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Does acid etching enhance remineralisation of arrested white spot lesions?

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European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Aim

To investigate the effect of acid etching procedure on the remineralisation of white spot lesions (WSL) which had undergone an initial phase of arrest, and to compare between the effect of fluoride and/or CPP-ACP on remineralisation before and after acid etching.

Study design

In vitro study.

Methods

WSL were prepared in vitro on 130 human enamel slabs which were allocated into four experimental groups (N = 30) and one control group (N = 10). Changes in mineral content were registered weekly by Quantitative Light Induced Fluorescence QLF. When changes had arrested (after 8 weeks), the enamel surface of 20 slabs in each group were acid etched. The remineralisation process was continued until it slowed down again (after 5 weeks).

Results

Mean fluorescence gain was 13.7 ± 0.9 % in the fluoride group, 16.5 ± 1.1 % in the CPP-ACP group, and 11.4 ± 1.2 % in the combination of fluoride and CPP-ACP group.

Conclusions

There was a tendency toward better remineralisation after acid etching but this did not reach a significant level; the effect of etching was more pronounced in the presence of fluoride. Although CPP-ACP seemed to give a steadier rate of remineralisation over time when compared with fluoride, the overall remineralisation in the regimens was similar. In this model, combined treatment of fluoride and CPP-ACP did not have an extra benefit over the fluoride or CPP-ACP alone.

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References

  • Al-Khateeb S, Exterkate R, Angmar-Månsson B, ten Cate JM. Effect of acid-etching on remineralization of enamel white spot lesions. Acta Odontol Scand. 2000;58:31–6.

    Article  PubMed  Google Scholar 

  • Al-Khateeb S, Exterkate RA, de Josselin de Jong E, Angmar-Månsson B, ten Cate JM. Light-induced fluorescence studies on dehydration of incipient enamel lesions. Caries Res. 2002;36:25–30.

    Article  PubMed  Google Scholar 

  • Amaechi BT, Ramalingam K, Mensinkai PK, Chedjieu I. In situ remineralization of early caries by a new high-fluoride dentifrice. Gen Dent. 2012;60:e186–92.

    PubMed  Google Scholar 

  • Baroni C, Marchionni S, Bazzocchi MG et al. A SEM and non-contact surface white light profilometry in vivo study of the effect of a crème containing CPP-ACP and fluoride on young etched enamel. Scanning. 2013. doi:10.1002/sca.21102.

  • Bhat SS, Hegde SK, Habibullah MA, Bernhardt V. Incipient enamel lesions remineralization using casein phosphopeptide amorphous calcium phosphate cream with and without fluoride: a laser fluorescence study. J Clin Pediatr Dent. 2012;36:353–5.

    PubMed  Google Scholar 

  • Bishara SE, Ostby AW. White spot lesions: formation, prevention, and treatment. Semin Orthod. 2008;14:174–82.

    Article  Google Scholar 

  • Brighenti FL, Takeshita EM, Sant’ana Cde O, Buzalaf MA, Delbem AC. Effect of low fluoride acidic dentifrices on dental remineralization. Braz Dent J. 2013;24:35–9.

    Article  PubMed  Google Scholar 

  • Cai F, Shen P, Morgan MV, Reynolds EC. Remineralization of enamel subsurface lesions in situ by sugar-free lozenges containing casein phosphopeptide-amorphous calcium phosphate. Aust Dent J. 2003;48:240–3.

    Article  PubMed  Google Scholar 

  • Chen H, Liu X, Dai J et al. Effect of remineralizing agents on white spot lesions after orthodontic treatment: a systematic review. Am J Orthod Dentofacial Orthop. 2013;143:376–82.

    Article  PubMed  Google Scholar 

  • Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010;89:1187–97.

    Article  PubMed  Google Scholar 

  • Dahlberg G. Statistical methods for medical and biological students. New York: Interscience Publications; 1940. p. 122–32.

    Google Scholar 

  • Danelon M, Takeshita EM, Sassaki KT, Delbem AC. In situ evaluation of a low fluoride concentration gel with sodium trimetaphosphate in enamel remineralization. Am J Dent. 2013;26:15–20.

    PubMed  Google Scholar 

  • de Josselin de Jong E, Sundström F, Westerling H et al. A new method for in vivo quantification of changes in initial enamel caries with laser fluorescence. Caries Res. 1995;29:2–7.

