develop through a dynamic process of de-and remineralization phases, they are usually characterized by an allegedly intact surface layer and a demineralized subsurface layer.…”

Comparison of Remineralization Effect of Casein Phosphopeptide Amorphous Calcium Phosphate and Sodium Fluoride on Enamel Surface after Orthodontic Debonding: An In vitro study

“…7,8 Demineralization is the removal of enamel's inorganic constituents by acids that are produced by bacteria existing in the plaque. 9 These acids soften calcium phosphate content JPDA Vol. 31 No.…”

“…10 Few teeth are extra prone to demineralization such as maxillary lateral incisors, canines, especially in the gingival third and first molars in the middle third. 9,11 Demineralization presents an aesthetic concern because it compromises the aesthetics of smile. 12 Regular remineralization via mineral ions existing in saliva occurs simply in the shallow layers of demineralized lesions.…”