AccScience Publishing / JCTR / Volume 6 / Issue 3 / DOI: 10.18053/jctres.06.202003.005
ORIGINAL ARTICLE

Comparative evaluation of enamel microhardness after using two different remineralizing agents on artificially demineralized human enamel: An in vitro study

J. Sai Sahiti1* N. Vamsee Krishna1 S. Datta Prasad1 C. Sunil Kumar1 S. Sunil Kumar1 K. S. Chandra Babu1
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1 Department of Conservative Dentistry and Endodontics, CKS Theja Institute of Dental Sciences and Research, Tirupathi, Andhra Pradesh, India
Submitted: 11 November 2019 | Revised: 30 January 2020 | Accepted: 28 June 2020 | Published: 5 September 2020
© 2020 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Aim. The purpose of this study was to compare the remineralization outcomes of two agents using the Vickers microhardness test on artificially induced enamel subsurface lesions.

Materials and Methods. Forty sound extracted premolars were selected as samples for the current study and divided into four groups of 10 teeth each: Clinpro (group 1), Remin Pro (group 2), untreated positive control (group 3) and a demineralized negative control (group 4). All the sample groups were assessed first at baseline then after demineralization and remineralization using DIAGNOdent. After the remineralization process, Vickers microhardness test was performed on all sample groups to assess surface microhardness (SMH). The results obtained were then compared using one-way ANOVA for difference in SMH.

Results. Vickers microhardness number values were analyzed using one-way ANOVA and samples in the experimental groups 1 and 2 showed a statistically significant difference compared to the control groups (p < 0.05). Remineralization was higher in the Remin Pro group followed by Clinpro group.

Conclusions. The results of this in vitro study show that both Remin Pro and Clinpro are equally effective as remineralizing agents. Although Remin Pro tended to yield a higher microhardness, no significant differences were observed between the two agents.

Relevance for patients. Enamel mineral loss leads to the degradation of the surface and subsurface structures of teeth. Natural remineralization that occurs physiologically is not sufficient to overcome the hurdles of mineral loss, a tooth undergoes due to changes in food habits and life style. A thought on remineralization and management such as prescribing remineralising agents and regular professional topical fluoride applications would definitely render satisfactory results by a strong healthy enamel.

Keywords
Tricalcium phosphate
hydroxyapatite
fluoride
remineralization
microhardness
References

[1] Bahrololoomi Z, Musavi SA, Kabudan M. In Vitro Evaluation of the Efficacy of Laser Fluorescence (DIAGNOdent) to Detect Demineralization and Remineralization of Smooth Enamel Lesions. J Conserv Dent 2013;16:362-6.

[2] Lussi A, Hibst R, Paulus R. DIAGNOdent: An Optical Method for Caries Detection. J Dent Res 2004;83:C80-3.

[3] Ghoncheh Z, Zonouzy Z, Kiomarsi N, Kharazifar MJ, Chiniforush N. In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations. J Lasers Med Sci 2017;8:172-6.

[4] Featherstone JD, Chaffee BW. The Evidence for Caries Management by Risk Assessment (CAMBRA®). Adv Dent Res 2018;29:9-14.

[5] Miake Y, Saeki Y, Takahashi M, Yanagisawa T. Remineralization Effects of Xylitol on Demineralized Enamel. J Electron Microsc (Tokyo) 2003;52:471-6.

[6] Rao R, Jain A, Verma M, Langade D, Patil A. Comparative Evaluation of Remineralizing Potential of Fluoride Using Three Different Remineralizing Protocols: An In Vitro Study. J Conserv Dent 2017;20:463-6.

[7] Chuenarrom C, Benjakul P, Daosodsai P. Effect of Indentation Load and Time on Knoop and Vickers Microhardness Tests for Enamel and Dentin. Mater Res 2009;12:473-6.

[8] Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative Evaluation of Remineralizing Potential of Three Agents on Artificially Demineralized Human Enamel: An In Vitro Study. J Conserv Dent 2013;16:116-20.

[9] Solomon RV, Byragoni C, Jain A, Juvvadi Y, Babu R. An In Vitro Evaluation of Microhardness of Different Direct Resin-based Restorative Materials on Using 10% Carbamide Peroxidegel as a Bleaching Agent. J Oral Res Rev 2016;8:59-65.

[10] Swarup JS, Rao A. Enamel Surface Remineralization: Using Synthetic Nanohydroxyapatite. Contemp Clin Dent 2012;3:433-6.

[11] Lata S, Varghese NO, Varughese JM. Remineralization Potential of Fluoride and Amorphous Calcium Phosphatecasein Phosphopeptide on Enamel Lesions: An In Vitro Comparative Evaluation. J Conserv Dent 2010;13:42-6.

[12] Jayarajan J, Janardhanam P, Jayakumar P, Deepika. Efficacy of CPP-ACP and CPP-ACPF on Enamel Remineralization an In Vitro Study Using Scanning Electron Microscope and DIAGNOdent. Indian J Dent Res 2011;22:77-82.

[13] Goel A, Chawla HS, Gauba K, Goyal A. Comparison of Validity of DIAGNOdent with Conventional Methods for Detection of Occlusal Caries in Primary Molars Using the Histological Gold Standard: An In Vivo Study. J Indian Soc Pedod Prev Dent 2009;27:227-34.

[14] Sandeep T, Darshana D, Mithra HN. Comparative Evaluation of Effect of Various Remineralizing Agents on Bleached Enamel Surface: An In Vitro Study. J Pharm Sci Innov 2015;4:324-8.

[15] Kamath U, Sheth H, Mullur D, Soubhagya M. The Effect of Remin Pro® on Bleached Enamel Hardness: An In-Vitro Study. Indian J Dent Res 2013;24:690-3.

[16] Jayashankara CM, John, Setty JK, Kumar PS, Girish SA. Comparative Evaluation of Shy-nm and Remin Pro on the Microhardness of Bleached Enamel: An In Vitro Study. Int J Inform Res Rev 2016;3:3464-8.

[17] Balakrishnan A, Jonathan R, Benin P, Kumar A. Evaluation to Determine the Caries Remineralization Potential of Three Dentifrices: An In Vitro Study. J Conserv Dent 2013;16:375-479.

[18] Prabhakar AR, Manojkumar AJ, Basappa N. In Vitro Remineralization of Enamel Subsurface Lesions and Assessment of Dentine Tubule Occlusion from NaF Dentifrices with and without Calcium. J Indian Soc Pedod Prev Dent 2013;31:29-35.

[19] Chokshi K, Chokshi A, Konde S, Shetty SR, Chandra KN, Jana S, et al. An In Vitro Comparative Evaluation of Three Remineralizing Agents Using Confocal Microscopy. J Clin Diagn Res 2016;10:ZC39-42.

[20] 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;39:518-25.

[21] Rirattanapong P, Vongsavan K, Saengsirinavin C, Phuekcharoen P. Effect of Adding Tricalcium Phosphate to Fluoride Mouthrinse on Microhardness of Demineralized Primary Human Tooth. Southeast Asian J Trop Med Public Health 2015;46:539-45.

[22] Lynch RJ, Navada R, Walia R. Low-levels of Fluoride in Plaque and Saliva and their Effects on the Demineralisation and Remineralisation of Enamel; Role of Fluoride Toothpastes. Int Dental J 2014;54 Suppl 1:304-9.

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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing