Effectiveness of Theobromine on Enamel Remineralization: A Comparative In-vitro Study

Parvathy Premnath, Joseph John, Nithin Manchery, Gireesh K Subbiah, Nagappan Nagappan, Prabhu Subramani, Parvathy Premnath, Joseph John, Nithin Manchery, Gireesh K Subbiah, Nagappan Nagappan, Prabhu Subramani

Abstract

Background Remineralizing agents demonstrate potential to reverse early carious lesions. Theobromine containing dentifrices claim to remineralize enamel lesions effectively. The aim of this in-vitro study was to evaluate and compare the remineralization potential of dentifrices containing theobromine, 0.21% sodium fluoride (NaF) with functionalized tricalcium phosphate (f-TCP) and amine fluoride on artificial enamel caries. Materials and methods Sound extracted human premolars were demineralized to produce deep artificial carious lesions. The teeth were sectioned longitudinally and allocated to three treatment groups with nine specimens in each group: Group A (NaF + f-TCP), Group B (amine fluoride), and Group C (theobromine). The specimens were then subjected to pH cycling for seven days. Confocal laser scanning microscopy (CLSM) was utilized to record the patterns of demineralization and remineralization. One-way ANOVA and paired t-test were used to analyze changes in lesion depth. The level of significance was set at p<0.05. Results All three dentifrices effectively remineralized artificial carious lesions (paired t-test, p<0.001). Of the groups, Group A (54.97%) reported the highest percentage change in lesion depth values followed closely by Group B (51.51%) and Group C (31.71%), respectively. Conclusion Within this in-vitro study, theobromine containing dentifrice was effective in remineralizing lesions of enamel. However, theobromine demonstrated less remineralization potential in comparison to dentifrices containing NaF + f-(TCP) and amine fluoride.

Keywords: enamel; fluoride; remineralization; theobromine; tricalcium phosphate.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2019, Premnath et al.

Figures

Figure 1. Representative confocal laser scanning microscopic…
Figure 1. Representative confocal laser scanning microscopic images [5x] of groups A, B, and C (a) before and (b) after pH cycling
Figure 2. Percentage change in lesion depth…
Figure 2. Percentage change in lesion depth among three groups after pH cycling

