Gayan Anushka, Sinha Ashish, Chaudhary Seema, Bezborah Bornisha, Agarwal Somy, Kumari Shilpi, Sharma Niharika
Department of Paediatric and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, IND.
Department of Paediatric and Preventive Dentistry, Grace Dental Clinic, Guwahati, IND.
Cureus. 2025 Jun 10;17(6):e85732. doi: 10.7759/cureus.85732. eCollection 2025 Jun.
Dental caries remains a highly prevalent condition in children, with primary teeth being particularly susceptible due to their lower mineral content and structural characteristics. Early intervention using remineralizing agents can reverse enamel demineralization and prevent disease progression. The aim of this study was to evaluate and compare the remineralizing efficacy of various fluoridated and non-fluoridated agents on the surface microhardness (SMH) of demineralized primary tooth enamel.
This in vitro experimental study was conducted on 50 extracted, caries-free primary molars, randomly divided into five groups as Group 1, who received casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (GC Tooth Mousse®, GC Corporation, Tokyo, Japan) (n = 10); Group 2, who was treated with nano-hydroxyapatite (nano-HA) toothpaste (Perfora™, Perfora Oral Care Pvt. Ltd., India) (n = 10); Group 3, who received grape seed extract solution (, Biomed Sensitive Toothpaste, Splat Global LLC, Moscow, Russia) (n = 10); Group 4, who was treated with sodium fluoride (NaF) (Mamaearth Natural Toothpaste, Honasa Consumer Pvt. Ltd., Haryana, India) (n = 10) serving as the positive control with 0.165% w/w NaF, which is equivalent to approximately 750 parts per million (ppm) fluoride; and Group 5, who was treated with normal saline (Baxter Healthcare Corporation, Deerfield, IL) (n = 10) serving as the negative control. Artificial enamel lesions were created using demineralizing solution (pH 4.5) for 72 hours. The agents were applied for four minutes daily for seven days. The samples were stored in artificial saliva for various applications. The SMH was measured using a Vickers microhardness tester at three time points: baseline (T0), after demineralization (T1), and after remineralization (T2). Statistical analysis was performed using one-way analysis of variance (ANOVA), paired t-tests, and Tukey's post-hoc tests (p < 0.05).
Post-remineralization analysis revealed statistically significant differences between groups (p = 0.002). The paired t-test showed that Groups 1 and 4 exhibited the most significant microhardness improvement. Group 2 showed moderate efficacy, whereas Groups 3 and 5 showed no significant remineralization effects. Post-hoc analysis confirmed the superior performance of Groups 1 and 4 compared to Group 5.
CPP-ACP and NaF demonstrated superior remineralization potential in demineralized primary enamel. Nano-HA showed moderate efficacy, whereas grape seed extract and saline were ineffective. These findings support the use of fluoridated and non-fluoridated agents in pediatric preventive dentistry.
龋齿在儿童中仍然是一种高度普遍的病症，乳牙因其较低的矿物质含量和结构特征而特别容易患病。使用再矿化剂进行早期干预可以逆转牙釉质脱矿并预防疾病进展。本研究的目的是评估和比较各种含氟和不含氟制剂对脱矿乳牙牙釉质表面显微硬度（SMH）的再矿化效果。
本体外实验研究使用了50颗拔除的、无龋的乳牙磨牙，随机分为五组。第1组接受酪蛋白磷酸肽 - 无定形磷酸钙（CPP - ACP）糊剂（GC护齿泡沫牙膏，GC公司，东京，日本）（n = 10）；第2组用纳米羟基磷灰石（nano - HA）牙膏（Perfora™，Perfora口腔护理私人有限公司，印度）治疗（n = 10）；第3组接受葡萄籽提取物溶液（，生物医学敏感牙膏，Splat Global LLC，莫斯科，俄罗斯）（n = 10）；第4组用氟化钠（NaF）（Mamaearth天然牙膏，Honasa消费者私人有限公司，哈里亚纳邦，印度）治疗（n = 10）作为阳性对照，含0.165% w/w NaF，相当于约百万分之750（ppm）氟化物；第5组用生理盐水（百特医疗保健公司，伊利诺伊州迪尔菲尔德）治疗（n = 10）作为阴性对照。使用脱矿溶液（pH 4.5）制造人工牙釉质病变72小时。每天将制剂涂抹4分钟，持续7天。样品储存在人工唾液中用于各种应用。在三个时间点使用维氏显微硬度测试仪测量表面显微硬度：基线（T0）、脱矿后（T1）和再矿化后（T2）。使用单因素方差分析（ANOVA）、配对t检验和Tukey事后检验进行统计分析（p < 0.05）。
再矿化后分析显示各组之间存在统计学上的显著差异（p = 0.002）。配对t检验表明，第1组和第4组的显微硬度改善最为显著。第2组显示出中等效果，而第3组和第5组未显示出显著的再矿化效果。事后分析证实，与第5组相比，第1组和第4组具有更优的性能。
CPP - ACP和NaF在脱矿乳牙牙釉质中表现出卓越的再矿化潜力。纳米羟基磷灰石显示出中等效果，而葡萄籽提取物和生理盐水无效。这些发现支持在儿童预防牙科中使用含氟和不含氟制剂。
