title: Synergistic effect of proanthocyanidin and CPP-ACFP on remineralization of artificial root caries.
abstract: This study evaluated the synergistic effect of proanthocyanidin (PA) and casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) on remineralization of artificial root caries.
  
  
  
  Demineralized root fragments (n = 90) were randomly divided into six groups based on treatments: (1) 6.5% PA; (2) CPP-ACP; (3) CPP-ACFP; (4) CPP-ACFP + 6.5% PA; (5) 1000 ppm fluoride; and (6) deionized water (control). Each specimen was immersed in demineralizing solution for 14 h, testing solutions/pastes for 2 h, remineralizing solution for 8 h and pH cycling was performed at 37 °C for 8 days. Specimens were evaluated using transverse microradiography (lesion depth and mineral loss), Knoop microhardness and confocal laser scanning microscopy.
  
  
  
  Lesion depth was significantly lower in CPP-ACFP+PA and 1000 ppm fluoride groups (p < 0.001) with no significant difference between the two groups (p > 0.05). Mineral loss was the lowest in CPP-ACFP+PA group (p < 0.05). Fluoride and CPP-ACFP groups showed similar mineral gain (p > 0.05). Artificial caries lesions treated with CPP-ACFP+PA showed significantly higher microhardness values at 130 μm and 150 μm from the surface (p < 0.05).
  
  
  
  Combined use of PA and CPP-ACFP has a synergistic effect on root caries remineralization by enhancing mineral gain and increasing hardness of artificial root caries.
authors.affiliation: Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: D J
authors.initials: DJ
authors.lastname: Epasinghe
authors.affiliation: Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Cky
authors.initials: C
authors.lastname: Yiu
authors.affiliation: Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: M F
authors.initials: MF
authors.lastname: Burrow
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use*; D002327:Cariostatic Agents / Q000627:therapeutic use; D002364:Caseins / Q000627:therapeutic use*; D003743:Dental Enamel / Q000187:drug effects; D004357:Drug Synergism; D006244:Hardness; D006801:Humans; D008852:Microradiography; D018613:Microscopy, Confocal; D008903:Minerals; D044945:Proanthocyanidins / Q000627:therapeutic use*; D017213:Root Caries / Q000188:drug therapy*; D014089:Tooth Remineralization
chemical_list: D000975:Antioxidants; D002327:Cariostatic Agents; D002364:Caseins; D008903:Minerals; D044945:Proanthocyanidins; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; C013221:proanthocyanidin
keywords: CPP-ACFP; proanthocyanidin; remineralization; root caries