Evaluation of two remineralizing agents used for treatment of artificial caries lesions:

Objectives : This study was conducted to evaluate the remineralizing effect of casein phosphopeptides -amorphous calcium phosphates (CPP-ACP) and tricalcium silicate using scanning electron microscope (SEM) ,Energy dispersive Xray (EDX) and laser induced fluorescence device(Diagnodent). Materials and methods: Thirty sound human maxillary incisors (n=30) that were extracted due to periodontal diseases and collected from Oral Surgery clinic at Faculty of Dentistry, Mansoura University, according to the regulation of the ethics committee The teeth were randomly divided into three groups (n=10) ; Group A: control group,Group B:CPPACP group and Group C :Tricalcium silicate group with 10 samples in each group(n=10). The specimens of control group were cut into two halves, one of them was used as negative sound control and the other section was subjected to demineralization process. All specimens of other remaining groups were subjected to the demineralization process, then subdivided into two subgroups by cutting the tooth longitudinally through the center of the tooth by carborundum bur. One half was left without any surface treatment, act as positive control group and the other received remineralizing treatment (test group). All specimens were measured by laser induced fluorescence device(Diagnodent pen, KAVO model 2095, Biberach, Germany) and prepared for elemental and morphological analysis by drying to ensure that the teeth moisture free. The tested groups were tested after 3 months,6months and 9months.They stored in artificial saliva that prepared in faculty of pharmacy Mansoura university Results:The results of Kolmogorov–Smirnov and Shapiro Wilk tests revealed that all data following normal distribution. Therefore, a parametric Two-way analysis of variance test (ANOVA) was conducted. The outcomes of ANOVA test revealed that “type of remineralizing agent” and “storage time ”significantly affected laser fluorescence and EDX mean values (p˂0.05) . For laser induced fluorescence results ,at 3 and 9 months there was a significant difference between the two materials but at 6 months ,there was no statistically significant difference. For EDX outcome (calcium and phosphorus),no statistically significant difference between the two remineralizing agents at 3 and 6 months but, there was a significant difference at 9 months. These results showed that thetricalcium silicate showed the highest remineralizing potential , while CPP-ACP showed the least . Conclusion:Under the limitation of this study, the outcomes reveled that tricalcium silicate performed better than CPP-ACP as remineralizing agent. . Evaluation of two remineralizing agents used for treatment of artificial caries lesions: Mansoura Journal of Dentistry 2021;8(30):37-38. 38 DALIA MOSTAFA Casein phospho-peptide amorphous calcium phosphate(CPP-ACP) is used in some remineralizing agents and its application significantly results in limiting the progression of early carious lesions.However , the application of CPP-ACP in a paste form , have shown controversial outcomes.Although, patients with milk protein allergies should not consume products containing CPP-ACP. 11 Tricalcium silicate materials as mineral trioxide aggregate promote bioremineralizatio. 80 This materials have biocompatible properties showing antimicrobial activity.Some studies 95, 107 reported that calcium silicate based materials play an important role in hard tissue reparative regeneration because of its bioactivity and biocomptabilty ,also they are capable of inducing in vivo osseointegration. ACKNOLEDGMENT: My profound gratitude and deepest appreciation are given toHananAbd-El RazakHegazi, Professor of Operative Dentistry, Faculty of Dentistry, Mansoura University, for her support , and it was an honor to work under her generous supervision. I would like also to express my profound appreciation to Hamdi Hosni Hamdan, Assistant professor of Operative Dentistry, Faculty of Dentistry, Mansoura University for his support,Special thanks to Dr.NohaSaleh,Lecturer at Pharmaceutical Department, Faculty of Pharmacy, Mansoura University for her efforts in preparation of the storage media. and Dr.Sara FathiAwad,Assistant Lecturer, Department of Biochemistry, Faculty of Medecine, Mansoura University, for helping me in preparing demineralizing solution.