A Comparative Evaluation of Remineralizing Potential of Three Commercially Available Remineralizing Agents: An In Vitro Study

Remineralizing potential of Calcium Sucrose Phosphate in white spot lesions: A Systematic Review

BACKGROUND

This systematic review aimedto evaluate the remineralizing efficacy of calcium sucrose phosphate (CaSP) for the treatment of white spot lesions (WSLs) that commonly occur after orthodontic treatment with fixed appliances using various randomized controlled trials (RCTs) available in the literature todate.

HIGHLIGHTS

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines, RCTs that assessed the efficacious remineralizing potential of CaSP on WSLs and demineralized enamel and compared it with either no intervention or other remineralizing agents wereselected. The methodological rigor of the included studies was subjected to the Risk of Bias tool-2 (ROB-2) and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tools. Furthermore, a Begg's Funnel Plot was used to assess publication bias. The qualitative analysis encompassed a corpus of 36 studies. The remineralization potential of CaSP was investigated using an array of parameters, including surface microhardness, surface morphology, surface roughness, mineral content, and lesion size and depth. Based on the ROB-2 tool, most of the included studies were judged to be high risk, largely attributable to the presence of attrition bias. Using the GRADE framework, the certainty of evidence was determined to be moderate.

CONCLUSION

This systematic review reveals that CaSP yields favorableoutcomes in terms of increased surface microhardness and calcium-phosphate content, reduced demineralized area and surface roughness, and enhanced surface topography.

Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study

Background

Despite the introduction of several anticaries products, dental caries continues to be a global problem. In recent years, there has been a rise in interest in noninvasive treatment for noncavitated caries lesions by employing remineralization concepts. Each remineralizing agent has its own drawbacks. Therefore, it is desirable to seek new agents that offer the advantages of earlier counterparts with lower detrimental reactions.

Aim

The purpose of this research is to evaluate the remineralization efficacy of nanoparticle-based materials on white spot lesion (WSL) in children.

Materials and methods

A total of 45 children between the age-group of 4 and 8 years with WSLs were selected and randomly divided into three groups. At baseline, the teeth with WSLs were confirmed and identified using International Caries Detection and Assessment System II (ICDAS II) criteria, and the dimensions of the lesions were measured using photographic methods. Then, they were randomly placed into three groups of 15 samples each-group I nanosilver fluoride (NSF), group II nanohydroxyapatite (nano-HAP) serum, and group III MI varnish. Following that, the varnish was applied, and follow-up was done in the 2nd, 4th, 12th, and 24th week.

Results

By the 4th week, all three groups had a statistically significant difference (p < 0.05). Baseline measurements for groups I, II, and III showed that their respective mean WSL dimensions were 4.9 ± 0.66, 4.27 ± 0.69, and 5.44 ± 2.95. The dimensions of each group were reduced by the 24th week to 1.22 ± 0.46, 0.93 ± 0.41, and 2.19 ± 1.40, respectively. Overall, group II (nano-HAP serum) showed a statistically significant decrease in the dimension of the lesion at the end of the 24th week, followed by groups I and III.

Conclusion

The remineralization of enamel was induced by all three agents. Nano-HAP serum is more successful than MI Varnish and NSF.

How to cite this article

Annadurai T, Vundela RR, Chowdhary N, et al. Evaluation of Remineralization Efficacy of Nanoparticle-based Materials on White Spot Lesions in Children: A Comparative Clinical Study. Int J Clin Pediatr Dent 2024;17(4):425-432.

Assessment of Antibacterial Effectiveness of SDF and Fluoride Varnish Agents for Application in Pediatric Dentistry

Objectives

To assess antibacterial effects of silver diamine fluoride (SDF) and fluoride varnish treatment against Streptococcus mutans and Lactobacillus acidophilus.

