Concentration of calcium, phosphate and fluoride ions in microbial plaque and saliva after using CPP-ACP paste in 6-9 year-old children

Statement of Problem: Dental caries is one of the most common chronic diseases in children. The balance between demineralization and remineralization of the decayed teeth depends on the calcium and phosphate content of the tooth surface. Therefore, if a product such as casein phospho peptides - amorphous calcium phosphate [CPP-ACP] which can significantly increase the availability of calcium and phosphate in the plaque and saliva should have an anti-caries protective effect

Objectives: The purpose of this study was to evaluate the concentration of calcium, phosphate and fluoride in the plaque and saliva of children before and after applying the CPP-ACP paste

Materials and Methods: A total of 25 children aged between 6-9 years were selected for this clinical trial study. At first, 1 ml of unstimulated saliva was collected and then 1 mg of the plaque sample was collected from the buccal surfaces of the two first primary molars on the upper jaw. In the next step, CPP-ACP paste [GC Corp, Japan] was applied on the tooth surfaces and then the plaque and saliva sampling was performed after 60 minutes. The amount of calcium ions was measured by Ion meter instrument [Metrohm Co, Swiss] and the amounts of phosphate and fluoride ions were measured by Ion Chromatography instrument [Metrohm Co, Swiss]. Data were analyzed using paired t-test at a p < 0.05 level of significance

Results: There were statistically significant differences in the calcium and phosphate concentration of the saliva and plaque before and after applying the CPP-ACP paste. There were also statistically significant differences in the fluoride levels of the plaque before and after applying the CPP-ACP paste. However, there were no statistically significant differences in the fluoride levels of the saliva before and after applying the CPP-ACP paste

Conclusions: In this study, the use of the CPP-ACP paste significantly increased the fluoride levels of the plaque and the calcium and phosphate levels of both saliva and plaque. Hence, CPP-ACP paste can facilitate the remineralization of tooth surfaces and is useful for protecting the primary teeth

[Comparison of fluoride uptake into enamel from sodium fluoride gel 0.05% produced in Iran and stannous fluoride 0.4% gel]

The present study compared fluoride uptake into enamel from sodium fluoride 0.05% gel and American Dental Association approved fluoride gel [Stannous fluoride 0.4%, Sultan Co.] when used on healthy enamel of the intact teeth. In an experimental study, 30 intact teeth extracted for orthodontic purposes were randomly assigned into two groups of 15 teeth. The teeth were sectioned in two mesial and distal halves as control and experimental sides. Defined semi-circular areas on the enamel of experimental halves were treated with gel for 4 minutes, the halves were stored in artificial saliva for 24 hours at 37§C, etched for 30 seconds by 0.5 M perchlorid Acid and washed by 0.2 ml KOH after each etching. Biopsy of the samples was obtained by Acid Etch Enamel Biopsy technique and the fluoride and calcium concentration were calculated by potentiometer and spectrophotometer respectively. Paired t test and student t test were used for statistical analyses. The results showed significant increase of enamel fluoride content in the experimental halves after exposure to both stannous fluoride 0.4% [P=0.0001] and sodium fluoride 0.05% [P=0.009]. Mean fluoride uptakes in stannous fluoride 0.4% gel and sodium fluoride 0.05% gel groups were respectively 4052.5 ppm and 892.5 ppm that shows statistically significant difference [P=0.0001]. Although both sodium fluoride 0.05% and stannous fluoride 0.4% increased fluoride Content of tooth enamel after application, stannous fluoride 0.4% caused more fluoride uptake into the tooth enamel that is due to its higher amount of fluoride ion [1000 ppm] compared to sodium fluoride gel [225 ppm]