Remineralization effects of enamel binding peptide, WGNYAYK, on enamel subsurface demineralization in vitro. Enamel binding peptide, WGNYAYK effect remineralization of enamel.

Objectives: We investigated remineralization effects of enamel binding peptide (EBP), WGNYAYK, on enamel subsurface demineralization in vitro.Methods: Bovine lower incisor crowns were used as subsurface enamel demineralization samples, and changes of EBP binding, remineraliztion rate, hardness and microstructure were investigated. Binding of EBP, remineralization rate, hardness and structural changes were investigated. Fluorescein isothiocyatate (FITC)-labeled EBPs (0.4 mM, 4.0 mM, and 7.0 mM) were applied to the samples for 30 min at 37 °C, with sample surfaces and cross-sections observed by confocal laser scanning microscope (CLSM). Mineralization analysis samples were divided into 4 experimental groups; distilled water (DW), EBP 0.4 mM, EBP 4.0 mM, and EBP 7.0 mM. Mineral density changes were measured by micro-CT with hardness measured by nano-indentation. Samples were also observed by scanning electron microscope (SEM) for surface and longitudinal microstructure. Results: CLSM images indicated that increased fluorescence was observed in the surface layer and up to about 20 µm below the surface layer. The remineralization rate was significantly higher for EBP 7.0 mM compared to DW (p = 0.008). Enamel surface hardness was significantly higher in all EBP groups compared to DW (p < 0.05) and was highest in the 7.0 mM group. SEM images showed obscuring of the superficial columnar structure in the 7.0 mM EBP group, indicating subsurface crystalline structure recovery. Conclusion: The results of this study suggest that EBP binds to demineralized enamel and promotes remineralization.

Material of choice for non-invasive treatment of dentin caries: An in vitro study using natural carious lesions.

INTRODUCTION: In community settings with limited dental personnel and equipment, and in an era when the aerosol transmission of infectious agents is on the rise, a non-invasive approach to caries management is critical. To provide information on non-invasive material selection, the aim of this study was to compare the remineralization effect of commonly used fluoride-containing materials, adjunctive to the everyday use of fluoride toothpaste (F-toothpaste), on primary tooth natural dentin caries. METHODS: Fifty-five specimens were randomly divided into five groups: 38% silver diamine fluoride (SDF), 5% fluoride varnish (F-varnish), glass-ionomer cement (GIC), deionized water (DW) with F-toothpaste slurry, and DW as a control group (n = 11). The lesion depth and mineral density were measured before and after bacterial pH-cycling using micro-computed tomography. The percentage of mineral density change (%MDchange) was quantified. The dependent t-test, Wilcoxon-Signed-Rank Test, and one way ANOVA with Bonferroni correction were used to analyse the data. RESULTS: SDF application reduced lesion depth from 844.6 to 759.1 µm (p < 0.045) while increasing mineral density from 551.4 to 763.0 mgHA/cm3 (p < 0.003). Only mineral density rose from 600.2 to 678.4 mgHA/cm3 (p < 0.013) when GIC was used. The other groups showed no difference. The highest %MDchange was also found after SDF treatment (49.7%, p < 0.05), whereas GIC (17.2%, p < 0.05) presented a higher percentage than the F-varnish (2.0%), F-toothpaste (-1.1%) and no-treatment groups (-1.4%). CONCLUSION: In this in vitro study, where the pH of cycling was almost neutral, using SDF as an adjunct to F-toothpaste resulted in the highest remineralization compared with other remineralizing materials.

Effects of bovine milk osteopontin on in vitro enamel remineralization as a topical application prior to immersion in remineralizing solutions with/without fluoride.

