Bhatara Supriya, Goswami Mousumi, Saxena Aditya, Gogoi Abhilash, Tuli Shivya, Saxena Bhawna
Post-Graduate Student, Department of Paediatric and Preventive Dentistry, ITS Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.
Head and a Professor, Department of Paediatric and Preventive Dentistry, ITS Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India.
Pediatr Dent. 2025 Mar 15;47(2):95-102.
To evaluate the effectiveness of various remineralizing agents on artificially induced enamel lesions in primary teeth by a pH-cycled model. Four remineralizing agents were tested on exfoliated/extracted primary human teeth in a pH-cycled model: fluoride varnish (FLV); casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); self-assembling peptides-P11-4 (SAP); and poly(amidoamine) (PAMAM) dendrimers. Surface microhardness (SMH) improvement was quantitatively evaluated using Vickers hardness number testing, and surface morphology changes were qualitatively assessed with scanning electron microscopy. Compared to SAP, PAMAM had a higher VHN value, and the difference was statistically significant (P<0.001). The comparison between the FLV and CPP-ACP groups showed a non-significant difference (P=0.56). FLV demonstrated a narrow interquartile range, underscoring its reliability. PAMAM and SAP resulted in a homogenous and smooth enamel surface, indicating successful mineral deposition. FLV and CPP-ACP showed more superficial mineral recovery. The findings demonstrate each remineralizing agent's distinctive benefits and limitations in a controlled setting. Poly (amidoamine) dendrimers' standout performance suggests potential enamel repair strategies, potentially revolutionizing early carious lesion management. Fluoride varnish remains a dependable choice for clinicians, while casein phosphopeptide-amorphous calcium phosphate and self-assembling peptides-P11-4 contribute to biomimetic advancements in dentistry. Guided enamel regeneration through biomimetic approaches is aligned with minimum intervention dentistry principles and could substantially improve oral health outcomes.
通过pH循环模型评估各种再矿化剂对乳牙人工诱导釉质病变的有效性。在pH循环模型中，对脱落/拔除的人乳牙测试了四种再矿化剂：氟化物漆（FLV）；酪蛋白磷酸肽-无定形磷酸钙（CPP-ACP）；自组装肽-P11-4（SAP）；以及聚（酰胺胺）（PAMAM）树枝状大分子。使用维氏硬度数测试定量评估表面显微硬度（SMH）的改善情况，并用扫描电子显微镜定性评估表面形态变化。与SAP相比，PAMAM的维氏硬度值更高，差异具有统计学意义（P<0.001）。FLV组和CPP-ACP组之间的比较显示差异不显著（P=0.56）。FLV的四分位间距较窄，突出了其可靠性。PAMAM和SAP使釉质表面均匀且光滑，表明矿物质成功沉积。FLV和CPP-ACP显示出更多的表面矿物质恢复。研究结果表明了每种再矿化剂在受控环境中的独特益处和局限性。聚（酰胺胺）树枝状大分子的出色表现表明了潜在的釉质修复策略，可能会彻底改变早期龋损的管理。氟化物漆仍然是临床医生的可靠选择，而酪蛋白磷酸肽-无定形磷酸钙和自组装肽-P11-4有助于牙科领域的仿生进展。通过仿生方法引导釉质再生符合微创牙科原则，并可显著改善口腔健康结果。
