Evaluating the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and Nd

Abstract

The regulation of the demineralizationEremineralization balance is a key to the dental caries prevention, therefore use of wide range of fluoridated and non-fluoride anti-caries agents and methods or combination of them has been postulated. Current evidence shows that treatment of enamel surface with laser irradiation or use of Casein phosphopeptide-Amorphous calcium phosphate, or CPP-ACP has been effective in the remineralization of incipient enamel lesions. Objectives: The aim of this in-vitro study was to assess the effect of Nd:YAG laser irradiation following casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) application on calcium and phosphate concentration and surface microhardness (SMH) of enamel surface in artificial white spot lesions of primary teeth. Study design: Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crU?me, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN) and the calcium and phosphate content was evaluated using energy dispersive X-ray analysis. Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. Results: The subjects of group D demonstrated a significant increase in the calcium and phosphate contents of enamel surface compared to those of groups A (P < 0.001, P < 0.001), B (P < 0.001, P < 0.001) and C (P = 0.024, P = 0.04), respectively. A statistically significant difference was seen for mean VHN between groups A and B (P = 0.002). SEM evaluations confirmed the results. Conclusions: The combination of Nd:YAG laser and CPP-ACP crU?me could be recommended as an effective preventive modality for remineralizing of white spot lesions in primary teeth