Comparison of CPP-ACP, Fluoride Varnish and Gel effects on enamel microhardness of permanent teeth: In-Vitro

Background:

 Dental caries occurs due to the imbalance in the course of demineralization-remineralization in favor of demineralization. With remineralization, some signs of halted progression could be observed in the primary stages. The aim of this study is to in-vitro investigation of the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP), fluoride varnish, and fluoride gel on the microhardness of the enamel of permanent teeth.

In this in vitro study, 344 specimens prepared from human premolars were randomly divided into four groups (n=86 specimens in each group). After preparing the specimens, the initial enamel value was first evaluated by Vickers microhardness technique. The specimens were immersed in a demineralizing solution and then treated with remineralizing compounds (I. Control, II. Fluoride varnish, III. Fluoride gel and IV. CPP-ACP). Microhardness values were re-measured at the end of demineralization and remineralization stages. The data were analyzed using SPSS software (version 16.0).

The results of the present study indicated a statistically significant difference in all groups in terms of initial enamel microhardness (0.288 ± 42.77), remineralization (0.213 ± 26.89), and demineralization values (0.167 ± 63.87) (p <0.001). Besides, there was a statistically significant difference in different groups in terms of remineralization values (p <0.001). In other words, the mean microhardness was 241.21 ±15.60 in Group III, 221.12 ± 75.69 in Group II, 211.16 ± 43.04 in Group IV, and 178.21 ± 63.9 in group- I.

Conclusion :

All remineralizing compounds resulted in enhanced microhardness of the enamel. Nevertheless, the fluoride-containing products showed greater potential in improving the level of microhardness and strength of the teeth compared to the compounds containing CPP-ACP.