The comparative evaluation for the efficacy of different remineralization agents on initial caries lesion

OBJECTIVE: To evaluate the effectiveness of different remineralization agents on artificially initial caries created teeth. METHOD: The bovine teeth crowns were divided into four equal-parts, and initial measurements (microhardness, micro-computed tomography (Micro-CT), scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS)) were recorded from each specimen (n = 6). Then the samples were subjected to a demineralization procedure for four-days, with the daily refreshed solution. After the demineralization process, second measurements were performed. In the experimental group, the products containing fluoride (Colgate Sensation White-Colgate Palmolive), hydroxyapatite (HAP) (Kinder Karex-Dr. Wolff), and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (Tooth Mousse-GC) were applied twice daily for 7 days, for 3 min each time. The control group specimens were only stored in artificial saliva. The final measurements were performed after the remineralization procedure. RESULTS: The initial microhardness, total mineral density (BMD), atomic % Ca, and P values of the groups did not show any statistical significant difference. The demineralization process resulted in a decrease in microhardness, BMD, Ca and P values (p < 0.05). The remineralization process led to an increase in microhardness and BMD values in all groups (p < 0.05). No statistically significant difference in microhardness values was detected when comparing the initial and remineralization measurements. A significant increase in BMD values was observed only in the HAP group when comparing the initial and remineralization measurements (p < 0.05). The remineralization process resulted in varied patterns and shapes of closures and accumulations on the enamel surface, which differed among the groups. CONCLUSION: The activity of the agents was observed as variable according to the parameters examined in the analyses. Considering the in vitro design of the study, further studies and clinical observations were suggested as necessary to clarify the action mechanism and differences of these agents.