The aim of the present study was to investigate the effects of bovine milk osteopontin (OPN) on enamel remineralization as a topical application prior to immersion in remineralizing solutions with/without fluoride. Bovine enamel blocks were demineralized then were divided into the following 3 groups: OPN (2.7 and 5.4 µM) solutions and deionized water (control). Each group was divided into 2 groups (remineralizing solution with or without 1 ppm of fluoride (F)). The specimens were analyzed by micro-CT and scanning electron microscope (SEM). The percentage of remineralization was higher in remineralization solution with than without F (p<0.05). The present results suggest that bovine milk OPN inhibits remineralization in solution without F, but 5.4 µM bovine milk OPN does not inhibit remineralization of the demineralized body using solution containing F by interrupting mineral deposition on the enamel surface.

Effect of fluoride-releasing 4-META/MMA-TBB resin on enamel demineralization around orthodontic brackets: An in vitro µCT analysis.

This study aimed to evaluate the impact of fluoride-releasing 4-META/MMA-TBB resin on the degree of enamel demineralization typically detected around orthodontic brackets using µCT. Enamel-dentin blocks were prepared from bovine teeth. Brackets were attached with either 4-META/MMA-TBB resin (SBC), fluoride-releasing 4-META/MMA-TBB resin (SBF), or fluoride-releasing RMGIC (FLC). The specimens were subjected to demineralization (pH 4.5, 21 days) and scanned by µCT (0, 7, and 21 days). Fluoride ion release under the experimental conditions was measured. The degree of demineralization detected in SBF and FLC was significantly lower than that in SBC; there were no significant differences in the degree of demineralization detected in SBF and FLC. The level of fluoride ion detected in FLC was significantly higher than that detected in SBC. Fluoride-releasing 4-META/MMA-TBB resin protected against enamel demineralization around orthodontic brackets when compared to the results from the fluoride-free resin.

In vitro remineralization of enamel with a solution containing casein and fluoride.

The aim of the present study was to investigate the effects of casein in a remineralization solution on enamel remineralization. Bovine blocks were demineralized for 21 days, then, allocated into four groups. The specimens were remineralized for 21 days in the following artificial saliva solutions: 1) 0 µg/mL casein, 0 ppm fluoride (F) (C0-F0); 2) 0 µg/mL casein, 1 ppm F (C0-F1); 3) 10 µg/mL casein, 0 ppm F (C10-F0); and 4) 10 µg/mL casein, 1 ppm F (C10-F1). Micro-CT analyses were performed once a week. Specimens were characterized by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The present results suggest that casein by itself inhibits remineralization, whereas the coexistence of casein and F promotes the remineralization of caries bodies by interrupting mineral deposition on the enamel surface.

Micro-CT assessment of the effect of silver diammine fluoride on inhibition of root dentin demineralization.

This study evaluated the ability of different types of silver diammine fluoride (SDF) to inhibit dentin demineralization using micro-focused X-ray computed-tomography (µCT). Dentin specimens were divided into five groups (n=10); no-treatment (control), 3.8% SDF (RC), 38% SDF, 38% SDF with potassium iodide (SDF/KI), and potassium fluoride (KF). The treated-dentin surfaces were subjected to demineralization for 7-days and assessed using µCT to determine mineral loss (ML) values. Specimens were also analyzed with scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). The ML values of the SDF and KF groups were significantly lower than those of the RC and SDF/KI groups. EDS detected fluoride ions in the SDF and KF groups but not in the RC and SDF/KI groups. It was concluded that 38% SDF demonstrated a high ability to inhibit dentin demineralization while additional application of KI may diminish the inhibitory effect of SDF. The amount of dentin demineralization with SDF treatments was material dependent.

Remineralization of enamel subsurface lesions using toothpaste containing tricalcium phosphate and fluoride: an in vitro µCT analysis.

