Effect of fluoride dentifrice and casein phosphopeptide-amorphous calcium phosphate cream with and without fluoride in preventing enamel demineralization in a pH cyclic study

Priscila de Pinto Sinfiteli, Thereza Christina Lopes Coutinho, Patrícia Regina Almeida de Oliveira, Wesley Felisberto Vasques, Leandra Matos Azevedo, André Maues Brabo Pereira, Monica Almeida Tostes, Priscila de Pinto Sinfiteli, Thereza Christina Lopes Coutinho, Patrícia Regina Almeida de Oliveira, Wesley Felisberto Vasques, Leandra Matos Azevedo, André Maues Brabo Pereira, Monica Almeida Tostes

Abstract

Objective: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) complexes are anticariogenic and capable of remineralizing the early stages of enamel lesions. The use of fluoride prevents dental decay and the association of CPP-ACP with fluoride can increase remineralization. To evaluate the effect of CPP-ACP and CPP-ACPF creams associated with a fluoride dentifrice to prevent enamel demineralization in a pH cyclic model.

Material and methods: Previously selected by surface microhardness (SH) analysis, human enamel blocks (n = 56) were submitted to daily treatment with dentifrice in a pH-cycling model. The enamel blocks were divided into four groups; G1: Crest™ Cavity Protection - Procter & Gamble (1,100 ppmF of NaF); G2: Crest™ +MI Paste (MP) - Recaldent™ GC Corporation Tokyo, Japan); G3: Crest™ + MI Paste Plus (MPP) - Recaldent™ 900 ppm as NaF, GC Corporation Tokyo, Japan), and G4: control, saliva. Specimens were soaked alternatively in a demineralizing solution and in artificial saliva for 5 d. The fluoride dentifrice, with proportion of 1:3 (w/w), was applied three times for 60 s after the remineralization period. The undiluted MP and MPP creams were applied for 3 m/d. After cycling, SH was re-measured and cross section microhardness measurements were taken.

Results: The SH values observed for the groups G3 (257±70), G1 (205±70), and G2 (208±84) differed from the G4 group (98±110) (one-way ANOVA and Tukey's post hoc test). There were no differences between the groups G1xG2, G2xG3, and G1xG3 for demineralization inhibition. The percentage of volume mineral showed that, when applied with fluoride dentifrice, MPP was the most effective in preventing enamel demineralization at 50 µ from the outer enamel surface (Kruskal-Wallis and Mann Whitney p<0.05).

Conclusion: Fluoride dentifrice associated with CPP-ACPF inhibited subsurface enamel demineralization.

Figures

Figure 1. Flow chart illustrating the study…
Figure 1. Flow chart illustrating the study protocol
Figure 2. Typical 3D images of enamel…
Figure 2. Typical 3D images of enamel blocks in the control group after pH cycling
Figure 3. Mineral profile in the groups…
Figure 3. Mineral profile in the groups (G1, G2, G3 and G4)

