title: Efficacy of calcium- and fluoride-containing materials for the remineralization of primary teeth with early enamel lesion.
abstract: The aim of the study was to determine the efficacy of different products containing fluoride, calcium and phosphate for enamel remineralization in eroded primary teeth. A total of 90 sound primary canine teeth were randomly divided into 5 groups of 18 teeth each: 1) control (polished enamel), 2) 5% DuraShield sodium fluoride varnish, 3) 500 ppm fluoridated toothpaste, 4) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) cream, and 5) Clinpro White varnish containing functionalized tri-calcium phosphate (fTCP). Enamel microhardness (EMH) was measured in all samples before and after demineralization and after 28 days of remineralization. Also 8 samples in groups 2 to 5 and four samples of sound and demineralized enamel were examined with atomic force microscopy (AFM). All data were analyzed with one-way ANOVA (p<0.05). Mean microhardness of demineralized enamel was significantly lower than in enamel at baseline (p<0.001). Remineralization significantly increased microharness in groups 2 to 5 compared to the control group (p<0.001). Percent EMH after remineralization with CPP-ACP was significantly higher than after fTCP (p=0.029), toothpaste (p< 0.001) or fluoride varnish (p<0.001); however, there was no significant difference between toothpaste and fluoride varnish (p=0.062). Microhardness increased more after fTCP treatment than after treatment with sodium fluoride varnish (p<0.001) or fluoridated toothpaste (p=0.045). AFM images showed that enamel roughness decreased most after treatment with fTCP, followed by CPP-ACP, toothpaste and fluoride varnish. The efficacy of CPP-ACP cream for remineralizing eroded enamel was greater than fluoride toothpaste, fluoride varnish or fTCP varnish.
authors.affiliation: Prevention of Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mahtab
authors.initials: M
authors.lastname: Memarpour
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Soltanimehr
authors.affiliation: Department of Medical Physics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Naghmeh
authors.initials: N
authors.lastname: Sattarahmady
mesh_terms: D002118:Calcium / Q000008:administration & dosage*; D003743:Dental Enamel / Q000187:drug effects*; D005459:Fluorides / Q000008:administration & dosage*; D018625:Microscopy, Atomic Force; D010710:Phosphates / Q000008:administration & dosage; D013499:Surface Properties / Q000187:drug effects; D014089:Tooth Remineralization / Q000379:methods*; D014094:Tooth, Deciduous / Q000187:drug effects*
chemical_list: D010710:Phosphates; D005459:Fluorides; D002118:Calcium
keywords: AFM; CPP-ACP; deciduous teeth; microhardness; three calcium phosphate