BACKGROUND: This study aimed to compare the efficacies of experimental toothpastes containing functionalized tricalcium phosphate (fTCP) with and without fluoride for in vitro enamel remineralization under pH-cycling conditions. METHODS: To create artificial white spot lesions, 36 bovine enamel specimens were immersed in a demineralization solution for 10 days. During pH-cycling for 12 days, the specimens were divided into four groups based on the experimental toothpaste type used: (a) fTCP-free, fluoride-free (fTCP - F -); (b) fTCP-containing, fluoride-free (fTCP + F -); (c) fTCP-free, fluoride-containing (fTCP - F +); and (d) fTCP-containing, fluoride-containing (fTCP + F +). Micro-focus X-ray computed tomography (µCT) scans of all specimens were obtained before demineralization, after demineralization, and after pH-cycling. The mineral density and mineral loss (ΔZ) in the enamel subsurface lesions were measured and the percentage of remineralization (%R) was calculated from ΔZ after demineralization and pH-cycling. One-way ANOVA with Tukey's test was used for statistical analysis of the %R values. The treated enamel surface was investigated via scanning electron microscopy (SEM). RESULTS: The fTCP - F - group presented with the lowest amount of mineral gain after pH-cycling. In contrast, the fTCP + F + group showed the highest degree of remineralization within all lesion parts. The %R was highest in the fTCP + F + group (38.2 ± 7.8, all P < 0.01). SEM revealed the presence of small crystals on the enamel rods in the fTCP + F - and fTCP + F + groups. CONCLUSIONS: The experimental toothpaste containing fTCP and fluoride increased remineralization of the artificial enamel subsurface lesions during pH-cycling. Furthermore, fTCP and fluoride appear to act independently on the remineralization of enamel subsurface lesions, although they coexisted in one toothpaste type. TRIAL REGISTRATION: This is not a human subject research.

Preventive effect of experimental polymer-based desensitizers with NaF on demineralization of root dentin -observed using micro-CT.

This study compared the effect of experimental polymer-based desensitizers with NaF and oxalic acid (OA) for preventing root demineralization via observation using micro-CT. Bovine root dentin surfaces were treated with coating materials: no treatment; MS0(+) (MS Coat One®); MS3000(+) (MS Coat®); MS0(-); MS3000(-); MS7000(+/-); fluoride gel (NaF9000). MS; MS polymer, 0-7000; NaF concentrations, (+/-); OA. The specimens were scanned using micro-CT before and after demineralization (pH4.5, 10 h). Following this, the mean mineral loss (ML) after demineralization was calculated, and the specimens were observed under a scanning electron microscope (SEM). The ML values of MS3000(+), MS7000(-), MS7000(+) and NaF9000 were significantly lower than the other groups (p<0.05). Under an SEM, a membrane structure was observed to have formed on the dentin surface in the presence of the MS, fluoride, and OA. The experimental polymer-based desensitizer with oxalic acid and a high concentration of fluoride is effective for preventing root demineralization.

Adjunctive use of fluoride rinsing and brush-on gel increased incipient caries-like lesion remineralization compared with fluoride toothpaste alone in situ.

Objective: The objective of this study was to compare the remineralizing effect of sodium fluoride (NaF) mouth rinse or NaF gel as an adjunct to NaF dentifrice on incipient caries-like lesions in an in situ cross-over design study, with three sessions of 30 days each. Materials and methods: Orthodontic brackets with artificial demineralized enamel slabs were attached to the upper first molars of 12 participants. A set of 3 test specimens from the same tooth was randomly assigned to each participant and allocated into three 30-day sessions: 1) brushing with 0.22% NaF dentifrice 2 times/day (F dentifrice), 2) brushing with 0.22% NaF dentifrice 2 times/day+ rinsing with 0.05% NaF before bedtime (F mouth rinse), 3) brushing with 0.22% NaF dentifrice 2 times/day + brushing with 1.1% NaF gel before bedtime (F brush-on gel). The mineral gain and lesion depth of the specimens were evaluated by micro-computed tomography. Results: The mean mineral gain from the NaF mouth rinse and the NaF brush-on gel was similar, but greater than that from the NaF dentifrice (p < .05). The NaF brush-on gel yielded the greatest mean depth of remineralization (168 µm), followed by the NaF mouth rinse (144 µm). Both depths were significantly greater than that of the NaF dentifrice (84 µm) (p < .05). Conclusions: Both 0.05% NaF mouth rinse and 1.1% NaF brush-on gel, used at bedtime, increased incipient caries-like lesion remineralization in situ in combination with brushing with NaF dentifrice twice a day.

