*Ayca Sarialogu Gungor, DDS, MSc, Department of Restorative Dentistry, Faculty of Dentistry, Istanbul Galata University, Istanbul, Turkey.
Evrim Dalkılıç, DDS, MSc, PhD, Department of Restorative Dentistry, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.
Oper Dent. 2024 May 1;49(3):353-363. doi: 10.2341/23-102-L.
This study aimed to evaluate the enamel remineralization efficacy of enamel matrix derivative (EMD), experimental bioactive glass (BAG), and fluoride varnish in vitro.
Artificial initial caries lesions were developed on fifty human enamel specimens using demineralization solution (pH 4.5, 37°C, 96 hours). Specimens were randomly assigned to five groups (n=10): I-5% NaF varnish (Enamelast), II-experimental 58S5 BAG+37% phosphoric acid (PA), III-EMD (Emdogain) + Ethylenediaminetetraacetic Acid (EDTA), IV-EMD+37% PA, V-Control (untreated). All remineralization agents were applied with pH cycling for seven days. The specimens were scanned by spectral domain optical coherence tomography (SD-OCT) at baseline, at demineralization, and after pH cycling. Lesion depths were measured using image analysis software (ImageJ). Lesions were evaluated using surface microhardness (SMH) and two fluorescence methods (FluoreCam and DIAGNOdent Pen [DDPen]). The data were statistically analyzed by Kruskal Wallis, Friedman, and Wilcoxon tests (α=0.05).
According to SD-OCT results, fluoride varnish was found to be the most effective agent in reducing lesion depth (p=0.005). All agents increased the SMH values after pH cycling. No significant difference was found among fluoride varnish, BAG, and EMD+PA groups. These SMH values were significantly higher than EMD+EDTA and control groups (p<0.001). All groups showed lower DDPen scores compared with the control group (p<0.001), however, no significant difference was found among the remineralization agents. In FluoreCam assessment, size and intensity values of all treated groups showed improvement. However, there was no significant difference between the treatment groups in terms of FluoreCam size measurements (p=0.186).
58S5 BAG and EMD+PA have remineralization capacity as effective as fluoride varnish. EMD+PA showed better SMH and lesion intensity results than EMD+EDTA.
本研究旨在评估釉基质衍生物（EMD）、实验性生物活性玻璃（BAG）和氟化物漆在体外对牙釉质再矿化的效果。
使用脱矿液（pH4.5，37°C，96 小时）在五十个人类牙釉质标本上制备初始人工龋损。标本随机分为五组（n=10）：I-5% NaF 漆（Enamelast）、II-实验性 58S5 BAG+37%磷酸（PA）、III-EMD（Emdogain）+乙二胺四乙酸（EDTA）、IV-EMD+37% PA、V-对照（未处理）。所有再矿化剂在 pH 循环下应用七天。在基线、脱矿化和 pH 循环后，使用光谱域光相干断层扫描（SD-OCT）对标本进行扫描。使用图像分析软件（ImageJ）测量病变深度。使用表面显微硬度（SMH）和两种荧光方法（FluoreCam 和 DIAGNOdent Pen [DDPen]）评估病变。数据采用 Kruskal Wallis、Friedman 和 Wilcoxon 检验（α=0.05）进行统计学分析。
根据 SD-OCT 结果，氟化物漆在降低病变深度方面被发现是最有效的试剂（p=0.005）。所有试剂在 pH 循环后均增加了 SMH 值。氟化物漆、BAG 和 EMD+PA 组之间没有发现显著差异。这些 SMH 值明显高于 EMD+EDTA 和对照组（p<0.001）。与对照组相比，所有组的 DDPen 评分均较低（p<0.001），但再矿化剂之间无显著差异。在 FluoreCam 评估中，所有治疗组的大小和强度值均有所改善。然而，在 FluoreCam 大小测量方面，治疗组之间没有显著差异（p=0.186）。
58S5 BAG 和 EMD+PA 具有与氟化物漆相当的再矿化能力。与 EMD+EDTA 相比，EMD+PA 显示出更好的 SMH 和病变强度结果。
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