Department of Pediatric Dentistry, Faculty of Dentistry, Altınbaş University, Istanbul, Turkey.
Private Practice, Istanbul, Turkey.
J Esthet Restor Dent. 2024 Nov;36(11):1536-1546. doi: 10.1111/jerd.13292. Epub 2024 Jul 31.
This study aimed to assess the remineralization efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro-CT analysis.
On extracted impacted third molars, artificial enamel lesions were prepared. Twenty-eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP-ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro-CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro-Wilk test, repeated measures two-way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established.
SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01).
All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization.
Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long-term.
本研究旨在评估酪蛋白磷酸肽-无定形磷酸钙（CPP-ACP）、银胺氟化钾/碘化钾（SDF/KI）和含功能性磷酸三钙的氟化钠（NaF/fTCP）对人工早期釉质龋的再矿化效果，采用激光荧光和微 CT 分析。
在离体阻生第三磨牙上制备人工釉质龋。将 28 个样本随机分为四组（每组 n=7）：对照组（人工唾液）、CPP-ACP（GC Tooth Mousse）、SDF/KI（Riva Star）和 NaF/fTCP（Clinpro White 釉质漆）。根据制造商的说明，将再矿化剂应用于脱矿表面。采用激光荧光和微 CT 评估各试剂的再矿化效果，并在四个阶段进行分析：脱矿前、脱矿后、再矿化第 1 天和第 30 天。采用 Shapiro-Wilk 检验、重复测量双向方差分析和 Spearman 相关检验进行统计学分析。建立了显著水平 p<0.05。
SDF/KI 可显著减少再矿化 30 天后脱矿釉质表面的龋损面积和体积。在 T3 期，与 T1 期相比，SDF/KI 显著增加了矿化密度。所有三种再矿化剂的激光荧光值均呈线性下降。荧光值与矿化密度之间存在显著相关性（p=0.01）。
三种研究用制剂对人工釉质龋均显示出积极的再矿化效果。然而，含银胺氟化钾和碘化钾的 SDF 比其他两种制剂在促进再矿化方面表现出更好的效果。
虽然三种再矿化剂对人工釉质龋均显示出积极的再矿化效果，但 SDF 的再矿化性能优于其他两种制剂。SDF 在长期治疗高龋风险儿童的龋齿进展方面具有潜在的应用价值。