Micro-computed tomography assessment of root dentin around fluoride-releasing restorations after demineralization/remineralization.

Using micro-computed tomography (micro-CT), this study assessed the inhibitory effect of three different types of restorations on root-caries formation under a cariogenic challenge. Bovine-root dentin blocks with a cylindrical cavity were divided into three restoration groups: a fluoride-free self-etch adhesive and a resin composite (SE-ES); a self-etch adhesive and a resin composite with multi-ion release (FL-BF); and a glass ionomer cement (Fuji-VII). After the restorative procedures, the specimens were stored in artificial saliva for 1 d, then subjected to a demineralization solution for 4 d and a remineralization solution for 28 d. Mineral density and mean mineral loss of dentin around the restorations were measured using micro-CT. The mean mineral loss values of dentin around the restorations were highest among SE-ES restorations and lowest among Fuji-VII restorations. Fuji-VII showed the highest mineral density and the lowest mineral loss after 28 d of remineralization. The observations made by scanning electron microscopy demonstrated that Fuji-VII created the smallest outer lesion followed by FL-BF and SE-ES. Fuji-VII has a larger inhibitory effect on root caries around the restorations and enhances remineralization more effectively than either FL-BF or SE-ES. Multi-ion and fluoride release from the restorative materials may be beneficial for inhibition of root-dentin caries around the restorations.

Micro-CT assessment of comparative radiopacity of adhesive/composite materials in a cylindrical cavity.

This study was performed to evaluate the comparative radiopacity of adhesive/resin composite materials in cylindrical cavities using micro-computed X-ray tomography (µCT). The two-step self-etch adhesive systems, Clearfil SE Bond (SE) and FL-Bond II (FL), and flowable resin composites, Beautifil Flow F10 (BF) and Clearfil Majesty ES Flow High (MJ), were used. The radiopacity of bovine tooth structures and restorative materials was measured by µCT. In addition, cylindrical cavities prepared in bovine teeth were restored with the following adhesive/composite combinations: SE-BF, SE-MJ, FL-BF, and FL-MJ. The mean gray values of the composite restorations were calculated. The threshold values of the µCT images were evaluated using the Otsu's thresholding method. The current results show that the comparative radiopacity of the materials and tooth structure varied, which affected distinguishing the µCT images of the composite restorations in the cylindrical cavity. The proper combination of restorative materials should be considered when conducting in vitro µCT assessments of composite restorations.

Effects of experimental pastes containing surface pre-reacted glass ionomer fillers on inhibition of enamel demineralization.

This study aimed to evaluate the inhibitory effect of experimental pastes containing surface pre-reacted glass ionomer (S-PRG) fillers on enamel demineralization. Bovine blocks were treated twice a day for 4 days by 7 groups; experimental pastes containing 0-30 wt% S-PRG filler (S00, S01, S05, S10, and S30), deionized water (DW) as negative control, and NaF paste (MP) as positive control. The surfaces were demineralized by acetic acid for 3 days. Mineral loss (ML) was calculated by micro-computed X-ray tomography. The treated surface was finally investigated with scanning electron microscope (SEM) and micro-focused particle induced X-ray emission (micro-PIXE). S05, S10 and S30 demonstrated significantly lower ML than S00, S01 and DW (p<0.05). S10 showed the greatest inhibitory effect, which was significantly greater than MP. The S-PRG filler containing experimental pastes demonstrated a potential to inhibit enamel demineralization. Sr ion incorporation was confirmed on the enamel surface with the experimental pastes.

Morphological Evaluation of the Adhesive/Enamel interfaces of Two-step Self-etching Adhesives and Multimode One-bottle Self-etching Adhesives.

