In vitro comparison of microabrasion, CPP-ACP, CPP-ACFP and combination therapies on the remineralization of white spot lesions

• Main Author: Parsons, Tetyana
• Format: Others
• Published: NSUWorks 2014
• Subjects: Health and environmental sciences; Amorphous calcium phosphate; MI paste; MI paste plus; Microabrasion; Remineralization; White spot lesions; Dentistry
• Online Access: https://nsuworks.nova.edu/hpd_cdm_stuetd/15; https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1010&context=hpd_cdm_stuetd

Objectives: To determine whether treatment of demineralized enamel white spot lesions with CPP-ACP paste, CPP-ACFP paste or microabrasion technique decreases lesion depth in vitro. Additionally, to determine whether treatment of demineralized enamel white spot lesions with microabrasion technique in combination with CPP-ACP paste or CPP-ACFP paste decreases lesion depth greater than any of the three techniques alone. Background: White spot lesions (WSLs) after the removal of orthodontic appliances remain a problem for clinicians and patients. Previous studies suggest that application of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) may promote enamel remineralization. Recently, microabrasion of enamel was proposed as another treatment modality of white spot lesions. A review of literature showed that there was no comprehensive in vitro study that combined microabrasion, casein phosphopeptide amorphous calcium phosphate and casein phosphopeptide amorphous calcium fluoride phosphate for treatment of WSLs. Methods: A total of one hundred and twelve bovine incisor teeth were randomly assigned to seven treatment groups: 1. Control 1 (demineralization control), 2. Control 2 (remineralization solution control), 3. CPP-ACP paste, 4. CPP-ACFP paste, 5. Microabrasion, 6. Microabrasion with CPP- ACP paste, and 7. Microabrasion with CPP-ACFP paste. Teeth in all groups were placed in demineralizing solution for 96 hours to produce artificial caries-like lesions. At the end of the 96 hr period, teeth in Control 1 group were sectioned to establish adequate amount of demineralization. The rest of samples were treated with assigned regimen once a day for 10 days and stored in remineralization solution. At the end of ten days, teeth were sectioned with a hard tissue microtome and observed under polarized microscopy to analyze enamel lesion depth. One-way ANOVA at α=0.05 was performed to assess difference in lesion depth between groups followed with post hoc Tukey's test. Results: Statistical analysis showed a significant difference between groups (pConclusions: Based on the results from this study, we can conclude that: (1) treatment of WSLs with CPP-ACP paste, CPP-ACFP paste or microabrasion decreases lesion depth in vitro; (2) microabrasion in combination with CPP-ACP paste or CPP-ACFP paste did not decrease lesion depth greater than that observed with either paste technique alone; (3) both CPP-ACP and CPP-ACFP pastes in combination with microabrasion treatments showed greater decrease in lesion depth than microabrasion alone.