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. Materials and Methods: In this in vitro study, ۳۴۴ specimens prepared from human premolars were randomly divided into four groups (n=۸۶ 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 ۱۶.۰). Results: The results of the present study indicated a statistically significant difference in all groups in terms of initial enamel microhardness (۰.۲۸۸ ± ۴۲.۷۷), remineralization (۰.۲۱۳ ± ۲۶.۸۹), and demineralization values (۰.۱۶۷ ± ۶۳.۸۷) (p <۰.۰۰۱). Besides, there was a statistically significant difference in different groups in terms of remineralization values (p <۰.۰۰۱). In other words, the mean microhardness was ۲۴۱.۲۱ ±۱۵.۶۰ in Group III, ۲۲۱.۱۲ ± ۷۵.۶۹ in Group II, ۲۱۱.۱۶ ± ۴۳.۰۴ in Group IV, and ۱۷۸.۲۱ ± ۶۳.۹ 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.

Keywords:

CPP-ACP , Fluoride , microhardness , tooth enamel , Remineralization