PURPOSE: To evaluate the acid-base resistant zone (ABRZ) at the adhesive/enamel interface of self-etching adhesives with or without prior phosphoric acid etching. MATERIALS AND METHODS: Four adhesives were used in 8 groups: Clearfil SE Bond (SEB), Optibond XTR (XTR), Scotchbond Universal Adhesive (SBU), and Clearfil BOND SE ONE (ONE) without prior phosphoric-acid etching, and each adhesive with phosphoric acid etching for 10 s (P-SEB, P-XTR, P-SBU and P-ONE, respectively). After application of self-etching adhesives on ground enamel surfaces of human teeth, a flowable composite was placed. For observation of the acid-base resistant zone (ABRZ), the bonded interface was exposed to demineralizing solution (pH 4.5) for 4.5 h, followed by 5% NaOCl with ultrasonication for 20 min. After the acid-base challenge, morphological attributes of the interface were observed using SEM. RESULTS: ABRZ formation was confirmed in all groups. The funnel-shaped erosion beneath the interface was present in SBU and ONE, where nearly 10 to 15 µm of enamel was dissolved. With phosphoric acid etching, the ABRZs were obviously thicker compared with no phosphoric acid etching. CONCLUSION: Enamel beneath the bonding interface was more susceptible to acid dissolution in SBU and ONE. In the case of the one-bottle self-etching adhesives and universal adhesives that intrinsically have higher pH values, enamel etching should be recommended to improve the interfacial quality.

Silver diamine fluoride and glass ionomer differentially remineralize early caries lesions, in situ.

OBJECTIVES: The aim of the present study was to evaluate the percent mean mineral density (MD) change of early caries lesions after the application of silver diamine fluoride (SDF) or glass ionomer cement (GIC). MATERIALS AND METHODS: This double-blind, crossover study involved two experimental phases of 28 days each. Thirty-two pairs of enamel slabs were created from the proximal surfaces of 16 premolars. Each pair of artificial carious slabs was randomly divided into the control or test group (38 % SDF or GIC). The slabs were attached to orthodontic brackets and bonded to the maxillary first permanent molars of 16 subjects for 28 days. After a 7-day washout period between phases, the subjects received the other material for the second phase. The mean MD of the lesions was measured by microcomputed tomography. RESULTS: SDF yielded a percent mean MD increase at a depth of 0-84 µm, although increase in the GIC group was observed at a depth of 24-108 µm. The percent mean MD changes of the SDF and GIC groups were similar (p = 0.100) and significantly higher than in control (p < 0.001, p = 0.003, respectively). CONCLUSIONS: The two materials increased the percent mean MD change of early proximal caries lesions to a similar extent, but with different spatial patterns. CLINICAL RELEVANCE: Due to deeper level of GIC remineralization, the refractive index of the GIC applied enamel might be closer to sound enamel. Hence, GIC is recommended for remineralization of anterior teeth. SDF staining makes it unsuitable for use in anterior teeth; thus, it is reserved for use in posterior teeth.

Assessment of natural enamel lesions with optical coherence tomography in comparison with microfocus x-ray computed tomography.

A technology to characterize early enamel lesions is needed in dentistry. Optical coherence tomography (OCT) is a noninvasive method that provides high-resolution cross-sectional images. The aim of this study is to compare OCT with microfocus x-ray computed tomography ([Formula: see text]) for assessment of natural enamel lesions in vitro. Ten human teeth with visible white spot-like changes on the enamel smooth surface and no cavitation (ICDAS code 2) were subjected to imaging by µCT (SMX-100CT, Shimadzu) and 1300-nm swept-source OCT (Dental SS-OCT, Panasonic Health Care). In [Formula: see text], the lesions appeared as radiolucent dark areas, while in SS-OCT, they appeared as areas of increased signal intensity beneath the surface. An SS-OCT attenuation coefficient based on Beer-Lambert law could discriminate lesions from sound enamel. Lesion depth ranged from 175 to [Formula: see text] in SS-OCT. A correlation between [Formula: see text] and SS-OCT was found regarding lesion depth ([Formula: see text], [Formula: see text]) and also surface layer thickness ([Formula: see text], [Formula: see text]). The images obtained clinically in real time using the dental SS-OCT system are suitable for the assessment of natural subsurface lesions and their surface layer, providing comparable images to a laboratory high-resolution [Formula: see text] without the use of x-ray.