References

    1. Al-Mullahi AM, Toumba KJ. Effect of slow-release fluoride devices and casein phosphopeptide/amorphous calcium phosphate nanocomplexes on enamel remineralization in vitro . Caries Res. 2010;44:364–371.
    1. Arends J, ten Bosch JJ. Demineralization and remineralization evaluation techniques. J Dent Res. 1992;71:924–928.
    1. Bröchner A, Christensen C, Kristensen B, Tranaeus S, Karlsson L, Sonnesen L, et al. Treatment of post-orthodontic white spot lesions with casein phosphopeptide-stabilised amorphous calcium phosphate. Clin Oral Investig. 2011;15:369–373.
    1. Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89:1187–1197.
    1. Elkassas D, Arafa A. Remineralizing efficacy of different calcium-phosphate and fluoride based delivery vehicles on artificial caries like enamel lesions. J Dent. 2014;42:466–474.
    1. Featherstone JD, Ten Cate JM, Shariati M, Arends J. Comparison of artificial caries-like lesion by quantitative microradiography and microhardness profiles. Caries Res. 1983;17:385–391.
    1. Hamba H, Nikaido T, Inoue G, Sadr A, Tagami J. Effects of CPP-ACP with sodium fluoride on inhibition of bovine enamel demineralization: a quantitative assessment using micro-computed tomography. J Dent. 2011;39:405–413.
    1. Karlinsey RL, Mackey AC, Stookey GK, Pfarrer AM. In vitro assessments of experimental NaF dentifrices containing a prospective calcium phosphate technology. Am J Dent. 2009;22:180–184.
    1. Kielbassa AM, Wrbas K-Th, Schulte-Monting J, Hellwig E. Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. Arch Oral Biol. 1999;44:243–251.
    1. Kumar VL, Itthagarun A, King NM. The effect of casein phosphopeptide-amorphous calcium phosphate on remineralization of artificial caries-like lesions: an in vitro study. Aust Dent J. 2008;53:34–40.
    1. Meyer-Lueckel H, Wierichs RJ, Schellwien T, Paris S. Remineralizing efficacy of a CPP-ACP cream on enamel caries lesions in situ . Caries Res. 2015;49:56–62.
    1. Mielczarek A, Gedrange T, Michalik J. An in vitro evaluation of the effect of fluoride products on white spot lesion remineralization. Am J Dent. 2015;28:51–56.
    1. Oliveira GM, Ritter AV, Heymann HO, Swift E, Jr, Donovan T, Brock G, et al. Remineralization effect of CPP-ACP and fluoride for white spot lesions in vitro. J Dent. 2014;42:1592–1602.
    1. Oliveira PR, Fonseca AB, Silva EM, Coutinho TC, Tostes MA. Remineralizing potential of CPP-ACP crèmes with and without fluoride in artificial enamel lesions. Aust Dent J. 2016;61:45–52.
    1. Pignatelli I, Kumar A, Shah K, Balonis M, Bauchy M, Wu B, et al. Vertical scanning interferometry: a new method to quantify re-/de-mineralization dynamics of dental enamel. Dent Mater. 2016;32:e251–e261.
    1. Pulido MT, Wefel JS, Hernandez MM, Denehy GE, Guzman-Armstrong S, Chalmers JM, et al. The inhibitory effect of MI paste, fluoride and a combination of both on the progression of artificial caries-like lesions in enamel. Oper Dent. 2008;33:550–555.
    1. Reynolds EC. Remineralization of enamel subsurface lesions by casein phosphopeptide-stabilized calcium phosphate solutions. J Dent Res. 1997;76:1587–1595.
    1. Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker G, Morgan MV, et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008;87:344–348.
    1. Shen P, Manton DJ, Cochrane NJ, Walker GD, Yuan Y, Reynolds C, et al. Effect of added calcium phosphate on enamel remineralization by fluoride in a randomized controlled in situ trial. J Dent. 2011;39:518–525.
    1. Sitthisettapong T, Doi T, Nishida Y, Kambara M, Phantumvanit P. Effect of CPP-ACP paste on enamel carious lesion of primary upper anterior teeth assessed by quantitative light-induced fluorescence: a one-year clinical trial. Caries Res. 2015;49:434–441.
    1. Sitthisettapong T, Phantumvanit P, Huebner CT, Derouen D. Effect of CPP-ACP paste on dental caries in primary teeth: a randomized trial. J Dent Res. 2012;91:847–852.
    1. Souza CC, Cury JL, Coutinho TC, Da Silva EM, Tostes MA. Effect of different application frequencies of CPP-ACP and fluoride dentifrice on demineralized enamel: a laboratory study. Am J Dent. 2014;27:215–219.
    1. Vyavhare S, Sharma DS, Kulkarni VK. Effect of three different pastes on remineralization of initial enamel lesion: an in vitro study. J Clin Pediatr Dent. 2015;39:149–160.
    1. White DJ. The application of in vitro models to research on demineralization and remineralization of teeth. Adv Dent Res. 1995;9:175–193.

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