    Article  PubMed  Google Scholar 

  • Flaitz CM, Hicks MJ. Role of acid-etch technique in remineralization of caries-like lesions of enamel: a polarized light and scanning electron microscopic study. J Dent Child. 1994;61:21–8.

    Google Scholar 

  • García-Godoy F, Hicks MJ. Maintaining the integrity of the enamel surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc. 2008;139(Suppl):25S–34S.

    Article  PubMed  Google Scholar 

  • Hidaka K, Nishimura K, Miyazawa K, Miwa H, Goto S. Effect of acid etchants used for bonding orthodontic brackets on remineralization of enamel white spot lesions. Orthod Waves. 2011;70:125–35.

    Article  Google Scholar 

  • Houston WJ. The analysis of errors in orthodontic measurements. Am J Orthod. 1983;83:382–90.

    Article  PubMed  Google Scholar 

  • Krithikadatta J, Fredrick C, Abarajithan M, Kandaswamy D. Remineralisation of occlusal white spot lesion with a combination of 10% CPP-ACP and 0.2% sodium fluoride evaluated using Diagnodent: a pilot study. Oral Health Prev Dent. 2013;11:191–6.

    PubMed  Google Scholar 

  • Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phospho peptide on enamel lesions: an in vitro comparative evaluation. J Conserv Dent. 2010;13:42–6.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ogaard B, Rølla G, Arends J, ten Cate JM. Orthodontic appliances and enamel demineralization. Part 2. Prevention and treatment of lesions. Am J Orthod Dentofacial Orthop. 1988;94:123–8.

    Article  PubMed  Google Scholar 

  • Patil N, Choudhari S, Kulkarni S, Joshi SR. Comparative evaluation of remineralizing potential of three agents on artificially demineralized human enamel: an in vitro study. J Conserv Dent. 2013;16:116–20.

    Article  PubMed Central  PubMed  Google Scholar 

  • Peariasamy K, Anderson P, Brook AH. A quantitative study of the effect of pumicing and etching on the remineralisation of enamel opacities. Int J Paediatr Dent. 2001;11:193–200.

    Article  PubMed  Google Scholar 

  • Reynolds EC, Cai F, Cochrane NJ et al. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Dent Res. 2008;87:344–8.

    Article  PubMed  Google Scholar 

  • Rose RK. Binding characteristics of Streptococcus mutans for calcium and casein phosphopeptide. Caries Res. 2000;34:427–31.

    Article  PubMed  Google Scholar 

  • Sudjalim TR, Woods MG, Manton DJ. Prevention of white spot lesions in orthodontic practice: a contemporary review. Aust Dent J. 2006;51:284–9.

    Article  PubMed  Google Scholar 

  • Sudjalim TR, Woods MG, Manton DJ, Reynolds EC. Prevention of demineralization around orthodontic brackets in vitro. Am J Orthod Dentofacial Orthop. 2007;131:705.e1–9.

    PubMed  Google Scholar 

  • ten Cate JM, Jongebloed WL, Arends J. Remineralization of artificial enamel lesions in vitro. IV. Influence of fluorides and diphosphonates on short- and long-term remineralization. Caries Res. 1981;15:60–9.

    Article  PubMed  Google Scholar 

  • ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med. 1991;2:283–96.

    PubMed  Google Scholar 

  • Willmot D. White spot lesions after orthodontic treatment. Semin Orthod. 2008;14:200–8.

    Article  Google Scholar 

  • Yamazaki H, Litman A, Margolis HC. Effect of fluoride on artificial caries lesion progression and repair in human enamel: regulation of mineral deposition and dissolution under in vivo-like conditions. Arch Oral Biol. 2007;52:110–20.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from the Scientific Research Fund at the Ministry of Higher Education and Scientific Research of Jordan. The authors are indebted to Professor Laurence J. Walsh, University of Queensland, Brisbane, for his critical revision of the manuscript.

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Correspondence to S. N. Al-Khateeb.

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Al-Khateeb, S.N., Tarazi, S.J., Al Maaitah, E.F. et al. Does acid etching enhance remineralisation of arrested white spot lesions?. Eur Arch Paediatr Dent 15, 413–419 (2014). https://doi.org/10.1007/s40368-014-0131-2

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  • DOI: https://doi.org/10.1007/s40368-014-0131-2

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