Effect of polymer-based desensitizer with sodium fluoride on prevention of root dentin demineralization.

PURPOSE: To evaluate the effect of a fluoride-containing polymer-based desensitizer on prevention of root demineralization using micro-computed tomography (micro-CT). METHODS: Bovine root dentin blocks were divided into four groups; no treatment (Control); 1% oxalic acid (OA); MS Coat One containing methacrylate-co-p-styrene sulfonic acid (MS polymer) and 1% oxalic acid (MSO); and MS Coat F containing MS polymer, 1% oxalic acid and 3,000 ppm sodium fluoride (MSF). A window of the dentin surface was treated with each solution. The blocks were scanned using micro-CT after demineralization (pH 4.5, 5 hours). The dentin surfaces before and after demineralization were examined by scanning electron microscopy (SEM). Fluoride ion release was measured using a fluoride ion-specific electrode. The data were statistically analyzed using one-way ANOVA and Tukey's test (α = 0.05). RESULTS: MSF showed the lowest mineral loss (3176.5 ± 630.5 vol%µm), which was significantly different from Control (4600.1 ± 1053.4 vol%µm), OA (3992.7 ± 899.0 vol%µm) and MSO (3900.2 ± 645.4 vol%µm). [corrected]. Under the SEM observations, the dentin tubules appeared to be blocked after all desensitizer treatments. After demineralization, the exposure of dentin tubules was clearer in OA and MSO compared to MSF which showed sealed dentin tubules after demineralization. Fluoride ion release was detected only in the MSF group.

Study on the influence of leucine-rich amelogenin peptide (LRAP) on the remineralization of enamel defects via micro-focus x-ray computed tomography and nanoindentation.

Regeneration of severely damaged enamel (e.g. deep demineralized lesions) is currently not possible, because the structural units of enamel crystal construction are removed after its maturation. The aim of this in vitro study was to evaluate the effect of surface impregnation by leucine-rich amelogenin peptide (LRAP) on the remineralization of eroded enamel using micro-focus x-ray computed tomography (µCT). Fifteen bovine enamel blocks were embedded in resin and three zones (sound, demineralization, and remineralization) were defined on each specimen. Lesions were prepared by immersing the samples in demineralization solution for 7 d. The samples were soaked in distilled water or 60 or 120 µg mL(-1) solution of LRAP in water for 30 min. After the surface treatment, specimens were incubated in artificial saliva for either 5 or 10 d at 37 °C. The amount of mineral gain (dΔZ%) and the relative changes in the lesion depth (dLD%), obtained from µCT, were used to evaluate the effect of LRAP on the remineralization of lesions. The effects of LRAP on cross-sectional integrated hardness ΔINH were studied after 10 d using nanoindentation. ANOVA test was used to determine the effect of time and/or LRAP concentration on dΔZ%, dLD% and ΔINH mean values. Tukey's analysis was used for multiple comparison testing (α = 0.05). Analysis of µCT data showed significant effect of time and LRAP concentration on the dΔZ% (p = 0.013, p = 0.003) and the dLD% (p < 0.001, p = 0.002) mean values. The nanoindentation hardness was significantly improved by 120 µg mL(-1) LRAP (p = 0.02). Also, the peptide treatment affected the mineral distribution throughout the lesion by inhibiting of superficial deposition. This study showed that the treatment of eroded lesions in enamel by LRAP can improve and regulate the pattern of remineralization in vitro.

Effect of different desensitizers on inhibition of bovine dentin demineralization: micro-computed tomography assessment.