Materials and Methods

The antibacterial effectiveness of SDF (group A) and fluoride varnish (group B) against S. mutans was investigated in an in vitro microbiological investigation, with distilled water (group C) serving as the positive and negative controls. After 24 hours of incubation, the antibacterial efficiency was assessed using the agar well diffusion technique, and the diameter of the zones of inhibition (ZOI) was quantified. Sumba mare's milk from MRS broth was extracted and then placed into a test tube. L. acidophilus was grown on Sumba mare's milk from MRS broth. On this media, each testing agent was poured and tested for the inhibitory zone. The obtained data was statistically analyzed.

Results

SDF group had a higher mean zone of inhibition against S. mutans and Lactobacillus followed by fluoride varnish, and there was no ZOI in the case of distilled water. Intergroup comparison was significant.

Conclusion

When compared to fluoride varnish, the SDF teeth remineralizing agent had greater antibacterial activity against S. mutans.

A Comparative Evaluation of the Effects of Three Remineralizing Agents on Bleached Enamel: A Scanning Electron Microscopy (SEM) Analysis

With the emerging concern of patients on esthetics, bleaching has become quite popular to get that "Shining White Smile." However, bleaching chemicals used on enamel's surface have been a clinical issue due to the fact that they might cause a variety of side effects, including sensitivity, gingival irritation, dentinal sensitivity, demineralization, and changes in the enamel's surface morphology. As a result, it is important to investigate different remineralizing agents that help to reduce the adverse effects. The researchers in this in-vitro study used a scanning electron microscope (quanta 200 SEM, California, USA) and a universal testing machine to assess the effects of three remineralizing products such as Tooth Mousse Plus (GC Corporation, India), Tooth Min (Abbott, India), and Elsenz (Group Pharmaceuticals Ltd, India) on bleached enamel. Based on the data available, we determined that bleaching greatly reduces the enamel microhardness of permanent human premolars; however, this loss could be recovered with a remineralizing agent. Tooth Mousse Plus is the most effective remineralizing agent among the three, followed by Elsenz and, finally, Tooth Min.

Remineralization Potential of a Combination of Chitosan with Nanohydroxyapatite and a Self-assembling Peptide with Nanohydroxyapatite: An In Vitro Study

AIM

This study explores the demineralizing potential of the combination of chitosan with nanohydroxyapatite (n-HA) and self-assembling peptides with n-HA.

MATERIALS AND METHODS

A total of 66 first premolar teeth of similar dimensions extracted for orthodontic purposes were collected for this study. These were then demineralized and randomly divided into the following three groups (n = 22): (i) Control group, (ii) n-HA + Chitosan (HAC), and (iii) self-assembling peptide + n-HA (SP-HA). The samples in each group were brushed every 24 hours with the respective agent. The specimens were stored in Fusayama Meyer's artificial saliva at room temperature and the solution was replenished daily. Mineral content (Ca, P) and surface morphology of the specimens was analyzed, using scanning electron microscopy and energy dispersion X-ray spectroscopy (SEM-EDAX), before demineralization, at 15 days of remineralization and 30 days of remineralization. A two-way analysis of variance (ANOVA) test followed by Tukey's honest significant difference (HSD) post hoc analysis was used to compare the mean elemental composition of the different groups (p < 0.05).

RESULTS

There was no significant difference in the calcium (Ca) and phosphate (P) weight percentage between the different groups at the baseline and after demineralization. The Ca and P weight percentages of all three groups after remineralization for 15 and 30 days showed no significant difference from the baseline or after demineralization. The surface morphology after 15 days of remineralization therapy showed decreased surface porosity and increased mineral deposition in the HAC group than the HP-SA group. Surface morphology after 30 days of remineralization showed a more homogenous and smoother surface in the HAC group than the HP-SA group.

CONCLUSION

From the results of this study, it can be concluded that the combination of chitosan with n-HA and self-assembling peptides with n-HA can be considered effective demineralizing agents.

CLINICAL SIGNIFICANCE

Considering the non-invasive nature of remineralization therapy understanding the effectiveness of different agents is of utmost importance. The demineralizing properties of chitosan, n-HA and self-assembling peptides make their combinations ideal for studying their effectiveness in treating white spot lesions.