References

    1. Loesche WJ. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Microbiology of dental decay and periodontal disease; p. 8259.
    1. Early childhood caries update: a review of causes, diagnoses, and treatments. Colak H, Dülgergil CT, Dalli M, Hamidi MM. J Nat Sci Biol Med. 2013;4:29–38.
    1. Demineralization-remineralization dynamics in teeth and bone. Abou Neel EA, Aljabo A, Strange A, et al. Int J Nanomedicine. 2016;11:4743–4763.
    1. Remineralization strategies in oral hygiene: a position paper of Italian society of oral hygiene sciences-S.I.S.I.O. Working group. Sanavia C, Tatullo M, Bassignani J, et al. Open Dent J. 2017;11:527–538.
    1. The fluoride debate: the pros and cons of fluoridation. Aoun A, Darwiche F, Al Hayek S, Doumit J. Prev Nutr Food Sci. 2018;23:171–180.
    1. Oral and dental delivery of fluoride: a review. Ullah R, Zafar MS. Fluoride. 2015;48:195–204.
    1. Effect of fluoride toothpastes on enamel demineralization. Arnold WH, Dorow A, Langenhorst S, Gintner Z, Bánóczy J, Gaengler P. BMC Oral Health. 2006;6:8.
    1. The relative anticaries effectiveness of three fluoride-containing dentifrices in Puerto Rico. Stookey GK, Mau MS, Isaacs RL, Gonzalez-Gierbolini C, Bartizek RD, Biesbrock AR. Caries Res. 2004;38:542–550.
    1. Statistical considerations related to a meta-analytic evaluation of published caries clinical studies comparing the anticaries efficacy of dentifrices containing sodium fluoride and sodium monofluorophosphate. Proskin HM. . Am J Dent. 1993;6:43–49.
    1. Overview of calcium phosphates used in biomimetic oral care. Meyer F, Amaechi BT, Fabritius HO, Enax J. Open Dent J. 2018;12:406–423.
    1. The effect of time in the exposure of theobromine gel to enamel and surface hardness after demineralization with 1% citric acid. Irawan MIP, Noerdinand A Eriwati YK. J Phys Conf Ser. 2017;884
    1. A neural analysis of theobromine vs. fluoride on the enamel surface of human teeth. Arman S. Diss Abstr;2007:150.
    1. Remineralization of artificial enamel lesions by theobromine. Amaechi BT, Porteous N, Ramalingam K, Mensinkai PK, Vasquez C, Sadeghpour A, Nakamoto T. . Caries Res. 2013;47:399–405.
    1. Comparative evaluation on antimicrobial activity of theobromine and two commercial kids fluoride toothpaste—an in vitro study. Arthilakshmi Arthilakshmi, Sharmin DD. Int J Dent Oral Health. 2016;2:52–56.
    1. Theobromine: a safe and effective alternative for fluoride in dentifrices. Nakamoto T, Falster AU, Simmons WB. J Caffeine Res. 2016;6
    1. The effect of nano-hydroxyapatite toothpaste on artificial enamel carious lesion progression: an in vitro pH-cycling study. Itthagarun A, King NM, Cheung YM. Hong Kong Dent J. 2010;7:61–66.
    1. Development of a root caries pH cycling model. Heilman JR, Wefel JS, Pyrz JW, Faller RV. J Dent Res. 1991;71:201.
    1. Evaluation to determine the caries remineralization potential of three dentifrices: an in vitro study. Balakrishnan A, Jonathan R, Benin P, Kuumar A. J Conserv Dent. 2013;16:375–379.
    1. The use of in vitro model systems to study dental biofilms associated with caries: A short review. Salli KM, Ouwehand AC. J Oral Microbiol. 2015;7
    1. PH-cycling models for in vitro evaluation of the efficacy of fluoridated dentifrices for caries control: strengths and limitations. Buzalaf MA, Hannas AR, Magalhães AC, Rios D, Honório HM, Delbem ACB. . J Appl Oral Sci. 2010;18:316–334.
    1. Protective potential of casein phosphopeptide amorphous calcium phosphate containing paste on enamel surfaces. Somasundaram P, Vimala N, Mandke LG. J Conserv Dent. 2013;16:152–156.
    1. Fluoride - is it capable of fighting old and new dental diseases? An overview of existing fluoride compounds and their clinical applications. Brambilla E. Caries Res. 2001;35:6–9.
    1. Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: a review. Reynolds EC. . Spec Care Dentist. 1998;18:8–16.
    1. In vitro assessments of experimental NaF dentifrices containing a prospective calcium phosphate technology. Karlinsey RL, Mackey AC, Stookey GK, Pfarrer AM. . Am J Dent. 2009;22:180–184.
    1. In vitro remineralization efficacy of NaF systems containing unique forms of calcium. Karlinsey RL, Mackey AC, Stookey GK. . Am J Dent. 2009;22:185–188.
    1. Fluoride and casein phosphopeptide-amorphous calcium phosphate. Reynolds EC, Cai F, Cochrane NJ, Shen P, Walker GD, Morgan MV, Reynolds C. J Dent Res. 2008;87:344–348.
    1. Effect of fluoride toothpastes on enamel demineralization. Arnold WH, Dorow A, Langenhorst S, Gintner Z, Bánóczy J, Gaengler P. BMC Oral Health. 2006;6:8.
    1. Evaluation of human enamel surfaces treated with theobromine: a pilot study. Kargul B, Ozcan M, Peker S, Nakamoto T, Simmons WB, Falster AU. . Oral Health Prev Dent. 2012;10:275–282.
    1. The effects of fluoride, strontium, theobromine and their combinations on caries lesion rehardening and fluoridation. Lippert F. Arch Oral Biol. 2017;80:217–221.

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