This study evaluated the effect of two desensitizers on inhibition of dentin demineralization, after immersion in artificial saliva using micro-computed tomography (µCT). Dentin blocks cut from bovine incisors were treated with deionized water (DW, a negative control) or one of three desensitizers: a fluoride varnish (Duraphat, a positive control), a calcium phosphate desensitizer (Teethmate Desensitizer), and a fluoro-alumino-calcium silicate-based desensitizer (Nanoseal). After each treatment, the specimens in Duraphat, Nanoseal, and Teethmate Desensitizer groups were pre-immersed in artificial saliva (pH 6.5) for either 1 d or 1 wk. The mineral loss of the specimens after demineralization (pH 5.0, 3 h) was evaluated by µCT. The treated surface was investigated with scanning electron microscopy. Mineral loss in all treatment groups was significantly lower than that in DW. Duraphat was the most effective treatment against demineralization, followed by Nanoseal. Nanoseal showed significantly better reduction in mineral loss following immersion for 1 wk in artificial saliva than for 1 d. However, Teethmate Desensitizer and Duraphat did not exhibit enhanced inhibition of demineralization over a longer period of immersion in artificial saliva. Scanning electron microscopy images showed deposition of particles on the dentin in both Teethmate Desensitizer. The application of Teethmate Desensitizer and Nanoseal to the exposed dentin surface resulted in inhibition of demineralization, with Nanoseal resulting in improved inhibition after prolonged immersion in artificial saliva.

Sodium fluoride mouthrinse used twice daily increased incipient caries lesion remineralization in an in situ model.

OBJECTIVES: To investigate the remineralizing effects of fluoride mouthrinses used at different times and frequency in addition to fluoride toothpaste. METHODS: A randomized crossover single blinded study comprised 4 experimental phases of 21 days each. Twelve orthodontic volunteers were fixed with an orthodontic bracket containing an artificial carious enamel slab, which was from the same tooth in all 4 phases, and were randomly assigned to the following groups: (1) brushing with F toothpaste 2× per day (F- brush), (2) F- brush+rinsing with 0.05% NaF (F- rinse) after lunch, (3) F- brush+F-rinse before bedtime, and (4) F- brush+F- rinse 2× per day. Mean mineral gain after each phase was determined from mineral density profiles obtained using Micro-CT. RESULTS: The mean mineral gain in all treatments with F- brush and F-rinse were significantly greater than those in F- brush (p<0.05). Moreover F- rinse 2× per day increased lesion remineralization more than F- rinse once a day. CONCLUSIONS: The twice-daily use of 0.05% NaF mouthrinse combined with twice-daily regular use of fluoride toothpaste resulted in the greatest remineralization of incipient caries. These data indicate that rinsing frequency is a factor affecting the effectiveness of fluoride mouthrinse. CLINICAL SIGNIFICANCE: The rinsing frequency of NaF mouthrinse, when used with fluoride toothpaste, also affects the remineralization. This finding, if confirmed by a clinical study, would lead to a new recommendation for fluoride mouthrinse used in high caries risk patients who could benefit from using it twice a day.

Casein phosphopeptide-amorphous calcium phosphate and glass ionomer show distinct effects in the remineralization of proximal artificial caries lesion in situ.

This study aimed to compare the ability of casein-phosphopeptide amorphous-calcium-phosphate (CPP-ACP) and glass-ionomer (GI) in remineralizing proximal artificial caries lesions (ACLs). Molar enamel-slabs were divided into: original-lesion control, intra-oral controls, and experimental (CPP-ACP or GI) groups. Specimens received ACLs and were bonded on subject maxillary first molars. After 4-weeks, mineral density (MD) was analyzed by µCT. Compared to control, CPP-ACP increased MD at 0-38/68-84 microns and the GI group had an increase at 0-68 microns, with a greater increase in MD compared to the CPP-ACP group from 0-53 microns. The mean percent remineralization (%R) showed differences between the GI, CPP-ACP groups and their paired controls. GI tended to increase remineralization more than CPP-ACP. In conclusion, CPP-ACP and GI demonstrated distinct remineralizing ability. GI induced greater remineralization in the superficial lesion, while CPP-ACP remineralized the lesion body. Their effects on percent remineralization and reducing lesion depth of proximal ACLs were similar.